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Biomedical subjects

A Qureshi

Publications and source records attributed to A Qureshi.

At least 19 recordsLinked to original sources
PubMed2006

Perinatal outcome with HELLP/partial HELLP complicating hypertensive disorders of pregnancy. An Indian rural experience.

A total of 615 women with hypertensive disorders during pregnancy were the study subjects. Of these, 145 (23.58%) women had HELLP or partial HELLP (only one or two of the three components H,EL, LP). Overall, eight (1.3%), i.e. five out of 399 primigravida (1.2%) and three of the 216 multigravida (1.3%), had complete HELLP and the remaining 137 (22.2%) had partial HELLP. Of the 399 primigravida with hypertensive disorders, 107 (26.5%) had partial HELLP, statistically significantly more (p<0.002) than the 30 out of the 216 (13.8%) multigravida. In 210 (44.6%) out of 470 women with hypertension without HELLP/partial HELLP, labour was induced and the perinatal mortality rate (PMR) was 138.9 (58.06 in term and 363.63 in pre-term cases), and in the other 260 women in whom labour was not induced, PMR was 96.15 (in term cases 74.07 and in pre-term 120). Among the women with HELLP/partial HELLP (145), out of the 64 women in whom labour was induced, the PMR was 359.37 (235.29 in term and 500 in pre-term) and of those in whom labour was not induced (81), PMR was 209.87 (106 in term cases and 352.94 in pre-term). All the eight women with the full HELLP syndrome had labour induced, the PMR in these cases was 500. Overall, in women with HELLP/partial HELLP, the PMR was 275.8 and in the remainder with hypertensive disorders without HELLP/partial HELLP, it was 114.89.

Female↗
PubMed2006

Sickle cell 'girdle syndrome' progressing to ischaemic colitis and colonic perforation.

Abdominal pain of presumed vasocclusive origin, often termed 'girdle syndrome' because of the circumferential distribution of the pain, is common in sickle cell anaemia (SCA). Evidence of progression to bowel infarction is rare. A 27-year-old man with SCA developed chest and abdominal pain unresponsive to opiate analgesia. Abdominal X-ray showed dilated bowel loops because of partial obstruction. Despite reduction of HbS to 23% by automated red cell exchange, abdominal pain worsened. A CT scan was the most informative investigation and showed free peritoneal air. He underwent emergency hemicolectomy and reversible ileostomy formation. Histology of the resected colon was consistent with acute ischaemic colitis. Early surgical intervention remains essential in SCA when abdominal pain does not respond to maximal therapy including red cell exchange: as this case illustrates, sickle girdle syndrome has the capacity to progress to irreversible ischaemic colitis and necrotic perforation of the bowel wall.

Abdominal Pain↗
PubMed2005

Effects of single high-dose and multiple low-dose streptozotocin on contraction and intracellular Ca2+ in ventricular myocytes from diabetes resistant and susceptible rats.

Administration of a single high-dose (SHD) of streptozotocin (STZ) to young adult rats causes a diabetic cardiomyopathy. Albino Oxford (AO) and Dark Agouti (DA) inbred strains of rats are susceptible to developing diabetes when administered a SHD of STZ but differ in susceptibility to multiple low-dose (MLD) STZ. We have investigated the effects of SHD and MLD-STZ on contraction and intracellular Ca2+, measured with fura-2, in ventricular myocytes from AO and DA rats at 18-20 weeks after treatment. Time to peak shortening was significantly prolonged in myocytes from DA rats after SHD-STZ but was not altered in DA rats after MLD-STZ or in AO rats by either MLD or SHZ-STZ treatment. Time to peak shortening in myocytes from DA control and DA rats after SHD-STZ were 88+/-2 ms and 107+/-4 ms, respectively. Time to half relaxation and the amplitude of myocyte shortening were not altered in AO or DA rats by either MLD or SHD-STZ treatment. Amplitude, time to peak fura-2 transient and time to half relaxation of the fura-2 transient were not significantly altered in AO or DA rats by either MLD or SHD-STZ treatment. Contractile defects reported in myocytes from SHD-STZ treated DA rats may be a consequence of altered myofilament sensitivity to Ca2+. The hyperglycaemic effects of MLD-STZ and SHD-STZ induced diabetes was much greater in DA compared to AO rats and the effects of the hyperglycaemia on the time-course of ventricular myocyte contraction was most profound in DA rats after SHD-STZ.

Animals↗
PubMed2005

Emergencies in the air.

Medical emergencies in the air are topical. This study, undertaken by the Faculty of Prehospital Care at the Royal College of Surgeons of Edinburgh, analyses retrospectively consecutive medical emergencies occurring over a 6 month period on a single major international airline. Clinical problems are related to pre-existing problems (65%), new medical problems (28%), and traumatic injury (7%). The paper highlights the need for better pre-flight health advice and screening, a reminder to carry personal medication-especially for asthma-and the need to include ankle and leg exercises prior to getting out of the seat to reduce the incidence of syncope, which was responsible for 91% of new medical problems.

Adult↗
PubMed2004

Ciliary body adenoma of non-pigmented epithelium.

Adenomas of the non-pigmented epithelium of the ciliary body are rare neoplasms and most of the studies are in the form of case reports. There are only 27 documented cases of acquired neoplasm of the non-pigmented ciliary epithelium (NPCE) reported in the English literature. In most reports, there was a clinical suspicion of melanoma and the diagnosis of NPCE adenoma was made on histopathological evaluation of the resected tissue. The entity has not been reported in the Pakistani population to date. This report describes a case of ciliary body adenoma of NPCE in a 27 year old Pakistani man. The histological and immunohistochemical profiles were typical of the adenomas described in the literature.

Adenoma↗
PubMed2003

Stenotrophomonas maltophilia contamination of nebulizers used to deliver aerosolized therapy to inpatients with cystic fibrosis.

There is circumstantial evidence that nebulizer equipment may be a source of Stenotrophomonas maltophilia for patients with cystic fibrosis. Eighty-nine inpatient nebulizers were examined for evidence of S. maltophilia contamination of which nine (10%) yielded 14 strains of the bacterium. Environmental samples were obtained from 73 different sites on the ward, of which 17 (23%) yielded a further 21 strains. Positive sites included taps, sink drains, and potable water. Genotyping using ERIC-PCR and pulsed-field gel electrophoresis revealed that two pairs of patients' nebulizers were contaminated with closely related strains. None of the S. maltophilia isolates obtained from the ward environment shared genotypes with those obtained from the nebulizers. The frequency of isolation of S. maltophilia from potable water sources on the ward suggests that contamination may result from using it to clean reusable nebulizer equipment, particularly if this is followed by inadequate drying. Although the actual source of S. maltophilia contamination of hospital-use nebulizer equipment in this study remained elusive, these results have important infection control implications.

Adolescent↗
PubMed2003

Effect of rituximab on peripheral blood stem cell mobilization and engraftment kinetics in non-Hodgkin's lymphoma patients.

Rituximab is used for in vivo tumor cell purging for non-Hodgkin's lymphoma (NHL) patients prior to autologous peripheral blood stem cell transplantation (PBSCT). However, its effects on PBSC mobilization and function are poorly understood. We compared the mobilization characteristics and engraftment kinetics of 13 NHL patients receiving and 34 NHL patients not receiving rituximab 6 months before PBSC mobilization. In the rituximab group, there was a significantly longer time to neutrophil engraftment (P=0.0466), a trend toward the need for BM harvest to supplement low-yield PBSC collections (31 vs 9%, P=0.08) and a significantly increased rate of bacteremia episodes (62 vs 26%, P=0.025). Median progression-free survival (PFS) and overall survival (OS) were significantly longer in the rituximab compared to the nonrituximab patients (P=0.049 and 0.042, respectively). However, patients in the nonrituximab group were at high risk for recurrence and expected to have shorter survival. Rituximab used within 6 months prior to collection may have a detrimental effect on PBSC mobilization and engraftment. However, rituximab is a major therapeutic breakthrough for NHL treatment and this negative effect may be offset by improved survival. Further studies are warranted in larger populations to determine the impact of rituximab on engraftment, PFS and OS.

Adult↗
PubMed2003

An evaluation of topical and local anesthesia in phacoemulsification.

OBJECTIVE: To assess the comparative efficacy of topical and local anesthesia in phacoemulsification. MATERIAL AND METHODS: The medical records of 186 men and women between the ages of 45-85 years, who underwent elective cataract surgery by phacoemulsification technique, under the care of one surgeon, over a period of one year, from March 1999-March 2000 were reviewed. RESULTS: Of 186 patients who underwent small incision, self-healing phacoemulsification cataract surgery, 124 received topical and 62 local anesthesia. The most common cataract types were nuclear sclerosis. The duration of surgery with topical anesthesia was shorter. Sutures and eye padding were more frequently applied for procedures done under local anesthesia. Uncorrected visual acuity in the first post-op week was between 20/20-20/50 for 53.6% of the cases done under topical compared to 30.9% in local anesthesia. A similar trend was noted in the visual acuity one month post operatively. CONCLUSION: The uncorrected visual acuity improves faster and the duration of surgery is shorter when topical anesthesia is used.

Administration, Topical↗
PubMed2003

Cross sectional review of children with ADHD presenting to an outpatient psychiatric institute in Pakistan.

OBJECTIVE: To establish baseline demographic information for Attention Deficit Hyperactivity Disorder (ADHD) in the children of Pakistan and to compare the results with similar studies elsewhere. MATERIALS AND METHODS: This study was a cross sectional review. We reviewed medical records of all children less than 14 years of age, presenting to The Institute of Behavioural Sciences (IBS), Karachi during a two year period. Twenty-six children diagnosed with ADHD were included in the study. The data was entered and analyzed using SPSS. RESULTS: Among the twenty-six children, there were 20 boys and 6 girls (male to female ratio 3:1). Mean age at onset of symptoms was 4.48 years. Fifteen children were diagnosed with the combined subtype, seven with the hyperactive subtype and four with the inattentive subtype. The most significant comorbids included mental retardation (MR) (53.8%) and epilepsy (23.1%). The combined subtype was found to be significantly associated with MR. Risk factors for brain damage, and hence ADHD, found in the history included maternal problems like eclampsia and prolonged labor, and perinatal problems like sepsis and low birth weight. Delayed milestones were present in 61.5% of children. CONCLUSION: Our study provides a broad view of ADHD in Pakistani children. This study can provide a platform for future analytical studies about this challenging research issue.

Ambulatory Care Facilities↗
PubMed2003

An audit of upper gastrointestinal bleeding at Seremban Hospital.

We retrospectively analyzed all patients presenting with upper gastrointestinal bleeding to Seremban Hospital over a one-year period. A quarter of the oesophagogastro-duodenoscopies (OGD) performed were performed as emergency for upper gastrointestinal tract bleeding. Gastric ulcers and duodenal ulcers were the two most common findings. Our results suggest that there is a male preponderance of 2:1, the Chinese were more likely to be affected and the elderly (> 60 years) were at highest risk.

Adolescent↗
PubMed2002

Comparative audit of intravenous lorazepam and diazepam in the emergency treatment of convulsive status epilepticus in children.

There is little evidence on which to judge the optimal treatment for convulsive status epilepticus (CSE) in children. This study compares the effect of intravenous (iv) lorazepam with iv diazepam as the first line of treatment of CSE. We studied all children with prolonged seizures arriving in the Accident and Emergency (A&E) Department in two separate periods. In the first 6-month period iv diazepam was used as standard treatment, in the second 1-year period iv lorazepam was used. We measured latency to stopping of seizure and any adverse events. A successful treatment was defined as one in which the seizure clinically ceased within 15 minutes after siting the iv cannula, requiring no further treatment.Intravenous diazepam (0.32 mg kg (-1)) was used in 17 of 26 patients, whilst iv lorazepam (0.13 mg kg (-1)) was used in 31 of 59. There were no differences between the two groups regarding age, sex and seizure type.The seizure was successfully controlled 15 minutes after siting the iv cannula in 11 (65%) patients treated with diazepam (median time of 3 minutes) and in 20 (65%) patients treated with lorazepam (median time of 5 minutes). These preliminary results suggest that iv lorazepam may be as effective as iv diazepam.

Anticonvulsants↗
PubMed2002

The importance of intraoperative evaluation in the management of anorectal atresia.

We report a neonate with anorectal atresia in whom preoperative evaluation prior to definitive operation revealed a short gap atresia. However, bidigital evaluation at operation revealed a septal atresia that was easily perforated from below through the anus. Unnecessary division of the anorectal sphincter complex was thus avoided.

Anus, Imperforate↗
PubMed2002

Comparative analysis of knowledge, attitudes and perceptions about induced abortions among medical and non-medical students of Karachi.

OBJECTIVE: To determine the knowledge, attitudes and perceptions regarding induced abortions among university students of Karachi and compare these aspects among medical and non-medical students. STUDY DESIGN: Cross sectional opinion survey. METHODS: The study is a cross sectional opinion survey of medical and non-medical students from four educational institutions of Karachi using a pretested questionnaire. RESULTS: Of the 381 students interviewed, 201 were medical and 180 were non-medical. More medical students were aware of the correct definition of induced abortion. An encouraging finding was the awareness of our study population about the only legally acceptable circumstance for induced abortion in Pakistan, that is, if conceptus is a risk to maternal health (p<0.001). More medical students cited complications that were technical like uterine perforation (p<0.001), cervical trauma (p<0.001), DIC (p<0.001), and sepsis (p<0.001). More medical students thought induced abortion to be a health issue (p=0.001) as compared to non-medical students. Most of the medical students felt the need to modify Pakistan's law regarding abortion (p=0.008) especially for fetal anomalies (13.9%) and rape (7%). CONCLUSION: Though medical students were more knowledgeable about induced abortions as compared to the non-medical population, there is a need to improve awareness regarding induced and unsafe abortions and their consequences.

Abortion, Induced↗
PubMed2002

Plasma from rheumatoid patients taking low dose methotrexate enhances platelet aggregation.

Methotrexate (MTX) in low doses is commonly used to treat rheumatoid arthritis (RA). At least 36 deaths have been attributed to bone marrow cytotoxicity associated with low dose MTX. The goal was to determine if plasma from arthritis patients taking low dose MTX induces platelet aggregation in platelet rich plasma from healthy volunteers. Plasma from patients on MTX alone caused a 3-fold increase in aggregation vs plasma from controls (P<0.05). Plasma from patients not taking MTX or taking MTX with diclofenac caused aggregation to a lesser extent. Diclofenac, along with several others NSAIDs and cyclooxygenase inhibitors, depressed aggregation produced by arachidonic acid in platelet rich plasma from healthy volunteers. A precise mechanism for amplification of aggregation by MTX plasma and its relationship to MTX toxicity remains unknown. However, a serum factor may be produced by MTX that modulates the activity of cyclooxygenase, thereby influencing aggregation.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2001

The impact on outcomes in a community hospital setting of using the AANS traumatic brain injury guidelines. Americans Associations for Neurologic Surgeons.

BACKGROUND: Traumatic brain injury poses a serious public health challenge. Treatment paradigms have dramatically shifted with the introduction of the American Association of Neurologic Surgeons (AANS) Guidelines for the Management of Severe Head Injury. Implementation of the AANS guidelines positively affects patient outcomes and can be successfully introduced in a community hospital setting. METHODS: Data were collected both retrospectively and prospectively from the records of all trauma patients between 1994 and 1999. A cohort of 93 patients was selected. Thirty-seven patients were treated before the implementation of the AANS guidelines, and these were statistically compared with 56 patients treated after the implementation of the guidelines. RESULTS: Implementation of the recommendations in the AANS guidelines in a standardized protocol resulted in a 9.13 times higher odds ratio of a good outcome relative to the odds of a poor outcome or death compared with a group managed before the practice change. A Glasgow Coma Scale (GCS) admission score > 8 was associated with a 6.58 times higher odds ratio of a good outcome compared with a GCS admission score < or = 8. Odds ratio of a good outcome decreased by a factor of 0.92 for each year increase in age of patients starting at age 9. A dedicated neurotrauma team and comprehensive treatment algorithms are critical elements to this success. Hospital charges increased by more than $97,000 per patient, but are justifiable in the face of significantly improved outcomes. CONCLUSION: Implementation of a traumatic brain injury protocol in a community hospital setting is practical and efficacious. Appropriate invasive monitoring of systemic and cerebral parameters guides care decisions. The protocol results in an increase in resource usage, but it also results in statistically improved outcomes justifying the increase in expenditures.

Adolescent↗
PubMed2001

IgM anticardiolipin antibodies are associated with stenosis of vascular access in hemodialysis patients but do not predict thrombosis.

AIM: The prevalence of anticardiolipin antibodies (ACA) is elevated amongst hemodialysis patients as compared with the general population. Previous studies have disagreed as to whether the presence of ACA represents a risk factor for access thrombosis. Other risk factors for access thrombosis (decreased blood flow, elevated venous pressure) have also been described. MATERIALS AND METHODS: We performed a combination retrospective and prospective cohort study of a single outpatient dialysis unit to assess the association between these potential risk factors and access thrombosis. ACA, access blood flow, presence of stenosis, and venous pressures were measured in 100 patients. Information on episodes of access thrombosis was gathered for 12 months prior to and 12 months after ACA measurement. RESULTS: ACA were present in 19% of patients with equal numbers of IgG- and IgM-ACA. The presence of IgM-ACA was significantly associated with the use of aspirin and the presence of stenosis by Doppler at the time of ACA testing (p < 0.05). A logistic regression model was used to estimate the association between clinical factors and access thrombosis. In this multivariate analysis, the presence of access stenosis and a history of access thrombosis were both significantly associated with the development of access thrombosis. Adjusted for these variables, neither IgG- nor IgM-ACA was significantly associated with access thrombosis. The presence of an ACA was not associated with episodes of access thrombosis in either the prospective or retrospective analyses. CONCLUSION: Further investigation is required to determine if the association between aspirin use and IgM-ACA, or of IgM-ACA and access stenosis, has implications for underlying pathogenetic mechanisms of access stenosis.

Adult↗