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Biomedical subjects

A Samad

Publications and source records attributed to A Samad.

At least 19 recordsLinked to original sources
PubMed2006

Stage specificity of novel growth factor expression during development of proliferative vitreoretinopathy.

OBJECTIVE: To compare the relative levels of connective tissue growth factor (CTGF), platelet-derived growth factor alpha (PDGF-AA), and hepatocyte growth factor (HGF) in glial and retinal pigment epithelial (RPE) cells of epiretinal membranes from proliferative vitreoretinopathy (PVR). METHODS: A total of 37 PVR membranes, of various stages, underwent fluorescent immunohistochemisty and confocal laser scanning microscopy to localize CTGF, HGF, and PDGF-AA in RPE and glial cells. RESULTS: Numerous RPE, and relatively fewer glial cells, were found in all stages of PVR. CTGF immunoreactivity increased from early to late stage PVR and was principally expressed by RPE cells in early stage, and by glial cells in late stage PVR. HGF, expressed by both RPE and glial cells, was principally expressed in mid-stage PVR. PDGF-AA, expressed by both cell types, demonstrated a uniform level of staining throughout all stages of PVR. CONCLUSIONS: RPE and glial cells contribute to the expression of CTGF, HGF, and PDGF-AA during PVR, but with specific developmental patterns. PDGF-AA is expressed uniformly throughout all stages of PVR, while HGF expression peaks during mid stage, and CTGF expression is highest during late stage PVR. These results allow for the development of stage-specific therapeutics for PVR that may allow targeting of the early proliferative and/or the late tractional stages of PVR.

Biomarkers↗
PubMed2006

Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer? A prospective randomized controlled trial.

OBJECTIVE: Postoperative ileus is common after colorectal resection and can prolong hospital stay. Gum chewing, a type of sham feeding, may to stimulate gut motility via cephalic-vagal stimulation, and thereby reduce the length of ileus. This study aimed to determine whether gum chewing in the immediate postoperative period facilitated recovery from ileus following resection for left-sided colorectal cancer. METHODS: In a prospective randomized control trial, 38 patients undergoing open surgery for left-sided colorectal cancer were allocated to standard postoperative care (control group, n = 19) or to standard postoperative care plus the immediate use of chewing gum (treatment group, n = 19). RESULT: Control patients passed flatus by mean of 2.7 days (SD 1.0) and faeces by 3.9 days (SD 1.5); for the treatment group, this was 2.4 days (SD 1.0) and 3.2 days (SD 1.5) respectively, (NS, P = 0.56 and P = 0.38). Length of hospital stay was 11.1 days (SD 7.3) in control group and 9.4 days (SD 2.5) in the treatment group (NS, P = 0.75). CONCLUSION: The addition of gum chewing to a standardized postoperative regimen did not reduce the period of postoperative ileus or shorten length of stay following open surgery for left-sided colorectal cancer.

Aged↗
PubMed2005

Ileostomy carcinomas a review: the latent risk after colectomy for ulcerative colitis and familial adenomatous polyposis.

BACKGROUND: Ileostomy carcinoma after colectomy for ulcerative colitis and familial adenomatous polyposis is rare. METHODS: Forty-three case reports from the literature and a case of ours are reviewed. RESULTS: The risk of malignancy following ileostomy formation appears to be increased compared to the very low incidence of primary small bowel carcinoma. Chronic physical or chemical irritation of the stoma may predispose the ileal mucosa to colonic metaplasia with subsequent adenoma formation, dysplasia and invasive malignant change. This is particularly so where ileostomies are fashioned for familial adenomatous polyposis and ulcerative colitis. CONCLUSION: Routine surveillance of patients who have had an ileostomy for 15 years or longer may lead to earlier detection of this complication.

Adenocarcinoma↗
PubMed2004

Status of rheumatic heart disease in rural Pakistan.

OBJECTIVES: To determine the community based prevalence of rheumatic heart disease (RHD) in the rural population of the district of Rahim Yaar Khan in Pakistan. SUBJECTS AND METHODS: A representative sample of the rural population of Rahim Yaar Khan district was selected. RHD was screened for by physical examination and the diagnosis was confirmed with echocardiographic Doppler studies. Sociodemographic data on each screened person were collected. RESULTS: 54 cases of RHD were found among the 9430 people screened (prevalence of 5.7 in 1000, 95% confidence interval 4.2 to 7.2). Females were significantly more likely to be affected. There was no significant relation with other factors studied (education, crowding, and socioeconomic status). Less than 20% of those found to have RHD were aware of their diagnosis before participation in this study and only three affected people (8%) were taking rheumatic prophylaxis. CONCLUSIONS: There is a high prevalence of RHD among the rural population of Pakistan. The prevalence has not declined over the past three decades. Nearly all people with RHD, including most of those who know their diagnosis, do not receive the benefit of potentially life saving secondary prevention measures.

Adolescent↗
PubMed2004

Mortality and morbidity of abdominal inferior vena-caval injuries.

OBJECTIVE: To evaluate the outcome of abdominal inferior vena-caval (IVC) injuries in patients presented to Accident and Emergency Department, Lady Reading Hospital, Peshawar. DESIGN: An observational study. PLACE AND DURATION OF STUDY: The study was conducted at Postgraduate Medical Institute (PGMI)/Lady Reading Hospital, Peshawar, from January 1995 to January 2003. PATIENTS AND METHODS: Case records of all patients operated within specified period for vascular trauma having injuries to the abdominal inferior vena cava. In all cases vascular trauma management was done mainly on clinical assessment in a low equipped set up. Data on age, gender, mechanism, nature and location of inferior vena-caval injuries, other vascular and non-vascular injuries were recorded. RESULTS: There were 22 patients, 77.27% male and 22.72% female. Age ranged from 10 to 40 years with mean age of 25.09 years. Majority of injuries were caused by penetrating injury (77.27%), blunt injury in 04.54% and 18.87% were iatrogenic. Majority (95.45%) were having single laceration of inferior vena cava and 04.54% were having more than one laceration. Associated vascular injuries involved aortic 9.09%, internal iliac in 4.54% and renal vein in 4.54%. Most common associated non-vascular injury involved small intestine (72.72%) and large gut (50%). CONCLUSION: Inferior vena-caval injuries carries high mortality rate. When associated with multiple organ injuries and retrohepatic inferior vena-caval injuries are almost fatal.

Abdominal Injuries↗
PubMed2002

Prevalence of methicillin-resistant Staphylococcus aureus colonization in surgical patients, on admission to a Welsh hospital.

Nosocomial infection with methicillin-resistant Staphylococcus aureus (MRSA) is on the increase and expensive to treat. Because surgical wound infection is one of the most frequent MRSA-induced infections with often disastrous consequences, it was decided to estimate the incidence and risk factors of MRSA colonization in surgical patients. All patients admitted to general surgical and orthopaedic wards were studied prospectively. At the time of admission, a detailed questionnaire was completed, nasal swabs and swabs of any pre-existing wound sites in each patient were sent for culture. Of 430 patients studied, 23 patients were positive for MRSA on admission. The prevalence of MRSA colonization in this study was 5.3% of whom 15 (65%) were nasal carriers and eight (35%) had MRSA colonization elsewhere. All nasal MRSA carriers had at least one documented hospital admission in the preceding year. Among the MRSA-positive patients, 10 (43%) either were admitted directly from, or had been previously admitted to, a nursing home. MRSA remains mainly a hospital-acquired infection although a significant proportion is acquired in the community. The risk factors identified were previous hospital admission, patients from nursing homes, male and aged over 70.

Adult↗
PubMed2002

Digital imaging versus conventional contact tracing for the objective measurement of venous leg ulcers.

OBJECTIVE: This study aimed to compare the accuracy and inter-observer reproducibility of leg ulcer measurements made using digital images and conventional contact tracing. METHOD: The accuracy of measurements made with these two methods by four observers of 11 shapes with a known area was assessed. The time taken to do this was also measured. Following this, the accuracy and inter-observer reproducibility of the two methods was measured for patients with leg ulcers presenting to the vascular clinic, with contact tracing as the reference. RESULTS: For the reference shapes, both methods had a mean error of less than 5%. Contact tracing significantly underestimated the area by 3.9% (p < 0.05), while digital tracing showed no significant error. Digital tracing was quicker than contact tracing, especially for larger shapes (p < 0.05). For leg ulcers, there was no significant difference between area measurements made by the two methods. Inter-observer variation of digital tracing was greater for the ulcers than the reference shapes. This was due to differences in subjective interpretation and technical problems in recording some images. CONCLUSION: Measurement of leg ulcer area using computer-aided tracing of digital camera images is more accurate and quicker than contact tracing provided that appropriate care is taken when taking the pictures. Digital images offer considerable advantages in the shared hospital-community care of patients with leg ulcers.

Humans↗
PubMed2001

The role of leptin in choroidal neovascularization.

PURPOSE: The purpose of this study was to investigate the role of leptin in choroidal neovascularization. METHODS: We examined the localization of leptin by immunohistochemistry in nine choroidal neovascular membranes surgically excised from patients with age-related macular degeneration, idiopathic choroidal neovascularization, and ocular histoplasmosis. Controls included omission of primary antibody, use of an irrelevant primary antibody and leptin staining of posterior segment of four normal donor eyes. RESULTS: Leptin was present in eight membranes and appeared vesicular, within the cytoplasm. The more vascular membranes and those consisting of a larger number of retinal pigment epithelium cells were associated with greater leptin staining. Leptin was not seen in the posterior segment of the four normal eyes. CONCLUSION: We suggest that leptin plays an active role in choroidal neovascularization, although further experiments are necessary to establish a causal relationship.

Adolescent↗
PubMed2001

Day care surgery at a university hospital--who is responsible after discharge.

OBJECTIVE: To computer the rate of morbidity and unplanned hospitalization amongst patients undergoing Day Care Surgery at this institute. METHODS: Retrospective study of all adult general surgical patients undergoing planned day care surgical procedures between November 1996 and December 1997. RESULTS: Six hundred and seventy four patients underwent ambulatory operations over one year. The morbidity rate was 6.2% and the rate of unplanned hospitalization was 13.6%. CONCLUSION: We conclude that timing of surgery and short duration operation on carefully selected patients is likely to reduce hospitalization. There is great scope of Day Care Surgery in developing countries and a major effort will be required to popularize it in Pakistan, which include development of infrastructure and patient education.

Adult↗
PubMed2000

Establishing a mobile coronary care service in a rural setting.

A mobile coronary care unit (MCCU) service was introduced at Sligo General Hospital in 1992. Initially, a medical registrar and CCU staff nurse drove a fully equipped MCCU car to the patient location (Phase 1). When the patient was medically stabilised and had received thrombolysis, if appropriate, the doctor and nurse travelled with him in the conventional ambulance to the hospital. Subsequently, on a pilot basis, the doctor, nurse and equipment were transported by taxi to the patient (Phase 2). Since 1995, the MCCU service has been provided routinely by Sligo General Hospital (Phase 3). During each Phase the proportion of patients with acute myocardial infarction (AMI) was as follows: Phase 1--16 of 35 (46%), Phase 2--7 of 19 (36%), Phase 3--53 of 154 (34%). The incidence of unstable angina (UA) was 25%, 32% and 26% during each of the three Phases. Five patients had successful out of hospital (OOH) defibrillation and 56(74%) of the 76 AMI patients had OOH thrombolysis. The MCCU reduced the median "Call to needle" time by 64 minutes in Phase 1 and 102 minutes in Phase 2 compared to the conventional service. Median delay to MCCU treatment was 46, 40 and 80 minutes during each of the three Phases. In an Irish setting, a MCCU service provided rapid safe and effective care, including thrombolysis and defibrillation for patients with suspected AMI.

Coronary Care Units↗
PubMed1999

Optical PCR: genomic analysis by long-range PCR and optical mapping.

Optical mapping is an approach for the rapid, automated, non-electrophoretic construction of ordered restriction maps of DNA from ensembles of single molecules. Previously, we used optical mapping to make high-resolution maps of large insert clones such as bacterial artificial chromosomes (BAC) and large genomic DNA molecules. Here, we describe a combination of optical mapping and long-range polymerase chain reaction (PCR), in a process we term optical PCR, which enables automated construction of ordered restriction maps of long-range PCR products spanning human genomic loci. Specifically, we amplified three long PCR products, each averaging 14.6 kb in length, which span the 37-kb human tissue plasminogen activator (TPA) gene. PCR products were surface mounted in gridded arrays, and samples were mapped in parallel with either ScaI, XmnI, HpaI, ClaI, or BglII. A contig of overlapping high-resolution maps was generated, which agreed closely with maps predicted from sequence data. The data demonstrate an approach to construct physical maps of genomic loci where very little prior sequence information exists, since the only sequence needed is that required to anchor PCR primers. Large segments of genomic DNA (within the practical limits imposed by long-range PCR) can be mapped quickly and to high resolution without the use of cloning vectors.

DNA Restriction Enzymes↗
PubMed1997

Optical mapping approaches to molecular genomics.

A variety of physical mapping methods exist for the analysis of nucleic acids or genomes, including hybridization, sequence tagged site mapping, restriction enzyme fingerprinting, radiation hybrid mapping and optical mapping. Single-molecule approaches offer numerous advantages, including very high resolution, small sample size requirements, and parallel sample processing. The convergence of recent advances in new single molecule techniques, surface chemistry and machine vision technology has contributed to novel approaches to genome analysis.

Biotechnology↗
PubMed1995

Anterior chamber contamination after uncomplicated phacoemulsification and intraocular lens implantation.

PURPOSE: To determine the frequency of anterior chamber contamination occurring during uncomplicated cataract surgery with intraocular lens implantation using phacoemulsification through a scleral tunnel incision. METHODS: In a prospective study, anterior chamber aspirates of one eye each of 103 consecutive ambulatory patients who underwent uncomplicated cataract surgery with lens implantation were cultured. The anterior chamber aspirate was withdrawn immediately upon the completion of surgery. Conjunctival cultures of the same eye were taken immediately before surgery, after the eye and periocular area had been prepared and draped. Multiple use topical medications used preoperatively on all patients were cultured at the end of the surgical day. RESULTS: Intraocular aspirates yielded positive cultures in five specimens (5%), four of which were identified as Staphylococcus epidermidis. Quantification disclosed colony counts ranging between 100 and 200 colony forming units per milliliter. Results of conjunctival cultures were positive in ten specimens (10%). Staphylococcus epidermidis was the most common isolate, identified in seven of the ten positive cultures. Positive intraocular and conjunctival culture results were not present concurrently in any patient. Microorganisms were recovered from the multiple use topical medications on nine of the 26 successive surgical days. Neisseria species was the most frequent isolate (7,44%), followed by S. epidermidis (5,31%). The frequency of contamination of the anterior chamber was independent of wound width (chi 2 = 0.869) and operative time (chi 2 = 4.77). CONCLUSION: Bacterial contamination of the anterior chamber was detected in five (5%) of the patients. This reduced incidence of contamination compared with that of previous studies may be related to the preoperative preparation, the surgical technique, or both. Contamination of the multiple use topical medications and bulbar conjunctiva define possible sources of pathogens that may enter the anterior chamber. The absence of any clinical ocular infection in all patients attests to the small inoculum sizes, as well as the ability of the anterior chamber to clear small bacterial loads.

Administration, Topical↗
PubMed1995

Screening--a unique way of better health care delivery for ENT patients.

A few Ear Camps were carried out amongst 25 schools and madrashas of Dhaka City having 10,102 pupils, to see the prevalence of ENT diseases and hearing impairment. A primary screening was done by the Bangladesh Council for Child Welfare (BCCW) with the possibilities of suffering from ear, nose & throat diseases with the help of questionnaire and clinical examination by qualified doctor. The word "Screening" is used in this paper not in the epidemiological sense but to imply primary selection. 1,403 (13.89%) were issued registration card for ENT consultation. Five otolaryngologist, one audiometrician, two ancillary staffs, BCCW workers, local volunteers and school teachers conducted the 3 days long camp. Secondary screening by the otolaryngologists revealed pathology in 1,101 students (10.89%). 26 children (0.26%) were attending schools with severe hearing loss. ENT diseases appeared to be common in urban school children and screened proved to be an efficient method for health care delivery.

Adolescent↗
PubMed1993

Efficacy, safety, and tolerability of isradipine in hypertension as used in general practice in a developing country (Pakistan).

This open-label trial of isradipine was carried out in 3422 outpatients by 893 general practitioners to assess the efficacy, safety, and tolerability of isradipine as monotherapy in mild-to-moderate hypertension. Patients received 2.5 mg isradipine twice daily as monotherapy for 6 weeks following a placebo wash-out period of 1 week. After 6 weeks of active treatment, diastolic blood pressure was significantly reduced from 106 +/- 7.7 to 89.4 +/- 8.0 mm Hg (P < .001). Systolic blood pressure also decreased significantly, from 166.8 +/- 19.6 to 141.8 +/- 15.7 mm Hg (P < .001). Blood pressure was normalized in 75.68% of the patients. A total of 629 patients (19%) reported adverse events, 79 (2.3%) of whom withdrew from the study for this reason. The most common side-effects were headache (8.7%), palpitations/tachycardia (3.8%), vertigo (2.89%) and flushing (1.00%). In conclusion, 2.5 mg isradipine twice daily is a safe, effective, and well tolerated form of monotherapy in the treatment of hypertension in general practice in a developing country (Pakistan).

Adult↗