Modified stripper for varicose vein surgery.
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Equipment Design↗
Biomedical subjects
A Zafar
Publications and source records attributed to A Zafar.
Prophylaxis against staphylococcal infection before tertiary knee joint replacement.
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Antibiotic Prophylaxis↗
Synthesis and characterization of nickel(II) bis(alkylthio)salen complexes.
NiX2(2-RSC6H4CH=NCH2CH2N=CHC6H4SR-2) (NiX2L; L = 5) (1a, X = Br, R = C6H13; 1b, X = Cl, R = C12H25) and NiX2(2-C6H13SC6H4CH2NHCH2CH2NHCH2C6H4SC6H13-2) (NiX2L; L = 6) (2a, X = Br; 2b, X = Cl; 2c, X = OClO3) were prepared from ligands 5 and 6, respectively. The 1:2 metal-ligand complex Ni(OClO3)2(2-RSC6H4CH2NHCH2CH2NHCH2C6H4SR-2)2 3, was obtained from an EtOH solution of 2c. The characterization of paramagnetic 1-3 included single-crystal X-ray diffraction studies of 1a and 3. Complex 2c converted into 3 in the presence of excess ligand 6 in CHCl3.
Journal Article↗
Cholesterol inhibits the nuclear entry of estrogen receptor activation factor (E-RAF) and its dimerization with the nonactivated estrogen receptor (naER) in goat uterus.
An alternative form of estrogen receptor isolated from goat uterus, the nonactivated estrogen receptor (naER), has no DNA-binding function, although it is closely similar to the classical estrogen receptor (ER) in its hormone binding affinity and specificity. The naER dimerizes with a DNA binding protein, estrogen receptor activation factor (E-RAF). The heterodimer binds to the DNA. Assays carried out during the purification of E-RAF showed that an endogenous inhibitor that is heat stable and dialyzable bound to the E-RAF and prevented the formation of the heterodimer. The inhibitor has been isolated and purified. GC-MS analysis identifies this molecule to be cholesterol. Circular dichroism measurement has shown that the high-affinity binding of cholesterol to E-RAF results in subtle changes in the secondary and the tertiary structure of the protein. The E-RAF with altered conformation fails to dimerize with the naER. Instead of facilitating E-RAF entry into the nucleus, dimerization with the naER prevents it. Similarly, cholesterol binding blocks the nuclear entry of the protein, showing that E-RAF with altered conformation is incapable of interaction with the nuclear pore complex/membrane proteins. The naER-E-RAF heterodimer remains at the nuclear periphery, incapable of further transport. These results indicate the possibility that the dimerization between naER and the E-RAF takes place only within the nuclear compartment. The observation that cholesterol binding prevents nuclear entry of the E-RAF reflects the similarity of E-RAF with the sterol regulatory element (SRE) binding protein that enters the nucleus and binds to SRE only when the intracellular level of cholesterol remains low.
Animals↗
In-vitro antimicrobial activity of Cefpirome: a new fourth-generation cephalosporin against clinically significant bacteria.
OBJECTIVE: To study the in-vitro antimicrobial activity of Cefpirome: A new fourth generation Cephalosporin in comparison with other agents against clinically significant Gram-negative and Gram-positive bacteria. SETTING: A multi-center in-vitro study was conducted in 13 centers. MATERIALS AND METHODS: Bacterial isolates--A total of 1300 isolates were collected from different clinical laboratories and hospitals at 13 centers. Organisms were identified by the API identification systems (API systems, SA Vericeu, France). The age and sex of each patient, type of hospital unit, source of the isolate and genus and species of the bacteria were recorded on standardized report forms. The sensitivity testing was carried out by the "NCCLS (modified Kirby-Bauer) method"--using Mueller-Hinton agar. RESULTS: The results suggest that Cefpirome has a potential clinical advantage against gram-positive and gram-negative bacteria resistant to other third generation cephalosporins. CONCLUSION: Cefpirome was active against both gram-negative and gram-positive organisms. Cefpirome was more active than ceftazidime, cefoperazone, ceftizoxime and ceftriaxone against E. coli, Klebsiella spp, Enterobacter spp, Proteus spp, Salmonella typhi, Enterococci, methicillin sensitive Staphylococci and Betahemolytic Streptococci. The activity of Cefpirome was comparable with ceftazidime against pseudomonas aeruginosa. Cefpirome had the smallest numbers of resistant isolates. Cefpirome was more active than other third generation cephalosporins compared in this study against E. coli (87% vs 61%), Klebsiella spp (84% vs 56%), Enterobacter spp (88% vs 59%), Proteus spp (97% vs 92%), Salmonella typhi (98% vs 96%), methicillin sensitive Staphylococci (86% vs 59%) and Enterococci spp (82% vs 72%).
Bacteria↗
The temporal order judgment paradigm: subcortical attentional contribution under exogenous and endogenous cueing conditions.
The role of subcortical attentional processing was investigated under exogenous and endogenous cueing conditions. As retinotectal projections arise predominantly from the nasal retina i.e., temporal hemifield, subcortical attention should be distributed asymmetrically under monocular viewing conditions with a temporal hemifield advantage. We compared the results of monocular and binocular viewing conditions using a temporal order judgment (TOJ) paradigm. Subjects fixated a centrally located cross and two stimuli were presented with a variable onset asynchrony. Three experiments were conducted: no cue, exogenous cue and endogenous cue. Subjects reported which stimulus seemed to appear first. An effect consistent with subcortical processing was found under exogenous cueing conditions. No such effect was found under endogenous cueing conditions. We believe that subcortical attentional processing in response to an exogenous cue facilitates rapid shifts in attention towards environmental stimuli. We found no evidence for subcortical processing in voluntary directed attention and believe this process to be cortical in nature.
Adolescent↗
The Regenstrief Medical Record System: a quarter century experience.
Entrusted with the records for more than 1.5 million patients, the Regenstrief Medical Record System (RMRS) has evolved into a fast and comprehensive data repository used extensively at three hospitals on the Indiana University Medical Center campus and more than 30 Indianapolis clinics. The RMRS routinely captures laboratory results, narrative reports, orders, medications, radiology reports, registration information, nursing assessments, vital signs, EKGs and other clinical data. In this paper, we describe the RMRS data model, file structures and architecture, as well as recent necessary changes to these as we coordinate a collaborative effort among all major Indianapolis hospital systems, improving patient care by capturing city-wide laboratory and encounter data. We believe that our success represents persistent efforts to build interfaces directly to multiple independent instruments and other data collection systems, using medical standards such as HL7, LOINC, and DICOM. Inpatient and outpatient order entry systems, instruments for visit notes and on-line questionnaires that replace hardcopy forms, and intelligent use of coded data entry supplement the RMRS. Physicians happily enter orders, problems, allergies, visit notes, and discharge summaries into our locally developed Gopher order entry system, as we provide them with convenient output forms, choice lists, defaults, templates, reminders, drug interaction information, charge information, and on-line articles and textbooks. To prepare for the future, we have begun wrapping our system in Web browser technology, testing voice dictation and understanding, and employing wireless technology.
Computer Terminals↗
Prevalent nosocomial gram negative aerobic bacilli and their antimicrobial susceptibility pattern in intensive care unit.
OBJECTIVE: To determine the type of prevalent aerobic gram-negative bacilli and their sensitivity pattern among nosocomial isolates. DESIGN: Prospective collection of clinically significant nosocomial gram negative bacilli. SETTING: Tertiary care hospital in Karachi. METHOD: One hundred isolates were identified by standard methods and minimum inhibitory concentration was checked by epsilometer test. RESULTS: The most frequent isolates were Eschericia coli (43%) followed by Klebsiella pneumoniae (18%) Acinetobacter spp. (7%) Enterobacter spp. (7%) and Klebsiella spp. other than pneumoniae (7%). Most of the isolates of dominant species (E. coli and Klebsiella pneumoniae) were multiresistant including third generation cephalosporins. CONCLUSION: This study indicates that most effective antibiotics imipenem and amikacin inhibited most of the isolates. Imipenem alone or amikacin in combination with one broad spectrum beta-lactam drug should be used in initial empiric therapy in any life threatening nosocomial infection.
Amikacin↗
Fine needle aspiration cytology in parotid lumps.
Over a period of two years, Fine Needle Aspiration Cytology (FNAC) was performed on 33 patients presenting with a parotid lump. Five patients were excluded as they were treated medically after FNAC report. The FNAC results of 28 cases were compared with histopathological diagnoses of surgically resected specimens. There were 8 true positive, 17 true negative, 1 false positive and 2 false negative cases. Sensitivity was 80%, specificity 94.4% and diagnostic accuracy 89.3%. FNAC is a simple quick, accurate and virtually complications free investigative modality. It is also helpful adjunct to assess preoperatively the suitability and extent of the surgical treatment.
Adolescent↗
Isolation and identification of Aeromonas species from human stools.
One thousand and three diarrhoeal stool samples were processed in our laboratory during the period 1996/1997 for the presence of enteric pathogens especially Aeromonas spp., which has emerged as a new agent causing diarrhoea. Ampicillin sheep blood agar was found to be the best medium for the isolation of Aeromonas spp. from stool specimens. Enteric pathogens were found in 200 (20%) stools, of which Aeromonas spp. was the second commonest pathogen isolated amounting to 21% of isolates. This study clearly indicates that Aeromonas spp. must be looked for in every diarrhoeal stool samples, specially in children below 10 years of age. Isolation and identification is cost effective and easy, if the given protocol is observed.
Aeromonas↗
Ossifying fibroma of nasal cavity.
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Adolescent↗
The detection of verocytotoxins in bacterial cultures from human diarrhoeal samples with monoclonal antibody-based ELISAs.
Bacterial cultures from 1801 human diarrhoeal faecal specimens were examined for verocytotoxins I and II by monoclonal antibody-based sandwich ELISAs. Of the 68 ELISA-positive cultures selected from initial screening, 32 were positive by ELISA on repeat or from freshly grown cultures. ELISA-positive pure cultures were obtained from 13 of these, of which seven were confirmed as verocytotoxin positive by cytotoxicity assay. These seven strains were typed as O26 (5) and O146 (2). The six false positive results were from isolates of Enterobacter sp. (1), Citrobacter Freundii (1) and Escherichia coli (4), one each of types O1, O18ac and O98 and an untypable strain. Despite the occurrence of false positive reactions, sandwich ELISA was a useful method for the rapid screening of samples, and detected verocytotoxin-positive E. coli strains, other than O157, from patients with clinical conditions in which they could be implicated.
Adult↗
Ruptured aneurysm of the sinus of Valsalva.
The objective of the present study was to assess the value of imaging techniques in the diagnosis of ruptured aneurysm of sinus of Valsalva (RASV). 38 patients were included in the study. 30 were male and 8 female. Their age ranged from 7 to 55 years (mean 25.8 years). Echocardiographic and doppler studies were done in all cases and 20 patients underwent catheterization and angiography. Two patients were asymptomatic, 20 (53%) had acute onset of symptoms and in the remaining 16 (42%) patients symptoms developed gradually. Twenty two (58%) patients were in NYHA functional class III or IV when first seen. Predominant symptoms were dyspnea (79%), palpitation (55%) and chest pain (52%). A continuous machinery murmur was detected in all the patients with associated thrill in 34 patients. Right coronary sinus (RCS) was the most common sinus involved (89%) followed by the noncoronary sinus (NCS) which was involved in 11% of patients. None of the patients in our series had aneurysm of the left coronary sinus. Twenty eight of the 34 RCS aneurysms ruptured into the right ventricular outflow tract (RVOT), 4 into right ventricular cavity (RVC), one into right atrium (RA) and one dissected into the ventricular septum and subsequently ruptured into the left ventricle. Of the 4 NCS aneurysms, 2 ruptured into RVC, one into RA and one into both the RA and RVC. Associated ventricular septal defect (VSD) was found in 10 (26%) patients and all of these patients had RCS aneurysm that ruptured into the RVOT. Aortic regurgitation (AR) was detected in 16 (42%) cases. Discrete subaortic stenosis was detected in one patient who also had associated VSD and AR. Vegetation of the aortic valve was detected in one patient who had RCS aneurysm. Twelve patients (11 male and one female) underwent surgical correction, 10 with and 2 without prior catheterization. Localization of the involved sinus, site of rupture and associated cardiac lesions by echocardiography and doppler study were found accurate at surgery and/or angiography in 22 cases of our series. Imaging techniques, thus appeared to be reliable tools for the diagnosis of RASV.
Adolescent↗
Conduction disturbances in acute myocardial infarction: incidence, site-wise relationship and the influence on in-hospital prognosis.
The study was designed to assess the incidence of conduction disturbances, the relationship of the site of infarction with the type of conduction disturbances and the influence of conduction disturbances on the in-hospital prognosis. One hundred consecutive patients (M:F = 89:11) with a age range of 35-60 years with the history of first attack of acute myocardial infarction were included in the study. There were 45 anterior, 43 inferior and 12 combined anterior and inferior myocardial infarction patients. 44 of the patients had some type of conduction disturbances (Group A) and 56 had none (Group B). Inferior myocardial infarction patients showed higher incidence of conduction disturbances than anterior myocardial infarction (56.8% and 31.8% respectively) (Odd's ratio 2.98, 95% ci 1.14 to 7.9). Conduction disturbances were mostly (92%) atrio-ventricular in inferior myocardial infarction and mostly (72%) intraventricular in anterior myocardial infarction. Of the 13 cases of complete atrioventricular block, 8 had inferior, 2 anterior and 3 combined anterior and inferior infarction. In inferior infarction, complete atrioventricular block developed gradually through 1 degree and 2 degrees atrioventricular block but in the anterior infarction it developed suddenly. Patients with conduction disturbances developed more complications (84%) than those without conduction disturbances (54%). Mortality rate was higher in Group A (25%) than in Group B (3.6%) (Odd's ratio 9.0, 95% ci 1.76 to 86.73) with a overall rate of 13%. Mortality rate was higher in anterior myocardial infarction (50%) than in inferior myocardial infarction (25%) when complicated by complete atrioventricular block. It was concluded that conduction disturbances are predominantly atrioventricular in inferior and intra-ventricular in anterior MI; conduction disturbances are associated with increased risk of complications and death. Anterior location of MI may have an independent risk attribute.
Adult↗
24h withdrawal following repeated administration of caffeine attenuates brain serotonin but not tryptophan in rat brain: implications for caffeine-induced depression.
Caffeine injected at doses of 20, 40 and 80 mg/kg increased brain levels of tryptophan, 5-hydroxytryptamine (5-HT) and 5-hydroxyindole acetic acid (5-HIAA) in rat brain. In view of a possible role of 5-HT in caffeine-induced depression the effects of repeated administration of high doses of caffeine on brain 5-HT metabolism are investigated in rats. Caffeine was injected at doses of 80 mg/kg daily for five days. Control animals were injected with saline daily for five days. On the 6th day caffeine (80 mg/kg) injected to 5 day saline injected rats increased brain levels of tryptophan, 5-HT and 5-HIAA. Plasma total tryptophan levels were not affected and free tryptophan increased. Brain levels of 5-HT and 5-HIAA but not tryptophan decreased in 5 day caffeine injected rats injected with saline on the 6th day. Plasma total and free tryptophan were not altered in these rats. Caffeine-induced increases of brain tryptophan but not 5-HT and 5-HIAA were greater in 5 day caffeine than 5 day saline injected rats. The findings are discussed as repeated caffeine administration producing adaptive changes in the serotonergic neurons to decrease the conversion of tryptophan to 5-HT and this may precipitate depression particularly in conditions of caffeine withdrawal.
Analysis of Variance↗
Association of cytoskeletal proteins with estrogen receptor in rat uterine cytosol: possible role in receptor movement into the nucleus.
Evidence is presented to demonstrate a close association between an estrogen receptor or an estrogen receptor activation factor and the cytoskeletal proteins, tubulin and actin in rat uterine cytosol. Exposure of uterine cytosol to protein kinase assay medium resulted in the phosphorylation of three proteins, of molecular mass 55, 50 and 45 kDa. These 55 and 50 kDa proteins apparently represent tubulin, while the 45 kDa protein, is presumed to be actin. Phosphorylation of these proteins is under the regulatory influence of estradiol and the cyclic nucleotides, cAMP and cGMP. It is proposed that the protein kinase involved in this process may be the non-activated estrogen receptor (naER).
Actins↗
Tolerance to diacetyl morphine antinociception: effects on brain serotonin.
The effects of 5 mg kg-1 diacetyl morphine (DAM) on brain serotonin metabolism of rats were investigated following tolerance to the antinociceptive effects of 2.5 mg kg-1 DAM. Brain levels of tryptophan and 5-hydroxy indoleacetic acid (5-HIAA) were higher in the DAM-tolerant rats killed 24 h after last daily administration of 2.5 mg kg-1 DAM. Administration of 5 mg kg-1 DAM produced less antinociception in DAM-tolerant than DAM-naive rats and increased brain tryptophan concentration in both tolerant and naive rats. 5-HIAA concentrations increased only in naive rats. Combined use of drugs interfering with brain 5-HT turnover along with opiates may be of future benefit for the treatment of chronic pain.
Analysis of Variance↗
Enhancement of hepatic tryptophan pyrrolase activity and decreases of open field locomotion following single and repeated administration of high doses of caffeine in rats.
In view of a possible role of kynurenine in caffeine-induced anxiety syndrome, the effects of single and repeated administration of caffeine on hepatic tryptophan (T)-pyrrolase activity are investigated. Single administration of caffeine at doses of 80 mg/kg decreased open field locomotion and increased hepatic T-pyrrolase activity. Locomotor stimulating effects of 80 mg/kg caffeine, monitored in the home cages of rats, were attenuated following daily administration of caffeine for 5 days. Open field locomotor activity of rats and its caffeine-induced decrement were also attenuated following 5 daily administrations of caffeine on the 6th day. Basal levels of hepatic T-pyrrolase activity increased after 5 daily administrations of caffeine on the 6th day. Acute administration of caffeine did not further elevate hepatic T-pyrrolase activity in 5 day caffeine injected rats. Drug adjuvants decreasing hepatic T-pyrrolase activity may prove valuable for extending the clinical utility of caffeine.
Animals↗