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Biomedical subjects

B Ali

Publications and source records attributed to B Ali.

At least 19 recordsLinked to original sources
PubMed2001

Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomised controlled trial.

BACKGROUND: Wound infection after clean surgery is an expensive and often underestimated cause of patient morbidity, and the benefits of using prophylactic antibiotics have not been proven. Warming patients during colorectal surgery has been shown to reduce infection rates. We aimed to assess whether warming patients before short duration, clean surgery would have the same effect. METHODS: 421 patients having clean (breast, varicose vein, or hernia) surgery were randomly assigned to either a non-warmed (standard) group or one of two warmed groups (local and systemic). We applied warming for at least 30 min before surgery. Patients were followed up and masked outcome assessments made at 2 and 6 weeks. FINDINGS: Analysis was done on an intention-to-treat basis. We identified 19 wound infections in 139 non-warmed patients (14%) but only 13 in 277 who received warming (5%; p=0.001). Wound scores were also significantly lower (p=0.007) in warmed patients. There was no significant difference in the development of haematomas or seromas after surgery but the non-warmed group were prescribed significantly more postoperative antibiotics (p=0.002). INTERPRETATION: Warming patients before clean surgery seems to aid the prevention of postoperative wound infection. If applied according to the manufacturers guidelines these therapies have no known side-effects and might, with the support of further studies, provide an alternative to prophylactic antibiotics in this type of surgery.

Body Mass Index↗
PubMed2001

Assessment of access blood flow after preemptive angioplasty.

In an effort to prolong the life of synthetic grafts used for hemodialysis access, current recommendations suggest regular monitoring of vascular access by means of measurements of access blood flows (ABFs) and/or pressures and prompt referral for prophylactic angiography with angioplasty when appropriate. Previous data suggested that angioplasty transiently reduces venous pressure, but repeated angioplasty is often required. Few data exist on the effect of angioplasty on ABF, especially the durability of the response. In this study, we report our experience with 49 consecutive angioplasties of 32 synthetic polytetrafluoroethylene grafts in which ABF was measured serially preangiography and postangiography using the Transonic hemodialysis monitor (Transonic Inc, Ithaca, NY). The primary indication for angiography was a low graft ABF rate (<600 mL/min). Although the most common site for stenosis was the venous anastomosis, the majority of grafts had multiple lesions requiring angioplasty. Mean ABF rate increased from 596 +/- 41 to 922 +/- 48 mL/min postangiography, an increase of almost twofold. This level of blood flow was maintained for the first month, but thereafter ABF began to decrease, reaching 672 +/- 70 mL/min at 3 months and 658 +/- 93 mL/min at 6 months. Two patients were lost to follow-up (one patient died, one patient received a transplant) and 2 grafts were electively ligated. The remaining 28 grafts were followed up for at least 6 months. Four grafts clotted within 3 months of angioplasty and were lost. Nine additional grafts required a second intervention (surgical revision, 2 grafts; repeated angioplasty, 7 grafts) within 6 months, either for a poor initial response to angioplasty or recurrent stenosis. Two of these 9 grafts subsequently clotted and were lost. In all, 22 of the 28 grafts remained patent at 6 months postangioplasty, and 15 grafts were maintaining an ABF greater than 600 mL/min without reintervention at 6 months. In summary, this study indicates that preemptive angioplasty of graft stenoses results in an initial doubling of ABF, but the effect is temporary, with the average ABF decreasing to baseline values by 3 months. Approximately half the grafts required reintervention for either thrombosis or recurrent low flow. However, sustained responses with ABF maintained at greater than 600 mL/min were achieved in the other half.

Angiography↗
PubMed2001

Using costing as a district planning and management tool in Balochistan, Pakistan.

This paper reports on two studies in the province of Balochistan, Pakistan, analyzing the costs of primary care facilities and district and divisional hospitals. There are no known previous cost studies within Balochistan and the information gained is a critical element in developing a more rational allocation of resources within the health sector. The results demonstrate both the high level of under-funding of primary care within the health sector and the current inefficiency of allocation towards primary care and, within budgets, between different line items. Medicines in particular are significantly under-funded at the expense of staffing costs. The results are of use in developing more bottom-up budgeting systems within a more rational resource allocation system that is being developed as an element of the more decentralized health system towards which the province is working.

Budgets↗
PubMed2000

Differential inhibition of xenobiotic-metabolizing carboxylesterases by organotins in marine fish.

The hydrolytic metabolism of xenobiotics in the liver of two tropical marine fish, Siganus canaliculatus and Acanthopagrus latus, was found to be catalyzed by both microsomal and cytosolic carboxylesterases; the latter forms were more active than the former. Remarkably greater efficiency of S. canaliculatus for p-nitrophenylacetate hydrolysis was attributed to manyfold higher V(max) and lower K(m) values of hepatic microsomal and cytosolic carboxylesterases of S. canaliculatus as compared with those of A. latus. Comparative characterization of the in vitro responses of hepatic microsomal and cytosolic carboxylesterases to the organotin group of marine pollutants-tributyltin (TBT), triphenyltin (TPT), and dibutyltin (DBT), a relatively persistent metabolite of TBT-revealed species-, isozymic form-, and organotin structure-related differences in the hydrolytic detoxication. In general, carboxylesterases of S. canaliculatus exhibited severalfold greater susceptibility to organotin inhibition and DBT was the most potent inhibitor (IC(50) in micromolar range). Notably, the IC(50) of SnCl(2), a metal present in all the compounds studied, was higher than 2 mM. Cytosolic forms in both species were more sensitive to organotin inhibition than microsomal counterparts. In line with these differences the nature of inhibition of cytosolic and microsomal carboxylesterases by organotins was competitive and noncompetitive, respectively. These results suggest that organotins may aggravate the toxicity of other environmental contaminants in fish and other aquatic organisms. Moreover, highly sensitive cytosolic carboxylesterases of S. canaliculatus liver may serve as molecular biomarkers of organotin pollution.

Animals↗
PubMed2000

Resource allocation and budgetary mechanisms for decentralized health systems: experiences from Balochistan, Pakistan.

This paper identifies key political and technical issues involved in the development of an appropriate resource allocation and budgetary system for the public health sector, using experience gained in the Province of Balochistan, Pakistan. The resource allocation and budgetary system is a critical, yet often neglected, component of any decentralization policy. Current systems are often based on historical incrementalism that is neither efficient nor equitable. This article describes technical work carried out in Balochistan to develop a system of resource allocation and budgeting that is needs-based, in line with policies of decentralization, and implementable within existing technical constraints. However, the development of technical systems, while necessary, is not a sufficient condition for the implementation of a resource allocation and decentralized budgeting system. This is illustrated by analysing the constraints that have been encountered in the development of such a system in Balochistan.

Budgets↗
PubMed2000

[Lipoprotein (a). A new risk factor for coronary artery disease].

Lp(a) may represent a link between the fields of atherosclerosis and thrombosis. Elevated Lp(a) levels > 300 mg/l have been associated with the presence of atherosclerotic disease. This prospective study initiated in 1995 and, until June 1999 enrolled 218 subjects divided in two groups: G1: subjects with/without angiographically proven coronary artery disease(CAD), n = 124 and GII: controls, n = 94 The objective of this study was to assess the influence of high Lp(a) serum levels on the CAD. Secondary end point was to demonstrate a correlation between the level serum Lp(a) and the severity of angiographic coronary findings. we found that The cases had significantly (p = 0.004) higher Lp(a) levels than the controls and that correlation exist between the value of Lp(a) serum levels and severity of angiographic findings. However, we do recommend Lp(a) screening for patients with early CA1:) or a family history of CAD.

Aged↗
PubMed1999

Evaluation of antiallergic activity (type I hypersensitivity) of Inula racemosa in rats.

Alcoholic extract of root of Inula racemosa, was studied for its antiallergic effect in experimental models of type I hypersensitivity, viz. egg albumin induced passive cutaneous anaphylaxis (PCA) and mast cell degranulation in albino rats. The alcoholic extract was prepared by the process of continuous heat extraction. LD50 of this extract was found to be 2100 +/- 60 mg/kg, i.p. Assessment of protection against egg albumin induced passive cutaneous anaphylaxix by different doses of Inula racemosa was done by giving drug intraperitoneally or orally for seven days or once only. Mast cell degranulation studies were done by using compound 48/80 as degranulation agent with same dosage schedule. Inula racemosa (i.p. as well as p.o.) showed significant protection against egg albumin induced PCA. Protection against compound 48/80 induced mast cell degranulation by alcoholic extract of Inula racemosa (single dose) was similar to that of disodium cromoglycate. The seven days drug treatment schedule showed greater protection than disodium cromoglycate intraperitoneally. The results suggest that Inula racemosa possesses potent antiallergic properties in rats.

Animals↗
PubMed1997

Teleophthalmology: rationale, current issues, future directions.

Relatively little information exists concerning the delivery of ophthalmic services via telemedicine, yet ophthalmology is particularly amenable to the utilization of such applications. This paper discusses the technological issues pertinent to the research, development, and assessment of teleophthalmology delivery systems and begins to define the parameters that will determine the sustainability of teleophthalmology. A prototype urban teleophthalmology delivery system is presented in the context of improving access to eye care for an underserved inner-city population. Potential enhancements to the prototype telephthalmology system are discussed.

Adolescent↗
PubMed1997

Prediction of renal function recovery in obstructive renal failure due to stones.

Two hundred and thirty-nine patients with renal and ureteric calculi associated with renal failure were evaluated for recovery potential before definitive surgery. Ultrasonography was carried out pre-operatively in all, followed by percutaneous nephrostomy (PCN) as an initial management before definitive surgery. Diethylene triamine penta acetic acid (DTPA) scan was done in 125 patients after percutaneous nephrostomy, findings of pre- operative DTPA scan were correlated with post-operative drop in serum creatinine. Urine pH, urine Na+, initial diuresis, creatinine clearance and serum creatinine were measured serially after 24 hours and then every week for 6 weeks. Patients were re-evaluated with serum creatinine after 3 months of surgery. Ultrasonography was found to be reliable in predicting future recovery of renal functions in 76.5% cases and true obstruction of shorter duration (F4-group) on DTPA scan in 81.9% cases. Urine pH of 6 or less, post-PCN diuresis and natriuresis were good prognostic indicators. PCN was found to be most reliable method of predicting future recovery of renal function after relief of obstruction with 97.8% accuracy.

Adult↗
PubMed1997

Cytochrome P450-dependent oxidation and glutathione conjugation of xenobiotics in alloxan-induced diabetic rat.

The status of cytochrome P450-dependent oxidative biotransformation of aminopyrine and benzo(a)pyrene (Phase I reaction) and glutathione S-transferase (GST) catalyzed conjugation with 1-chloro-2,4-dinitrobenzene (CDNB) (Phase II reaction) was evaluated in diabetic rats sacrificed 3 weeks after alloxan treatment (2 doses of 75 mg/kg at an interval of 48 h, i.p.). Alloxan treatment caused 3-4 fold increase in blood glucose level and 68% rise in glycosylated hemoglobin content. There were significant decreases in the activities of the hepatic aminopyrine N-demethylase and aromatic hydrocarbon hydroxylase (AHH) in diabetic rats as compared with the controls. The activity of GST was also significantly reduced in liver and kidney, whereas remained unchanged in the brain. These results suggest that a prolonged diabetic state depresses the metabolism of xenobiotics and probably of some endogenous compounds as well in liver and kidney.

Animals↗
PubMed1995

Management of urinary calculi associated with renal failure.

Three hundred and sixty patients of urinary calculi associated with renal failure were included in this prospective study. The male to female ratio was 4.1:1 while adult to paediatric ratio was 6.5:1. One hundred and eighteen (32.8%) patients presented with calculus anuria while 242 (67.2%) were admitted with symptoms of chronic renal failure. Serum creatinine at the time of first admission ranged from 3-35 mg/100 ml. In the initial management, percutaneous needle nephrostomy was done in 217 cases, dialysis in 106, dialysis and PCN in 22 and retrograde catheterisation followed by JJ stent in 15. Definitive surgical procedures were undertaken in 277 cases; 29 passed stones spontaneously after PCN. At two year follow-up 72% patients of calculus anuria and 49.5% of calculus renal failure improved their renal function and remained with serum creatinine below 2 mg/100 ml. There was 13.6% mortality in calculus anuria group and 17.4% in calculus renal failure. Overall loss to follow-up was 7.6% and 12% in the two groups respectively.

Adolescent↗