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Biomedical subjects

E M Ibrahim

Publications and source records attributed to E M Ibrahim.

At least 37 records · Page 2Linked to original sources
PubMed1991

Antiemetic efficacy of cimetidine randomized, double-blind, crossover study with dexamethasone in cancer patients receiving emetogenic chemotherapy.

In a randomized, double-blind, crossover study the antiemetic effect of cimetidine was compared with that of dexamethasone in cancer patients receiving emetogenic chemotherapy. Thirty-two patients were evaluable and all were chemotherapy-naive. Eight patients (25%) received high doses of cisplatin, 17 (53%) had cyclophosphamide in combination treatment, 2 (6%) received adriamycin, and 1 another chemotherapy of less emetogenic potential. Complete protection (CR) rates of 59.4% and 62.5% were achieved with cimetidine and dexamethasone, respectively. In addition, three (9.4%) and 1 (3%) patients attained partial protection with cimetidine and dexamethasone, respectively. No significant difference was noted between the two antiemetic therapies (p = 0.07). Although CR has not been achieved in any of those patients who received cisplatin, a comparable antiemetic effect was attained. Both antiemetic regimens were well tolerated with minimal side effects. We conclude that the antiemetic potential of cimetidine and its safety deserve further investigation in a larger study, perhaps in combination with other antiemetic agents.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Splenic foam cells: a clinico-pathologic analysis of 92 splenectomized patients.

Spleens from 92 patients who underwent splenectomy for various indications were examined. These indications included hematologic disease in 38 patients and nonhematologic problems in 54. Of all the group foam cells were seen in hematoxylin and eosin (HE)-stained sections of spleens from 12 patients. This number increased to 21 (23%) when the diastase periodic acid-Schiff stain was used as a screening test. The cells in these 9 additional cases were too scanty to be observed on HE-stained sections alone. All the 21 spleens with positive foam cells were from patients with hematologic disease, specifically beta-thalassemia major, hemoglobin S/beta-thalassemia, hemoglobin AS, and idiopathic thrombocytopenic purpura. None of the spleens from the 54 nonhematologic patients showed foam cells. Factors that determine the probability of presence of foam cells were calculated. Also, certain differences in the staining reactions of foam cells were observed. The results of both, and the relation of these foam cells to the 'syndrome of the sea-blue histiocyte' are presented and discussed.

Adolescent↗
PubMed1990

Helicobacter pylori-associated upper gastrointestinal disease in Saudi Arabia: a pathologic evaluation of 298 endoscopic biopsies from 201 consecutive patients.

In a prospective study, histopathological examination 298 upper gastrointestinal (UGI) biopsies, obtained from 201 consecutive patients, was made. Patients were referred with mild to severe dyspeptic symptoms. The aim of the study was to compare the rate of identification of Helicobacter pylori (H. pylori) in the histologically normal gastric mucosa with that in histologically confirmed gastritis or peptic ulcer disease. The gastroduodenal mucosa was histologically normal in 35 patients (17.4%); among those patients, H. pylori was identified in only three (9%). Chronic gastritis was histologically confirmed in 162 patients (80.6%). H. pylori was identified in 123 (76%) of those patients. The difference was statistically significant (p less than 0.00001). Furthermore, when cases with a histological diagnosis of superficial chronic active gastritis (SCAG) are considered separately, the identification rate of H. pylori increases to 88% (121 of 137). When this rate is compared with that of 8% (two of 25), found in superficial chronic quiescent gastritis (SCQG), the difference is highly significant (p less than 0.00001). Of 38 endoscopically diagnosed peptic ulcers, H. pylori was identified in the gastric mucosa of 34 (89%). The organisms were always seen in the antral gastric mucosa, but never in duodenal mucosa. Identification of H. pylori correlates significantly with the histologic activity of chronic gastritis, in both peptic ulcer disease and non-ulcer dyspepsia.

Adolescent↗
PubMed1990

Hepatic granuloma in Saudi Arabia: a clinicopathological study of 59 cases.

The identification of hepatic granuloma (HG) as a histiocytic or epithelioid cell collection is generally an easy task for the pathologist. However, most workers agree that arriving at a specific etiologic diagnosis, based solely on the morphology of the granuloma, may prove quite a tedious exercise. Of 404 histologically reviewed liver biopsies from 404 patients, 40 were normal, 62 showed carcinoma, and 243 revealed evidence of either acute or chronic nongranulomatous liver disease (NGLD). The remaining 59 biopsies had HG, constituting an incidence figure of 14.6%. The latter 59 patients qualified for further clinicopathological analysis, which constituted the material for this study. The HG was due to schistosomiasis in 32, tuberculosis in 19, brucellosis in four, drugs in two, and to typhoid and ruptured fat cysts (lipogranuloma) in one patient each. The study was done to delineate the histological and other features that might be of value in identifying the etiology of HG.

Adult↗
PubMed1990

Late relapse of Hodgkin's disease after 25 years.

This short report documents a late relapse of Hodgkin's disease 25 years later after initial complete remission. The case represents the second longest ever reported disease-free survival that was followed by late recurrence. Data about late occurrence in Hodgkin's disease of relapses are reviewed. The biological and clinical significances of those events of late relapses are emphasized.

Adult↗
PubMed1989

The outcome of head injury: the Saudi experience.

The outcome in 159 cases of head injury was evaluated in terms of the Glasgow Coma Scale (GCS) score, age, and computed tomographic (CT) findings. Children below the age of 10 accounted for 30% of the head-injured patients, and 69% were Saudis. 81% of the patients had a GCS score of 8 or higher, and in this group the outcomes were favorable. In contrast, 19% had an initial GCS score of 7 or less, tended to be older, and had worse outcomes, with a mortality rate of 68%. The initial GCS score, age, presence or absence of associated injuries, and the degree of midline shift according to CT were useful prognostic indices in patients with head injury.

Adolescent↗
PubMed1989

Tuberculosis in patients with malignant disease.

Of 2,143 biopsy proven cancer patients seen at our hospital over a six year period, 4 (0.19%) patients developed active tuberculosis (TB) during anticancer therapy or shortly after its completion. The cancer diagnoses of those patients were non-Hodgkin's lymphoma, breast cancer, chronic myelogenous leukemia, and astrocytoma. Institution of antituberculous therapy was successful in three patients, however, the TB course was rapidly fatal in the fourth patient with non-Hodgkin's lymphoma despite therapy. The association between TB and neoplasia is emphasized. TB complicating malignant disorders represents complex problem regarding its early recognition and its managements.

Adult↗
PubMed1989

Campylobacter pylori in Saudi patients undergoing upper gastrointestinal endoscopy: prevalence and effect of conventional therapy.

Patients with symptoms of gastritis or peptic ulcer disease were recruited to study the prevalence of Campylobacter pylori. On the basis of the endoscopic diagnosis only, the isolation rates of the organisms in normal, gastritis or gastroduodenitis (GD), and peptic ulcer (PU) disease patients, were not significantly different among the 89 patients evaluated. However, analysis based on histopathological evaluation (in 73 out of these 89 patients) revealed a significant difference (p = 0.00016) in the isolation rate between histologically normal individuals (14%) and those with GD (89%). Also, a significant (p = 0.03) difference was observed in the C. pylori detection rate among patients with GD and those with PU disease (61%). After adjustment for multiple comparisons, only the difference in C. pylori prevalence between normal and GD patients was maintained. After conventional therapy, 23 patients who initially had GD or PU disease were submitted to re-endoscopy. In the latter group, a correlation between presence or absence of organisms and histological healing was noted. The potential pathogenesis of C. pylori in gastritis and peptic ulcer disease, and designs for future trials are discussed.

Adult↗
PubMed1989

Malignant bone tumours in pregnancy (a report of two cases and review of literature).

Two cases of malignant bone tumours in pregnancy are reported. The optimum management is not clearly defined due to the rarity of the condition and limited individual experience. Our patients delivered healthy babies without any signs of maternal malignant disease. Cancer chemotherapy was instituted during the postmortem period. Pregnancy did not appear to exacerbate the tumour growth nor in any way affect the ultimate outcome of the patients.

Adult↗
PubMed1989

The prevalence of allergic disorders in Saudi Arabia: preliminary analysis based on surveying 300 individuals.

Prospective surveying of 300 (150 males, and 150 females) randomly selected individuals was carried out to study the pattern and prevalence of allergic disorders in the community. The mean age was 32.8 and 26.8 years for males and females, respectively. A total of 28 participants (17 males, and 11 females) (9.3%) were found to have personal history of allergic disorders. No significant sex difference was noted in the distributions of those allergies, except for more male predominance for allergic rhinitis. The latter was seen in 7 males and only one female (p = 0.033). Prevalence of bronchial asthma was rather rare as it was identified in only 2 individuals (0.7%). More males (16) than females (2) admitted a positive family history of allergy (P = 0.0005). Most of the familial history of allergic disorders was due to bronchial asthma (11 relatives). We conclude that allergic disorders are common in our local community. However, for more detailed assessment, a larger sample that includes various age distributions and different socioeconomic classes should be screened.

Adult↗
PubMed1989

The outcome of head injuries: the Saudi experience.

One analysis of the outcome of 159 cases of head injuries was based on patients' admission Glasgow Coma Scale (GCS), score, age, CT scan findings and uniform protocol of management. Fifty-three percent of the patients were children below the age of 10 years and 70% of all patients were Saudis. Eighty-point-five percent (80.5%) of the patients had a GCS score of 8 or more and their outcome was favorable. By contract, the 19.5% who had an initial GCS score of 7 or less tended to be older and had a worse prognosis (mortality 68%). A high initial GCS score, old age, associated multiple injuries and a shift of more than 4 mm of the midline structures on CT scan of the brain are useful prognostic indices in predicting the outcome of head injury.

Adolescent↗
PubMed1988

Non-Hodgkin's lymphoma in Saudi Arabia: prognostic factors and an analysis of the outcome of combination chemotherapy only, for both localized and advanced disease.

Seventy-eight previously untreated patients with clinical stage (CS) I and II (42 patients) and CS III and IV (36 patients) and non-Hodgkin's lymphoma (NHL) were treated with systemic chemotherapy only. All patients had intermediate or high grade lymphoma. Two different regimens were used: bleomycin, adriamycin, cyclophosphamide, vincristine and prednisone (BACOP); and a combination of methotrexate with folinic acid rescue, epirubicin, cyclophosphamide, vincristine, prednisone and bleomycin (MECOP-B), for 57 and 21 patients respectively. Objective clinical remission was achieved in 90% of the cases, of which 73% were complete. Complete remission (CR) was demonstrated in 90% and 53% of patients with CS I + II and III + IV respectively (P = 0.0008). Two variables, bone marrow and liver involvement, were negatively associated with CR rate in a multivariate analysis. The actuarial overall survival for the entire group was 65%. The median survival for complete responders has not been reached, but a projected 80% relapse-free survival at 3 years is estimated. The Cox proportional hazards model predicted that advanced stage (CS III and IV) and pretreatment lactic dehydrogenase serum level above 400 iu/l (N less than 200 iu/l) independently influenced survival adversely. The latter prognostic variables were used to identify several groups with different risk probabilities. Despite an apparent comparability between patients receiving the two regimens, no significant difference in response or survival rates was noted between the two protocols. We conclude that the results of systemic chemotherapy compared favorably with radiation therapy for early stage disease and is an acceptable strategy for developing countries with limited availability of radiotherapy facilities. Based on certain risk factors, therapy should be individualized so that more intense regimens, with or without radiation, should be offered only to those patients in the high risk group at highly specialized centers.

Adolescent↗
PubMed1988

Antiemetic efficacy of high-dose dexamethasone: randomized, double-blind, crossover study with a combination of dexamethasone, metoclopramide and diphenhydramine.

A double-blind, randomized, crossover study was conducted to compare the efficacy and safety of high-dose dexamethasone (Protocol D) with a combination of dexamethasone, metoclopramide and diphenhydramine (Protocol DMD) in the management of chemotherapy-induced nausea and vomiting in cancer patients. All entered patients had received no prior chemotherapy. During the study chemotherapy was administered on an inpatient basis. The majority of patients (94%) were treated with cytotoxic drugs of significant emetogenic activity and 40% of the study group received cis-platin-containing combinations. Of the 60 evaluable patients, complete antinausea and antivomiting effects of D were observed in 30 (50%) and 34 (57%), respectively and of DMD in 17 (28%) and 26 patients (43%) respectively. The difference was not statistically significant (P = 0.09 and 0.24, respectively). Lack of significant difference between the two regimens was demonstrated irrespective of the administered cytotoxic drugs. The DMD protocol caused more adverse reactions than D. While 27 patients (45%) experienced no side effects from D, only 14 (24%) remained free of complications due to DMD (P = 0.001). Furthermore, DMD produced more sedation, insomnia, headache, diaphoresis, dizziness and diarrhoea than the D regimen. In addition it gave rise to more adverse effects on appetite and activity. Upon direct questioning, 37 patients (62%) expressed a preference for D, 14 (23%) preferred DMD and 9 (15%) found no difference between the two regimens. We conclude that, while the short DMD protocol has an antiemetic activity equivalent in its effectiveness to D, its associated adverse reactions would minimize its usefulness. Therefore, further investigations should be conducted to find a safer and more potent combination of antiemetics suitable for therapy in an outpatient setting.

Adolescent↗
PubMed1988

Digestive system malignancies in the eastern province of Saudi Arabia: an analysis of 158 patients.

Retrospective evaluation of 158 patients with digestive system neoplasms was carried out. The disease pattern was compared to that noted in other parts of Arabia, other Middle East countries, Africa, and the West. An attempt was made to analyze potential aetiological factors in the Saudi population. At all cancer sites of the digestive system the male to female ratio was 3:1. Generally more younger patients with advanced cancer were encountered than reported in series from the Western hemisphere. The poor results of therapy were generally attributed to the advanced stage at presentation. The high frequency of GIT cancer and in particular the apparently rising incidence rate of colorectal cancer was attributed to dietary habits and the changing lifestyle of the population. Hepatitis B viral infection was the likely cause of primary hepatocellular cancer (PHC) although dietary factors could not be ruled out. Schistosomiasis was found not to play a role in the causation of either PHC or colorectal cancer.

Adult↗
PubMed1987

Granulomatous oesophagitis: a case of tuberculosis limited to the oesophagus.

In this paper we report on a 31-year-old Saudi male with tuberculosis limited to the oesophagus, presenting with dysphagia. Radiological examination revealed oesophageal ulceration with diverticulum formation. The diagnosis of oesophageal tuberculosis was made only after endoscopy and histopathological examination. The patient gained weight and became symptomless after three months of chemotherapy with antituberculous drugs. The rarity of such a presentation prompted this case report.

Adult↗
PubMed1986

Combination chemotherapy only for stage II non-Hodgkin's lymphoma.

Twenty-six previously untreated patients with clinical stage (CS) II B non-Hodgkin's lymphoma (NHL) were treated with systemic chemotherapy only. Patients received bleomycin, adriamycin, cyclophosphamide, vincristine and prednisone (BACOP). All patients had intermediate- or high-grade lymphoma. Objective response was demonstrated in 25 patients (96%), with 21 patients (81%) achieving complete remission (CR). Two of CR patients developed unsalvageable relapse, the remaining 19 patients are still alive and disease-free. The median duration of CR has not been reached. Of four patients (15%) with documented partial remission (PR), three were salvaged using second-line therapy. Over a median follow-up of 12 months (range, 3-30), 22 patients (85%) are alive and disease-free, of whom 16 (62%) have survived more than 1 yr. Bulky disease or gastrointestinal tract (GIT) involvement did not influence the CR rate. Our results compared favorably with radiation therapy for stage II NHL; however, a larger controlled and randomized study is warranted.

Adolescent↗