Biomedical subjects
Publications and source records attributed to Ejaz Ahmed.
Silymins A (1) and B (2), the new pentacyclic triterpenes, have been isolated from ethyl acetate fraction of Silybum marianum and their structures assigned from 1H and 13C NMR spectra, DEPT and by 2D COSY, NOE and HMBC experiments.
A new flavanone Persinol (1) and the new flavanone glucosides persinosides A (2) and B (3), along with known flavonoids (4 and 5) have been isolated from the ethyl acetate soluble fraction of the whole plants of Aerva persica. Their structures were elucidated on the basis of extensive analysis of nuclear magnetic resonance (1D and 2D-NMR) spectral data. All of them showed profound antioxidative activities by DPPH and cytochrome-c-reduction assays using the HL-60 cell culture system.
Marianine, the new lanostane triterpene (1) and marianosides A (2) and B (3) have been isolated from the whole plant of Silybum marianum. Their structures were elucidated on the basis of extensive analysis of their one dimensional and two dimensional nuclear magnetic resonance (1D, 2D-NMR) spectral data. All inhibited chymotrypsin in a concentration-dependent manner.
Hyperinols A (1) and B (2) are new taraxastane type triterpenes which have been isolated from the chloroform soluble fraction of Hypericum oblongifolium and their structures elucidated on the basis of spectroscopic data. Both showed significant inhibitory activity against chymotrypsin enzyme.
Two new sterols, halosterols A (1) and B (2), have been isolated from the CHCl(3) soluble fraction of Haloxylon recurvum, and their structures were elucidated by spectroscopic techniques including two dimensional-NMR. Both the compounds displayed chymotrypsin enzyme inhibitory potential.
OBJECTIVE: To ascertain the pattern and management strategies of coital injuries in married females in Pakistan. DESIGN: An observational, case series. PLACE AND DURATION OF STUDY: Gynaecology and Surgical wings - Fatima Medical Centre, Multan, over a period of seven years from January 1997 to December 2003. SUBJECTS AND METHODS: Records of 33 adult married females sustaining coital injuries were studied. Only married females were included. Injuries raising suspicion of indecent assault, sexual abuse and trauma were excluded. Results were recorded and analyzed. RESULTS: Three vulvar haematomas (9%) settled on conservative management. One labial (3%), 9 posterior fourchette (27%) and 16 vaginal wall lacerations (48%) were stitched. A broad ligament haematoma (3%) and a ruptured ovarian cyst (3%) were laparoscopically dealt with. One posterior fornix perforation (3%) with secondary peritonitis and a ruptured ectopic pregnancy (3%) with life-threatening haemorrhage underwent laparotomy. No mortality occurred in this series. CONCLUSION: Varied presentation of the coital injuries demand careful evaluation to help correct diagnosis, timely management and successful outcome with minimal morbidity.
Haloxysterols A-D (1-4), new C-24 alkylated sterols, have been isolated from the chloroform soluble fraction of Haloxylon recurvum, along with five known sterols 5-9, which are reported for the first time from this species. Their structures were determined by means of 1D- and 2D-NMR techniques. Compounds 1-9 inhibited cholinesterase enzymes in a concentration-dependent manner with K(i) values ranging between 0.85-25.5 and 1.0-19.0 microM against acetylcholinesterase (AChE; EC 3.1.1.7) and butyrylcholinesterase (BChE; EC 3.1.1.8) enzymes, respectively. Lineweaver-Burk, Dixon plots and their secondary replots indicated that compounds 1-9 are non-competitive inhibitors of both AChE and BChE enzymes.
BACKGROUND: Long-term effects of uninephrectomy for kidney donation are of particular interest in the currently increasing practice of living-donor transplantation. We have retrospectively analyzed the general health status and renal and cardiovascular consequences of living-related kidney donation. METHODS: Data of living-related kidney donors who were regularly followed up in a dedicated clinic at the Sindh Institute of Urology and Transplantation between July 2000 and January 2004 was retrieved. They had donated their kidneys from 1986 onward. Data on weight, blood pressure, creatinine clearance, level of proteinuria, and new onset diabetes mellitus were analyzed. RESULTS: Seven hundred and thirty-six donors with a mean age of 36+/-10.9 years (M:F 1.1:1) were evaluated. With a mean postnephrectomy duration of 3+/-3.2 years (range 6 months-18 years), the creatinine clearance fell to 87% of prenephrectomy values, and 49 (6.7%) had a creatinine clearance of less than 60 mL/ min. Hypertension developed in 76 (10.3%) donors, and 179 (24.3%) had proteinuria exceeding 150 mg/24 hr. Overweight (27.8%) and obese subjects (11.5%) had a higher prevalence of hypertension and new onset diabetes mellitus. One donor developed end-stage renal failure. CONCLUSION: Donor nephrectomy has minimal adverse effects on overall health status. Regular donor follow-up identifies at-risk populations and potentially modifiable factors.
Salvadorin, a new dimeric dihydroisocoumarin (1), was isolated from the chloroform fraction of Salvadora oleoides. Its chemical structure was established as 8-benzyl-6-[6-(6-ethyl-7-methyl-5,8-dihydro-2-naphthalenyl)-1-oxo-3,4-dihydro-1H-isochromen-8yl]-3, 4-dihyro-1H-isochromen-1-one, through spectroscopic techniques and chemical analysis.
Indigin, alkylated xanthene (1) and indigoferic acid (2) have been isolated from the chloroform soluble fraction of Indigofera oblongifolia, along with beta-sitosterol (3) and 3-hydroxybenzoic acid (4), which are reported for the first time from this species. Their structures were determined through spectroscopic techniques. Both the new compounds 1 and 2 showed significant activity against enzyme lipoxygenase, while 2 further showed moderate inhibition against BChE.
Haloxylines A (1) and B (2), new piperidine alkaloids, have been isolated from the chloroform soluble fraction of Haloxylon salicornicum and their structures elucidated by spectroscopic techniques including 2D-NMR. Both the compounds displayed antifungal and cholinesterase enzymes inhibitory potentials.
Crescentic glomerulonephritis complicating the course of bacterial endocarditis carries a poor prognosis. Ideal treatment strategy is not clearly defined. In addition to antibiotic treatment, plasmapheresis and steroids have been used with variable results. Here we report a case of 40-year old female who was referred because of generalized body swelling and decrease urine output associated with low grade fever on and off for two to three months. She was diagnosed to have acute renal failure secondary to tricuspid valve endocarditis. Staph aureus was isolated from blood culture and renal biopsy showed crescentic glomerulonephritis. She received dialysis support and antibiotics and had complete recovery of renal function 6 weeks after initiation of therapy. Eradication of infection with antibiotics treatment may be sufficient for resolution of crescentic glomerulonephritis associated with infective endocarditis in some cases.
Two new lignans trivially named negundins A (1) and B (2), were isolated along with (+)-diasyringaresinol (3), (+)-lyoniresinol (4), vitrofolal E (5) and vitrofolal F (6), reported for the first time from this species. The structures of the new compounds were established through spectral studies. Compound 2 showed potent inhibitory activity against lipoxygenase enzyme, while 5 showed moderate activity against butyryl-cholinesterase.
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OBJECTIVE: To confirm or refute the validity of the fear associated with anal sphincterotomy for anal fissure, particularly when performed with other anorectal procedures. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Surgical Wings - Medicare Hospital and Fatima Medical Center, Multan, over a period of 8 years from January 1994 to December 2001. SUBJECTS AND METHODS: Records of 112 anal fissure patients, 46 (41.0%) males and 66 (58.9%) females, ranging in age from 12-95 years (mean 39) were studied. All patients with acute or chronic anal fissures with or without other anorectal pathologies were included. Seventeen patients who had anal dilatation and 2 recurrent fissures were excluded. Open technique of anal sphincterotomy was employed in all cases. Results were recorded and analyzed. RESULTS: Fissures were acute in 16 (14.2 %) and chronic in 96 (85.7 %) patients. Anterior fissure was present in 20 (17.8%), posterior in 80 (71.4%), both in 9 (8.0%) and lateral or multiple fissures in 3 (2.6%) cases. Commonest associated pathology was haemorrhoids; encountered in 64 (57.1%) patients. Minor complications, taken together, occurred in 20 (17.8%) patients. Urinary retention was seen in 3 (2.6%) with lateral internal anal sphincterotomy (LIAS), and in 6 (5.3%) where haemorrhoidectomy was added. Haemorrhage in 2 (1.7%), temporary loss of flatus control in 3(2.6%) and soiling of clothes in 2 (1.7%) patients was encountered. No permanent loss of flatus or faecal control and recurrence has been reported to-date. CONCLUSION: Anal sphincterotomy with or without other anorectal procedures can be safely practiced in properly selected patients. Postoperatively, ablution with mild antiseptic added to plain water is adequate in maintaining hygiene to promote healing.
Healthcare in developing countries less funded than developed nations (0.8 to 4% vs. 10 to 15%, respectively), and must contend against approximately 1/3 of the population living below the poverty line ($1US/day), poor literacy (58% males/29% females), and less access to potable water and basic sanitation. Cultural and societal constraints combine with these economic obstacles to translate into poor transplantation activity. Donor shortage is a universal problem. Paid donation comprises 50% of all transplants in Pakistan. Post-transplant infections are a major problem in developing countries, with 15% developing tuberculosis, 30% cytomegalovirus, and nearly 50% bacterial infections. The solutions to these problems may seem simplistic: alleviate poverty, educate the general population, and expand the transplant programs in public sector hospitals where commerce is less likely to play a major role. The SIUT model of funding in a community-government partnership has increased the number of transplantations and patient and organ survival substantially. Over the last 15 years, it has operated by complete financial transparency, public audit and accountability. The scheme has proven effective and currently 110 transplants/year are performed, with free after care and immunosuppressive drugs. Confidence has been built in the community, with strong donations of money, equipment and medicines. We believe this model could be sustained in other developing nations.