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Biomedical subjects

Ishak A Mansi

Publications and source records attributed to Ishak A Mansi.

8 recordsLinked to original sources
PubMed2004

Rhabdomyolysis in response to weight-loss herbal medicine.

The authors report rhabdomyolysis following the ingestion of weight-loss herbal medicine in an otherwise healthy 54-year-old woman. Three hours after ingestion of the herbal medicine, the patient suffered chest pain that continued for 2 hours and resolved gradually. Laboratory investigation showed the presence of rhabdomyolysis with peak serum creatine kinase (CK) of 1028 IU/L, which gradually decreased and normalized after the herbal medicine was discontinued. The pharmacological effects of the active ingredients of the herbal medicine, ma huang (ephedrine), guarana (active alkaloid caffeine), chitosan, Gymnena sylvestre, Garcinia cambogia (50% hydroxycitric acid), and chromium, are discussed, and similar case reports are reviewed. The elevation of CK in this case is of concern, as it may denote that muscle breakdown may be one of the mechanisms of weight loss in these herbal remedies. Further studies are needed to investigate their effects on muscle bulk or CK. Physicians should be aware of the potential side effects of many herbal medicines. It may be advisable to measure serum CK enzyme for patients who admit using weight-loss herbs.

Anti-Obesity Agents↗
PubMed2002

ANCA-associated small-vessel vasculitis.

Antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is the most common primary systemic small-vessel vasculitis to occur in adults. Although the etiology is not always known, the incidence of vasculitis is increasing, and the diagnosis and management of patients may be challenging because of its relative infrequency, changing nomenclature, and variability of clinical expression. Advances in clinical management have been achieved during the past few years, and many ongoing studies are pending. Vasculitis may affect the large, medium, or small blood vessels. Small-vessel vasculitis may be further classified as ANCA-associated or non-ANCA-associated vasculitis. ANCA-associated small-vessel vasculitis includes microscopic polyangiitis, Wegener's granulomatosis, Churg-Strauss syndrome, and drug-induced vasculitis. Better definition criteria and advancement in the technologies make these diagnoses increasingly common. Features that may aid in defining the specific type of vasculitic disorder include the type of organ involvement, presence and type of ANCA (myeloperoxidase-ANCA or proteinase 3-ANCA), presence of serum cryoglobulins, and the presence of evidence for granulomatous inflammation. Family physicians should be familiar with this group of vasculitic disorders to reach a prompt diagnosis and initiate treatment to prevent end-organ damage. Treatment usually includes corticosteroid and immunosuppressive therapy.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed2002

Retroperitoneal leiomyosarcoma and enlarged epididymis associated with a positive pregnancy test.

A 57-year-old man presented with a 1-month history of progressive abdominal pain and weight loss. A palpable, nonpulsatile, firm abdominal mass was felt below the xiphisternum down to the pelvis. A pregnancy test performed on a urine sample was positive. Testicular examination and testicular ultrasound were normal. Computerized tomography of the abdomen revealed a retroperitoneal mass measuring 30 x 21 x 13 cm. Serum beta-human chorionic gonadotropin (beta-HCG) was serially increased (19.71-22.71 mIU/mL). Results of histopathology tests confirmed the diagnosis of leiomyosarcoma. The level of serum beta-HCG decreased to < 0.2 mlU/mL after chemotherapy. Beta-HCG is usually increased in germ-cell tumors but few reports in the literature describe beta-HCG-secreting leiomyosarcomas. The incidence of increased levels of beta-HCG in sarcomas in general, and its potential role as a tumor marker, is not known. A simple urine pregnancy test may be done in the work-up of abdominal masses.

Abdominal Pain↗
PubMed2002

Myocardial infarction in sickle cell disease.

Vasculo-occlusive crisis with organ infarctions occur in sickle cell disease (SCD). However, heart infarction is not commonly reported. We reviewed 19 cases of documented myocardial infarction (MI) in SCD patients. The true incidence may be higher because the diagnosis was often made at autopsy and was overshadowed during life by other musculoskeletal symptoms. Electrocardiography is frequently unhelpful. Skeletal muscle enzymes confound serum cardiac enzyme interpretation. The mechanism of MI in SCD is not exactly known, as coronary angiography is usually normal. MI frequently occurs in association with hypoxia, cor pulmonale, anemia, sepsis, acidosis, and renal failure. The aim of this article is to increase awareness for this complication and to prompt prospective studies to look at treatment strategies for myocardial infarction in SCD.

Anemia, Sickle Cell↗
PubMedDate not supplied

Ethnic differences in electrocardiographic amplitude measurements.

BACKGROUND: There is controversy regarding ethnic differences in electrocardiographic (ECG) patterns because of potentially confounding socioeconomic, nutritional, environmental and occupational factors. METHODS: We reviewed the first 1000 medical files of a multi-ethnic community, where all individuals shared similar living conditions. Only healthy adults age 15 to 60 years were included. Wave amplitudes were measured manually from the standard 12 lead ECG. Minnesota coding was used. RESULTS: ECGs from 597 subjects were included in the study: 350 Saudi Arabians, 95 Indians, 39 Jordanians, 17 Sri-Lankans, 39 Filipinos, and 57 Caucasians; 349 were men. The mean+/-SD of Sokolow-Lyon voltage (SLV) in men was significantly different among ethnic groups (2.9+/-0.86, 2.64+/-0.79, 2.73+/-0.72, 3.23+/-0.61, 2.94+/-0.6, 2.58+/-0.79 mV; P=0.0006, for Saudis, Indians, Jordanians, Filipinos, Sri-Lankans, and Caucasians, respectively). SLV was similar among ethnic groups in women. The prevalence of early transition patterns was also different among ethnic groups in men but not women (15.8%, 34.6%, 17.9%, 21.7%, 35.3%, 26.8% in Saudi, Indian, Jordanian, Filipino, Sri-Lankan, and Caucasian men, respectively, P=0.037). T wave amplitude was significantly different among ethnic groups in selected leads. CONCLUSIONS: ECG wave amplitude differs with ethnic origin even when other factors are similar. Using SLV of 3.5 mV as a criterion may overestimate the incidence of left ventricular hypertrophy in some ethnic groups. The pattern of high R wave in lead V1 is common in healthy adults in certain ethnic groups. T wave height differs with ethnic origin and sex.

Electrocardiography↗