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Biomedical subjects

J Akhtar

Publications and source records attributed to J Akhtar.

15 recordsLinked to original sources
PubMed2004

Mass sociogenic illness--real and imaginary.

Mass sociogenic illness is the occurrence of a group of nonspecific physical symptoms for which no organic cause can be determined and is often transmitted by 'line of sight'. The fear of bioterrorism can also lead to panic and produce cases of mass sociogenic illness, in which people develop symptoms in response to an imaginary threat. Poison centers are faced with resolving the dilemma of sociogenic vs poison related symptoms. We report 2 situations of mass sociogenic illnesses involving school age children where multiple victims exhibited similar symptoms prompted by the presence or suggestion of fumes. Symptoms resolved spontaneously. When clusters of unexplained illness occur, a sociogenic etiology should be considered in the differential diagnosis. As fears about bioterrorism increase, the frequency of such incidents and the anxiety generated may increase.

Child↗
PubMed2003

Acute hepatitis induced by kava kava.

BACKGROUND: Herbal preparations are available widely and regarded generally by the public as harmless remedies for a variety of medical ailments. We report a case of acute hepatitis associated with the use of kava kava, derived from the root of the pepper plant, Piper methysticum. It is used in the United States as an antianxiety and sedative agent. CASE REPORT: A previously healthy 14-year-old female was admitted to the hospital with hepatic failure. Initial therapy, including plasmapheresis, was unsuccessful and she deteriorated. She ultimately required a liver transplant and now remains well. The liver biopsy showed hepatocellular necrosis consistent with chemical hepatitis. A work-up for alternative causes of liver failure was negative. The patient gave a history of taking a kava kava-containing product for four months. The use of kava kava and liver failure, is supported by kava kava use, a negative work-up for alternative causes of liver failure, and histological changes in the liver. CONCLUSIONS: Health care professionals need to be aware of the possibility of kava kava-induced hepatotoxicity. The toxicity of these alternative remedies emphasizes the importance of surveillance programs and quality control in the manufacture of these products. Clinicians must remain aware of the toxic potential of herbal products and always inquire about their intake in cases of unexplained liver injury.

Adolescent↗
PubMed2001

Retropharyngeal lipoma causing dysphagia.

Lipomas of the retropharyngeal region are rare, slow-growing tumours that attain a large size before producing symptoms such as dysphagia and dyspnoea. Clinical diagnosis may be difficult. However computed tomography or magnetic resonance imaging is the investigation of choice and helps in definitive diagnosis preoperatively, although final histological confirmation is essential. Surgery is the treatment of choice. In the following paper we report a case of retropharyngeal lipoma presenting with dysphagia which was managed surgically with complete amelioration of symptoms.

Aged↗
PubMed1997

Atypical mycobacterial infection in childhood: a "surgical disease'.

Atypical mycobacterial (AMB) infection is an important cause of lymph node enlargement in children. Over the period, January 1992 to December 1993, 17 patients with lymphadenitis because of AMB infection were treated at the Royal Hospital for Sick Children in Glasgow. These case notes of the patients were reviewed. The mean age at presentation was 5.37 years (range 1.5-10.6 years). The patients had a short history (1-11 weeks) of unilateral single focus, usually cervicofacial (16/17), disease. The tuberculin skin test was not helpful in diagnosis (negative in 14/15). Primary excision was curative (11/11). Incision and drainage of an abscess or drainage with partial excision led to chronically discharging sinus in all cases (6/6). AMB were not always seen on staining (11/17) of drained or excised material and cultures were negative in eight cases. The diagnosis in the remaining patients was made on the basis of clinical features and particular histopathological patterns. We are currently assessing the use of polymerase chain reaction (PCR) techniques for making the diagnosis in non-cultured cases.

Child↗
PubMed1993

Invasive evaluation of patients with heat stroke.

Right-heart catheterization was performed in ten patients who suffered heat stroke on their pilgrimage to Mecca, Saudi Arabia. The group included seven men and three women who had mean rectal temperatures of 42.4 degrees C. Other findings included the following: heart rate (mean, 120 beats/min); cardiac output (mean, 8.2 ml/min/m2); arterial pressure (mean, 65 mm Hg); cardiac indices (mean, 4.4 ml/min/m2); right atrial pressure (mean, 6 mm Hg); pulmonary capillary wedge pressure (mean, 10 mm Hg); systemic vascular resistance (mean, 684 dyne.s.cm-5); pulmonary vascular resistance (mean, 86 dyne.s.cm-5); oxygen delivery (mean 837 ml/min/m2); oxygen consumption (mean 160 ml/min/m2); mixed venous oxygen tension (mean, 56 mm Hg); and shunt fraction (mean, 20 percent). Nine patients survived. One, who had a cardiopulmonary arrest before any treatment could be administered, died.

Adult↗
PubMed1992

Congenital duodenal obstruction.

Over the period 1980-1989, 49 patients with congenital duodenal obstruction due to duodenal atresia, duodenal stenosis or annular pancreas were treated. There were three deaths, all related to associated severe congenital anomalies and none related to surgery for duodenal obstruction; 78 per cent of the patients had associated congenital anomalies which, in some instances, complicated their management. Prenatal diagnosis by ultrasonography was made in 18 per cent of the patients and these patients had operations relatively earlier.

Child↗
PubMed1986

Oral acyclovir (Zovirax) in herpes simplex dendritic corneal ulceration.

Sixty patients with simple dendritic corneal ulceration were randomly assigned to double blind treatment with either acyclovir tablets (400 mg) or acyclovir ophthalmic ointment administered five times daily. There was no significant difference in the proportions of patients healed in either treatment group (88.9% on oral acyclovir and 96.6% on acyclovir ointment). The median healing time was five days in both groups. No systemic or significant local side effects were noted in either treatment group. Trough levels of acyclovir in the tear fluid of those who received the oral preparation were within or above the range of mean in-vitro ID50 levels for herpes simplex virus type 1. We conclude that oral administration of acyclovir (400 mg, five times daily) may be an effective alternative to topical therapy in selected patients.

Acyclovir↗
PubMed1986

Adult respiratory distress syndrome and disseminated intravascular coagulation complicating heat stroke.

Fifty two consecutive patients with heat stroke were examined for evidence of adult respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). Twelve patients were found to have ARDS (incidence of 23 percent) of whom nine (75 percent) died. All of these 12 patients had DIC as compared to only one among the 40 patients without ARDS. Review of the evidence in literature linking ARDS and DIC and our own observations in this study lead to the conclusion that the coagulopathy may be an essential mediator of lung damage in heat stroke and is a reliable marker of its occurrence. This suggests the possibility that screening of heat stroke victims for DIC may identify patients at increased risk of developing overt ARDS and allow early institution of measures which may possibly improve survival.

Adult↗
PubMed1986

Intracranial tuberculoma: case report and review of the literature.

A case of multiple intracranial tuberculomas with miliary lesions of the lungs is reported. Atypical clinical presentation; non-specific computed tomographic findings showed large intracranial masses producing a midline shift and progressive neurological deficit necessitating excision of the symptomatic mass. Acid fast bacilli were found in the excised lesion and cultured from biopsy specimens.

Brain Diseases↗
PubMed1985

Endocarditis due to Actinobacillus actinomycetemcomitans.

A case of infective endocarditis in a 38-year-old Saudi male caused by Actinobacillus actinomycetemcomitans is reported. The patient was treated successfully with a combination of benzyl penicillin and gentamicin. Previously reported cases are reviewed.

Actinobacillus↗
PubMed1985

Oral acyclovir in herpetic keratitis.

A double blind comparative study of oral acyclovir and acyclovir ophthalmic ointment was carried out on 29 patients with simple herpetic dendritic corneal ulceration. Patients were randomly allocated to the study. Healing was achieved in all fourteen patients treated with acyclovir ointment, and in fourteen out of fifteen patients treated with oral acyclovir. The mean healing time of 5.6 days was identical for both patient groups. There was no significant systemic or local side effects recorded in either group. The level of acyclovir in tear fluid was measured, and in patients receiving oral acyclovir the level was in excess of the ED50 of herpes simplex virus type 1.

Acyclovir↗
PubMed1980

Prognostic value of a prepartum and intrapartum risk-scoring method.

A simple prepartum and intrapartum scoring technic for the identification of high-risk patients was applied to 1,224 patients managed at the Charleston Area Medical Center, Memorial Division. The patients were classified as being at low, moderate, or high risk, according to the total risk score. Perinatal mortality worsened as the risk category increased. Seventy percent of all perinatal deaths occurred in 25% of patients who were identified as moderate- and high-risk patients. The simple one-page scoring form that we used seems to be practical and effective in identifying patients at risk. Such information can be very useful in providing appropriate levels of obstetric care.

Female↗