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Biomedical subjects

K Rasheed

Publications and source records attributed to K Rasheed.

At least 19 recordsLinked to original sources
PubMed2006

Prevalence of HIV, hepatitis B and C amongst health workers of Civil Hospital Karachi.

OBJECTIVE: To determine the prevalence of HIV, Hepatitis B (HBV) and Hepatitis C (HCV) amongst the health workers of Civil Hospital Karachi (CHK). MATERIAL AND METHODS: Prospective study. A precoded Proforma was filled out which included questions regarding the knowledge, attitude and practices (KAP) of HIV, HBV and HCV. SETTING: Departments of a tertiary health care facility at CHK. Antibodies to HIV, HCV and Hepatitis B surface antigen (HBsAg) were done using enzymes linked immunosorbent assay [ELISA]. RESULTS: Uptake of screening was 98% to those offered. The prevalence was 5.6% for antibodies to HCV, 2.4% for HBsAg, while none of those studied had antibodies to HIV. CONCLUSION: Our results show the prevalence of antibodies to HCV in health workers are 20 folds higher than health workers in the developed countries. Similarly, the prevalence of HBV although not as high as HCV is significant. Seroprevalence of HIV does not exist in this group. We need to ensure better training; regulations regarding preventive and safety measures also need to be enforced (JPMA 52:92; 2002).

Journal Article↗
PubMed2002

Prevalence of HIV, hepatitis B and C amongst health workers of Civil Hospital Karachi.

OBJECTIVE: To determine the prevalence of HIV, Hepatitis B (HBV) and Hepatitis C (HCV) amongst the health workers of Civil Hospital Karachi (CHK). MATERIAL AND METHODS: Prospective study. A precoded Proforma was filled out which included questions regarding the knowledge, attitude and practices (KAP) of HIV, HBV and HCV. SETTING: Departments of a tertiary health care facility at CHK. Antibodies to HIV, HCV and Hepatitis B surface antigen (HBsAg) were done using enzymes linked immunabsorbant assay [ELISA]. RESULTS: Uptake of screening was 98% to those offered. The prevalence was 5-6% for antibodies to HCV, 2.4% for HBsAg, while none of those studied had antibodies to HIV. CONCLUSION: Our results show the prevalence of antibodies to HCV in health workers are 20 folds higher than health workers in the developed countries. Similarly, the prevalence of HBV although not as high as HCV is significant. Seroprevalence of HIV does not exist in this group. We need to ensure better training; regulations regarding preventive and safety measures also need to be enforced.

Adult↗
PubMed2000

Surgical treatment of advanced pellucid marginal degeneration.

PURPOSE: To determine the efficacy of simultaneous peripheral crescentic lamellar keratoplasty (LK) and central penetrating keratoplasty (PK) for advanced pellucid marginal degeneration (PMD). DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Five patients with advanced PMD. METHOD: Simultaneous peripheral crescentic LK and central PK followed by selective suture removal and astigmatic keratotomy in the postoperative period. MAIN OUTCOME MEASURES: These included interval of time required for visual rehabilitation, best spectacle-corrected visual acuity achieved, and amount of corneal astigmatism, as measured by videokeratography. Measuring the change in corneal astigmatism by videokeratography over the subsequent follow-up period after spectacle correction had been prescribed assessed stability of the achieved refraction. RESULTS: Visual acuity results were 20/40 in three eyes, 20/80 in one eye, and 20/400 in one eye. The latter two had decreased acuity from posterior subcapsular cataract formation, which may have been caused by topical steroid use. The time required for visual rehabilitation ranged from 5.13 to 10.93 (mean, 9.92) months, and the amount of corneal astigmatism at the end of this period ranged from 0.3 diopters (D) to 5.3 D. A tendency for an increase in "with the rule astigmatism" after the rehabilitation period was noted. Two patients had elevations of intraocular pressure that responded to reduction in topical steroid dose. CONCLUSIONS: The short-term results with this technique are excellent in that it provides early and stable visual rehabilitation in patients with advanced PMD. Low to moderate levels of postkeratoplasty astigmatism were achieved in all the eyes treated. The usual tendency of an increase in "against the rule astigmatism" that occurs when PK alone is done for PMD was eliminated.

Adult↗
PubMed1999

Fluorescein test for the detection of striae in the corneal flap after laser in situ keratomileusis.

PURPOSE: To report a technique for detecting striae in the corneal flap after laser in situ keratomileusis. METHODS: Fluorescein dye was instilled in the eye, and the patient was asked to blink. The tear film was examined at the slit lamp with the cobalt filter 1 or 2 seconds after blinking. RESULTS: The uneven pattern of pooling in the tear film was a sensitive indicator of the presence of striae in the flap. CONCLUSION: This technique may be useful in detecting minimal striae in the corneal flap in patients with unexplained suboptimal visual acuity after laser in situ keratomileusis.

Adult↗
PubMed1999

Superficial lamellar keratectomy using an automated microkeratome to excise corneal scarring caused by photorefractive keratectomy.

Corneal haze is a recognized complication of excimer laser photorefractive keratectomy. When severe, it can result in the formation of a dense corneal scar, with a reduction in best corrected visual acuity. In extreme cases, medical treatment and repeated phototherapeutic excimer ablations may fail to restore corneal transparency. In these patients, penetrating keratoplasty (PKP) has been used to restore visual function. We describe a technique for excising a superficial corneal scar using an automated microkeratome. The resultant corneal surface is quite smooth, and good visual acuity may be restored without resorting to PKP.

Adolescent↗
PubMed1999

KISA% index: a quantitative videokeratography algorithm embodying minimal topographic criteria for diagnosing keratoconus.

PURPOSE: To formulate and test an algorithm using minimal topographic criteria for accurately diagnosing clinical keratoconus. SETTING: Subspecialty cornea practice and Keratoconus Genetic Research Project. METHODS: Both eyes of 86 keratoconic patients who had never worn contact lenses and 195 normal participants were studied with the TMS-1 videokeratoscope to evaluate the KISA% index, an algorithm that topographically quantifies the phenotypic features of keratoconus. The diagnostic efficacy of the KISA% index was compared with that of the modified Rabinowitz/McDonnell (K- and I-S values) and the Maeda/Klyce (KCI% and KPI) indices. The same indices were calculated for an additional 8 eyes with keratoconus-suspect topography and 12 eyes with early keratoconus. RESULTS: The mean KISA% was significantly greater in the keratoconus group (10,382%) than in the normal control group (20.44%) with minimal overlap. At a cutoff point for KISA% of 100, 280 of 281 participants (99.6%) were correctly classified. In contrast, the correct classification rate for the other indices were KCI%, 274 of 281 (97.5%); KPI, 249 of 281 (88.6%); K, 272 of 281 (96.8%); I-S, 269 of 281 (95.7%). Six of the 8 eyes with keratoconus-suspect topography had a KISA% between 60% and 100%, and 11 of the 12 eyes with early keratoconus had a KISA% greater than 100%. CONCLUSIONS: The KISA% index set at 100 was highly sensitive and specific for diagnosing keratoconus; a range of 60% to 100% may be useful for designating suspects. This index is more useful than any of the other currently available tools for classifying patients with keratoconus for computerized segregation analysis and for distinguishing eyes with keratoconus from normal eyes in topographic screening of refractive surgical candidates.

Algorithms↗
PubMed1999

Irinotecan therapy in adults with recurrent or progressive malignant glioma.

PURPOSE: To determine the activity, toxicity, and pharmacokinetics of irinotecan (CPT-11, Camptosar; Pharmacia & Upjohn, Kalamazoo, MI) in the treatment of adults with progressive, persistent, or recurrent malignant glioma. PATIENTS AND METHODS: Patients with progressive or recurrent malignant gliomas were enrolled onto this study between October 1996 and August 1997. CPT-11 was given as a 90-minute intravenous (i.v.) infusion at a dose of 125 mg/m2 once weekly for 4 weeks followed by a 2-week rest, which comprised one course. Plasma concentrations of CPT-11 and its metabolites, SN-38 and SN-38 glucuronide (SN-38G), were determined in a subset of patients. RESULTS: All 60 patients who enrolled (36 males and 24 females) were treated with CPT-11 and all were assessable for toxicity, response, and survival. Pharmacokinetic data were available in 32 patients. Nine patients (15%; 95% confidence interval, 6% to 24%) had a confirmed partial response, and 33 patients (55%) achieved stable disease lasting more than two courses (12 weeks). Toxicity observed during the study was limited to infrequent neutropenia, nausea, vomiting, and diarrhea. CPT-11, SN-38, and SN-38G area under the plasma concentration-time curves through infinite time values in these patients were approximately 40%, 25%, and 25%, respectively, of those determined previously in patients with metastatic colorectal cancer not receiving antiepileptics or chronic dexamethasone treatment. CONCLUSION: Response results document that CPT-11, given with a standard starting dose and treatment schedule, has activity in patients with recurrent malignant glioma. However, the low incidence of severe toxicity and low plasma concentrations of CPT-11 and SN-38 achieved in this patient population suggest that concurrent treatment with anticonvulsants and dexamethasone enhances drug clearance.

Adult↗
PubMed1998

Phase II study of carboplatin (CBDCA) in progressive low-grade gliomas.

In this study, the authors sought to investigate the response rate and toxicity of carboplatin in patients with progressive low-grade glioma (LGG). Thirty-two patients with progressive LGG were treated with carboplatin at a dosage of 560 mg/m(2). Treatment was given at 4-week intervals and continued until the disease progressed, unacceptable toxicity supervened, or for 12 additional courses after achieving maximal response. Patients with stable disease were treated with a total of 12 cycles. All patients were treated as outpatients. Patients were evaluated for response to treatment and toxicity. All patients received a minimum of two cycles of carboplatin, and were examined for response. A partial response was achieved in nine patients (28%) and a minimal response in two (6%), for an overall response rate of 34% (11 of 32 patients). Eighteen patients (56%) had stable disease. A partial response was achieved in the nine patients after a median of six cycles (range 4-11 cycles), a minimal response was achieved in the two patients after five cycles. Glioma progression was noted in three patients after three, five, and five cycles, respectively. The 11 patients in whom some response was achieved had either an optic pathway tumor or a juvenile pilocytic astrocytoma. Twenty-six of the 32 patients had those characteristics, making the response rate in that group 42% (11 of 26 patients). Thirty-two patients received a total of 387 cycles of chemotherapy. Hematological toxicity was moderate. Twenty-one patients developed thrombocytopenia (platelet count < 50,000/microl); three patients required one platelet transfusion each. Nine patients developed neutropenia (absolute neutrophil count < 500/microl); one developed fever and required administration of antibiotic agents. One dose adjustment in each of the patients prevented further thrombocytopenia and neutropenia. Two patients with stable disease died of respiratory complications. One patient developed Grade III ototoxicity after receiving five cycles, one patient developed hypersensitivity to carboplatin, and none developed nephrotoxicity. Carboplatin given at a dosage of 560 mg/m(2) every 4 weeks has activity in patients with progressive LGG. This drug regimen is relatively simple and well tolerated. Further investigation and longer follow-up study are warranted.

Journal Article↗
PubMed1998

Treatment of adults with progressive oligodendroglioma with carboplatin (CBDCA): preliminary results. Writing Committee for The Brain Tumor Center at Duke.

BACKGROUND: Exploration of the role of chemotherapy in the treatment of low grade glioma, including oligodendroglioma, has been limited to the pediatric population, reflecting the sensitivity of young patients to radiation-induced toxicity and a desire to avoid this intervention (7-12). PROCEDURE: Nine adults with progressive oligodendroglioma were treated with carboplatin at a dose of 560 mg/m2 administered at 4 week intervals. RESULTS: Eight patients have demonstrated stable disease as determined by serial MRI imaging at 2-3 month intervals with neither tumor regression nor growth noted. The ongoing duration of tumor control ranges between 6-22 months. Three patients have completed therapy with carboplatin and continue with stable dis-ease off chemotherapy. One patient progressed after 1 year of therapy with histologic confirmation of growth of well differentiated oligodendroglioma. Toxicity was limited to grade 3 thrombocytopenia in 3 patients and grade 3 neutropenia in 2 patients. CONCLUSIONS: Carboplatin appears to be active in the treatment of adults with progressive oligodendroglioma. Further trials are warranted to more precisely define the role of carboplatin in the treatment of these tumors.

Adult↗
PubMed1998

Accuracy of ultrasonic pachymetry and videokeratography in detecting keratoconus.

PURPOSE: To compare the accuracy of ultrasonic pachymetry measurements and videokeratography-derived indices in distinguishing keratoconus patients from those with normal eyes. SETTING: A subspecialty cornea practice (Los Angeles, California, USA) and the Keratoconus Genetics Research Project. METHODS: Corneal thickness was measured by ultrasonic pachymetry at the center and inferior margins of the pupil of 142 normal and 99 keratoconus patients The corneal surface topography of patients was studied with the Topographic Modeling System (TMS-1). The videokeratographs obtained were analyzed with a computer program that automatically calculates two indices derived from data points in the central and paracentral cornea: central K and I-S values. Linear discriminant analysis was used to determine the correct classification percentages using pachymetry measurements and indices derived from videokeratography as the independent variables. RESULTS: The range of corneal thickness in normal and keratoconic eyes overlapped considerably. In the discriminant analysis, videokeratography indices provided a 97.5% correct classification rate and pachymetry data, an 86.0% rate (P < .01, McNemar's test). CONCLUSION: Keratoconus is more accurately distinguished from the normal population by videokeratography-derived indices than by ultrasonic pachymetry measurements. This may be due to the large variation in corneal thickness in the normal population or the inability of ultrasonic pachymetry to accurately detect the location of corneal thinning in keratoconus by measuring standard points on the cornea. Pachymetry should not be relied on to exclude or diagnose keratoconus because the false-negative and false-positive rates are unacceptably higher than those obtained by videokeratography.

Cornea↗
PubMed1998

Interobserver and intraobserver reliability of a classification scheme for corneal topographic patterns.

AIMS: To determine the interobserver and the intraobserver reliability of a published classification scheme for corneal topography in normal subjects using the absolute scale. METHOD: A prospective observational study was done in which 195 TMS-1 corneal topography maps in the absolute scale were independently classified twice by three classifiers--a cornea fellow, an ophthalmic technician, and an optometrist. From these observations the interobserver reliability for each category and the intraobserver reliability for each observer were determined in terms of the median weighted kappa statistic for each category and for each observer. RESULTS: For interobserver reliability, the median weighted kappa statistic for each category varied from 0.72 to 0.97 and for intraobserver reliability the range was 0.79 to 0.98. CONCLUSION: This classification scheme is extremely robust and even in the hands of less experienced observers with minimal training it can be relied upon to provide consistent results.

Corneal Topography↗
PubMed1998

DNA mismatch repair and O6-alkylguanine-DNA alkyltransferase analysis and response to Temodal in newly diagnosed malignant glioma.

PURPOSE: We evaluated the response to Temodal (Schering-Plough Research Institute, Kenilworth, NJ) of patients with newly diagnosed malignant glioma, as well as the predictive value of quantifying tumor DNA mismatch repair activity and O6-alkylguanine-DNA alkyltransferase (AGT). PATIENTS AND METHODS: Thirty-three patients with newly diagnosed glioblastoma multiforme (GBM) and five patients with newly diagnosed anaplastic astrocytoma (AA) were treated with Temodal at a starting dose of 200 mg/m2 daily for 5 consecutive days with repeat dosing every 28 days after the first daily dose. Immunochemistry for the detection of the human DNA mismatch repair proteins MSH2 and MLH1 and the DNA repair protein AGT was performed with monoclonal antibodies and characterized with respect to percent positive staining. RESULTS: Of the 33 patients with GBM, complete responses (CRs) occurred in three patients, partial responses (PRs) occurred in 14 patients, stable disease (SD) was seen in four patients, and 12 patients developed progressive disease (PD). Toxicity included infrequent grades 3 and 4 myelosuppression, constipation, nausea, and headache. Thirty tumors showed greater than 60% cells that stained for MSH2 and MLH1, with three CRs, 12 PRs, three SDs, and 12 PDs. Eight tumors showed 60% or less cells that stained with antibodies to MSH2 and/or MLH1, with 3 PRs, 3 SDs, and 2 PDs. Eleven tumors showed 20% or greater cells that stained with an antibody to AGT, with 1 PR, 2 SDs, and 8 PDs. Twenty-five tumors showed less than 20% cells that stained for AGT, with 3 CRs, 12 PRs, 4 SDs, and 6 PDs. CONCLUSION: These results suggest that Temodal has activity against newly diagnosed GBM and AA and warrants continued evaluation of this agent. Furthermore, pretherapy analysis of tumor DNA mismatch repair and, particularly, AGT protein expression may identify patients in whom tumors are resistant to Temodal.

Adult↗
PubMed1996

Increased ALZ-50 immunoreactivity in sudden infant death syndrome.

Neuronal expression of the ALZ-50 epitope was investigated in hippocampus and medulla from infants dying of sudden infant death syndrome or known causes (controls). Hippocampal studies include data from 31 infants dying of known causes between 32 weeks' gestation and 16 months postpartum and 46 infants who died of sudden infant death syndrome. The medulla at the level of the mid olivary protuberance was investigated in 22 infants with sudden infant death syndrome and 11 controls matched for age and postmortem interval. Medullary sections were also examined using immunohistochemical methods to demonstrate reactivity to glial fibrillary acidic protein antibody. The density of ALZ-50-immunodecorated neurons in control hippocampus rises from the level observable in utero to a maximum between 1 and 4 months of age and declines thereafter. The density of ALZ-50-immunoreactive neurons in hippocampus is significantly increased in infants with sudden infant death syndrome at all ages. Significant regionally specific increases in the number of ALZ-50-immunoreactive neurons, and glial fibrillary acidic protein-reactive cells were found in sudden infant death syndrome medulla; coincidental increases were observed in only the solitary nucleus. Neurons exhibiting the ALZ-50 epitope may reflect apoptotic neuron death of normal development, and increased numbers of immunoreactive neurons may suggest enhanced neurodegeneration in sudden infant death syndrome.

Antibodies↗
PubMed1993

Extrarenal Wilms' tumor.

Extrarenal nephroblastoma (Wilms' tumor) is very rare with to date just 34 cases described. Two such cases out of a total of 61 patients with WT presenting to a single institution over a 10-year period are presented. Both children, a boy aged three years and a girl aged four years, both presented with an abdominal mass which had crossed the midline. Ultrasonography and contrast studies in the two patients revealed retroperitoneal tumors distinct from kidneys, but unilateral hydronephrosis was noted in both patients. Primary surgical excision was performed and both patients grouped as stage III favorable histology. Postoperative treatment included chemotherapy and radiotherapy as per UKCCSG protocols. The patients are clinically well with no evidence of disease 7 years and 20 months respectively from diagnosis. An individualized approach to treatment of extrarenal WT is advocated.

Child, Preschool↗
PubMed1993

Endoscopic correction of vesicoureteric reflux in children.

Vesicoureteric reflux (VUR) is a common cause of recurrent urinary tract infections in children. Mild reflux (grade I-II) is usually managed conservatively with antibiotics but severe degree of reflux (grades III, IV, V) requires surgical intervention. We present our initial experience with endoscopic correction of vesicoureteric reflux by sub-ureteric teflon injection (STING) in ten patients. Results are available for 15 ureters with a success rate of 86.6%. There was no change in the grade of VUR in two ureters. There were no complications. Endoscopic correction of vesico-ureteric reflux by sub-ureteric teflon injection is effective and simple with no pain to the child. It averts the need for open operations.

Child↗
PubMed1993

Penile constrictive band injury.

Penile strangulation caused by a thread or human hair is an uncommon cause of urethral injury described in paediatric practice. Five children presented with this entity to the Aga Khan University Hospital, Karachi between August, 1991 and August, 1992. Three children had uneventful recoveries after removal of the constricting agent. Two patients developed urethrocutaneous fistulae and partial amputation of the penis because of late presentation. Early recognition and removal of the constricting agent is necessary to prevent serious complications.

Child↗