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Biomedical subjects

K Sharif

Publications and source records attributed to K Sharif.

50 records · Page 3Linked to original sources
PubMed1995

Mock embryo transfer with a full bladder immediately before the real transfer for in-vitro fertilization treatment: the Birmingham experience of 113 cases.

The technique of embryo transfer can have a great impact on the outcome of in-vitro fertilization (IVF) treatment. Transcervical embryo transfer is a blind procedure and difficulty can unexpectedly arise. Many IVF programmes therefore perform a 'mock' embryo transfer prior to the treatment cycle to determine the most suitable catheter and technique for transfer. This, however, adds an extra separate procedure with time and cost implications. Moreover, as the uterus is mobile, its direction may vary on the day of the embryo transfer from what it was during the mock embryo transfer. Performing mock embryo transfer immediately before the real transfer would circumvent these problems. We report here on 113 embryo transfer procedures where a 'step-wise' mock embryo transfer protocol was performed with a full bladder immediately before the embryo transfer. The number of embryos transferred (mean +/- SD) was 2.6 +/- 0.67, the pregnancy rate per embryo transfer was 45.1%, and the intrauterine implantation rate per embryo transferred was 20.6%.

Embryo Implantation↗
PubMed1994

Heterotopic pregnancy obtained after in-vitro fertilization and embryo transfer following bilateral total salpingectomy: case report.

Heterotopic (coexistent ectopic and intra-uterine) pregnancy is common following in-vitro fertilization and multiple embryo transfer. Total bilateral salpingectomy is generally considered to eliminate the risk of ectopic, and hence heterotopic pregnancy. This is, however, not strictly correct as it does not eliminate the risk of interstitial tubal pregnancy. This is the first reported case of a heterotopic pregnancy following total bilateral salpingectomy. The diagnostic pitfalls and a suggested method of avoiding them are discussed.

Adult↗
PubMed1992

Radiocontrast-induced nephropathy. Prevention is better than cure.

The principal predisposing factor in radiocontrast-induced nephropathy appears to be underlying renal insufficiency. Identifying patients at risk is of paramount importance when a diagnostic study is being chosen. Contrast-reliant studies should be avoided, if possible, in high-risk patients. If challenge with a contrast medium is essential, appropriate risk stratification and adequate patient preparation should be done beforehand. Ultimately, prevention is a better approach than cure.

Acute Kidney Injury↗
PubMed1986

Efficacy of clonidine as transdermal therapeutic system: the international clinical trial experience.

Worldwide clinical trial data concerning the pharmacokinetic and pharmacodynamic characteristics of the clonidine transdermal therapeutic system (TTS) are reviewed with reference to its antihypertensive efficacy. The amount of clonidine delivered to the systemic circulation is a direct function of TTS size. After initial patch application, there is a delay of 2 to 3 days before the onset of action, but after removal of the patch, plasma clonidine levels decline slowly, at an elimination half-life of about 20 hours. Evaluation in approximately 2000 patients with mild to moderate hypertension has shown that the bioavailability of transdermal clonidine is comparable to that of oral clonidine and that equivalent blood pressure reductions are achieved. The rate at which dose increases were found necessary to maintain adequate blood pressure control over extended periods reflects a low incidence of tolerance to this new once-a-week dosage form of clonidine, and there has been little evidence of rebound hypertension after discontinuation of TTS treatment.

Administration, Cutaneous↗
PubMed1986

Digital intravenous angiography for the study of hemodialysis vascular access.

Digital intravenous angiography is a simple and safe procedure and can be performed on an outpatient basis. Poor function of a hemodialysis vascular access due to increased graft resistance, reduced arterial inflow or shunt steal can be evaluated by this technique. Complications of direct graft puncture or conventional arteriography can be avoided using digital angiography.

Angiography↗
PubMed1983

Pharmacokinetics and pharmacodynamics of clonidine in varying states of renal function.

Previous studies have reported a therapeutic window of 0.8 to 2.0 ng/ml within which clonidine exerts its antihypertensive effect. This study was designed to investigate whether there was any loss of blood pressure control when plasma clonidine concentrations exceeded this window owing to its accumulation in renal insufficiency. The results indicate that clonidine concentrations of up to 30 ng/ml in patients with end-stage renal disease (ESRD) can be associated with a maintenance of blood pressure control. It remains to be learned whether this phenomenon of high concentrations and control of blood pressure in our ESRD patient population may be related to altered (decreased) peripheral alpha-receptor sensitivity and inability to develop vasoconstriction. There is precedence for autonomic imbalance and altered tissue sensitivity in ESRD.

Adult↗
PubMedDate not supplied

Is serum gentamicin level a good predictor of graft injury in intestinal transplantation?

INTRODUCTION: Following intestinal transplant (SBT), the early diagnosis and treatment of rejection is a major management aim. The diagnosis of rejection is based on histology of stomal biopsies. Oral gentamycin (2.5 mg/kg) was used for selective decontamination of the digestive system. Our hypothesis was that gentamycin might be absorbed in the presence of graft dysfunction. AIM: Our goal was to assess the correlation between serum gentamycin level and the health of the intestinal graft. SUBJECTS AND METHODS: Among 33 SBT performed from 1993 to 2005, serum gentamycin levels were performed once weekly or more often when there was a suspicion of rejection. All data were analyzed retrospectively. RESULTS: Adequate trough levels were achieved for only 23 patients, six of whom had histologically proven rejection and only one did not have a raised gentamycin content. Five patients with raised levels but no rejection included two with severe intestinal ischemia and three with bowel obstruction/ileus. Four of the five patients required laparotomies. CONCLUSION: We concluded that in our study raised serum gentamycin levels were a good predictor of rejection or significant injury to the graft.

Biomarkers↗
PubMedDate not supplied

Podocyte phenotypes as defined by expression and distribution of GLEPP1 in the developing glomerulus and in nephrotic glomeruli from MCD, CNF, and FSGS. A dedifferentiation hypothesis for the nephrotic syndrome.

Glomerular epithelial protein 1 (GLEPP1) is a podocyte receptor membrane protein tyrosine phosphatase located on the apical cell membrane of visceral glomerular epithelial cell (VGEC) foot processes. Double label immunofluorescence, immunoelectron microscopy, and peroxidase immunohistochemistry were used to map the GLEPP1 distribution in the developing glomerulus and in minimal-change nephropathy (MCN), congenital nephrotic syndrome of the Finnish type, and focal-segmental glomerulosclerosis (FSGS). In MCN GLEPP1 was shifted away from the glomerular basement membrane on the apical cell membrane of effaced foot processes. These data are compatible with the previously suggested concept that MCN can be considered a form of dedifferentiation of the podocyte phenotype. Similarly, changes seen in congenital nephrotic syndrome of the Finnish type can be considered a consequence of failure to complete normal podocyte development. In FSGS glomeruli GLEPP1 was frequently absent from VGECs, even when no sclerosis was detectable in that glomerulus. Therefore, in FSGS, VGECs may lose GLEPP1, and this loss appears to occur in the absence of scarring and may, therefore, precede the scarring process. We speculate that a changed VGEC phenotype that does not express GLEPP1 might have properties similar to the early undifferentiated VGEC developmental phenotype. GLEPP1 distribution pattern and absence from glomeruli of individuals with nephrotic syndrome may, therefore, represent a useful phenotypic marker.

Animals↗
PubMedDate not supplied

The 6-week postnatal visit: are we doing it right?

The 6-week postnatal visit has been practised for a long time as a follow-up visit after childbirth. Although the idea behind it is still as sound as it was half a century ago, its timing and contents need to change in line with recent research findings.

Family Planning Services↗
PubMedDate not supplied

Organisation of a local revision course for postgraduate examinations.

Revision courses for postgraduate examinations are usually held at central teaching hospitals. The ingredients for these courses, however, are available at most local hospitals. This article describes the practicalities of organising a successful local revision course for postgraduate examinations.

Clinical Competence↗
PubMedDate not supplied

Management of the first stage of labour.

The management of delay in labour has been dominated by the use of oxytocin to augment the 'powers' of labour. However, this empirical approach has not been rigorously tested and 'failure to progress' remains a major clinical problem. A return to an analysis of the underlying pathophysiology is advocated.

Adult↗