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Biomedical subjects

M Akram

Publications and source records attributed to M Akram.

16 recordsLinked to original sources
PubMed2006

Determination of gamma-emitting radionuclides in the inter-tidal sediments off Balochistan (Pakistan) Coast, Arabian Sea.

Natural radionuclide contents of 226Ra, 228Ra and (40)K were studied for inter-tidal sediments collected from selected locations off the745 km long Balochistan Coast using HPGe detector based gamma-spectrometry system. The sampling zone extends from the beaches of Sonmiani (near Karachi metropolis) through Jiwani (close to the border of Iran). The natural radioactivity levels detected in various sediment samples range from 14.4 +/- 2.5 to 36.6 +/- 3.8 Bq kg(-1) for 226Ra, 9.8 +/- 1.2 to 35.2 +/- 2.0 Bq kg(-1) for (228)Ra and 144.6 +/- 9.4 to 610.5 +/- 23.9 Bq kg(-1) for (40)K. No artificial radionuclide was detected in any of the marine coastal sediment samples. 137Cs, (60)Co, 106Ru and 144Ce contents in sediment samples were below the limit of detection. The measured radioactivity levels are compared with those reported in the literature for coastal sediments in other parts of the world. The information presented in this paper will serve as the first ever local radioactivity database for the Balochistan/Makran Coastal belt of Pakistan. The presented data will also contribute to the IAEA's, Asia-Pacific Marine Radioactivity Database (ASPAMARD) and the Global Marine Radioactivity Database (GLOMARD).

Gamma Rays↗
PubMed2005

Gamma-emitting radionuclides in the shallow marine sediments off the Sindh coast, Arabian Sea.

Determination of gamma emitting radionuclides in shallow marine sediments off the Sindh coast has been carried out using a gamma spectrometry technique. The activity concentration measured in various sediment samples off the Sindh coast has been found to vary from 15.93 +/- 5.22 to 30.53 +/- 4.70 Bq kg(-1) for 226Ra, from 11.72 +/- 1.22 to 33.94 +/- 1.86 Bq kg(-1) for 228Ra and from 295.22 +/- 32.83 to 748.47 +/- 28.75 Bq kg(-1) for 40K. The calculated mean values of radium equivalent activity, absorbed dose rate and effective dose are 98 Bq kg(-1), 49 nGy h(-1) and 0.06 mSv y(-1), respectively. No artificial radionuclide was detected in the samples measured from the study area. As no data on radioactivity of the coastal environment of Pakistan are available, the data presented here will serve as baseline information on radionuclide concentration in shallow sea sediments off the Sindh coast. The data will also be useful for tracking pollution inventories from unusual radiological events (if any) in the territorial waters of the study area. Further, the information presented will contribute to modelling of a regional radioactivity database from the perspectives of the International Atomic Energy Agency's Asia-Pacific Marine Radioactivity Database and Global Marine Radioactivity Database.

Asia↗
PubMed2004

Fission track estimation of uranium concentrations in drinking water from Azad Kashmir, Pakistan.

The analysis of uranium in water samples can be very helpful for providing guidelines to the general public regarding necessary remedial measures. A fission-track technique has been applied for the estimation of the uranium concentration in drinking water collected from natural springs of Muzaffarabad and hilly areas of Reshian, Azad Kashmir. The technique involved simultaneous irradiation with thermal neutrons of a sample and a standard in contact with a track detector, and the counting of the fission tracks in the detector from the (n, f) nuclear reaction. Uranium concentrations of the samples were determined by comparing fission-track density with that of a standard of known uranium concentration. Uranium concentration in water samples from the Muzaffarabad and Reshian area varied from 0.03 +/- 0.01 microgL(-1) to 6.67 +/- 0.14 microgL(-1) with an average of 1.36 +/- 0.05 microgL(-1). The observed concentrations of uranium in drinking water were found to be less than the Maximum Acceptable Concentration levels of 9-30 microgL(-1). Thus, the observed values are within safe limits as far as uranium related health hazards are concerned.

Environmental Monitoring↗
PubMed2004

Socioeconomic status and breast cancer survival in Pakistani women.

OBJECTIVES: No data is available from developing countries correlating socioeconomic status (SES) with survival in female breast cancer patients. We decided to test the hypotheses whether SES is an independent determinant for disease stage, access to minimal expected treatment (MET) and survival. METHODS: Two hundred eighty six patients diagnosed with breast cancer were recruited between April 1996 to May 1998. Patients were divided into three groups according to their SES. Prognostic factors analyzed were age, tumor size, nodal status; stage at presentation, estrogen receptor status, time elapsed before diagnosis and access to MET. Disease free survival (DFS) and overall survival (OS) were determined according to the SES of the patients. RESULTS: Patients were categorized into three socioeconomic groups, high (21%), middle (44%) and low (35%). Mean age of all patients was 46 years, in patients from lower SES mean age was 43 years compared to 50 years in high SES. Mean time elapsed before diagnosis for women from high-income group was 4.3 months versus 10.6 months in low-income group. Early breast cancer was more common in affluent strata, 70% versus 41% in the lower strata. Eighty-nine percent patients received MET from the affluent group compared to only 43% patients in the lower strata. Literacy rate of patients from high SES was 73.7% compared to 15% in the low SES. Five year DFS and OS are 79% and 86% for high income group, 48% and 68% for middle income group and 31%,49% for lower strata which were statistically significant (P=.0001 and P<.0001). CONCLUSION: In our cohort of patients strong association was noted between low SES and advanced disease, delay in diagnosis, limited access to MET and inferior DFS and OS. The outcome of these patients may be improved by patient education and availability of better health care facilities.

Adult↗
PubMed2003

Institution based tumor registry from Punjab: five year data based analysis.

INTRODUCTION: There are no population based cancer registries in Pakistan except for Karachi Cancer Registry (KCR). No data from Punjab is available in the last decade. We decided to conduct a data base analysis to see the frequencies of different cancers in Punjab. PATIENTS AND METHODS: A retrospective analysis of 5100 patients presenting to Jinnah Hospital between January 1997 to December 2001 with histological diagnosis of cancer was performed. A tumor registry performa on all patients was filled which included demographic data as age, sex, duration of symptoms and disease stage at presentation. All cancers were coded according to international classification of Disease-oncology (ICD-10) classification. RESULTS: Male cancers accounted for 47.7% and female cancers 52.2% of the total cases. In males the three most frequent cancers were leukemias, non-Hodgkins lymphoma and lung cancer. In females breast cancer was the most common cancer accounting for 38.5% female followed by ovarian cancer 13.6%. CONCLUSIONS: Our institution based cancer registry indicates hematological malignancies are the most common cancers in males in Punjab followed by lung and colorectal cancer. In females breast cancer is the commonest cancer followed by ovarian cancer. Gall bladder cancer is relatively more frequent in women while cervical cancer is less commonly observed in our patient population. Despite biases until population based incidences are available, studies like ours may prove beneficial for future health planning and research.

Demography↗
PubMed2001

Neuroblastic and Schwannian stromal cells of neuroblastoma are derived from a tumoral progenitor cell.

The coexistence of neuroblastic and Schwannian stromal (SS) cells in differentiating neuroblastoma (NB), and derivation of Schwannian-like cells from neuroblastic clones in vitro, were accepted previously as evidence of a common pluripotent tumor stem line. This paradigm was challenged when SS cells were suggested to be reactive in nature. The advent of microdissection techniques, PCR-based allelic analysis, and in situ fluorescent cytometry made possible the analysis of pure cell populations in fresh surgical specimens, allowing unequivocal determination of clonal origins of various cell subtypes. To overcome the complexity and heterogeneity of three-dimensional tissue structure, we used: (a) Laser-Capture Microdissection to obtain histologically homogeneous cell subtype populations for allelotype analysis at chromosomes 1p36, 11q23, 14q32, and 17q and study of MYCN copy number; (b) multiparametric analysis by Laser-Scanning Cytometry of morphology, DNA content, and immunophenotype of intact cells from touch imprints; and (c) bicolor fluorescence in situ hybridization on touch imprints from manually microdissected neuroblast and stroma-rich areas. Histologically distinct SS and neuroblastic cells isolated by Laser-Capture Microdissection had the same genetic composition in 27 of 28 NB analyzed by allelic imbalance and gene copy number. In all 20 cases studied by Laser-Scanning Cytometry, SS cells identified by morphology and S-100 immunostaining had identical DNA content and GD2-staining pattern as their neuroblastic counterparts. In 7 cases, fluorescence in situ hybridization demonstrated the same chromosomal makeup for SS and neuroblastic cells. These results provide unequivocal evidence that neuroblastic and SS cells in NB are derived from genetically identical neoplastic cells and support the classical paradigm that NB arises from tumoral cells capable of development along multiple lineages.

Adolescent↗
PubMed2001

Isolated pulmonic valve endocarditis caused by group B streprococcus (Streptococcus agalactiae)--a case report and literature review.

The pulmonic valve is the least commonly involved valve in infective endocarditis. Pulmonic valve endocarditis is usually associated with tricuspid valve endocarditis, and isolated pulmonic valve endocarditis is exceedingly rare. The predisposing factors for developing pulmonic valve endocarditis include a congenitally anomalous pulmonic valve, intravenous drug abuse, and the presence of indwelling intravenous or flow-directed pulmonary artery catheters. More cases of group B streptococcus endocarditis are being reported. The risk factors for group B streptococcus endocarditis include diabetes mellitus, cancer, alcoholism, malnutrition, immunocompromised status, intravenous drug abuse, postpartum and postabortion states, and underlying valvular disease. The vegetations of this type of endocarditis are usually large and have a higher tendency to result in embolism. The presentation of group B streptococcus endocarditis is usually acute and may result in rapid valve destruction if not treated promptly. A case of isolated pulmonic valve endocarditis caused by group B streptococcus, Streptococcus agalactiae, is presented that was diagnosed with multiplane transesophageal echocardiography in a 40-year old, alcoholic, malnourished man, who was successfully treated with intravenous penicillin G. The literature on the isolated pulmonic valve endocarditis caused by group B streptococcus is reviewed.

Adult↗
PubMed2001

Phase 1 trial of ifosfamide and adriamycin in metastatic breast cancer.

OBJECTIVE: A Phase 1 trial was conducted in patients with estrogen negative receptors (ER) or hormone refractory metastatic breast cancer to determine the maximum tolerated dose (MTD) of ifosfamide with a fixed dose of doxorubicin. A secondary objective was to determine the efficacy of the combination in metastatic breast cancer. METHODS: Fifteen patients were entered in the study in cohorts of three patients at each dose level of ifosfamide. The dose of doxorubicin was fixed at 45 mg/m2. Five different dose levels of ifosfamide were tested ranging from dose level 1 of 1.5 gms/m2 day 1-3 to level V at 2.5 gms/m2 day 1-3. RESULTS: Dose escalation of ifosfamide was stopped at 2.5 gms/m2. The MTD of ifosfamide was 2.25 gms/m2 day 1-3 in combination with doxorubicin. All patients in the study were assessable for toxicity. Neutropenia and thrombocytopenia were the major dose limiting toxicities. Other toxicities included anemia, confusion and hematuria. Objective responses were documented in 11 of 15 patients (73.3%). Median time to treatment failure (TTF) was 13 months. Median overall survival (OS) was 18 months. CONCLUSION: The combination of ifosfamide and doxorubicin was a practical well tolerated regimen. There was substantial evidence of clinical activity in this phase I trial. This combination should be further evaluated, as an attractive alternative to taxanes for patients in developing countries where cost effectiveness is important.

Adult↗
PubMed2000

Laser-capture microdissected schwannian and neuroblastic cells in stage 4 neuroblastomas have the same genetic alterations.

BACKGROUND: Neuroblastoma (NB) is a heterogeneous tumor composed of mixed populations of neuroblastic, Schwannian, and gangliocytic cells. PROCEDURE: We examined the genetic lineage of Schwannian and neuroblastic cells in stage 4 NB using laser-capture microdissection (LCM) and allelic analysis of microsatellite markers of chromosomes 1p, 11q, and 14q. RESULTS: In 18 out of 19 cases, individual cell types exhibited the same allelotype. CONCLUSION: Our results provide evidence that the majority of Schwannian and neuroblastic cells in stage 4 NB are of neoplastic origin, and support the hypothesis of a tumor stem cell capable of development along multiple lineages.

Child↗
PubMed1999

Non-Hodgkin's lymphoma in Pakistan: a clinicopathological profile of 175 patients.

OBJECTIVE: Non-Hodgkin's Lymphomas (NHL) are common in Southeast Asia, Middle East and Africa. The study was primarily undertaken to establish the demographic and clinicopathologic features of NHL in Pakistan. A secondary aim was to determine the applicability of the International Prognostic Index (IPI) developed by the international lymphoma task force in a developing country. METHODS: A retrospective and prospective analysis was performed on 175 patients over 14 years age who presented to the Department of Oncology between August 1994 and December 1996. All patients underwent initial staging according to Ann Arbor Staging System. Histopathologic classification was done according to the International Working Formulation. The IPI was applied to patients with aggressive lymphomas and age adjusted index to patients < 60 years, complete remission (CR), disease free survival (DFS) and overall survival (OS) were calculated. RESULTS: All 175 patients were evaluable. Median age of our patients was 45 years. Male to female ratio was 1.9:1. Seventeen (9.7%) patients were classified as low grade lymphomas while 158 (91.3%) had intermediate and high grade NHL. Large cell lymphoma was present in 30.9% patients. CHOP (cyclophosphamide 650 mg/m2 day 1, vincristine 1.4 mg/m2 day 1, doxorubicin--45 mg/m2 day 1 and prednisone 100 mg/m2 day 1-5) was the most common chemotherapy regimen used. Advanced stage (74.9%) > B symptoms (51%) and extranodal involvement (74.3%) were present. One hundred sixty-seven patients were evaluable for response of which 42.8% achieved CR. Median DFS was 19 months and median OS was 22 months. The IPI was applicable to 153 patients and age adjusted IPI to 124 of 153 patients. CONCLUSION: Aggressive histology, extranodal diseases, B symptoms and advanced disease are common. International index and age adjusted international index predicted outcome accurately in various risk groups.

Adolescent↗
PubMed1999

Process stability assessed by selecting Shewhart's psi statistical analysis technique of the influence of matrix modifier and furnace program in the optimization and precision of zinc determinations by graphite furnace atomic absorption spectroscopy.

The method previously used in the Toxicology Laboratories of King Faisal Specialist Hospital and Research Center for determining the zinc concentration in serum by Zeeman atomic absorption spectrometer was improved by modifying the matrix modifier and by changing the heated graphite furnace atomization (HGA) program. After trying several methods we failed to achieve the required precision and the accuracy of methods for serum zinc determination. We changed the matrix modifier to a fifty percent mixture (v/v) of 3.90 grams per liter of ammonium phosphate in Type 1 water with 0.2% nitric acid and 1.0 gram per liter of magnesium nitrate in acidic water (0.2% HNO3) with 0.1% triton X-100 was used as matrix modifier. A twenty-five fold dilution of the sample in matrix modifier was injected on the L'vov's platform of the furnace. In order to reduce the high sensitivity of Zn the furnace program was modified. The method is found very robust. The average reproducibility between inter-runs and intra-run is less than 1.59% with a high degree of accuracy. We used two levels of controls i.e. normal or low level and abnormal or high level. The linearity and the detection limit of the assay were 0.9992 and 0.010 micromol/L respectively. Average recovery of the analyte was 98.65%. The X-Bar and R charts were constructed by using Shewhart's statistical analysis technique to assess the test methodology. It was found that the assay is capable and stable for routine clinical and research analysis. The capability index (C(P)) of the assay, an indicator of the precision, was calculated.

Data Interpretation, Statistical↗
PubMed1991

Investigation of the Alkaloid Content of Rauwolfia serpentina Roots from Regenerated Plants.

The indole alkaloid content of RAUWOLFIA SERPENTINA roots from regenerated plants (from stem-and root-callus) was compared with the parental stock. Although the total alkaloid content seems to be slightly higher in the roots from regenerated plants, HPLC-analysis of individual alkaloids indicated that the contents of the alkaloids ajmaline ( 1), serpentine ( 2), and reserpine ( 3) are lower than in the roots of the parental stock. The glucoalkaloid raucaffricine ( 4) was identified as a constituent of all samples, thus providing the first evidence for its occurrence in roots of RAUWOLFIA SERPENTINA.

Journal Article↗