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Biomedical subjects

M Yousuf

Publications and source records attributed to M Yousuf.

At least 19 recordsLinked to original sources

Need and duration of antibiotic therapy in clean and clean contaminated operations.

OBJECTIVE: To define the need and duration of prophylactic antibiotic administration in clean and clean contaminated surgery in the prevailing operating theatre environment in Karachi. SETTING: Surgical Department of Hamdard University Hospital and three other private hospitals in Karachi. METHODS: One hundred consecutive patients undergoing elective clean and clean contaminated surgery were recruited from October 2000 to October 2001. Patients were admitted either a day prior to surgery or on the day of surgery, depending on the nature of procedure. Prophylaxis was provided by single dose of antibiotic at induction. The rest of the pre-operative preparation was done in standard way. Patients were discharged home as dictated by the nature of the operation and social circumstances. Wounds were examined for Surgical Site Infection (SSI) on day 4 and day 11. Patients who had post-operative pyrexia or signs of SSI were given extended antibiotic treatment for 5 days or until resolution of infection. RESULTS: Four out of 8 patients who developed SSI required extended antibiotic treatment. CONCLUSION: Single dose prophylactic antibiotic therapy is satisfactory in our surgical environment. This practice would be efficient, cost effective and prevent the emergence of nosocomial infections in a developing country such as Pakistan with extremely limited health care resources.

Adolescent↗

Meningococcal infection among pilgrims visiting Madinah Al-Munawarah despite prior A-C vaccination.

OBJECTIVE: To study the profile of meningococcal infection among pilgrims despite prior A-C vaccination. SETTING: King Abdul Aziz Hospital, Madinah Al-Munawarah, Saudi Arabia. SUBJECTS AND METHODS: Fifteen patients admitted to the hospital during the study period of April 1992 to June 1993 were evaluated prospectively regarding their clinical and laboratory features, culture and antibiotic sensitivity and meningococcal serotypes. RESULTS: Twelve cases presented as meningitis while 3 cases had meningococcaemia. Most (53.3%) were from Pakistan while rest were from 6 other countries. Clinical and laboratory features at presentation were similar as reported in the literature. In 13 cases where serotyping could be done, most belonged to group A (54%) and C (23%). Antimicrobial sensitivity showed the isolates to be sensitive to most of the antibiotics commonly used to treat this infection. Mortality was 33% with the poorest outcome in patients with W135 infection. CONCLUSION: This study underscores the need of further studies in Makkah and Madinah, Saudi Arabia to find out the serotypes and immunological factors responsible for meningococcal infection in A-C vaccinated pilgrims so as to explore the possibility of use of polyvalent meningococcal vaccine.

Adult↗

Comparison of seroepidemiology of hepatitis C in blood donors between Bangladesh and Japan.

To compare the seroepidemiology of hepatitis C and hepatitis B between Bangladesh and Japan, we tested the second generation antibody to hepatitis C virus (anti-HCV-2) and hepatitis B surface antigen (HBsAg) in serum samples from 163 professional blood donors (161 males and 2 females, mean age 28.6 yr.) and 83 voluntary blood donors from Bangladesh, and 7479 Japanese voluntary blood donors (5036 males and 2443 females; mean age 37.1 yr.). In Bangladesh, anti-HCV-2 is detected in 2.4% of professional blood donors and 0% of voluntary blood donors, furthermore, HBsAg is detected in 29% and in 2.4% of professional and voluntary blood donors, respectively. In Japan, anti-HCV-2 is detected in 0.6% in voluntary blood donors, and HBsAg also in 0.6%. These results indicate that professional blood donors in Bangladesh are highly contaminated by hepatitis B virus and moderately by hepatitis C virus, while voluntary blood donors in both countries are not so highly contaminated by either hepatitis viruses.

Adult↗

Persistence of viremia in patients with type-C chronic hepatitis during long-term follow-up.

To clarify the evolution of antibody to hepatitis C virus (anti-HCV) and of liver histologic findings during the natural course of type-C chronic hepatitis, 111 patients with biopsy-proven chronic hepatitis type C were consecutively enrolled in this study and were followed up biochemically, serologically, and histologically for more than 5 years. All were positive for the first- and second-generation antibody to HCV (anti-HCV-1 and anti-HCV-2). None received antiviral therapy during the follow-up period. At the end of follow-up, all remained positive for anti-HCV-2, but four patients turned negative for anti-HCV-1. HCV RNA, detected by the polymerase chain reaction method, was tested serially in 20 patients who persisted positive anti-HCV-1 and in 4 patients who lost anti-HCV-1. HCV RNA disappeared from only two patients, who lost anti-HCV-1 during the follow-up period. A normalization of the serum transaminase level was found in only two patients, who lost both anti-HCV-1 and HCV RNA. A repeat liver biopsy was performed in 62 patients with chronic hepatitis who were persistently positive for all HCV markers and in 4 patients who lost anti-HCV-1. Of the 62 patients who retained all HCV markers, 16 progressed to hepatocellular carcinoma, 6 to cirrhosis of the liver, and 1 had a normal liver, whereas the remaining 39 had chronic hepatitis. Two patients who lost both anti-HCV-1 and HCV RNA showed a normal liver. Of two patients who lost only anti-HCV-1 one progressed to hepatocellular carcinoma and one to chronic hepatitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Al-type generalized amyloidosis showing a solitary duodenal tumor.

An amyloid tumor of the duodenum is a rare occurrence. A patient who presented with epigastric discomfort, in whom a barium meal study revealed a tumor of the duodenum is described. Upper gastrointestinal endoscopy showed a submucosal location of the tumor, and examination of a biopsy revealed amyloid deposition of the AL type. Diffuse tumor involvement of adjacent tissues of the duodenum and also deposits of amyloid fibrils in the liver and skin with no evidence of a chronic pre- existing disease in the patient led to the diagnosis of primary systemic amyloidosis. The distinguishing feature of this case was the formation of a solitary and relatively large tumor in the duodenum mimicking a submucosal tumor, which is in contrast to most reported cases of multiple and smaller amyloid tumors in other parts of the gastrointestinal tract.

Amyloidosis↗

Transition of antibody to hepatitis C virus from chronic hepatitis to hepatocellular carcinoma.

Fifty-eight patients with chronic hepatitis C were followed for more than 7 years. Of them, 10 patients were found to develop hepatocellular carcinoma, 14 to develop liver cirrhosis, 30 to sustain chronic hepatitis, and 4 to show subsidence of hepatitis. Antibody to hepatitis C virus (anti-HCV) disappeared from the 4 patients whose hepatitis subsided, but it persisted in the remaining 54 patients. The mean titer of anti-HCV was almost the same at the stages of chronic hepatitis and of cancer in the 10 patients who developed hepatocellular carcinoma. These results indicate that chronic infection of hepatitis C virus may lead to hepatocellular carcinoma.

Carcinoma, Hepatocellular↗

Treatment of chronic non-A non-B hepatitis with human interferon beta: a preliminary study.

Twenty-four patients with chronic non-A non-B hepatitis were randomly assigned to receive either human fibroblast interferon (HuIFN-beta) at doses of 1 or 3 million international units (MIU) per day for 4 or 12 weeks (12 patients) or to receive no therapy (12 patients), and were then compared with 5 patients with chronic type B hepatitis who were treated with HuIFN-beta. Elevated serum aminotransferase levels decreased more rapidly during the treatment of chronic non-A non-B hepatitis than of chronic hepatitis B. Variations in serum aminotransferases were not observed in any of the untreated chronic non-A non-B hepatitis patients. In 3 of the 9 patients with chronic non-A non-B hepatitis who responded to HuIFN-beta therapy, serum aminotransferase levels remained normal 15, 21 and 31 months after therapy was discontinued; liver biopsy specimens obtained after therapy from 2 patients showed marked histological improvement. In the six other patients aminotransferase activity levels became again elevated following cessation of interferon therapy. No response to HuIFN-beta was seen in the remaining 3 patients with chronic non-A non-B hepatitis.

Adult↗

Comparison of anamnestic history, alcohol intake and smoking, nutritional status, and liver dysfunction between thorotrast patients who developed primary liver cancer and those who did not.

In order to clarify the differences in past history, nutritional condition and, consumption of alcohol and tobacco, and liver dysfunction between the thorotrast patients who developed primary liver cancer and those who did not, 103 persons who had no primary liver cancer in January 1980 were studied. All subjects were military men who had undergone angiography with thorotrast between 1943 and 1946. Twenty persons developed hepatocellular carcinoma and 16 developed intrahepatic bile duct carcinoma by April 1987, whereas 67 are still alive without any cancer. There was no difference in age or period after thorotrast infusion between those two groups of patients in January 1980. A difference in history of hepatitis and/or jaundice and presence of hepatic dysfunction was found between the subjects who developed primary liver cancers and those who did not. These findings suggest that an anamnestic history of hepatitis and liver dysfunction are risks for development of thorotrast-induced liver cancer. On the basis of the above findings, early detection of liver dysfunction offers a possibility of early diagnosis of primary liver cancer.

Aged↗

A case of double pylorus accompanied by adrenal adenoma.

We report here a case of double pylorus diagnosed endoscopically in a patient with adrenal adenoma. A 44-yr-old man was found to have double pylorus during examinations for recurrent epigastric pain and obesity. We think that the formation of double pylorus in this case resulted from recurrent peptic ulcer which, in turn, probably was induced by the hypersecretion of endogenous corticosteroids accompanying adrenal adenoma.

Adenoma↗

In-vitro antagonism by N-formimidoyl thienamycin and cefoxitin of second and third generation cephalosporins in Aeromonas hydrophila and Serratia marcescens.

Antagonism of beta-lactam antibiotics by second and third generation cephalosporins was studied in 28 clinical strains of Serratia marcescens and Aeromonas hydrophila. Of the antibiotics tested, both cefoxitin and N-formimidoyl thienamycin (N-f-thienamycin) were capable of antagonism in Ser. marcescens (17 of 20) but in Aerom. hydrophila (7 of 8), only cefoxitin induced antagonism. Antagonism was observed to the greatest degree with cefotaxime and cefoperazone; intermediate with cefamandole and latamoxef (moxalactam) and essentially none with N-f-thienamycin. Inducible beta-lactamase was found in all strains of both genera which exhibited antagonism. The induced beta-lactamase showed enhanced inactivation for other antibiotics in only four strains with none occurring in Aeromonas.

Aeromonas↗

Control mechanisms in platelet activation.

Those activation stages that are energy dependent rely upon a complex control mechanism involving the interaction of platelet thrombasthenin, free ionic calcium, cyclic AMP and the prostaglandins. This article describes the feedback mechanisms inherent in these controls, and the sources, activities and degradation of all control materials. Particular attention is paid to the prostaglandins and their activating enzymes, both within the dense tubular system of the platelet and the cytoplasm of endothelial cells. The implications of the prostaglandin pathway for both therapy and laboratory diagnosis are explored.

Biological Transport, Active↗

A review of platelet function and testing.

Platelet function testing is an area of recent growth and development in clinical laboratories. Additions to classical testing procedures include aggregation and retention tests and measurement of platelet release products. The necessity exists for understanding platelet structure and function. In this paper, the various platelet structures are demonstrated, their composition is described, and their individual contribution to platelet activation discussed. Platelet activation is described in four phases: adhesion, reversible contraction, aggregation, and release. Each is described in relationship to the others and laboratory test procedures marking each are described. The question of the relationship of measurement of platelet release markers to clinical condition is reviewed.

Blood Platelets↗