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Biomedical subjects

R Naqvi

Publications and source records attributed to R Naqvi.

At least 19 recordsLinked to original sources
PubMed2006

Efficacy of isoniazid prophylaxis in renal allograft recipients.

The efficacy of isoniazid (INH) prophylaxis in renal allograft recipients who are on long-term immunosuppression in a region highly prevalent for tuberculosis (TB) was studied. INH (300 mg/d in patients weighing more than 35 kg and 5 mg/kg/d in patients with <35 kg body weight) together with Pyridoxine 50 mg/d for 1 year was started in randomly assigned renal allograft recipients. Occurrence of clinical tuberculosis during the initial 2 years posttransplantation was observed in the risk group and patients at no risk. Risks were defined as acute rejection episodes and exposure to antirejection therapy, past history of TB completely or incompletely treated, radiological evidence of past tuberculosis, history of tuberculosis in close contacts. Among 480 patients registered in the study, INH prophylaxis was given to 219 randomly assigned renal allograft recipients. Results were compared among patients developing TB during the initial 2 years posttransplantation in both the groups. Risk factors were analyzed for comparison in both groups. No significant difference was observed in terms of past history of TB, TB in close contacts, episodes of acute rejection during the initial 3 months, and comorbidities such as cytomegalovirus infection, hepatitis C virus infection, and posttransplant diabetes. One patient from the INH group and 10 patients from the non-INH group developed TB during the initial 2 years posttransplantation (P < .0001). None of patients required discontinuation of INH. INH was observed to be safe and effective as a chemoprophylactic agent in renal allograft recipients.

Antitubercular Agents↗
PubMed2006

Outcome of pregnancy in renal allograft recipients: SIUT experience.

The course of pregnancy and its outcome was studied in renal allograft recipients. Between November 1985 and November 2005, a total of 1481 renal transplants were carried out at the Sindh Institute of Urology and Transplantation (SIUT); among them were 348 females, with 73 potential females for pregnancy. All patients received cyclosporine and prednisolone, with 82% also receiving azathioprine and 4 patients mycophenolate mofetil as a third immunosuppressant drug. We evaluated incidence of hypertension, diabetes, pre-eclampsia, urinary tract infection (UTI), rejection during pregnancy and during 3 months' postdelivery as well as outcomes of pregnancy. Among 73 potential candidates, 31 had 47 pregnancies, after an average of 31 months (8-86 months). Of 31 subjects, 21 subjects were hypertensive on one or two drugs prior to conception. A rise in blood pressure during pregnancy was noticed in 7 patients. Albuminuria from trace to 3+ appeared in 13 patients and glycosuria in one other. Blood sugar levels remained within normal range in all subjects. UTIs occurred during pregnancy in 7 patients. Among 47 pregnancies, 9 had abortions (7 spontaneous, 2 therapeutic) and 6 had preterm deliveries. The others were full-term deliveries: 12 via a lower segment caesarean section and 20 were normal vaginal deliveries. Average birth weight was 4.8 lbs. At an average follow-up of 38 months the serum creatinine values ranged from 0.94 to 2.3 mg %. One patient developed acute irreversible graft dysfunction soon after delivery. Our study demonstrated that pregnancy did not reduce renal graft survival, but newborns are at greater risk of premature birth and low birth weight.

Albuminuria↗
PubMed2002

Recruiting the community for supporting end-stage renal disease management in the developing world.

Although the incidence of new end-stage renal disease (ESRD) patients in Pakistan is estimated at 100 patients per million (ppm), the prevalence of those alive on renal replacement therapy (RRT) is around 40 ppm, reflecting the severe shortage of facilities. A national program was launched in 1998 to provide free RRT, but the funds were extremely limited, leading to the flourishing of suboptimal treatment in private dialysis and transplant centers. The Sindh Institute of Urology and Transplantation (SIUT), started as a small unit in 1975, took the lead in recruiting nongovernmental funds for RRT. Through the devotion of several groups, it was possible to raise funds from individuals, pharmaceutical firms, and other organizations, which permitted the development of SIUT into an independent, large, and fully equipped institution that provides free RRT including dialysis and transplantation to many thousands of patients. This prompted the government to increase its contributions to encourage SIUT to pursue its unique path.

Developing Countries↗
PubMed1996

Acute renal failure due to traumatic rhabdomyolysis.

Between 1990 and 1993, we studied 14 cases of acute renal failure due to prolonged muscular exercise (e.g., squat jumping, sit-ups) and blunt trauma inflicted by law enforcement personnel using sticks or leather belts. None of the patients had a prior history of myopathy, neuropathy, or renal disease. All were critically ill and required renal support in the form of dialysis. Although the morbidity was high, 13 of the patients recovered normal renal function. One patient expired due to sepsis.

Acute Kidney Injury↗
PubMed1996

Acute renal failure of obstetrical origin during 1994 at one center.

Although preventable, acute renal failure (ARF) of obstetrical origin continues to be common in developing countries. During the year 1994, we treated a total of 238 cases of ARE. Of these cases, 43 (18%) were of obstetrical origin. All of the patients were known to be previously healthy. Acute renal failure occurred in association with antepartum hemorrhage in 15, postpartum hemorrhage in 10, intrauterine death of fetus in 11, preeclampsia or eclampsia in 9, and septic abortions or puerperal sepsis in 7. Thirty-six patients required dialysis therapy because of moderate to severe azotemia. Renal histology was studied in 12 cases. Acute cortical necrosis was present in 9, extensive tubular necrosis in 2, and 1 patient had membranoproliferative glomerulonephritis. Twenty-two (51%) patients recovered normal renal function, while 11 (26%) developed irreversible renal dysfunction and 10 (23%) expired. Mortality and morbidity in this region is still quite high in obstetrical situations. Poor health infrastructure and lack of antenatal health clinics leads to development of major complications at the time of childbirth, which is mostly conducted at home by untrained personnel in quite a few cities of the country.

Acute Kidney Injury↗
PubMed1996

Predictors of outcome in malarial renal failure.

We studied 38 patients with acute renal failure (ARF) due to malaria over a 5-year period between 1990 and 1994 at the Institute of Urology and Transplantation. There were 30 males and 8 females who ranged in age from 13 to 75 years. Most were critically ill on presentation with blood urea levels between 116 and 587 mg% and serum creatinine concentrations between 3 and 30 mg%. Anemia accompanied by hyperbilirubinemia was a result of severe hemolysis. Antimalarial therapy consisted of quinine sulfate, chloroquine, or both. Of the 38 patients, 32 required hemodialysis and eventually recovered normal (n = 29) or near normal (n = 3) function. Six patients died.

Acute Kidney Injury↗
PubMed1996

Analysis of factors causing acute renal failure.

Factors leading to acute renal failure (ARF) were analysed in 376 consecutive patients between January 1993 and December, 1994 in a Karachi centre. Two hundred and sixteen (57%) had medical conditions, 86 (24%) obstetrical, 28 (7%) obstructive, 18 (5%) surgical and in 28 (7%) the causes were uncertain. Within the medical group, the causes were diarrhoea 30%, drugs 23%, malaria 15% and liver disease 5%. In the obstetrical group majority of the patients had multiple etiologies. Sixty percent of patients had ante-partum haemorrhage, 33% post-partum haemorrhage, intrauterine deaths were seen in 31%, septic abortions in 20% and pre-eclamptic toxemia in 22% cases. In the obstructive group, most of the patients had stone disease, where bilateral ureteric calculi constituted 57% of the cases. In surgical group, 11 (61%) had ARF due to post-operative complications. This data confirms the pattern of ARF from other third world countries where obstetrical and obstructive causes are high as compared to western countries.

Acute Kidney Injury↗