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Biomedical subjects

S H Ansari

Publications and source records attributed to S H Ansari.

At least 19 recordsLinked to original sources

In-vivo purging with the anti-CD20 antibody rituximab along with standard allogeneic peripheral blood stem cell transplantation (PBSCT) for relapsed childhood pre-B acute lymphoblastic leukaemia (ALL).

This case report describes the use of Rituximab for in vivo purging (by intravenous infusion) in a 12 years old boy with second remission of pre-B ALL. It was followed by conditioning therapy consisted of Busulphan and Cyclophosphamide. rh-G-CSF primed stem cells from an HLA identical sibling donor were infused. Standard graft versus host disease prophylaxis was given. He engrafted within two weeks. He did not develop acute graft versus host disease (aGvHD) but localized chronic GvHD developed. He had been on regular follow-up at CMH, Rawalpindi and is in complete remission 13 months post-PBSCT with no evidence of chronic GvHD at present.

Antibodies, Monoclonal↗

Febrile neutropenia in paediatric peripheral blood stem cell transplantation, in -vitro sensitivity data and clinical response to empirical antibiotic therapy.

OBJECTIVE: To find the in-vitro sensitivity data and clinical response in order to determine the changes required in empiric antibiotic therapy for management of febrile neutropenia in paediatric patients undergoing peripheral blood stem cell transplantation. DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Paediatric bone marrow transplant unit at Bismillah Taqee Institute of Health Sciences and Blood Disease Center from September 1999 to May 2004. PATIENTS AND METHODS: All patients were treated according to institutional protocol for febrile neutropenia. Empirical antibiotics include Ceftriaxone and Amikacin. In non-responders, changes made included Imipenem and Amikacin, Piperacillin Tazobactum/Tiecoplanin or Vancomycin/Cloxacilin/Ceftazidime. In non-responders, amphotaracin was added until recovery. RESULTS: Out of 52 patients, 5 did not develop any fever; in the remaining 47 patients there were 57 episodes of febrile neutropenia. The mean days of febrile episodes were 4.71 (range 3-8). Fever of unknown origin (FUO) occurred in 31 (54.3%) episodes. Microbiologically documented infection (MDI) occurred in 17 (29.8%) episodes of fever. Clinically documented infection (CDI) occurred in 9 (15.7%) episodes. Gram-negative organisms were isolated in 10 while gram-positive organisms in 7. Klebseilla, S. aureus were the most common isolates. Empirical therapy was effective in 12 of the 33 (36%) episodes. Out of 28, 26 (92%) responded to Imipenem/Amikacin as second line therapy while those who received any other second line combination, only 11 out of 22 (50%) showed response. Systemic Amphotericin was used in 4 patients, 2 responded. Infection related mortality rate was 4%. CONCLUSION: Gram-negative infections predominated, Imipenem/ Amikacin found to be most effective therapy while a low mortality rate is recorded in our setting suggesting good infection control.

Anti-Bacterial Agents↗

Antidiabetic activity of an ethanol extract obtained from the stem bark of Psidium guajava (Myrtaceae).

This study analyzed the antidiabetic properties of an ethanol extract of the stem bark of Psidium guajava, an indigenous medicinal plant used to control diabetes in Indian System of Medicine. The anti-hyperglycaemic activity of this plant on blood glucose levels of normal, normal glucose loaded (OGTT) and alloxan-induced hyperglycaemic rats was evaluated. The results showed that ethanol stem bark extract exhibited statistically significant hypoglycaemic activity in alloxan-induced hyperglycaemic rats but was devoid of significant hypoglycaemic effect in normal and normal glucose loaded rats (OGTT).

Animals↗

Hepatoprotective activity of Abutilon indicum on experimental liver damage in rats.

The aqueous extract of Abutilon indicum was tested for hepatoprotective activity against carbon tetrachloride- and paracetamol-induced hepatotoxicities in rats. A. indicum exhibited significant hepatoprotective activity by reducing carbon tetrachloride- and paracetamol-induced change in bio-chemical parameters that was evident by enzymatic examination. The plant extract may interfere with free-radical formation, which may conclude in hepatoprotective action. Acute toxicity studies revealed that the LD50 value is more than the dose of 4 g/kg body wt.

Acetaminophen↗

Effect of Aralia cachemirica Decne root extracts on blood glucose level in normal and glucose loaded rats.

An aqueous and alcoholic extract of the roots of Aralia cachemirica (Araliaceae) were evaluated for hypoglycemic activity in normal fasted and glucose induced hyperglycemic rats. The aqueous and alcoholic extracts at a dose of 250 mg/kg showed statistically significant (p < 0.01) hypoglycemic activity in glucose loaded animals however no effect was observed in normal fasted rats.

Animals↗

Allogeneic peripheral blood stem cell transplantation in patients with haematological malignancies.

OBJECTIVE: To report the initial data on allogeneic peripheral blood stem cell transplantation for haematological malignancies in Pakistan. DESIGN: A single centre descriptive study. PLACE AND DURATION OF STUDY: Bismillah Taqee Institute of Health Sciences and Blood Diseases Centre from September 1999 to June 2004. PATIENTS AND METHODS: Patients with haematological malignancies were included who had received allogeneic PBSC transplantation of Filgrastim (rhG-CSF) mobilized peripheral blood stem cells from HLA-identical siblings (except one 5/6 antigen sibling) with Busulphan and Cyclophosphamide standard conditioning therapy in all patients. No patient received antibiotics for gut decontamination. Empirical antibiotics included Ceftriaxone and Amikacin for febrile neutropenia, oral Itraconazole for antifungal prophylaxis while oral acyclovir was used for antiviral prophylaxis. All donors and recipients were CMV IgG positive Cyclosporin A / Methotrexate were given for graft versus host disease (GvHD) prophylaxis. Stem cells were harvested using Haemonetics MCS+ cell separator. All patients received G-CSF starting from day +4 until their neutrophil count rose to normal. RESULTS: There were 21 patients with age range of 8-38 years and male to female ratio of 2:1. Engraftment was achieved in all patients; median time to absolute neutrophil count of > 0.5 x 10(9)/l was 10 days (range 8 - 12 days) and platelet count of > 20 x 10(9)/l was 14 days (12-17 days). Acute graft versus host disease ( aGvHD) was seen in 7 patients; one patient had grade IV skin and hepatic GvHD; another patient had grade III gut GvHD, grade II GvHD was seen in 3 patients while grade I skin aGvHD was seen in 2 patients. Median hospital stay was 34 days. Treatment related mortality was seen in 3 patients (18%). Chronic GvHD was seen in 5 patients. Four more patients died during the follow-up period. Malaria was seen in 2 while tuberculosis developed in one case. Relapse was seen in 2 patients. The estimated probability of survival at one hundred day, at one year and five years was 82, 47 and 40 percent respectively. CONCLUSION: Haematopoietic stem cell transplant programme can be developed in a developed country setting. Post transplant complications are similar to what have been reported in the developed countries. In endemic areas malaria could prove to be fatal if not recognised and treated early.

Adolescent↗

Effect of aqueous extract of Cyamopsis tetragonoloba Linn. beans on blood glucose level in normal and alloxan-induced diabetic rats.

Effect of feeding orally the aqueous extract of beans of Cyamopsis tetragonoloba was investigated on fasting blood glucose levels in glucose loaded, normal and alloxan-induced diabetic rats and compared with gliclazide, a reference drug. The aqueous extract of beans at 250 mg/kg body wt significantly lowered blood glucose levels in alloxan-induced diabetic rats within 3 hr of administration. Continued administration of the extract at the same dose daily for 10 days produced statistically significant reduction in the blood glucose levels while marginal activity was seen in normal and glucose-loaded rats.

Animals↗

Peripheral blood stem cell transplantation in children with beta-thalassemia major.

OBJECTIVE: To share the preliminary data on stem cell transplantation in Pakistan. DESIGN: This is a single center retrospective analysis of the outcome of allogeneic peripheral blood stem cell (PBSC) transplantation in b-thalassemia major patients. PLACE AND DURATION OF STUDY: Bismillah Taqee Blood Diseases Centre, Karachi; a tertiary care hematology center from September 1999 to September 2002. PATIENTS AND METHODS: Twelve patients with b-thalassemia major received allogeneic PBSC transplantation from HLA identical sibling donors except in one case where mother was the donor. All patients received busulphan and cyclophosphamide conditioning therapy and cyclosporin A/methotrexate for graft versus host disease (GVHD) prophylaxis. Donors were primed with G-CSF for 4 days and stem cells were harvested using Haemonetics MCS + cell separator on 5th day. All patients received G-CSF starting from day + 4 until their neutrophil count rose to normal. RESULTS: Engraftment was achieved in all patients except one who required a second dose of bone marrow graft on day +21. Median time to achieve absolute neutrophil count of > 0.5 x 10(9)/l was 9.0 days (range 8-31 days) and platelet count of > 20 x 10(9)/l was 14 days (12-35 days). Acute GVHD was seen in 3 patients, one patient had grade IV gut GVHD; another patient had grade III gut GVHD while third patient had grade II skin GVHD. Median hospital stay was 29 days. Six patients were well and transfusion independent 3 to 36 months posttransplant. One episode of primary graft failure required a second dose of bone marrow harvest. Another episode of graft rejection received two doses of donor lymphocytes infusion. There were 4 deaths due to grade IV gut GVHD because of uncontrolled systemic Candida infection and one due to hepatic veno-occlusive (VOD) disease. CONCLUSION: Allogeneic peripheral blood stem cell transplantation can be safely and economically carried out in Pakistan. Although there had been 4 deaths during 36 months follow-up, with increasing understanding and experience the outcome is expected to improve.

Child, Preschool↗

Two new anthraquinones from the roots of Rubia cordifolia Linn.

Two new anthraquinones, named cordifoliol and cordifodiol, have been isolated from the roots of Rubia cordifolia. Their structures have been established as 1-hydroxy-3-ethyl-9,10-anthraquinone (1) and 1,8-dihydroxy-11, 20 (15-pentyl-naphthaquinonyl) phenanthrene (2) on the basis of spectral data analyses and chemical reactions.

Anthraquinones↗

New oleanene and fernane-type triterpenes from the stem bark of Betula pendula roth.

A new oleanene-type triterpene, named betuloleanolic acid acetate and fernane-type triterpenes, namely betufernanediol A and betufernanediol B (isomers) have been isolated from the stem bark of Betula pendula. Their structures have been established as olean-12-en-3beta-ylacetate-29-oic acid, fern-22(29)-en-3beta,12beta-diol and fem-22(29)-en-3alpha,12beta-diol, respectively, on the basis of spectral data analysis and chemical reactions.

Betula↗

Allogeneic peripheral blood stem cell transplantation for aplastic anaemia: a single centre experience.

OBJECTIVE: To assess the feasibility of stem cell transplantation in local setting. SETTING: A tertiary care haematology centre. STUDY DESIGN: This is a single centre retrospective analysis of the outcome of allogeneic peripheral blood stem cell transplantation for severe aplastic anaemia. OBJECTIVES: Preliminary data on stem cell transplantation in Pakistan. PATIENTS AND METHODS: Aplastic anaemia is an uncommon disorder with a high mortality without treatment. Immunosuppression and bone marrow transplantation remains the mainstay of treatment. Stem cell transplantation facility became available in Pakistan in 1999, since then both allogeneic and autologous procedures are carried out for severe aplastic anaemia, b-thalassaemia major and haematological malignancies. Between April 2000 and July 2002, 20 allogeneic peripheral blood stem cell transplants were carried out for aplastic anaemia from HLA identical siblings. Donors were primed with G-CSF 10 mcg/kg/day subcutaneously for 4 days; stem cells were harvested on 5th day using Haemonetics MCS+ cell separator. Cyclophosphamide was used for conditioning; cyclosporin A and methotrexate were given for graft versus host disease prophylaxis. RESULTS: Eighteen out of 22 patients survived transplant in a follow up period of 788 days. The causes of death were intra-cranial haemorrhage on day +7, herpes encephalitis on day +180, graft failure and mucour mycosis on day +353 and TB meningitis on day +544. Allogeneic peripheral blood stem cell transplantation resulted in 81% event free survival in our hands. CONCLUSION: Allogeneic peripheral blood stem cell transplantation is feasible and life saving in an otherwise fatal disorder. This could be carried out effectively in Pakistan.

Adolescent↗

Norditerpenic ester and pentacyclic triterpenoids from root bark of Calotropis procera (Ait) R. Br.

A new norditerpenyl ester, named Calotropterpenyl ester, and two unknown pentacyclic triterpenoids, namely calotropursenyl acetate and calotropfriedelenyl acetate have been isolated from the root bark of Calotropis procera. Their structures have been established as 6,10,14-trimethylpentadec-6-enyl-2',4',8',12',16'-pentamethyl nonadecane ester, urs-12,19(29)-diene-3 beta-yl acetate and friedelin-1-ene-3 beta-yl acetate, respectively, on the basis of spectral data analyses and chemical reactions.

Diterpenes↗

Antihyperglycemic activity of Euphrasia officinale leaves.

The effects of the aqueous extract of the leaf of Euphrasia officinale on blood glucose levels in normal and alloxan-diabetic rats were investigated. The treatment of alloxan-induced diabetic rats brought down the raised glucose levels, while the extract was devoid of hypoglycemic effect in normal rats.

Alloxan↗