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Biomedical subjects

S Ismael

Publications and source records attributed to S Ismael.

At least 19 recordsLinked to original sources
PubMed2003

Severe jaundice in Sweden in the new millennium: causes, investigations, treatment and prognosis.

BACKGROUND: The aims of the study were to assess the causes of jaundice in Gothenburg, Sweden, to study the types of investigations applied in cholestatic and hepatocellular types of jaundice and treatment and to evaluate the prognosis of these patients up to a year from the diagnosis. METHODS: Over a 3-month period, all adult patients with bilirubin > 100 micromol/l were identified by the clinical chemistry laboratory serving all three hospitals in Gothenburg. Relevant clinical information was obtained from medical records. Follow-up was performed 9-12 months later. RESULTS: A total of 173 patients were identified; 40% were under surgical care while 38% were in the care of internists. The most common cause of jaundice was malignancy in 58 patients, liver metastases in 20, cholangiocarcinoma in 16, pancreatic cancer in 13, cancer of papilla Vateri in 2 and primary liver cancer in 7. Alcoholic liver disease was the second most common cause, found in 29 patients, followed by bile duct stones (28 patients). Only 3% had viral hepatitis. Ultrasound and/or CT were performed in 95% of those with cholestasis and ultrasound had been performed in 75% of those with hepatocellular type and CT in almost 50%. Thirty-two patients were operated on, 27 patients were treated endoscopically and 17 patients required liver transplantation. Total mortality was 51% and in malignancy 82%. CONCLUSION: Malignancy and alcoholic liver disease are the most common causes of severe jaundice, whereas viral hepatitis is a rare cause. Many patients are under surgical care, probably due to historical reasons as surgery is rarely indicated.

Adult↗
PubMed2001

A new surgical strategy for breast conservation in locally advanced breast cancer that achieves a good locoregional control rate: preliminary report.

The scope of breast conserving surgery has recently expanded to include locally advanced breast cancer (LABC) patients who are downstaged following neoadjuvant chemotherapy (NACT). However, the efficacy of this approach in achieving adequate locoregional control of disease is in doubt. Some reports have attributed the failure to the association of NACT-induced tumour downstaging which can leave multifocal in situ and invasive lesions around the main tumour mass. In the present study, in order to eradicate all possible tumour satellites, a very wide local excision that included the whole original tumour-bearing area was performed regardless of the expected wide defect. This defect was then immediately reconstructed by an ipsilateral pedicled latissimus dorsi myocutaneous (LDM) flap. The study included 26 patients with LABC without evidence of primary tumour-multicentricity. Tumours were downstaged following NACT. The early cosmetic outcome was good in the majority of cases. Early complications were minimal. Twenty-two patients had a mean follow up period of 30.2 (range 7-50) months. In those evaluable cases, locoregional control of the disease was excellent (100%) but distant metastases occurred in seven cases (31.8%).

Journal Article↗
PubMed2000

A review of Hib epidemiology in Asia.

Meningitis due to an invasive Haemophilus influenzae type b (Hib) infection, has been previously perceived to be relatively uncommon in Asia. However, the incidence of disease and its impact may have been underestimated. In addition to a lack of microbiological facilities in some hospitals, difficulties in culturing the organism and the widespread use of antibiotics may have hidden the true incidence of the disease in some countries. Furthermore, the reported disease burden probably underestimates the incidence of Hib pneumonia. The epidemiology of invasive Hib disease for various Asian nations is reviewed in this paper. Hospital-based studies show that Hib is a major cause of bacterial meningitis and/or pneumonia in the Philippines, India, Thailand, Malaysia, Indonesia and Vietnam. Singapore and Hong Kong have a low incidence of infection compared with Western and other Asian nations. This low incidence is not due to a higher level of natural protective antibodies, but may be related to an interaction between environmental and genetic factors. Therefore the widespread belief that Hib infection is unimportant in Asia does not refer to Asia as a whole and possibly to Chinese patients only, and failure to recognize this has serious implications. The inclusion of Hib vaccine in the routine infant immunization schedule in many industrialized nations has significantly reduced the incidence of invasive disease. Recent studies have shown Hib vaccination is also effective in preventing invasive disease in children in developing countries. While population-based data may be required to confirm the need for public-funded infant Hib immunization in Asia, its introduction in countries with a high incidence of Hib meningitis and/or pneumonia has the potential to significantly improve pediatric health and survival.

Asia↗
PubMedDate not supplied

Some clinical aspects of periventricular-intraventricular hemorrhage (PVH-IVH) in the newborns.

Twenty seven cases of neonatal intracranial PVH-IVH were studied. Twenty-three (83.3%) cases were born with birth weight of less than 2,500 grams; out of which 8 (29.7%) had birth weight of less than 1,500 grams. Twenty (74.1%) cases were born after less than 37 weeks gestation, and 7 (25.9%) were born after more than 37 weeks of gestation. Out of the 18 cases with known Apgar scores, 11 (61.1%) were born with asphyxia. We could not make any conclusion on the correlation between mortality of newborn infants with PVH-IVH and severity of the bleeding, as most of them had other associated illness as well, which may directly or indirectly affect the mortality.

Cerebral Hemorrhage↗
PubMedDate not supplied

Guillain Barre syndrome in children: clinical manifestations, laboratory findings, and the results of steroid treatment.

We report 28 cases diagnosed as GBS in the Department of Child Health, Medical School, University of Indonesia, DR. Cipto Mangunkusumo General Hospital in 7 years period. There were 17 males and 11 females with a ratio of 1.5:1. The age ranged from 9 months to 9.5 years, with a mean age of 4.57 +/- 2.36 years. Twelve (42.86%) cases were preceded by acute respiratory infection, 8 (28.57%) cases by non specific fever, 1 (9.57%) case by gastrointestinal tract infection and 7 (25%) cases did not have any history of acute infection. The clinical manifestations were motor weakness (100%), cranial nerves involvement (14.29%) and disturbance of sensation (17.80%). Most cases (92.86%) showed albuminocytologic dissociation feature with the CSF protein content more than 40 mg/dl. The number of cells was less than 10 cells/mm3 in 96.43% of cases. The specific NCV feature (peripheral NCV decrease) was found in 96.15% of patients and only 1 patient (3.85%) showed normal peripheral NCV. The severity of the disease was in accordance with the prognosis later. Corticosteroid was not beneficial in the treatment of GBS.

Adrenal Cortex Hormones↗
PubMedDate not supplied

The efficacy of phenobarbital in controlling epilepsy in children.

Most of the new anti epileptic drugs are hard to find and expensive to be used in developing countries. We prefer phenobarbital as the first line drug because it is easily available and quite cheap. In 1986 we had 117 cases of epilepsy, excluding infantile spasms, that were treated with phenobarbital as the first line drug and had been followed up regularly from 6 months to 10 years. The cases consisted of 54 boys and 63 girls; the age of the initial visit varied between 5 months and 12 years. Overall, good results were obtained in 73 cases (62.40%), fair result in 9 cases (7.69%) and poor in 35 cases (29.91%). In relation to the type of seizures, good results occurred in 72.60% of grand-mal type, 60% of absences, 43.75% of complex partial seizures and 47.05% of partial seizures secondarily generalized. The results in myoclonic and akinetic types were poor to fair. Better results were also found in group with normal neurological status and in group without spikes in EEG examination. In only 2 cases had their phenobarbital discontinued due to its intolerable side effects. Otherwise, the only indication to change phenobarbital to other anticonvulsant was the persistence of seizures for more than 75%. We concluded that in spite of its disadvantages, phenobarbital is still good to be used as the first line drug in the treatment of epilepsy, especially in developing countries.

Child↗
PubMedDate not supplied

A case of Rett syndrome.

A case of Rett syndrome in a-3 1/2 year-old girl is presented. The patient had normal pre and perinatal period and normal psychomotor development till the age of 14 months, followed by behavioural, social and psychomotor regression. Physical examination revealed a below normal head circumference, loss of eye and psychic contact, stereotypic hand movements and gait disturbance. No laboratory test can confirm the diagnosis of Rett syndrome, therefore the diagnosis was established by virtue of history of illness and clinical manifestations. This is the first case of Rett syndrome found and reported in Indonesia.

Child, Preschool↗