PubMed Health⌕ Search

Biomedical subjects

S Mirza

Publications and source records attributed to S Mirza.

54 records · Page 3Linked to original sources
PubMed1999

Type 2 diabetes: one disease, multiple cardiovascular risk factors.

Type 2 diabetes mellitus is a major independent risk factor for coronary artery disease. Atherosclerosis accounts for about 80% of all deaths from type 2 diabetes, of which roughly 75% are attributable to coronary artery disease and the remainder to cerebrovascular or peripheral vascular events [1]. The earlier onset and accelerated course of atherosclerosis in individuals with type 2 diabetes mellitus is multifactorial. Type 2 diabetes is associated with abnormalities in lipoprotein metabolism and increased propensity for oxidative damage. The hyperglycemia of patients with type 2 diabetes, in itself, may accelerate vascular damage. Type 2 diabetes is a hypercoagulable state attributable to enhanced coagulation and decreased fibrinolysis, as well as platelet hyperaggregability and endothelial dysfunction. Hypertension is common in individuals with type 2 diabetes and has a major impact in the accelerated atherosclerosis of this disease. This review provides an overview of selected aspects of these alterations.

Arteriosclerosis↗
PubMed1999

Anterior cortical allograft in thoracolumbar fractures.

A prospective cohort study of consecutive patients with thoracolumbar fractures from two centers was conducted to evaluate the use of cortical allograft for anterior spine reconstruction. The purpose was to determine whether allograft bone had deleterious effects on fusion rates and maintenance of correction. Thirty-six patients were followed for a minimum of 2 years. A radiologic fusion rate of 81% was found, and there was a loss of postoperative correction in eight patients. The addition of posterior instrumentation was not significantly different from anterior surgery alone with respect to union rates but did provide a more reliable maintenance of correction of deformity. There were no cases of disease transmission. The authors conclude that cortical allograft for anterior spine reconstruction in trauma is safe and despite having a fusion rate lower than autogenous iliac crest, little clinical significance is attributable to the radiologic appearance of nonunion at the host-allograft junctions.

Adult↗
PubMed1998

Outbreak of Crimean-Congo haemorrhagic fever in Quetta, Pakistan: contact tracing and risk assessment.

In December 1994 in a private hospital in Quetta, Pakistan, 3 health-workers contracted Crimean-Congo haemorrhagic fever (CCHF) after surgery on a bleeding patient who later died. We conducted a retrospective study to determine transmission risks among contacts. Fifty contacts gave blood for antibody tests and answered questions about exposure. Two of four people exposed percutaneously and one of five with cutaneous exposure contracted CCHE The person with cutaneous exposure was a surgeon who tore his glove during surgery and noted blood on his hand but no cut. There were no anti-CCHF antibodies or CCHF cases among persons whose skin came into contact with body fluids other than blood (0/4), who had skin-to-skin contact (0/16) with patients or were physically close to them (0/21). Three index case relatives reported that although 10 family members had cutaneous exposure, none developed CCHF. The family refused blood tests. CCHF transmission in resource-constrained settings can be limited by focusing on avoiding health worker contact with blood.

Disease Outbreaks↗
PubMed1998

Detection of Mycobacterium tuberculosis in paraffin embedded intestinal tissue specimens by polymerase chain reaction: characterization of IS6110 element negative strains.

Tuberculosis is still one of the most widespread infection known to mankind. Although lung is the predominant site of disease, a sizeable population in Pakistan gets intestinal disease. Clinical presentation, radiologic and endoscopic examination provide clues to the diagnosis. However, a definitive diagnosis requires biopsy material with granulomas and/or caseation complemented by acid fast staining and culture. There are many occasions when biopsy material is scanty and even in some intestinal resection cases histologic evaluation fails to confirm or rule out tuberculosis. Therefore, an investigation was conducted to assess the efficacy of PCR in the detection of mycobacterial DNA in paraffin embedded intestinal tissue. In this study 12 histologically confirmed cases of intestinal tuberculosis and 2 cases with non specific inflammation but clinically suspected for abdominal tuberculosis were selected. One case of rectal polyp was included to serve as a negative control. M. tuberculosis DNA was amplified in 8 out of 12 histologically confirmed cases and in 2 cases diagnosed with non specific inflammation. Amplified products were obtained in 6 out of 10 PCR positive specimens with IS6110 region specific primers while 4 samples were negative, suggesting the absence of insertion sequence 6110 in these strains. However, amplification was obtained in these negative specimens with a second primer pair confirming them as M. tuberculosis complex species. On the basis of this study we conclude that; (1) Processed and paraffin embedded tissue material is suitable for PCR analysis, (2) PCR assay can be used to complement the diagnosis of intestinal tuberculosis especially in situations where a definite conclusion can not be drawn by conventional methods, (3) M. tuberculosis species lacking insertion sequence 6110 element are present in our population. Therefore, several primer pair sets should be included when applying PCR for the detection of mycobacterial DNA.

Adult↗
PubMed1996

A whole blood assay for platelet HPA1 (PLA1) phenotyping applicable to large-scale screening.

Any future programme of antenatal screening of pregnancies for risk of neonatal alloimmune thrombocytopenia will have as a major requirement the availability of cost-effective assays which can be applied to large numbers of samples. To address this, we developed a competitive ELISA to type whole blood samples for the platelet alloantigen HPA1a, based on the use of purified glycoprotein (GP) IIb/IIIa from donors of known HPA1 genotype along with well characterized anti-HPA1a antiserum. Microtitre plates were coated with purified GPIIb/IIIa from donors of genotype HPA1a1a/3a3a. Anticoagulated whole blood of unknown HPA1 type was added to each well followed by anti-HPA1a. Residual antiHPA1a antibody not bound to the platelets in the test blood sample, bound to the immobilized HPA1a on the plate and was quantitated by standard ELISA. 475 blood donors were typed by the assay and the results compared in a blinded comparison with typing in the Capture-Ptm assay. Concordance was 100% (468 HPA1a positive and seven HPA1a negative). The HPA1 type of control samples stored as whole blood could be discriminated by this assay for up to 23 d of storage at 4 degrees C. This assay should be suitable for use in large-scale population screening programmes.

Antigens, Human Platelet↗
PubMed1995

Crimean Congo-haemorrhagic fever treated with oral ribavirin.

Crimean-Congo Haemorrhagic Fever (CCHF) is an often-lethal haemorrhagic fever caused by a tick-borne virus. There are no published data on ribavirin treatment of CCHF-infected patients, despite established in-vitro and in-vivo sensitivity. We report three health workers--two surgeons and a hospital worker--infected with CCHF virus in Pakistan who were treated with oral ribavirin 4 g/day for four days, then 2.4 g/day for six days. Intravenous ribavirin was unavailable. All three patients were severely ill with low platelet and white-cell counts, raised aspartate transaminase and evidence of impaired haemostasis. Based on published reports, all had an estimated probability of death of 90% or more. The patients became afebrile, and their haematological and biochemical abnormalities returned to normal within 48 h of ribavirin treatment; all made a complete recovery, and developed IgG and IgM antibody to CCHF virus. Our experience with ribavirin treatment is encouraging, but does not constitute evidence of efficacy. Given the difficulties in gathering adequate treatment data, we propose a consensus protocol for both intravenous and oral treatment of CCHF. This protocol could be distributed to key medical personnel in areas endemic for CCHF and used to provide a firm basis for effective treatment recommendations.

Acute Disease↗
PubMed1995

Morbid jealousy in alcoholism.

BACKGROUND: Morbid jealousy is an incompletely understood syndrome. The association between morbid jealousy and alcoholism is unclear. METHOD: Morbid jealousy was assessed in 207 male patients with alcohol dependence (DSM-III-R) using a semi-structured interview schedule administered both to patients and their spouses. RESULTS: Thirty-four per cent (71 out of 207) suffered from morbid jealousy. Morbid jealousy had different manifestations. Some patients expressed it only when intoxicated, others even when sober and in some the jealousy took the form of a delusional disorder. CONCLUSIONS: Alcoholism appears to have an aetiological role in the development of morbid jealousy. Detecting morbid jealousy when it is expressed only under the influence of alcohol has preventive implications.

Adult↗
PubMed1991

The Bradford Somatic Inventory. A multi-ethnic inventory of somatic symptoms reported by anxious and depressed patients in Britain and the Indo-Pakistan subcontinent.

In the development and evaluation of a multi-ethnic inventory (the BSI) of somatic symptoms associated with anxiety and depression, symptoms were derived from psychiatric case notes of Pakistani and indigenous British patients with a clinical diagnosis of anxiety, depression, hysteria or hypochondriasis. The inventory was constructed simultaneously in Urdu and English. A pilot version of the BSI was checked against psychiatric case notes in north and south India, and Nepal. The revised BSI achieved over 90% coverage of all somatic symptoms recorded in each centre. The linguistic equivalence of the Urdu and the English versions was established in a bilingual student population in Pakistan. Conceptual equivalence of the BSI was explored using factor analysis of responses by functional patients presenting to medical clinics in Britain and Pakistan. Four principal factors (head, chest, abdomen, fatigue) were similar in both populations.

Adult↗
PubMedDate not supplied

Expansion of epidemic dengue viral infections to Pakistan.

OBJECTIVES: Antibodies to dengue viruses have occasionally been reported in individuals in Pakistan, but the frequency of occurrence of dengue infection in Pakistan is unclear. The first confirmed dengue hemorrhagic fever outbreak in Pakistan occurred in 1994. In October 1995, the authors investigated an outbreak of a febrile illness among employees of a construction contractor at a power generation plant in Baluchistan, Pakistan, to determine the cause of illness and recommend appropriate preventive measures. METHODS: The work site and living arrangements were inspected, a questionnaire was administered, and serum samples were collected from all consenting contractor employees and their families if they lived at the camp. Sera were analyzed for IgM against dengue virus, using an enzyme-linked immunosorbent assay. RESULTS: Interviews were conducted with 76 persons (mean age, 42y); 95% were men. Forty-two persons (55%) reported having experienced fever, headache, or myalgia in the preceding 6 weeks. Fifty-seven subjects (75%) had IgM antibodies against at least one dengue serotype; 45 subjects (59%) had IgM antibodies against dengue serotype 2. CONCLUSION: This was an outbreak of dengue fever due to multiple serotypes of dengue virus. This confirms that epidemic dengue infection was present in southern Pakistan for 2 consecutive years.

Adult↗
PubMedDate not supplied

Lacrimal gland abscess: an unusual complication of rhinosinusitis.

We report the case of a 72-year-old female suffering from mild myelodysplasia who initially presented with a peri-orbital cellulitis secondary to rhinosinusitis. The pre-septal infection failed to completely resolve despite intensive antibiotic therapy and endoscopic drainage of the sinuses. Computerised tomography revealed a complicating suppuration of the lacrimal gland. Incision and drainage of the lacrimal gland abscess led to a complete resolution of the pre-septal cellulitis. Suppuration of the lacrimal gland is, as far as we are aware, a previously unreported complication of rhinosinusitis. Its presence could be borne in mind when evaluating computerised tomography scans of patients presenting with orbital complications of sinusitis, particularly in the immunocompromised.

Abscess↗
PubMedDate not supplied

Extensive tension pneumocephalus complicating continuous lumbar CSF drainage for the management of CSF rhinorrhoea.

We report a case of tension pneumocephalus developing after a continuous lumbar CSF drain had been inserted for the treatment of CSF rhinorrhoea following translabyrinthine removal of a vestibular schwannoma. Despite conservative management, the patient developed recurrent CSF rhinorrhoea and hydrocephalus requiring explorations of the petromastoid cavity, an external ventricular drain and eventually a lumbar-peritoneal shunt. The prevention and management of pneumocephalus secondary to continuous lumbar CSF drainage is briefly reviewed.

Aged↗