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Biomedical subjects

W Ali

Publications and source records attributed to W Ali.

17 recordsLinked to original sources
PubMed2004

Value of D-dimers assay in diagnosis of pulmonary embolism.

OBJECTIVE: To determine the value of D-Dimers assay in the diagnosis of Pulmonary Embolism (PE) at Armed Forces Institute of Pathology, Rawalpindi, Pakistan from January to November 2000. METHODS: Forty three consecutive patients clinically suspected of suffering from pulmonary embolism and referred to Armed Forces Institute of Pathology for Ventilation-Perfusion scan of lungs were inducted in the study. A detailed history was taken and clinical examination was performed. All patients were then subjected to Perfusion and/or Ventilation scan, which was taken as the standard for the diagnosis of PE. Blood samples were collected from all patients in trisodium citrate. Platelet poor plasma obtained from the samples was tested for D-Dimers semi-quantitatively using latex agglutination method. RESULTS: Out of 43 patients 14 (32.6%) had completely normal ventilation-perfusion scan hence the diagnosis of PE was excluded. In 6 (13.9%) patients the results were considered indeterminate. Abnormalities suggestive of pulmonary embolism were detected in 23 (53.5%) patients. D-Dimers were less than the cut off value of 500 ng/ml in 19 (44.2%) patients, whereas in 24 (55.8%) the levels were more than 500 ng/ml. When compared with the results of ventilation-perfusion scan the sensitivity of D-Dimers was 91.3% and specificity was 100%. Positive predictive value of the test was 100% whereas negative predictive value was 87.5%. CONCLUSION: D-Dimers assay combined with high clinical evidence is a cost effective, readily available test which can safely exclude the diagnosis of pulmonary embolism in majority of the cases.

Adult↗
PubMed2001

Stroke in Indonesia: a first large prospective hospital-based study of acute stroke in 28 hospitals in Indonesia.

Stroke is an increasing cause of morbidity and mortality in Indonesia. Data on clinical patterns of hospitalized Indonesian stroke patients are still not available. This study is a part of ASNA (ASEAN Neurological Association) Stroke Epidemiological Stu dy aimed to investigate clinical profile of stroke in seven ASEAN countries with the same protocol. From 2065 acute stroke patients admitted to 28 hospitals all over Indonesia, the mean age was 58.8 (Standard Deviation [SD] 13.3) years (range: 18-95 year s). 12.9% were younger than 45 years, and 35.8% were older than 65 years. There were more men than women. Mean admission post-stroke time was 48.5 h (SD 98.8) (range: 1-968 h). Most of them arrived at hospital more than 6 h from stroke onset. The reasons for delayed admission were unawareness of stroke symptoms and long distance transportation. The most frequent stroke symptoms were motor disability. The most common risk factors were hypertension, heart disease, cigarette smoking and diabetes mellitus. Recurrent stroke was found in nearly 20% of patients. Ischemic stroke was the most frequent and the majority of the study subjects were discharged alive and improved.

Acute Disease↗
PubMed2000

Interferon-gamma downregulates ion transport in murine small intestine cultured in vitro.

Effects of IFN-gamma on mammalian small intestinal ion transport were studied in vitro using incubated sheets of murine small intestine in Ussing chambers. In oxygenated standard culture medium containing hydrocortisone and antibiotics, they maintained their short-circuit current (I(sc)) responses to glucose and theophylline for 48 h. Histological examination revealed a 50% diminution of villus height over 36 h but no change in crypts. Height was better maintained during a 36-h incubation of small intestine from SCID mice, suggesting a role for B or T lymphocytes in villus atrophy. Exposure of small intestine to 100 U/ml IFN-gamma for 36 h decreased basal I(sc) by 40% and I(sc) responses to glucose and theophylline by approximately 70%; at 1,000 U/ml for 36 h, IFN-gamma inhibited these I(sc) responses by 90%. An inhibitor of inducible NO synthase did not reverse these effects, suggesting that they are not mediated by NO. Tissue resistance, mucosal K(+) content, and epithelial morphology were not affected. Ouabain-sensitive ATPase activity in homogenates was inhibited 60% by IFN-gamma (100 U/ml for 36 h). IFN-gamma inhibition of I(sc) responses to glucose and theophylline also occurred in SCID mouse small intestine. Thus murine small intestinal sheets can be maintained viable in vitro for at least 48 h, although villus blunting develops (but less so in SCID mouse small intestine). Also, prolonged exposure to IFN-gamma downregulates Na(+)-coupled glucose absorption, active Cl(-) secretion, and Na(+)-K(+)-ATPase activity, effects unlikely to be mediated by enhanced NO.

Animals↗
PubMed1999

Prenatal diagnosis of haemophilia-A: a basis for the Pakistani families.

OBJECTIVE: To determine the feasibility of a PCR based strategy for prenatal diagnosis of Haemophilia-A in Pakistani Families. DESIGN: Prospective. SETTING: Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi. SUBJECTS: Five families with at least one child affected with Haemophilia-A. Each family comprised of father, mother, affected child and fetus when present. MAIN OUTCOME MEASURES: Short Tandem Repeat (STR) analysis in the Intron 22 of factor VIII gene. RESULTS: PCR based analysis of the STR in intron 22 of factor VIII gene showed that the marker was informative in 4/5 study families and could be used in these families for the prenatal diagnosis of Haemophilia-A. In two families prenatal diagnosis was carried out by Chorionic Villus Sampling at 10-13 weeks gestation and the results in both the cases showed a carrier female fetus. CONCLUSION: Linkage based prenatal diagnosis of Haemophilia-A by an intragenic STR marker is feasible in most of the Pakistani families. The long term response of the Haemophiliac families to the availability of prenatal diagnosis remains to be seen. The STR marker can also be used for carrier detection of female subjects in the affected families.

Chorionic Villi Sampling↗
PubMed1997

Duodenogastric reflux after choledochoduodenostomy.

Duodenogastric reflux (DGR) has been implicated in several disease processes. The present study was carried out to document the incidence and evaluate the clinical significance of DGR after choledochoduodenostomy (CDD). A total of 13 patients who had undergone cholecystectomy with a standard side-to-side CDD for choledocholithiasis or chronic pancreatitis were studied by symptom evaluation, scintigraphy, endoscopy, and gastric mucosal histology at least 6 months after surgery. The scintigraphic findings were then compared with those of 10 patients who had undergone cholecystectomy alone. Only two patients (15%) had mild dyspeptic symptoms. The incidence of DGR after CDD was 69% compared to 20% in the cholecystectomy alone group (P < 0.05). In the majority of patients the DGR was only mild to moderate and the severity correlated well with the degree of endoscopic gastritis, but not with the clinical symptoms or histological findings. These results indicate that while CDD is associated with a high incidence of DGR, its occurrence does not produce significant clinical symptoms.

Adult↗
PubMed1995

Serum lipid profile in children of coronary heart disease patients.

Serum lipid and lipoprotein cholesterol levels were analysed in 44 children from 5-14 years of age (index), belonging to 29 parents diagnosed as coronary artery disease (CAD). 314 children of parents without any CAD served as control. Index group had significantly (P < .05) higher levels of total cholesterol (Tch), triglycerides (TG) and very low density lipo-proteins cholesterol (VLDLc) and low levels of high density lipoprotein cholesterol (HDLc) (P < .05). Index group revealed higher levels of cholesterol, triglycerides and low density lipoprotein cholesterol in 31.8%, 6.8% and 36% cases respectively. HDLc did not show any significant variation. Index group whose parents had hypercholesteremia (Tch > 260 mg/dl) with CAD had raised levels of Tch, TG, LDLs and VLDLc when compared with control group (P < .05).

Adolescent↗
PubMed1994

Comparative evaluation of scintigraphy and upper gastrointestinal tract endoscopy for detection of duodenogastric reflux.

Duodenogastric reflux, the reflux of duodenal bile into stomach, when suspected clinically requires an objective evaluation for proper management. In this study hepatobiliary scintigraphy in 91 patients of different clinical conditions was evaluated for presence of duodenogastric reflux. Upper gastrointestinal endoscopy was also performed in 44 of these patients. On scintigraphy duodenogastric reflux was present in 26 (29%) of 91 patients. Upper gastrointestinal endoscopy revealed presence of refluxed bile in the stomach in 12 (27%) of 44 patients. In the same groups of patients scintigraphy detected reflux in 18 (41%) of 44 patients. This shows that hepatobiliary scintigraphy is superior to upper gastrointestinal endoscopy in detection of duodenogastric reflux and also has the advantage of being non-invasive and physiological.

Cholecystectomy↗
PubMed1993

Gastroduodenal tuberculosis.

Nine patients with gastroduodenal tuberculosis (GDTB) were seen over a period of 2 years at a tertiary level referral institute. Clinical presentation of GDTB is similar to that of peptic ulcer disease. Endoscopic biopsy and/or laparotomy and biopsy establish the diagnosis. Medical treatment is the mainstay of therapy, although surgical intervention may be required for the management of complications. Gastroduodenal tuberculosis should be suspected in patients, residing in areas where the disease is endemic, with a short history suggestive of peptic ulcer disease and an early onset of gastric outlet obstruction.

Adult↗
PubMed1977

Surveillance of rabies in Dacca.

A total of 977 human and animal (including livestock) cases of rabies exposure attributed to the bite of a variety of animals during a period of one year in an area covering 22 thanas has been analysed. Dog-bite, mostly from stray dogs constituted the highest risk of exposure to rabies in humans and animals including livestock. Prophylactic vaccination of pet animals including livestock and elmination of stray dogs will considerably reduce the exposure to rabies.

Adult↗
PubMedDate not supplied

Neonatal cholestasis in Kashmiri children.

Neonatal cholestasis is prolonged elevation of conjugated serum bilirubin (more than 20% of total bilirubin) beyond first 14 days of life. After extensive evaluation a diagnosis of either biliary atresia or neonatal hepatitis is made in 70-80% of cases. Neonatal hepatitis and biliary atresia form a pathophysiologic process directed at various levels of the hepatobiliary tract. Inflammation in the bile duct epithelium may result in the sclerosis and obliteration of the bile ducts and manifest as biliary atresia. Primary hepatocellular inflammation is more likely to result in neonatal hepatitis. Half of the cases of neonatal hepatitis resolve without sequelae, while most of the biliary atresia cases require surgical intervention for repair or, ultimately, liver transplant.

Asia↗
PubMedDate not supplied

Bile leak after T-tube removal--a scintigraphic study.

BACKGROUND/AIMS: A prospective study was performed to evaluate the incidence of bile leak after T-tube removal, using 99mTc labelled BULIDA scintigraphy. PATIENTS AND METHODS: Thirty seven patients with choledocholithiasis underwent choledocholithotomy and T-tube drainage. T-tubes were removed on 9--26 postoperative day (mean 13.4 days). RESULTS: Six (16%) patients had scintigraphic evidence of bile leak; 4 patients had leak demonstrated in the early phase only. One patient each had partial persistent leak and complete bile leak. All patients were managed nonsurgically; conservative treatment: (4), percutaneous drainage (PCD) of intra-abdominal collection (1) and endoscopic sphincterotomy and PCD of intra-abdominal collection (1). There was no significant difference in the leak rate when T-tubes were removed at < 2 weeks versus later than 2 weeks (P=.97). CONCLUSIONS: T-tubes should be removed with extreme caution and treatment of symptomatic patients should be guided by clinical and scintigraphic findings.

Bile↗