Biomedical subjects

Y al-Gindan

Publications and source records attributed to Y al-Gindan.

13 recordsLinked to original sources

PubMed1997

Treatment of cutaneous leishmaniasis with antimony: intramuscular versus intralesional administration.

The various methods used to treat cutaneous leishmaniasis (CL) have not given consistent results. The aim of the present study was to compare the efficacy of a solution of meglumine antimoniate (MA; 85 mg Sb/ml) given intralesionally (i.l.) with that of the same solution given intramuscularly (i.m.). Eighty CL patients, with a total of 147 lesions, were randomly allocated into the two treatment groups. Forty were injected i.m. with MA (15 mg Sb/kg.day) on 6 days/week until 12 injections had been given to each. The lesions of the other 40 patients were infiltrated with MA (0.2-0.8 ml/lesion) every other day for 30 days. After 15 days' therapy, none of the lesions on those treated i.m. had fully healed (although five lesions showed some improvement) whereas two lesions on those treated i.l. had fully healed and 10 showed good improvement. After 30 days, 46 (68%) of the 68 lesions on those treated i.m. had healed completely, 11 (16%) had improved, and five (8%) worsened. The corresponding values for the 66 lesions on those treated i.l. were 48 (73%), 10 (15%) and three (5%). There was no statistically significant difference between the two treatment groups, either in terms of satisfactory response (lesions fully healed or improved) or unsatisfactory response (lesions unchanged or advanced), when assessed on day 30 (P > 0.5). Intralesional antimony is a rapidly effective, safe and economical method of treating simple CL, particularly in patients with cardiac, liver or renal disease, for whom antimonials are contra-indicated.

Adolescent↗

PubMed1995

A randomized, double-blind, clinical trial of topical clotrimazole versus miconazole for treatment of cutaneous leishmaniasis in the eastern province of Saudi Arabia.

The parenteral treatment currently available for cutaneous leishmaniasis (CL) is painful and potentially exposes patients to serious side effects. Thus, effective, topical therapy would be valuable. We assessed the efficacy of topical 1% clotrimazole and 2% miconazole creams in relation to early healing of lesions in CL in a randomized, double-blind clinical trial in 54 patients with 151 lesions treated for 30 consecutive days. Response to treatment was assessed at two weeks and 30 days and classified as fully healed, size reduced, no change, and size increased or worse. Of 89 lesions treated with clotrimazole, 14 (15.7%) healed fully, 42 (47.2%) were reduced in size, 20 (22.5%) showed no change, and 13 (14.6%) got worse. Correspondingly, in the 62 lesions treated with miconazole, none healed fully, 22 (35.5%) were reduced in size, 16 (25.8%) showed no change, and 24 (38.7%) got worse. The differences were statistically significant (P < 0.001). No side effects were observed. It is concluded that clotrimazole was the more effective of the two imidazoline compounds and is recommended as initial treatment for simple lesions.

Administration, Topical↗

PubMed1994

Pattern of chronic liver disease in the eastern province of Saudi Arabia. A hospital-based clinicopathological study.

During the period 1982-1990, 544 patients with clinical evidence of liver disease were admitted to King Fahd University Hospital, Al-Khobar, Saudi Arabia. Besides routine laboratory and sonographic investigations, all were subjected to either a needle liver biopsy, laparoscopy or a laparotomy. The tissue diagnoses were as follows: liver cirrhosis 17.3%, periportal fibrosis 14.3%, metastatic cancer 12.9%, primary hepatoma (hepatocellular carcinoma: HCC) 12.1%, hepatic granuloma 11.2%, chronic active hepatitis 7.7%, chronic persistent hepatitis 2.2%, fatty liver 7.2%, hydatid liver disease 4.6% and others 2.8%. In 7.7% the histology was normal. These results will be discussed and compared with results reported in local and international literature.

Chronic Disease↗

PubMed1992

Subacute toxicity of pentavalent antimony compounds in rats.

A subacute toxicity study of pentavalent antimony (Sb) compounds, sodium stibogluconate (SSG) and meglumine antimoniate (MA) was carried out in rats. Three groups of 10 rats each were treated with saline (control group), 300 mg Sb kg-1 d-1 or 900 mg Sb kg-1 d-1 of SSG for 30 d. A parallel study of similar type was conducted for MA. Compared with controls, drug-treated rats showed an impairment of feeding habits and retardation of weight gain (P less than 0.01) during the treatment period. In both SSG- and MA-treated rats there was a dose-related reduction in haemoglobin concentration (P less than 0.001), and hematocrit (P less than 0.001). Red cell count was reduced in SSG-treated rats only. Both drugs, however, significantly raised the white cell count (P less than 0.05). These changes were more pronounced with SSG them with MA. There was no change in MCV, MCH and MCHC. SSG, 900 mg Sb kg-1 d-1, significantly raised AST (P less than 0.005), ALT (P less than 0.01) and alkaline phosphatase activity (P less than 0.01). SSG-treated rats also had raised BUN (P less than 0.01) and creatinine (P less than 0.001), but no significant change in bilirubin levels. MA significantly raised AST (P less than 0.01), ALT (P less than 0.01), BUN (P less than 0.001) and serum creatinine levels (P less than 0.001), but had no appreciable effect on bilirubin and alkaline phosphatase levels. Both SSG and MA decreased blood glucose levels (P less than 0.01) and induced proteinuria.(ABSTRACT TRUNCATED AT 250 WORDS)

Alkaline Phosphatase↗

PubMed1992

Evaluation of topical ketoconazole in cutaneous leishmaniasis.

The efficacy of topical ketoconazole in cutaneous leishmaniasis (CL) caused by L. major was assessed in an open trial. Ten patients with twenty two lesions of CL, confirmed by smear/or biopsy, were recruited into the study. Of the twenty two lesions treated, three increased in size and lesion characteristics worsened, ten showed no change but in nine there was some improvement in lesion characteristics. No lesion healed completely. No side effects were reported in nine. Topically applied ketoconazole is safe but does not significantly alter the course of CL. The differences in the results of systematically administered and topically applied ketoconazole may be due to differences in the pharmacokinetics of the drug when it is administered by different routes.

Administration, Oral↗

PubMed1990

Oesophageal diseases diagnosed by upper gastrointestinal endoscopy in the eastern province of Saudi Arabia.

Upper gastrointestinal endoscopy was performed on 2982 patients who presented with symptoms and signs related to the upper gastrointestinal tract. Of all these patients, 743 (25%) had the pathology limited to the oesophagus with a normal stomach and duodenum. These 743 patients constituted the material for this study. Of all oesophageal diseases, the most frequent endoscopic diagnosis was mild or moderate oesophagitis occurring in 350 patients (47%). Hiatal hernia with oesophagitis occurred in 232 (31%), oesophageal varices in 87 (12%) and ulcerative strictures in 74 patients (10%). Further histopathological examination of oesophageal biopsies from the latter 74 patients confirmed oesophageal carcinoma in 27 (3.7%), ulcerative oesophagitis in 43 (5.8%) and tuberculous oesophagitis in 4 patients (0.5%). The endoscopic and pathologic findings of these patients are presented and discussed.

Adolescent↗

PubMed1990

Helicobacter pylori-associated upper gastrointestinal disease in Saudi Arabia: a pathologic evaluation of 298 endoscopic biopsies from 201 consecutive patients.

In a prospective study, histopathological examination 298 upper gastrointestinal (UGI) biopsies, obtained from 201 consecutive patients, was made. Patients were referred with mild to severe dyspeptic symptoms. The aim of the study was to compare the rate of identification of Helicobacter pylori (H. pylori) in the histologically normal gastric mucosa with that in histologically confirmed gastritis or peptic ulcer disease. The gastroduodenal mucosa was histologically normal in 35 patients (17.4%); among those patients, H. pylori was identified in only three (9%). Chronic gastritis was histologically confirmed in 162 patients (80.6%). H. pylori was identified in 123 (76%) of those patients. The difference was statistically significant (p less than 0.00001). Furthermore, when cases with a histological diagnosis of superficial chronic active gastritis (SCAG) are considered separately, the identification rate of H. pylori increases to 88% (121 of 137). When this rate is compared with that of 8% (two of 25), found in superficial chronic quiescent gastritis (SCQG), the difference is highly significant (p less than 0.00001). Of 38 endoscopically diagnosed peptic ulcers, H. pylori was identified in the gastric mucosa of 34 (89%). The organisms were always seen in the antral gastric mucosa, but never in duodenal mucosa. Identification of H. pylori correlates significantly with the histologic activity of chronic gastritis, in both peptic ulcer disease and non-ulcer dyspepsia.

Adolescent↗

PubMed1989

Peripheral neural involvement in cutaneous leishmaniasis. A pathologic study of human and experimental animal lesions.

Peripheral neural involvement in cutaneous leishmaniasis has recently been recognized. A man presented with several tender hyperesthetic skin nodules. Histopathologic examination confirmed the diagnosis of cutaneous leishmaniasis. Of most interest was the presence of a striking lymphohistocytic inflammatory infiltrate around and within cutaneous nerves in addition to demonstrable leishmania organisms in the perineural space. This observation led to a detailed histopathologic evaluation of leishmanial skin lesions that developed in 13 mice after subcutaneous injection with leishmania major promastigotes. Varying degrees of neural involvement was noted in skin lesions from nine animals. In some lesions, in addition to inflammatory cells in the nerves, organisms were demonstrable within probable schwann cells. Three pathologic stages of dermal neural involvement were identified, namely, an early, intermediate, and late stage, depending on the severity of damage; however no correlation was found between the pathologic stage and the duration of the leismanial skin lesion of a specific animal.

Adult↗

PubMed1989

Dissemination in cutaneous leishmaniasis. 3. Lymph node involvement.

In a study of zoonotic cutaneous leishmaniasis (CL) due to leishmania major in an endemic focus in Saudi Arabia, lymph node enlargement was observed in 66 of 643 patients (10.26%). The epitrochlear lymph nodes were most commonly involved (68%), but cervical (11%), axillary (15%), and inguinal (18%) lymph nodes were also involved. In eight patients (12%), two lymph node areas were involved. The affected lymph nodes were typically solitary, firm, mobile, nontender, only moderately enlarged, and appeared to persist beyond the clinical healing of the associated skin lesions. The results of pathologic and immunopathologic studies carried out on eight lymph nodes obtained from this group of patients supported the leishmanial etiology. Although amastigotes were only demonstrated in two lymph nodes, the leishmanial antigen was found in all eight specimens. The lymph node involvement is another manifestation of dissemination in infection with a dermotropic leishmania. It appears that in some cases, instead of the parasite, it may be the leishmanial antigen that disseminates and produces lymphadenitis.

Adolescent↗

PubMed1989

Campylobacter pylori in Saudi patients undergoing upper gastrointestinal endoscopy: prevalence and effect of conventional therapy.

Patients with symptoms of gastritis or peptic ulcer disease were recruited to study the prevalence of Campylobacter pylori. On the basis of the endoscopic diagnosis only, the isolation rates of the organisms in normal, gastritis or gastroduodenitis (GD), and peptic ulcer (PU) disease patients, were not significantly different among the 89 patients evaluated. However, analysis based on histopathological evaluation (in 73 out of these 89 patients) revealed a significant difference (p = 0.00016) in the isolation rate between histologically normal individuals (14%) and those with GD (89%). Also, a significant (p = 0.03) difference was observed in the C. pylori detection rate among patients with GD and those with PU disease (61%). After adjustment for multiple comparisons, only the difference in C. pylori prevalence between normal and GD patients was maintained. After conventional therapy, 23 patients who initially had GD or PU disease were submitted to re-endoscopy. In the latter group, a correlation between presence or absence of organisms and histological healing was noted. The potential pathogenesis of C. pylori in gastritis and peptic ulcer disease, and designs for future trials are discussed.

Adult↗

PubMed1988

Dissemination in cutaneous leishmaniasis. II. Satellite papules and subcutaneous induration.

In a field study of cutaneous leishmaniasis (CL) due to Leishmania major, zymodeme Lon-4, in an endemic focus in Saudi Arabia, 80 patients in a group of 643 patients (12.44%) were found to have multiple, inflammatory, satellite papules (SP) around one or more CL lesions. The SP often appeared to erupt after commencement of antileishmanial treatment. They showed a range of morphology and pathology, and comparisons with corresponding CL lesions showed important differences. Amastigotes were seen in only one of seven biopsy specimens. Another morphologic feature, subcutaneous induration (SCI), was noted on routine palpation in 20 patients in the same patient group (3.11%). The SCI either was radiating all around the lesion and appeared as an "iceberg nodule" or was present as a "tonguelike" process proximal to the CL lesion. Amastigotes were seen in four of nine biopsy specimens of SCI. SP and SCI represent reactions to local dissemination of the parasite or its antigenic products, and as morphologic features aid in the clinical diagnosis of CL.

Humans↗

PubMedDate not supplied

Zoonotic cutaneous leishmaniasis in Saudi Arabia: results of a preliminary epidemiological survey in Al-Ahsa oasis.

This paper reports the results of a cross-sectional survey of lesions (active cases) and scars (past cases) of zoonotic cutaneous leishmaniasis (ZCL) carried out in 1986 in 2 villages in the eastern region of Al-Ahsa oasis in Saudi Arabia. The epidemiological pattern of ZCL was strikingly similar in both villages. Overall, 2.8% residents were found to have lesions. Only 3.7% were found with scars, presumably due to under-recording. The age distribution of lesions was bimodal, the number of cases being highest in the age-groups 0-3 and 24-27 years. The sharp fall between 3 and 15 years in the number of persons with lesions is typical of an active endemic infection which induces long-lasting immunity. The exceptional number of active adult cases were predominantly non-Saudi males. Infected non-Saudis also contributed substantially to statistically significant clustering of case in households and influenced the sex ratio of cases. More active cases were found in males than in females, and more active cases were male than were past cases. In 1985, residents reported a broad peak in the monthly discovery of lesions--from July to February. Interpretation of the available information was limited because it was not possible to standardize the data for age and sex.

Adolescent↗

PubMedDate not supplied

Pattern of upper gastrointestinal disease in the eastern province of Saudi Arabia. Endoscopic evaluation of 2,982 patients.

The records of 2,982 patients who were subjected to upper gastrointestinal (UGI) endoscopy were retrospectively analyzed. All patients were seen at King Fahd Hospital of the University, Al-Khobar during the period 1982-1986. All were adult patients with a mean age of 46 years, of whom two thousand nine (67.4%) were males. The commonest endoscopic diagnosis was chronic gastritis (21.4%) followed by duodenal ulcer (17%) and chronic oesophagitis (11.7%). Of 1,256 biopsied patients a 'histologically normal' diagnosis was obtained in 565 (45%) from all sites. However, chronic non-specific superficial gastritis (22.6%) followed by chronic duodenitis (17.5%) constituted the two commonest histological diagnoses. Helicobacter pylori was identified histologically on the gastric mucosa of 72% of patients with superficial chronic active gastritis, with or without associated peptic ulcer disease. Duodenal ulcers followed by oesophageal varices were the two commonest diagnoses encountered in 200 patients presenting with UGI bleeding. These results are discussed and compared to those of other studies.

Chronic Disease↗