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Biomedical subjects

Z Abbas

Publications and source records attributed to Z Abbas.

8 recordsLinked to original sources
PubMed1992

Randomised comparison of oral ofloxacin alone with combination of parenteral antibiotics in neutropenic febrile patients.

Prompt treatment with empirical antibiotics in neutropenic febrile patients reduces morbidity and mortality. Most patients have been treated with parenteral combination antibiotics, but newer antibiotics with broad-spectrum bactericidal activity have made monotherapy feasible. Ofloxacin, a broad-spectrum fluoroquinolone, has the additional advantage that bactericidal concentrations can be achieved with oral administration. We have compared ofloxacin as an oral single agent with standard parenteral combination antibiotics for the management of neutropenic febrile patients in a prospective, randomised trial. Patients with severe neutropenia (absolute neutrophil count less than or equal to 0.5 x 10(9)/l), fever above 38 degrees C, and ability to take drugs by mouth were eligible for the study. After initial investigations, 60 patients were randomly assigned to oral ofloxacin 400 mg twice daily and 62 to parenteral combination antibiotic therapy (amikacin 15 mg/kg daily, plus, at various times in the trial, carbenicillin, cloxacillin, or piperacillin). Patients were examined 72 h and 7 days after the start of treatment and when neutropenia resolved. 24 (40%) ofloxacin-treated and 26 (42%) combination-treated patients had pyrexia of unknown origin (PUO). In both treatment groups, the treatment success rate was higher for such patients than for those with clinically or microbiologically documented infections (92% vs 67% [p less than 0.05] for ofloxacin; 85% vs 64% for combination). There were no significant differences in success rates of ofloxacin and combination treatment for these subgroups or overall (77% vs 73%). Patients with neutropenia for less than 1 week had better responses to both treatments than patients with longer-lasting neutropenia. There were 4 (7%) deaths in the ofloxacin group and 6 (10%) in the combination group. Both regimens were well tolerated. We conclude that oral single-agent ofloxacin is as effective as parenteral combination antibiotic therapy in neutropenic febrile patients, especially those expected to have short durations of neutropenia.

Administration, Oral↗
PubMed1992

Prognostic factors in ganglionic and thalamic haemorrhages: a clinical and radiological study.

Clinical and radiological features of 43 patients admitted for ganglionic (21) and thalamic (22) haemorrhages were studied to ascertain the factors that would determine prognosis in the acute stage of the illness. Nineteen patients died, 16 of them in the first week. The adverse clinical factors were an altered state of consciousness, decorticate/decerebrate posturing, ataxic respiration, abnormalities of gaze and presence of bilateral Babinski's sign. Adverse radiological factors were the presence of thalamic haemorrhage of 3 cm or more, intraventricular spread of the haemorrhage and midline shift of 0.5 cm of more. The significance of these findings is discussed.

Acute Disease↗
PubMed1991

Yet another cause of chronic viral hepatitis?

The clinical features, course and histology of liver in 20 patients; mostly middle aged to elderly females, closely resembling chronic Non A Non B hepatitis is presented. They presented quite late in their disease and therefore, complications such as variceal bleeds, ascites and encephalopathy were frequent. Our patients were negative for hepatitis B and C virus serology. Metabolic and immune causes of chronic liver disease were also ruled out. To the best of our knowledge, this is the first study of its kind elaborating the clinical features, course and histology of liver in chronic Non B Non C hepatitis and raises a number of questions as to the nature of the infecting virus and the epidemiology of disease.

Chronic Disease↗
PubMed1991

Supervised training of practical procedures in the internal medicine residency.

In order to get feedback whether the medical residents are getting adequate supervised training to perform practical procedures, a questionnaire was distributed among the residents asking their involvement in sixteen frequently performed procedures in the medical unit of the Aga Khan University Medical Centre. Though the residents were satisfied about their training in doing lumbar punctures, pleural and peritoneal aspirations, bone marrow aspiration and trephine and chest tubes placement, they showed their concern about training in putting central lines, venous cut downs, cardiac pacing and biopsies. A better schedule training programme, organized subspecialty rotation, continuous evaluation of resident's skill, credentialing procedures and willingness on the part of faculty to teach and residents to learn may improve the training.

Internal Medicine↗