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Biomedical subjects

Z H Khan

Publications and source records attributed to Z H Khan.

At least 19 recordsLinked to original sources
PubMed2006

Propofol-alfentanil vs propofol-remifentanil for posterior spinal fusion including wake-up test.

BACKGROUND: Wake-up test can be used during posterior spinal fusion (PSF) to ensure that spinal function remains intact. This study aims at assessing the characteristics of the wake-up test during propofol-alfentanil (PA) vs propofol-remifentanil (PR) infusions for PSF surgery. METHODS: Sixty patients with scoliosis and candidates for PSF surgery were randomly allocated in either alfentanil (PA) or remifentanil (PR) group. After an i.v. bolus of alfentanil 30 microg kg(-1) in the PA group or remifentanil 1 microg kg(-1) in the PR group, anaesthesia was induced with thiopental and atracurium. During maintenance, opioid infusion consisted of alfentanil 1 microg kg(-1) min(-1) or remifentanil 0.2 microg kg(-1) min(-1), in the PA group and the PR group, respectively. All patients received propofol 50 microg kg(-1) min(-1). Atracurium was given to maintain the required surgical relaxation. At the surgeon's request, all infusions were discontinued. Patients were asked to move their hands and feet. Time from anaesthetic discontinuation to spontaneous ventilation (T(1)), and from then until movement of the hands and feet (T(2)), and its quality were recorded. RESULTS: The average T(1) and T(2) were significantly shorter in the PR group [3.6 (2.5) and 4.1 (2) min] than the PA group [6.1 (4) and 7.5 (4.5) min]. Quality of wake-up test, however, did not show significant difference between the two groups studied. CONCLUSION: Wake-up test can be conducted faster with remifentanil compared with alfentanil infusion during PSF surgery.

Adolescent↗
PubMed2003

Oesophageal cancer and cachexia: the effect of short-term treatment with thalidomide on weight loss and lean body mass.

BACKGROUND: Cachexia is common in patients with advanced cancer and has a direct impact on well-being and mortality. AIM: To test the hypothesis that thalidomide can promote weight gain and lean body mass in patients with advanced oesophageal cancer. METHODS: In an open-label study, 11 patients with non-obstructing and inoperable oesophageal cancer were established on an isocaloric diet for 2 weeks, followed by 2 weeks on thalidomide, 200 mg daily. The primary end-points were weight change and lean body mass. Secondary end-points were quality of life and changes in resting energy expenditure. RESULTS: Ten patients completed the study protocol. The average caloric intake remained the same throughout the study period in all patients. Nine of 10 patients (95% confidence interval, 0.60, 0.98) lost weight on diet alone. The mean weight gain on thalidomide in the following 2 weeks was 1.29 kg (median, 1.25 kg). A similar trend was shown in the lean body mass. Eight of nine patients (95% confidence interval, 0.57, 0.98) initially lost lean body mass on diet alone (missing data in one patient). The mean gain in lean body mass on thalidomide in the following 2 weeks was 1.75 kg (median, 1.33 kg). CONCLUSIONS: Thalidomide treatment appeared to reverse the loss of weight and lean body mass over the 2-week trial period.

Aged↗
PubMed2000

Electronic spectra of 1-methyl and 2-methyl phenanthrenes and their radical cations.

Electronic spectra of phenanthrene (P), 1-methyl phenanthrene (1-MeP), 2-methyl phenanthrene (2-MeP) and their monopositive ions are investigated experimentally as well as theoretically. The ions were produced by photo-oxidation of the hydrocarbons in boric acid matrix. The electronic absorption spectrum of 2-methyl phenanthrene cation (2-MeP+) is entirely new. For the interpretation of the electronic spectra of neutral and ionized MePs, semi-empirical AM1 (Austin Model 1) calculations are carried out for the first time. The bathochromic shifts in the spectral bands of the neutral and ionized MePs are attributed to 'conjugative' effect. The present experiments reveal that the 448 nm band of 1-methyl phenanthrene cation (1-MeP+) and the 486 nm band of 2-MeP+ show close matching with the respective 450 nm and 488 nm 'diffuse interstellar bands'. This suggests the possibility of the existence of such ionic species in the interstellar matter.

Cations↗
PubMed2000

Electronic absorption spectra of benzoquinone and its hydroxy substituents and effect of solvents on their spectra.

The electronic absorption spectra of 1,4-benzoquinone (BQ) and its 2,5-dihydroxy and tetrahydroxy derivatives have been studied in detail. The interpretation of the electronic bands is made on the basis of PPP and CNDO calculations. It is found that the pi --> pi* transitions are well predicted by the PPP method. The predictions of the CNDO method are however superior both in their accuracy as well as ability to predict the n --> pi* transitions. The effect of solvents on the electronic absorption bands have also been investigated in detail. Linear correlations are found between the solvent's dielectric constant and wavelength of the absorption bands. The solvent shifts are explained on the basis of the polarities of the solute and solvent molecules as well as due to hydrogen bonding.

Benzoquinones↗
PubMed2000

Retrospective case series analysis of patients with inflammatory bowel disease on azathioprine. A district general hospital experience.

OBJECTIVES: The aim of this study was to look at our practice of using azathioprine and to compare our results with those in published trials both from the point of view of response and also the side-effect profile. DESIGN: A retrospective case series analysis was done on patients with inflammatory bowel disease (IBD) who were on azathioprine at Leicester General Hospital. METHODS: 111 patients (47 males, 64 females, mean age 35.3 years) were included from gastroenterology outpatients records between November 1997 and August 1998. Clinical and demographic details were collected. Response in Crohn's disease was determined using the Harvey-Bradshaw index. In case of ulcerative colitis the following parameters were used: stool frequency; rectal bleeding, weight gain, and general well-being. Logistic regression was performed to look at the influence of age, sex and diagnosis in relation to the response/relapse rate. RESULTS: The average duration of treatment with azathioprine was 28.6 months. The starting dose of 1.53 mg/kg was similar to the maintenance dose (1.51 mg/kg). 58 patients had Crohn's disease and 53 patients were diagnosed with ulcerative colitis. 85 patients were steroid-dependent, 9 steroid-resistant, and 17 patients were started on azathioprine on the basis of extensive disease either seen at the time of endoscopy or radiologically. Improvement in clinical features at 3, 6 and 12 months was 69.5, 77 and 84.1%, respectively. 74% patients showed an improvement in relapse rates during the first year on azathioprine compared to 1 year prior to treatment. 68% patients who had shown improvement at 1 year were no longer taking steroids (p = 0.002). Logistic regression did not show any statistically significant influence of age, sex or diagnosis on response. 4.5% patients had leukopenia requiring dose reductions. Severe leukopenia (leukocyte count <2.5 x 10(9)/l) occurred in 3.6% patients. CONCLUSIONS: Response rates in our IBD patients on azathioprine are comparable with those of the published data despite using a relatively smaller dose.

Adolescent↗
PubMed1999

Anesthetic and surgical experience in a case of total vertical craniopagus.

BACKGROUND: A case of craniopagus twins is presented. The twins were attached to each other at the parietal vertex with an interaxis angle of 180 degrees and an interface angle of 90 degrees. To assess the bony, vascular, and nervous system interconnections, the twins underwent computerized tomographic scanning and cerebral angiography under inhalational general anesthesia. CASE DESCRIPTION: To provide adequate skin, tissue expanders were implanted under the scalp at 3 and 7 months of age. Separation became necessary at 1 year of age on an emergency basis, because of respiratory complications in the small twin. Profuse bleeding and hypovolemia led to the death of the healthy big twin. While one would expect that at least one of the twins could have been saved, the small twin also succumbed to air emboli and hypotension hours later. Postmortem examination revealed that the brains were joined at both medial and lateral hemispheric surfaces and shared a common circumferential sinus. CONCLUSION: This case was quite different as regards cerebral anatomy compared to those already reported in the literature.

Anesthesia, General↗
PubMed1998

Prevalence of dental caries in nursery school children of Akola city.

A study of prevalence and severity of dental caries was undertaken in seven nursery schools of Akola city in the age group of 5-6 years. A total of 508 children were examined out of which 288 were boys and 220 girls. The examination for dental caries and data collection was carried out as per W.H.O. (1987) criteria. Out of the total 508 children examined 61.41% were observed to be having caries with mean dmft/dmfs of 2.75+/-3.98 & 4.04+/-6.84 respectively. Total 17.91% school children were found to be having decay in either all upper or lower molars. In the high risk caries group 0.98% children were found to be affected with nursing caries and 0.2% children with rampant caries. Only a negligible proportion of filled teeth (1.42%) and missing due to caries (0.14%) was observed in the population. Occlusal surface caries was the most prevalent type of decay (44.71) and the mandibular deciduous second molars were the most affected by caries. Due to high prevalence of dental caries (61.41%) research must be carried out in the direction of identification of the children population at high risk of caries, so that a rigorous preventive programme be implemented.

Child↗
PubMed1998

Relationship between caries status, colony forming units (cfu) of Streptococcus mutans and Snyder caries activity test.

It is a well established fact that dental caries is caused by streptococcus mutans. For qualitative and quantitative analysis of streptococcus mutans, saliva samples are often preferred and are processed according to Kohler and Brathall method. In the present study an attempt is made to relate caries status (caries free, average caries, and rampant caries group) with cfu counts of streptococcus mutans and Snyder test. The streptococcus mutans were isolated using MSB agar and cfu were determined of each individual from different caries groups. The saliva of the same individual was drooled into a culture bottle containing Snyder test agar and extent of colour change was observed after 24, 48, and 72 hours incubated at 37 degrees C. The time and extent of colour change determined the conduciveness of diet. It has been observed that caries free individuals have low cfu count and their diet was mild or moderately conducive, while the individuals having average caries had medium cfu count and their diet was moderately-high conducive. In rampant caries, individuals however the cfu count were high and the diet was highly conducive. In caries free, average caries and rampant caries group 40, 60, and 80 per cent samples showed colour change, in Snyder test up to full length in 72 hours respectively. Thus a definite correlation exists between caries status, cfu count of streptococcus mutans and Snyder caries activity test.

Child↗
PubMed1998

Dystonic movements following thalamonal and alfentanil induction--a case report.

A 62 year old woman developed dystonic movements following induction of anesthesia with thalamonal and alfentanil. The patient remained awake during the episode. A small dose of thiopental sodium followed by succinylcholine aborted the unpleasant state. The case is being presented to emphasize the point that even small doses of opioid narcotic can cause tonic movements and frank seizures in some patients.

Alfentanil↗
PubMed1998

Artificial neural network and medicine.

The introduction of human brain functions such as perception and cognition into the computer has been made possible by the use of Artificial Neural Network (ANN). ANN are computer models inspired by the structure and behavior of neurons. Like the brain, ANN can recognize patterns, manage data and most significantly, learn. This learning ability, not seen in other computer models simulating human intelligence, constantly improves its functional accuracy as it keeps on performing. Experience is as important for an ANN as it is for man. It is being increasingly used to supplement and even (may be) replace experts, in medicine. However, there is still scope for improvement in some areas. Its ability to classify and interpret various forms of medical data comes as a helping hand to clinical decision making in both diagnosis and treatment. Treatment planning in medicine, radiotherapy, rehabilitation, etc. is being done using ANN. Morbidity and mortality prediction by ANN in different medical situations can be very helpful for hospital management. ANN has a promising future in fundamental research, medical education and surgical robotics.

Humans↗