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Biomedical subjects

Z Morad

Publications and source records attributed to Z Morad.

35 records · Page 2Linked to original sources
PubMed1994

Computed tomography and ultrasonography: a comparative study in the diagnosis of analgesic nephropathy.

Computed tomography (CT) and ultrasonography (US) were performed in 40 patients who had consumed excessive quantities of analgesics (> 1 kg) to compare their value in the diagnosis of analgesic nephropathy (AN). The computed tomography and sonographic features were renal papillary calcifications. Renal papillary necrosis (RPN) was documented in 20 of 40 patients by US and in 14 of 40 patients by CT. In 11 patients, both US and CT were positive. In 9 patients, US was positive whilst CT was negative. In 3 patients, CT was positive whilst US was negative. Prevalence of RPN was 50% using US and 35% using CT. Using US as a gold standard, sensitivity of CT was 55%, specificity 85%, positive predictive value 78.6% and negative predictive value 34.6%. Percent agreement with CT and US was 70%. Cohen's kappa statistic adjusting for chance agreement was 40%. Based on these results, it is found that US yielded a higher percentage of positive cases of RPN.

Adult↗
PubMed1993

Urinary erythrocyte morphology as a diagnostic aid in haematuria.

The value of urinary erythrocyte morphology in diagnosing glomerular and nonglomerular haematuria was studied using phase contrast microscopy in 105 patients with significant haematuria. Fifty-eight (93.6%) out of 62 patients with glomerulonephritis had dysmorphic erythrocytes and 40 (93.1%) out of the 43 patients with nonglomerular disease had isomorphic erythrocytes in the urine. A mixed picture of glomerular and nonglomerular haematuria was seen in 5 patients. The sensitivity was 93.6%, the specificity was 97.7% and the positive predictive value was 98.3% for glomerulonephritis in patients with dysmorphic haematuria. The positive predictive value for a nonglomerular source of bleeding was 96.7% with isomorphic haematuria. It is concluded that phase contrast microscopic examination of erythrocytes in urine is a simple, inexpensive and noninvasive technique that reliably distinguishes between glomerular and nonglomerular bleeding in patients.

Erythrocyte Count↗
PubMed1991

Asymptomatic proteinuria and/or haematuria in 265 Malaysian adults.

Two-hundred and sixty-five patients with asymptomatic proteinuria and/or haematuria were studied at the Department of Medicine, Universiti Kebangsaan Malaysia and Department of Nephrology, General Hospital Kuala Lumpur. They represented 25.4% of all the renal biopsies performed during the period 1980-88. All the three races were affected with 71.3% occurring between the ages of 20-39 years and 41.1% were detected during routine medical examination. Excluding those patients with lupus nephritis, IgA nephropathy was the commonest histological diagnosis (51.7%). The presence of severe and advanced histological changes in a significant number of biopsies emphasises the need for more effective screening and early referral of this group of patients.

Adolescent↗
PubMed1990

Cryptococcosis in a renal unit.

Cryptococcosis is a known opportunistic infection in immunosuppressed hosts. We report our experience of all cases presenting to our Department between December 1975 and September 1988. Eight post-renal transplant patients and three systemic lupus erythematosus (SLE) patients were affected. All were receiving treatment with steroids, in association with either azathioprine or cyclosporin. The diagnosis of cryptococcal meningitis was initially based on a positive cerebrospinal fluid (CSF) cryptococcal antigen, by latex agglutination test, and subsequently confirmed by cultures. Common clinical presentations, in descending order of frequency, included headaches, fever, mental confusion, epilepsy and papilloedema. Meningism was not a prominent feature. CT brain scans were obtained in eight patients and one showed a focal lesion and one showed cerebral atrophy. Four patients also had an abnormal chest X-ray (CXR) and one had disseminated cryptococcosis. Amphotericin and 5-fluorocytosine were the mainstay of therapy, although ketoconazole alone was subsequently used in three selected patients with cure. Four early deaths occurred in patients with delayed diagnosis and treatment, usually in association with other severe concurrent infections. We conclude that awareness of cryptococcosis is essential in immunocompromised hosts presenting with headache with, or without, mental confusion or fever.

Adolescent↗
PubMed1990

Spectrum of nocardiosis in renal patients.

Nocardiosis is an increasingly recognised opportunistic infection in immunologically incompetent hosts but diagnosis is often delayed. Between December 1975 to October 1988, our two Nephrology Units have encountered five cases of nocardiosis occurring in two post-renal transplant patients, two patients with systemic lupus erythematous (SLE) and one patient with mesangiocapillary glomerulo--nephritis. All were on immunosuppressants at the time. The first three patients presented with predominant pulmonary disease and were cured by combined trimethoprim-sulphamethoxazole (cotrimoxazole) and doxycycline therapy. The patient with limited skin involvement responded to cotrimoxazole alone. However, the last patient with lymphocutaneous disease initially responded to cotrimoxazole (+ chloramphenicol) but developed acute-on-chronic renal failure and relapsed with dose reduction of cotrimoxazole. Alternative treatment with amikacin and doxycycline was instituted with good response. We shall review potential clues that may suggest the diagnosis of nocardiosis and discuss other effective antimicrobial agents.

Adolescent↗
PubMed1989

Subclavian catheters as temporary vascular access.

We reviewed our experience with subclavian vascular catheters (SVC) as temporary vascular access in the 18 month period 1 January 1984-30 June 1985. 37 consecutive patients using 49 vascular catheters received a total of 461 haemodialyses. Only 8 patients had acute renal failure. The rest were endstage renal failure (ESRF) patients awaiting definitive vascular access. Most of these latter patients were ambulant and were generally dialysed on an outpatient basis. 27 episodes of clinical septicaemia occurred and was the ONLY significant complication encountered. All but one patient responded to empiric therapy with cloxacillin +/- gentamicin and removal of the catheter. We conclude that SVC's are safe and suitable for use on an extended short-term basis especially in ESRF patients with vascular access problems.

Acute Kidney Injury↗
PubMed1988

Tuberculosis in living related donor renal transplant recipients.

Ten out of 237 patients who underwent renal transplantation between 1975 and October 1986 developed tuberculosis. Most patients presented with vague symptoms, and typical symptoms commonly associated with tuberculosis were not common. Six had positive urine cultures. One patient had positive sputum and urine cultures and one had positive sputum and cerebrospinal fluid cultures for tuberculosis. In this last patient cryptococcus was also cultured from the sputum and CSF. Nine of the 10 patients responded well to antituberculosis therapy and was cured of the infection. The patient with associated cryptococcal infection died 2 months after presentation. Side effects of antituberculous therapy was minimal and easily resolved on stopping the offending drug.

Adolescent↗
PubMed1987

Mortality in SLE nephritis.

In a review of 112 patients with SLE nephritis treated between 1976 and 1982, 31 were known to have died. Renal failure (32.2%) was the commonest cause of death. Gastrointestinal haemorrhage (16%), infections (12.8%) and central nervous system involvement (6.5%) were important causes of death. Thirteen out of 17 patients dying in the presence of renal failure had initially presented with renal impairment. Renal biopsies in 16 patients who have died showed diffuse proliferative glomerulonephritis in all except 1 patient, and uraemia was the commonest cause of death in these patients. Pregnancies terminating in abortions were followed by complications in 5 patients. Discontinuation of steroid therapy by patients was followed by complications, and ended in death in 6 patients.

Adult↗