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Biomedical subjects

A A Shah

Publications and source records attributed to A A Shah.

At least 37 records · Page 2Linked to original sources
PubMed1999

Assessment of deep venous thrombosis using routine pelvic CT.

OBJECTIVE: The purpose of this study was to assess routine pelvic CT both for accuracy in diagnosis of deep venous thrombosis and for frequency of detection of clinically unsuspected pelvic thrombi. MATERIALS AND METHODS: We reviewed the CT records of patients who had undergone pelvic CT during a 6-month period and cross-referenced these records to reports on lower extremity venous sonography to identify patients who had undergone this test within 1 week of pelvic CT. We compared the frequency and location of venous thrombosis revealed through these two tests. To identify unsuspected deep venous thrombosis detected on pelvic CT, we reviewed the charts of patients for whom a clot was reported to determine if it had been clinically suspected before CT. RESULTS: Among the 52 patients who underwent both CT and lower extremity venous sonography, the findings were in agreement for 49 (94%). The techniques disagreed for three patients; two patients had deep venous thrombosis detected on sonography but not on CT and the other had a clot detected on CT but not on sonography. The prevalence of unsuspected deep venous thrombosis detected by CT was 1.1%, and 73% of these patients underwent anticoagulation therapy without further confirmatory tests. CONCLUSION: Unsuspected deep venous thrombosis is commonly seen on routine pelvic CT and should be carefully sought during such examinations. CT appears to be relatively accurate in the detection of deep venous thrombosis. Thus, CT venography combined with pulmonary CT angiography may significantly increase the percentage of patients who are appropriately treated for thromboembolic disease because both deep venous thrombosis and pulmonary emboli can be identified by this combined test.

Contrast Media↗
PubMed1998

Measurement of serosal temperatures and depth of thermal injury generated by thermal balloon endometrial ablation in ex vivo and in vivo models.

OBJECTIVE: To evaluate the safety profile of endometrial ablation performed with a thermal balloon as defined by serosal temperature elevation and depth of injury. DESIGN: Observational study with histopathologic correlation conducted in ex vivo and in vivo phases. SETTING: Academic medical center. PATIENT(S): Twenty patients undergoing total abdominal hysterectomy. INTERVENTION(S): Endometrial ablation with a thermal balloon. MAIN OUTCOME MEASURE(S): Serosal temperature elevation and histologic depth of injury. RESULT(S): Ex vivo phase results revealed serosal temperatures remained within a safe physiologic range (<45 degrees C). Greatest depth of myometrial injury in the premenopausal uteri was 5.8 mm over the anterior lower uterine segment. In postmenopausal uterus. the greatest depth of myometrial injury was 3.8 mm in the anterior midline. In vivo phase results revealed mean (+/- SD) peak serosal temperatures of 36.1 +/- 1.6 degrees C. As with the ex vivo phase. histologic examination revealed deep endometrial and superficial myometrial damage to all areas. The greatest depth of myometrial injury occurred in the midfundus at 3.4 mm. CONCLUSION(S): No patients experienced complications or adverse events secondary to treatment. Results showed that transuterine thermal injury is a highly unlikely scenario. In both phases of this study, histologic examination revealed that temperatures exposed to the endometrial layer were sufficient to cause tissue damage.

Adult↗
PubMed1997

A comparison of omeprazole and placebo for bleeding peptic ulcer.

BACKGROUND: The role of medical treatment for patients with bleeding peptic ulcers is uncertain. METHODS: We conducted a double-blind, placebo-controlled trial in 220 patients with duodenal, gastric, or stomal ulcers and signs of recent bleeding, as confirmed by endoscopy. In 26 patients the ulcers showed arterial spurting, in 34 there was active oozing, in 35 there were nonbleeding, visible vessels, and in 125 there were adherent clots. The patients were randomly assigned to receive omeprazole (40 mg given orally every 12 hours for five days) or placebo. The outcome measures studied were further bleeding, surgery, and death. RESULTS: Twelve of the 110 patients treated with omeprazole (10.9 percent) had continued bleeding or further bleeding, as compared with 40 of the 110 patients who received placebo (36.4 percent) (P<0.001). Eight patients in the omeprazole group and 26 in the placebo group required surgery to control their bleeding (P<0.001). Two patients in the omeprazole group and six in the placebo group died. Thirty-two patients in the omeprazole group (29.1 percent) and 78 in the placebo group (70.9 percent) received transfusions (P<0.001). A subgroup analysis showed that omeprazole was associated with significant reductions in recurrent bleeding and surgery in patients with nonbleeding, visible vessels or adherent clots, but not in those with arterial spurting or oozing. CONCLUSIONS: In patients with bleeding peptic ulcers and signs of recent bleeding, treatment with omeprazole decreases the rate of further bleeding and the need for surgery.

Adult↗
PubMed1997

The relationship between therapeutic injections and high prevalence of hepatitis C infection in Hafizabad, Pakistan.

To determine the prevalence and routes of transmission of hepatitis C virus (HCV) infection in Hafizabad, Pakistan, we collected sera in 1993 from a geographically based random sample of residents, and in 1994 identified 15 HCV-infected individuals (cases) and 67 age and sex matched uninfected individuals (controls). Initially we approached 504 households, and collected serum from a randomly selected household member in 309 (64%). Twenty persons (6.5%) had anti-HCV antibody; 31% percent had hepatitis B core antibodies, and 4.3% had hepatitis B surface antigen. In the case-control study, persons who received more therapeutic injections (categorized as averaging 1, 2-4, 5-9 or > 10 injections per year in the previous 10 years) were more likely to be infected with HCV (odds ratio 0, 1.5, 2.5 and 6.9 respectively, P = 0.008) compared to persons averaging 0 injections per year. Efforts to limit therapeutic injections to only those that are medically indicated and that use sterile equipment are essential in order to prevent transmission of HCV.

Adolescent↗
PubMed1997

Chronic invasive aspergillosis in apparently immunocompetent hosts.

Seventeen cases of invasive aspergillosis occurring since 1987 in apparently immunologically normal hosts have been reviewed: 9 of invasive sinus aspergillosis, 2 of isolated brain abscesses, 3 of pneumonia (1 in a patient who developed mediastinitis), 2 of lymph node aspergillosis, and 1 of osteomyelitis of the foot. Two of the 9 patients with sinus aspergillosis died; the rest were stable up to March 1993. They responded initially to combined surgical and medical therapy. Both patients with brain abscesses survived following surgery, but one had neurological sequelae. Both patients with pneumonia were well following therapy with amphotericin B; one also received itraconazole. The patient with mediastinitis died, but this disease was diagnosed late. The patients with lymph node involvement were lost to follow-up, as was the patient with osteomyelitis. Invasive aspergillosis may be common in Pakistan. Greater awareness would allow earlier diagnosis and therapy, thereby improving the outcome.

Adolescent↗
PubMed1995

Home environment and peer relations of addicted and nonaddicted university students.

This study was designed to examine the differences between addicted and nonaddicted university students on measures of home environment and peer relations. Participants were 45 addicts and 45 nonaddicts with mean ages of 23 years drawn from three Pakistani universities located in Islamabad, Lahore, and Peshawar. The two groups were matched for age, gender, education, area of residence, and marital status. A booklet containing an Index of Family Relations and a Peer Relations Questionnaire was administered. Results showed that the addicts perceived more stress in their families than the non-addicts did. Family income of the addicts was greater than that of the nonaddicts. Addicts were under greater peer influence and had more deviant and drug-using friends than the nonaddicts.

Adult↗
PubMed1994

Anterolateral decompression for traumatic spinal cord compression.

Nine patients with traumatic fractures of dorsolumbar spine leading to pain and neurological deficit are presented. All had radiological evidence of spinal cord or quada equina compression, with either monoparesis, paraparesis or sphincter dysfunction alone. All patients underwent anterolateral decompression through a transpleural or retroperitoneal approach. Seven patients had bone grafting and spinal stabilization with Webb-Morley system. Two patients had decompression only. The results were favourable. This approach is safe and effective and allows early mobilization and functional recovery.

Adult↗
PubMed1993

Microvascular decompression for trigeminal neuralgia.

Eleven patients with intractable trigeminal neuralgia were treated by posterior fossa microvascular decompression. Complete pain relief was achieved in 7 patients (63.3%). Partial relief of symptoms was noted in 3 patients (27%). There was no operative mortality. Two patients developed transient lower cranial nerve palsies whereas one patient developed a CSF leak, requiring treatment by lumbar drain. Compared to ablative procedures, microvascular decompression is an effective and safe method of treatment for trigeminal neuralgia.

Adult↗
PubMed1992

Bone tuberculosis in Abbottabad.

Eighty patients of bone and joint tuberculosis were diagnosed and treated at DHQ Teaching Hospital, Abbottabad from August, 1987 to December, 1990. Majority of them were children and young adults. There were more females (57.5%) than males (42.5%). A major fraction of the cases were Afghan refugees. Most of the patients were malnourished and belonged to low socioeconomic class.

Adolescent↗
PubMed1991

Anaerobic threshold as a measure of physical work capacity.

Fifty healthy subjects underwent incremental exercise on a treadmill. Anaerobic threshold (AT) and maximum oxygen consumed in litres per minute (VO2 max) were measured. VO2 max (mean +/- SD) in males and females was 2.71 +/- 0.5 and 2.014 +/- 0.4 L/min respectively. AT as a percentage of VO2 max predicted was 58 in males and 56 in females. These values were comparable to Western studies. Anaerobic threshold is the most sensitive indicator of exercise performance.

Adult↗