Broken chest tube: a rare complication from use of Bonanno catheter for drainage of a malignant pleural effusion.
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Aged↗
Biomedical subjects
A Hussain
Publications and source records attributed to A Hussain.
Medial meniscal cyst of the knee--an unusual presentation: a case report.
We report an unusual case of a large, asymptomatic, medial meniscal cyst of the knee. Medial meniscal cysts are relatively uncommon, are usually symptomatic and in most cases are so small that only magnetic resonance imaging can confirm the diagnosis.
Humans↗
HIV prevalence in Zimbabwean women: 54-67% knowledge and perceived risk.
This study examined the level of knowledge of sexually transmitted infections (STI) and HIV, knowledge of symptoms and potential sequelae of STI and perceived personal risks of infection among urban women in Zimbabwe. The women consented to being interviewed, examined, tested and treated for curable diagnosed STIs. Prevalence of both STI and HIV was high 11.4% and 54.5% among women aged 15-19 years, 28.5% and 62.4% among those 20-29 years and was highest among the age group >/=30 years 39.0% and 67.0% respectively. Women aged 15-19 years least perceived their risk of infection. Of the women with the highest rates of STI/HIV infection, less than 30% were aware of their vulnerability to such infections. Knowledge of specific STIs, their symptoms and sequelae was generally low. Women who did not know about syphilis, gonorrhoea, chancroid or warts were more likely to perceive themselves at no risk of infection. Condom use was very low (16.5%). There is an urgent need to improve current education programmes to raise awareness of STIs and the dangers of their long-term sequelae along with behavioural skills building interventions that include equipping women with negotiating skills, making female condoms available at affordable prices and motivating condom use.
Adolescent↗
Hepatitis B and C single and co-infection in chronic liver disease and their effect on the disease pattern.
OBJECTIVE: To find the frequency of hepatitis B and C virus (HBV and HCV) infection and their coinfection in chronic liver disease and any differences in the clinical features of single and coinfections. METHODOLGY: All clinically recognisable adult CLD patients admitted to Military Hospital, Rawalpindi in years 1999-2000, were included in the study. Their history and clinical features were recorded. Seromarkers for HBV (HBsAg, anti-HBc) and HCV (anti-HCV) were done. RESULTS: A total of 97 (52 male, 45 female) patients were included in the study. Mean age was 51.6 years (range 16-75 years). Cirrhosis was present in 74.2%, chronic hepatitis (Ch Hep) in 18.6% and hepatocellular carcinoma (HCC) in 7.2%. Among the 74.1% patients with cirrhosis 28.5% were HBsAg positive, 55.5% anti-HBc positive and 68.1% anti HCV positive. In the chronic hepatitis cases 27.8% were HBsAg positive, 23.6% anti-HBc positive and 61.1% anti HCV positive. Among the patients of HCC 59.7% were HBsAg positive, 71.4% anti-HBc positive and 42% anti HCV positive. Regarding coinfection 7.2% were anti-HCV and HBsAg positive while 35.1% were anti-HCV and anti-HBc positive. CONCLUSION: Ninety percent of patients with CLD had evidence of HBV, HCV or coinfection. Disease was more severe in patients with coinfection. Anti-HBc was found to be a sensitive indicator of past HBV.
Adolescent↗
Optimization of photoconducting receivers for THz spectroscopy.
We have studied the sensitivity and noise of optically gated dipole receivers made from ion implanted Si and GaAs in an optimized time domain THz spectrometer. The spectrometer uses a room temperature, dc biased, semi-insulating GaAs stripline source capable of generating up to 30 microW average power. The 10% amplitude system bandwidth for 10 microm (50 microm) dipole receivers is 3 THz (1.5 THz). A dynamic range of 4 x 10(5) Hz(-1/2) is achieved using a 10 microm dipole GaAs receiver and 2 x 10(6) Hz(-1/2) using a 50 microm dipole for a total laser power of 110 mW and THz beam power of 20 microW. The dynamic range achieved with comparable silicon receivers is a factor of 2 smaller.
Electric Conductivity↗
The effect of amiloride on the in vivo effective permeability of amoxicillin in human jejunum: experience from a regional perfusion technique.
The purpose of this human intestinal perfusion study (in vivo) was twofold. Firstly, we aimed to determine the effective in vivo jejunal permeability (P(eff)) of amoxicillin and to classify it according to the Biopharmaceutics Classification System (BCS). Secondly, we investigated the acute effect of amiloride on the jejunal P(eff) of amoxicillin. Amoxicillin, a beta-lactam antibiotic, has been reported to be absorbed across the intestinal mucosa by both passive diffusion and active transport. A regional single-pass perfusion of the jejunum was performed using a Loc-I-Gut perfusion tube in 14 healthy volunteers. Each perfusion lasted for 200 min and was divided into two periods of 100 min each. The concentration of amoxicillin entering the jejunal segment was 300 mg/l in both periods, and amiloride, an inhibitor of the Na+/H+ exchanger, was added at 25 mg/l in period 2. The concentrations of amoxicillin and amiloride in the outlet jejunal perfusate were measured with two different HPLC-methods. Antipyrine and [14C]PEG 4000 were added as internal standards to the perfusion solution. Amiloride had no significant effect on the jejunal P(eff) of amoxicillin. The human in vivo jejunal P(eff) for amoxicillin was 0.34+/-0.11 x 10(-4) and 0.46+/-0.12 x 10(-4) cm/s in periods 1 and 2, respectively. The high jejunal P(eff) for amiloride was 1.63+/-0.51 x 10(-4) cm/s which predicts an intestinal absorption of more than 90%. Following the BCS amoxicillin was classified as a low P(eff) drug, and amiloride had no acute effect on the in vivo jejunal P(eff) of amoxicillin.
Adult↗
Lateral rhinotomy through nasal aesthetic subunits. Improved cosmetic outcome.
The traditional lateral rhinotomy incision described originally by Moure in 1902 has proved a versatile approach to the mid-facial skeleton. It is not, however, without its complications, particularly poor cosmesis due to depression of the nasofacial groove. In one series 10 per cent of patients developed wound complications. We present our modification of the lateral rhinotomy incision, that takes account of the nasal aesthetic subunits by placing the incision between the dorsal and side wall nasal subunits with extension inferiorly along the alar groove. From November 1994 to February 2001, a retrospective review of case notes showed that 20 patients underwent modified lateral rhinotomy incision for a variety of pathology. Ten cases were for transitional papilloma, nine for malignant disease and one for chronic osteitis of the maxilla and ethmoids post-trauma. Follow up ranged from two weeks to five years. In five cases we were able to preserve the bony piriform aperture without compromising the excision or exposure. We believe that preservation of the bony piriform aperture will further enhance the overall cosmesis and nasal function. No complaints related to the incision were recorded. Our experience with the modified lateral rhinotomy incision has been very satisfactory. It provides good exposure, a low complication rate and excellent cosmetic outcome without undue technical difficulty. It is our preferred incision for all surgery on the mid-facial skeleton and anterior skull base.
Cohort Studies↗
Association of herpes simplex virus type 2 with the human immunodeficiency virus among urban women in Zimbabwe.
A cross-sectional study at two urban primary health care clinics in Zimbabwe was conducted among 393 consecutive women. The purpose was to determine the seroprevalence of herpes simplex virus type 2 (HSV-2), to identify coinfections and to determine the association between HSV-2, HIV and other sexually transmitted infections (STIs). Sera were tested for HSV-2, HIV and syphilis. Genital specimens were tested for the other STIs. The seroprevalence of ulcerative STIs tested was 42.2% for HSV-2 and 3.9% for syphilis. HSV-2 seropositive women had twice the risk of being HIV infected compared to HSV-2 seronegative women, adjusted OR=2.05 (95% CI=1.29-3.23). HSV-2 seropositivity was also associated with older age, a lower level of education, increase in the number of lifetime sexual partners and history of genital ulcers in the past six or more months. Our data suggest that in this population HSV-2 may contribute more to HIV infection than syphilis because of its high frequency. There is an urgent need for development of an effective HSV-2 vaccine.
Adolescent↗
Reproductive tract infections among women attending primary health care facilities in Moshi, Tanzania.
OBJECTIVES: To determine the prevalence and risk factors for reproductive tract infections (RTIs), the frequency of asymptomatic genital tract infections, the frequency of genitourinary symptoms and signs and to assess their associations with vaginal and cervical infections. DESIGN: A cross sectional study carried out between September and December 1999. SETTING: Three primary health care centres in Moshi, Tanzania. SUBJECTS: A total of 382 consenting women attending Maternal Child Health (MCH) and Family planning clinics (FP). INTERVENTIONS: Women were interviewed and then pelvic examination was performed. Blood and genital specimens were collected for laboratory diagnosis of RTIs. RESULTS: Of the 382 women, 64% had-at least one RTI (33.9% bacterial vaginosis, 27% C. albicans, 21.2% T. vaginalis, 5% C. trachomatis, 4% syphilis and 0.5% N. gonorrhoea) and 26% had at least one STI. Nearly 43% of laboratory diagnosed RTIs were asymptomatic. Although none of the women had reported abnormal urogenital symptoms during routine clinical consultation, 64% revealed such symptoms on direct questioning. Reported genital symptoms and signs were significantly associated with vaginal, but not cervical infection. CONCLUSIONS: Curable RTIs are prevalent among women attending the MCH and FP clinics. Symptomatic infections were frequently not recognised or reported. We recommend introduction of routine RTI screening and treatment service in the MCH and FP clinics. Strategies to improve women's awareness and knowledge of urogenital symptoms should be instituted.
Adolescent↗
Abnormalities of conduction after total correction of Fallot's tetralogy: a prospective study.
OBJECTIVE: To determine the frequency of post-operative conduction abnormalities in Pakistani patients undergoing total correction for Fallot's Tetralogy. PATIENTS AND METHODS: One hundred and fifteen patients of Fallot's Tetralogy underwent definitive repair between January, 1999 and April, 2000. Their mean age was 12.89 years (range 3-30 years). One hundred nine patients (94.78%) had severe cyanosis and 6 patients (5.21%) were moderately cyanotic due to mild right ventricular outflow tract (RVOT) obstruction. Thirty percent patients required frequent hospital admissions within 6 months before the time of operation due to -hyper-cyanotic spells. The mean haematocrit was 50.83 (range 28-71). The majority of patients were in NYHA class-III (57%) and 45% had previous palliative shunt procedures done. Surgical access was through the RVOT in 90% cases and trans-atrial in 10%. RVOT patch was used in 55.9%, Pulmonary artery patch in 13.5% and trans-annular patch in 17.1% of cases. RESULTS: The mean bypass time was 79.15 min and the mean cross clamp time 51.23 min. Average stay in the intensive care unit was 4.48 days. Twenty-three patients required re-exploration for bleeding. Sixty-nine patients required inotropic support. Fifteen patients had transient heart blocks and two had complete heart block requiring permanent pace-maker. Nineteen patients had various transient arrhythmias which were managed medically. Univariate analysis showed that higher age at operation, low preoperative heart rate, prolonged bypass time, prolonged cross clamp time and presence of patch on pulmonary artery were more common in patients who developed various heart blocks. However, none of these factors had statistical significance or definitive cause-effect relationship with heart blocks. CONCLUSION: With careful surgical technique, total correction of Fallot's tetralogy can be conducted in children and young adults, with a very low risk of conduction abnormalities.
Adolescent↗
Declaring financial competing interests: survey of five general medical journals.
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Biomedical Research↗
Phase II study of docetaxel, estramustine, and low-dose hydrocortisone in men with hormone-refractory prostate cancer: a final report of CALGB 9780. Cancer and Leukemia Group B.
PURPOSE: To investigate the combination of docetaxel, estramustine (EM), and low-dose hydrocortisone in men with hormone-refractory prostate cancer (HRPC). PATIENTS AND METHODS: Combinations of EM with other antimitotic agents such as docetaxel are synergistic in vitro and show significant clinical activity in patients with HRPC. We studied intravenous administration of docetaxel 70 mg/m(2), oral estramustine, and low-dose daily hydrocortisone in men with HRPC who demonstrated progression after initial hormone therapy. RESULTS: Of the 47 men enrolled onto this multicenter cooperative group study, 46 were assessable for response and/or toxicity. In the 24 patients with measurable disease, there were three complete and nine partial responses for a measurable disease response rate of 50% (12 of 24 patients; 95% confidence interval [CI], 27% to 73%). In the 44 patients in whom pretreatment prostate-specific antigen (PSA) was elevated, 30 (68%) had a 50% or greater decrease, and 25 (57%) had a 75% or greater decrease in PSA. The combined measurable disease and biochemical response rate in all 46 assessable patients was 54% (three complete responses, 22 partial responses, 95% CI, 37% to 71%). The predominant toxicity was neutropenia, with 26% of patients having grade 3 and 30% having grade 4 granulocytopenia; there were no episodes of febrile neutropenia. Other common but mild adverse effects included malaise/fatigue, peripheral edema, and hyperglycemia. The incidence of thromboembolic events during therapy was 9%. With a median follow-up of 17 months, the median survival was 20 months. The median time to disease progression was 8 months for all patients, and 10 months for those with measurable disease. CONCLUSION: This therapy is efficacious and moderately well tolerated in HRPC and should be compared in a phase III trial with mitoxantrone and prednisone.
Aged↗
Acute pulmonary toxicity after low-dose amiodarone therapy.
Amiodarone-induced pulmonary toxicity is usually seen in cardiac surgical patients who have received large doses of amiodarone for ventricular arrhythmias over prolonged periods. In this report, we describe a case of amiodarone-induced pulmonary toxicity after a short course of therapy for postoperative atrial fibrillation.
Acute Disease↗
The morphology of periodic breathing in infants and adults.
To test the hypothesis that the crescendo-decrescendo type of pattern of periodic breathing is more common in infants than in adulthood, we examined the morphologies of periodic breathing in four groups of subjects: group 1 (n=10, gestational age 30+/-1 week), group 2 (n=10, GA 31+/-1 week), group 3 (n=10, GA 38+/-1 week), and group 4 (n=10, age 50+/-4 years). Respiratory pattern and ventilation were measured using a flow-through system. The breathing morphologies were defined according to the respiratory flow. We found (1) a predominant crescendo-decrescendo pattern in preterm infants (groups 1 and 2, >50%) and this changed to a predominant decrescendo breathing in adults (group 4, 50%); (2) total breathing cycle and its phases did not change significantly among the neonatal groups, but they almost doubled in adult subjects; however, the number of breaths per breathing interval remained the same (crescendo-decrescendo) or less (flat and decrescendo) in adults as compared to preterm infants; (3) the duty cycle (breathing interval/cycle duration) remained consistent with age; and (4) at the beginning of each breathing interval, alveolar P(CO2) was highest and alveolar P(O2) and O2 saturation lowest. The findings suggest a change in the strategy of the respiratory control system during periodic breathing between the infant and the adult, perhaps dictated by mechanical and chemoreceptor limitations early in age, with a switch from a crescendo-decrescendo to a predominantly decrescendo pattern.
Adult↗
Docetaxel followed by hormone therapy after failure of definitive treatments for clinically localized/locally advanced prostate cancer: preliminary results.
An increasingly important issue in the management of prostate cancer is the occurrence of biochemical failure (ie, increasing serum prostate-specific antigen [PSA] levels) in patients with clinically localized prostate cancer who initially underwent definitive treatments with curative intent (prostatectomy and/or radiation therapy). This pilot trial evaluated chemotherapy followed by hormone therapy for a defined period in patients with biochemical (and possibly clinical) recurrence after initial local therapies for localized/locally advanced prostate cancer. Patients who developed increasing PSA > 4 ng/mL after initial prostatectomy and/or radiation therapy received docetaxel, 70 mg/m(2) every 3 weeks for up to 6 courses, followed by 4 months of total androgen suppression (using a luteinizing hormone-releasing hormone agonist plus bicalutamide, 50 mg/d) and 8 months of peripheral androgen blockade (using finasteride, 5 mg/d, plus bicalutamide, 50 mg/d). Twenty-seven patients have enrolled to date, 23 of whom received four or six cycles of docetaxel before hormonal therapies. Seventeen (74%) of 23 patients who completed four to six cycles of chemotherapy had a > or =40% decrease in PSA, and 16 (89%) of 18 patients who completed 4 months of total androgen suppression achieved PSA values of < or =0.1. The most common hematologic toxicity was grade (3/4) neutropenia; grade 3 nonhematologic toxicities were rare, and no grade 4 nonhematologic toxicities were reported. Thus, the preliminary results suggest that docetaxel before hormonal therapy includes a PSA response in many prostate cancer patients with biochemical failure after definitive local therapies.
Adenocarcinoma↗
The erosive effect of herbal tea on dental enamel.
OBJECTIVES: The aim of this study was to determine whether conventional black tea and a herbal tea were capable of eroding dental enamel. A further aim was to investigate whether herbal tea of the type tested eroded dental hard tissues to a greater or lesser extent than conventional black tea. METHODS: Three groups of 21 teeth were exposed to a conventional black tea Typhoo (Group A), a herbal tea Twinings Blackcurrant, Ginsing and Vanilla (Group B) and water, which acted as a control (Group C). Sequential profilometric tracings of the specimens were taken, superimposed and the degree of enamel loss calculated as the area of disparity between the tracings before and after exposure. RESULTS: Conventional black tea and herbal tea, of the type tested, both resulted in tooth surface loss. Tooth surface loss, which resulted from exposure to herbal tea (mean 0.05mm(2), s.d. 0.02), however, was significantly greater (P=0.00) than that which resulted from exposure to conventional black tea (mean 0.01mm(2), s.d. 0.00) and water (mean 0.00mm(2), s.d. 0.00). CONCLUSIONS: It was concluded that herbal tea and conventional black tea of the type tested result in erosion of dental enamel. The erosive effect of the herbal tea of the type tested was five times more severe than that of the conventional black tea tested. The cumulative effects of regular consumption of herbal tea of the type tested are likely, therefore, to be of clinical significance.
Analysis of Variance↗
Human jejunal permeability of two polar drugs: cimetidine and ranitidine.
PURPOSE: To determine the human jejunal permeability of cimetidine and ranitidine using a regional jejunal perfusion approach, and to integrate such determinations with previous efforts to establish a baseline correlation between permeability and fraction dose absorbed in humans for soluble drugs. METHODS: A sterile multi-channel perfusion tube, Loc-I-Gut, was inserted orally and positioned in the proximal region of the jejunum. A solution containing cimetidine or ranitidine and phenylalanine, propranolol, PEG 400, and PEG 4000 was perfused through a 10 cm jejunal segment in 6 and 8 subjects, respectively. RESULTS: The mean Peff (+/- se) of cimetidine and ranitidine averaged over both phases were 0.30 (0.045) and 0.27 (0.062) x 10(-4) cm/s, respectively, and the differences between the two were found to be statistically insignificant. The mean permeabilities for propranolol, phenylalanine, and PEG 400 averaged over both phases and studies were 3.88 (0.72), 3.36 (0.50), and 0.56 (0.08) x 10(-4) cm/s, respectively. The differences in permeability for a given marker were not significant between phases or between the two studies. CONCLUSIONS: The 10-fold lower permeabilities found for cimetidine and ranitidine in this study, compared to propranolol and phenylalanine, appear to be consistent with their less than complete absorption in humans.
Adolescent↗
Bioavailability and bioequivalence: an FDA regulatory overview.
Bioavailability and/or bioequivalence studies play a key role in the drug development period for both new drug products and their generic equivalents. For both, these studies are also important in the postapproval period in the presence of certain manufacturing changes. Like many regulatory studies, the assessment of bioavailability and bioequivalence can generally be achieved by considering the following three questions. What is the primary question of the study? What are the tests that can be used to address the question? What degree of confidence is needed for the test outcome? This article reviews the regulatory science of bioavailability and bioequivalence and provides FDA's recommendations for drug sponsors who intend to establish bioavailability and/or demonstrate bioequivalence for their pharmaceutical products during the developmental process or after approval.
Biological Availability↗