Search PubMed⌕ Search

Biomedical subjects

A Iqbal

Publications and source records attributed to A Iqbal.

At least 19 recordsLinked to original sources
PubMed2007

Effects of prior endoluminal gastroplication on subsequent laparoscopic Nissen fundoplication.

BACKGROUND: The long-term results of endoluminal gastroplication (ELGP) for gastroesophageal reflux disease (GERD) are still under investigation. Laparoscopic Nissen fundoplication (LNF) has unquestionable results in the treatment of GERD and, therefore, it would be unfortunate to compromise this treatment option by performing alternative therapies such as ELGP. METHODS: Six patients underwent ELGP for the treatment of GERD symptoms. After symptoms returned, these patients elected to have a LNF. RESULTS: There was no sign of periesophagitis or intraperitoneal adhesion formation found at hiatal dissection that hindered or complicated the LNF procedure. Recent follow-up has shown that the patient's GERD symptom scores have decreased, as expected after a de novo LNF. CONCLUSION: ELGP does not alter the surgical dissection or results of a subsequent LNF.

Adult↗
PubMed2006

Blood pressure in relation to serum thyrotropin: The Tromsø study.

It appears to be an association between hypothyroidism and hypertension. However, the relation between thyroid function and blood pressure within the normal serum thyrotropin (TSH) range is uncertain. In the fifth Tromsø study, which is a population-based health survey, serum TSH and blood pressure were measured. This gave us the opportunity to test the hypothesis of a relation between serum TSH and blood pressure within the normal serum TSH range. In all 5872 subjects (2623 male subjects) not using blood pressure or thyroxine medication were included in the present study. Within the normal serum TSH range (0.20-4.00 mIU/l), there was a significant and positive relation between serum TSH and both systolic and diastolic blood pressure. Within this range, and adjusted for age, body mass index and smoking status, the systolic blood pressure was 1.4 mm Hg and the diastolic 1.6 mm Hg higher in male subjects in the highest versus those in the lowest serum TSH quartile. The corresponding differences in the female subjects were 4.0 and 2.7 mm Hg, respectively. When dividing this cohort in those with systolic (>160 mm Hg) and diastolic (>95 mm Hg) hypertension, serum TSH was higher in the hypertensive subjects, but the differences were only statistically significant for diastolic hypertension (serum TSH 1.88+/-0.82 versus 1.69+/-0.74 mIU/l for male subjects, and 1.79+/-0.78 versus 1.63+/-0.75 mIU/l for female subjects, P < 0.05). In conclusion, there is a modest, but significant positive association between serum TSH and blood pressure within the normal serum TSH range.

Adult↗
PubMed2006

Technique and follow-up of minimally invasive Heller myotomy for achalasia.

BACKGROUND: Laparoscopic Heller myotomy has been proven effective. Reliable predictive factors for outcome and the true benefit of the da Vinci robotic system, however, remain unknown. METHODS: Seventy patients underwent laparoscopic Heller myotomy. The number of intraoperative perforations and the symptom-predictive value of postoperative esophagogram width measurement at the gastroesophageal junction were analyzed. RESULTS: The overall complication rate was 11%. Four patients experienced intraoperative perforation during the laparoscopic technique. No perforations were experienced with the da Vinci robotic system (n = 19). Of the total, 82% of patients had resolution of dysphagia, 91% of regurgitation, 91% of heartburn and 82% of chest pain. Immediate postoperative esophagogram gastroesophageal junction width demonstrated a positive predictive trend from 0 to 10 mm for dysphagia. CONCLUSION: Laparoscopic Heller myotomy is an effective treatment for achalasia. Immediate postoperative esophagogram gastroesophageal junction width measurement as a predictor for symptom resolution requires further study.

Adolescent↗
PubMed2006

Breast reconstruction using deep inferior epigastric perforator flaps in EEC syndrome.

Ectrodactyly, ectodermal dysplasia, cleft lip/palate (EEC) syndrome is a rare condition that may result in failure of breast development. Breast reconstruction in these patients may pose a challenging problem, as they are young and reconstructive options should have minimal long-term complications. The use of deep inferior epigastric perforator (DIEP) flaps in breast reconstruction following breast cancer has been well described with good results. The use of DIEP flaps in breast augmentation, however, is far less common. We present the case of a young patient with EEC syndrome and mammary hypoplasia who underwent DIEP flap reconstruction for breast augmentation. The outcome was satisfactory to both patient and surgeon.

Adolescent↗
PubMed2006

The presence of a BCR-ABL mutant allele in CML does not always explain clinical resistance to imatinib.

The expansion of a leukemia clone bearing a Bcr-Abl kinase domain mutation is associated with acquired resistance to imatinib and may also predict disease progression in patients with Philadelphia-positive chronic myeloid leukemia (CML). Here we report results of pyrosequencing to quantitate the non-mutated and mutant alleles in 12 CML patients monitored over periods ranging from 11 to 58 months, and describe three contrasting kinetic patterns: Group 1 - in four patients total BCR-ABL transcript numbers remained high with the mutant allele predominating; Group 2 - in four patients the total number of BCR-ABL transcripts fell to low levels but the mutant allele predominated; and Group 3 - in four other patients the total level of transcripts remained high (n = 2) or fell (n = 2) but the mutant clone persisted at relatively low level. In Group 2 the mutant leukemia clone was presumably still relatively sensitive to imatinib but in Group 1 the leukemia could be classified as resistant. In Group 3 patients the imatinib sensitivity of the leukemia was variable. We conclude that a mutant clone does not necessarily have a proliferative advantage and its presence does not always account for resistance to imatinib. Other mechanisms underlie resistance in at least some patients.

Adult↗
PubMed2006

Serum lipid levels in relation to serum thyroid-stimulating hormone and the effect of thyroxine treatment on serum lipid levels in subjects with subclinical hypothyroidism: the Tromsø Study.

OBJECTIVE: To evaluate the relation between serum thyroid-stimulating hormone (TSH) and lipids. DESIGN: Cross-sectional epidemiological study, nested case-control study, and a placebo-controlled double-blind intervention study. METHODS: In the 5th Tromsø study serum TSH, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured. Subjects with subclinical hypothyroidism (SHT) and a matching control group were re-examined and apolipoprotein A1 (Apo A1) and apolipoprotein B (Apo B) were also measured. Subjects with SHT were included in an intervention study with thyroxine supplementation for 1 year. RESULTS: A total of 5143 subjects from the 5th Tromsø study were included. A significant and positive correlation between serum TSH levels and serum TC and LDL-C levels were found in both genders. However, in the females this did not reach statistical significance after adjusting for age and BMI. The serum LDL-C were significantly higher and the Apo A1 levels significantly lower in 84 SHT subjects compared with 145 controls, and in the SHT females the TC levels were also significantly elevated. In the intervention study (32 subjects given thyroxine and 32 subjects given placebo), we observed a significant reduction in the Apo B levels after thyroxine medication. In those that at the end of the study had serum TSH levels in the range 0.2-2.0 mIU L(-1), the serum TC and LDL-C levels were also significantly reduced. CONCLUSIONS: There is a positive association between serum TSH levels and TC and LDL-C levels. These lipid levels are reduced with thyroxine treatment in subjects with SHT.

Adult↗
PubMed2006

Sub-diaphragmatic fascia: role in the recurrence of hiatal hernias.

One of the most common causes of a failed Nissen fundoplication is disruption of the crural repair. We investigated the thickness of the subdiaphragmatic fascia overlying the right and left limb of the right crus in cadavers to determine any difference. Sub-diaphragmatic fascia specimens were obtained from three sites adjacent to the hiatus in 20 preserved cadavers. One square centimeter of fascia was excised 3 cm from the arch of the hiatus on each side and approximately 2-3 mm from the edge of the hiatal opening (labeled RL and LPL). A third sample was taken 1 cm from the arch of the hiatus on the left side (labeled LAL). The thickness of these tissues was measured. The mean tissue thickness of RL, LPL and LAL were 0.22 mm, 0.23 mm and 0.4 mm, respectively. There was no difference in tissue thickness between the lower specimens on both sides (RL vs. LPL); however, LAL was significantly thicker than both RL and LPL (P < 0.05). The thickness of the subdiaphragmatic fascia overlying the right and left limb of the right crus does not differ significantly in the region used for crus closure during antireflux surgery; however, the fascia on the left is thicker anteriorly.

Cadaver↗
PubMed2006

Laparoscopic re-operation for failed Heller myotomy.

Laparoscopic Heller myotomy for achalasia has a 10-20% failure rate and may require re-operation to control persistent or recurrent symptoms. We report follow-up of 15 patients who underwent laparoscopic re-operation for failed Heller myotomy. Between 1993 and 2004, 15 patients underwent laparoscopic re-operation for failed Heller myotomy at our center. The mean duration between procedures was 23 months. Follow-up was completed at a mean duration of 30 months in 14 patients (93%) via a telephone questionnaire. Our overall failure rate for primary surgery (n = 106) was 5.6%. The mechanisms of failure were incomplete myotomy (33%), myotomy fibrosis (27%), fundoplication disruption (13%), too tight fundoplication (7%) and a combination of myotomy fibrosis and incomplete myotomy (20%). Significant symptom improvement was observed with postoperative symptom resolution seen in 71% of patients with dysphagia, 89% for regurgitation, 58% for heartburn and 40% for chest pain. Fifty percent reported excellent results and 79% would recommend the procedure to a friend. Subsequent dilations were performed in four patients (29%). Two patients required conversion to open surgery (13%). Three patients (20%) failed the re-operation and required further revisional surgery. Complications included intraoperative perforation in three (none of which resulted in postoperative morbidity) and a pneumothorax in one patient. Prior endoscopic therapies (pneumatic dilation or Botulinum toxin) were not associated with poor results. Laparoscopic re-operation for failed Heller myotomy is feasible and results are encouraging.

Adolescent↗
PubMed2005

Stem cell transplantation for patients with Fanconi anemia with low-dose cyclophosphamide and antithymocyte globulins without the use of radiation therapy.

In all, 22 patients with confirmed Fanconi anemia (FA) underwent stem cell transplantation (SCT) from HLA-matched, related donors at KFSHRC. Median age at SCT was 7.6 years (range, 2.5-14.6 years). Conditioning regimen consisted of cyclophosphamide (CY) 15 mg/kg/day intravenously (i.v.) for 4 consecutive days, in addition to equine antithymocyte globulins (ATG) given i.v. at 40 mg/kg/day for four doses pre-SCT. No radiation therapy was given. For graft-versus-host disease prophylaxis, we used cyclosporin at the standard doses; ATG was added at 20 mg/kg/dose i.v. on days 2, 4, 6, 8, 10, and 12 post-SCT (total of six doses). All patients engrafted and are alive and transfusion independent with a median follow-up time of 20.2 months (range, 3.3-59 months). One patient however developed a decrease in her WBC and platelet count. Her work-up revealed slightly hypocellular bone marrow, and a series of chimerism studies over 1 year confirmed that she has stable mixed chimerism; she remains transfusion independent. We conclude that low-dose CY without radiation therapy can be used satisfactorily in the conditioning of patients with FA undergoing related SCT.

Adolescent↗
PubMed2004

Diuretic and nephroprotective effect of Jawarish Zarooni Sada--a polyherbal unani formulation.

A number of drugs, both single and compound preparations are used widely in Tibb-e-Unani (Unani medicine) in the management of renal diseases. But such drugs mostly, have not been investigated for their described effects. Jawarish Zarooni Sada (JZS) is one such polyherbal preparation containing 15 ingredients, mainly described to be diuretic and nephroprotective. Therefore, in the present study ethanol and water extracts of JZS (300 mg each) were investigated for diuretic activity by measuring the total urine output over a period of 6h. Sodium and potassium level in urine sample was also estimated. Nephroprotective activity of JZS against gentamicin-induced nephrotoxicity was investigated by administering JZS along with high dose of gentamicin (40 mg/kg) and elevation of serum urea and serum creatinine was taken as the index of nephrotoxicity. JZS showed significant diuretic and nephroprotective effect.

Animals↗
PubMed2004

Fission track estimation of uranium concentrations in drinking water from Azad Kashmir, Pakistan.

The analysis of uranium in water samples can be very helpful for providing guidelines to the general public regarding necessary remedial measures. A fission-track technique has been applied for the estimation of the uranium concentration in drinking water collected from natural springs of Muzaffarabad and hilly areas of Reshian, Azad Kashmir. The technique involved simultaneous irradiation with thermal neutrons of a sample and a standard in contact with a track detector, and the counting of the fission tracks in the detector from the (n, f) nuclear reaction. Uranium concentrations of the samples were determined by comparing fission-track density with that of a standard of known uranium concentration. Uranium concentration in water samples from the Muzaffarabad and Reshian area varied from 0.03 +/- 0.01 microgL(-1) to 6.67 +/- 0.14 microgL(-1) with an average of 1.36 +/- 0.05 microgL(-1). The observed concentrations of uranium in drinking water were found to be less than the Maximum Acceptable Concentration levels of 9-30 microgL(-1). Thus, the observed values are within safe limits as far as uranium related health hazards are concerned.

Environmental Monitoring↗
PubMed2004

A comparison of topical formulations for the prevention of human schistosomiasis.

Recently, a dimeticone formulation has been shown to be effective at preventing Schistosoma cercariae infecting skin, while DEET (N,N-diethyl-m-toluamide), a highly effective insecticide, has been shown to have activity against cercariae. Seven formulations, 3 containing DEET, were prepared and applied to excised human skin in Franz cells for 1 h. Schistosoma cercariae were applied for 30 min at 1 and 24 h, and the number that penetrated the skin calculated (n = 9). DEET could not be incorporated into the dimeticone formulation, yet it remained the most effective at preventing cercarial penetration, both 1 and 24 h after application. The ointments that contained DEET did prevent penetration but their mode of action was due to the toxicity of DEET against the cercariae. The persistence of the protection afforded by the dimeticone formulation after washing suggests that the formulation may be interacting with the stratum corneum to prevent cercarial recognition of skin.

Animals↗
PubMed2004

Spontaneous recovery from depression in women: a qualitative study of vulnerabilities, strengths and resources.

OBJECTIVE: To gain insight into the perceived vulnerability and restitution factors for anxiety/or depression. METHODS: Focus group discussion of seven married women recovered spontaneously from anxiety and/or depression, belonging to a lower middle class semi-urban community of Karachi. RESULTS: Poverty, unemployment, abuse and on going difficulties were perceived as risk factors for depression. A reliable social support system, positive thinking approach, faith, prayers, and experiencing a "turning point" event were reported as factors that promoted recovery from anxiety and/or depression. CONCLUSION: Individual vulnerabilities, strengths and resources can have an important role in recovery from anxiety and/or depression in women.

Adult↗
PubMed2003

Osteomyelitis of the ischiopubic synchondrosis: imaging findings.

Osteomyelitis of the ischiopubic synchondrosis in children is not rare and presents a diagnostic problem because of the diversity of presentation and the deceptive nature of symptoms. Radiological assessment is extremely difficult because of the variation in normal ossification on radiography and normal physiological uptake on radioisotope bone scan. We present two cases of osteomyelitis of the ischiopubic synchondrosis and describe findings on radiographs, isotope bone scan, computed tomography (CT) and magnetic resonance imaging (MRI). MRI changes have not been described in any of the case reports in the English literature. Aspiration and biopsy remain the gold standard for diagnosis. However, MRI appearances can significantly increase diagnostic confidence prior to intervention.

Acute Disease↗
PubMed2003

The transformative effect of training in counselling and its application, on the community counsellors themselves.

OBJECTIVE: To identify the changes in community counsellors' own level of anxiety and depression as a result of learning counselling skills and to explore their subjective experiences after learning and providing counselling. DESIGN: Quantitative: Repeated Measures. / Qualitative: Focus Group Discussions. SETTING: A lower middle class semi urban community of Karachi, Pakistan. PARTICIPANTS: Twenty-one self selected women from the community. RESULTS: Reduction was seen in the post training scores of anxiety and/or depression in the trainees. As a result of learning and then providing counselling the community counsellors' self esteem, self confidence and sense of competence were enhanced and they developed a more positive attitude towards life. CONCLUSION: A minimal level of training in counselling skills and their application led to significant positive changes in the community counsellors themselves, though self-selection and information bias cannot be ruled out.

Adult↗
PubMed2002

General dental practitioners' knowledge of and attitudes towards evidence based practice.

AIMS: To assess general dental practitioners' understanding of, and attitudes towards, evidence based practice (EBP). SUBJECTS: A random sample of general dental practitioners currently practising in the North West of England. METHOD: A cross-sectional survey using self administered, structured, postal questionnaires in January 2001. RESULTS: A majority of the respondents had some understanding of technical terms associated with EBP. Only 29% (60/204) could correctly define the term EBP. When faced with clinical uncertainties 60% (122/204) of general dental practitioners turned to friends and colleagues for help and advice. Eighty one percent of respondents were interested in finding out further information about EBP (165/204). Barriers to its use included a lack of available time and financial constraints. CONCLUSIONS: EBP is not a concept that every dentist is familiar with, however, the general dental practitioners surveyed were enthusiastic and expressed a desire to find out more information on EBD. It appears to be the right time for an educational program targeted at GDPs to enhance their knowledge and use of EBD in everyday practice.

Attitude of Health Personnel↗