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Biomedical subjects

A Shah

Publications and source records attributed to A Shah.

At least 469 records · Page 26Linked to original sources
PubMedDate not supplied

Digital clubbing in sarcoidosis.

We present two cases with a rare association of sarcoidosis and clubbing. Therapy with prednisolone could not control the progress of interstitial fibrosis nor could clubbing be reversed. Both patients expired 5-1/2 years after diagnosis which suggests that clubbing, when present in sarcoidosis, may signify an unfavourable prognosis.

Female↗
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The electrocardiographic diagnosis of left ventricular hypertrophy: correlation with quantitative angiography.

The 12-lead scalar electrocardiogram has been correlated with angiographically determined left ventricular dimensions in 103 consecutive patients in order to determine the reliability of the electrocardiographic diagnosis of left ventricular hypertrophy. Simple and multiple correlations between various parameters of QRS complex voltage and left ventricular mass, volume and wall thickness were poor but statistically significant. Mean voltage of QRS complex parameters was higher in patients with increased left ventricular mass and volume than in those with normal mass and volume, but the sensitivity of individual voltage parameters in identifying increased mass and volume was poor. A negative T wave in lead l or V6 was the most sensitive indicator of increased left ventricular mass and volume, but the specificity of this variable was poor. The sensitivity of "high voltage" of the QRS complex was increased (67 percent true positives) when moderate to marked increase in left ventricular mass had occurred, but at the expense of decreased specificity (13 percent false positives). It is concluded that while an increase in left ventricular dimensions tends to be associated with an increase in QRS voltage and a repolarization abnormality, the currently used electrocardiographic criteria for the diagnosis of left ventricular hypertrophy are both insensitive and nonspecific.

Adult↗
PubMedDate not supplied

Presentation and management of empyema thoracis at Lady Reading Hospital Peshawar.

BACKGROUND: Empyema thoracis remains a common thoracic problem with challenging management strategies. We undertook the present study to outline key aspects of the presentation and management of this condition at our tertiary care hospital. METHODS: We analyzed 105 consecutive patients treated for empyema thoracis over a one-year period at Thoracic Surgical unit, Lady Reading Hospital Peshawar Pakistan. The study included patients aged 10-60 years of either sex. Patients were subjected to detailed diagnostic and management protocols with a view to define successful diagnostic and management strategies. RESULTS: The majority of patients (68%) were male, with a mean age of 28.5 +/- 14.2 years, a majority (42%) being in the 10-20 years age group. Common presentation was with fever (73%), cough (65%) and chest pain (60%). The mean duration of symptoms was 6.1 weeks. Common aetiologies of empyema were pneumonia (46.7%), iatrogenic (21.9%), traumatic (16.2%) and malignancies (11.4%). Forty patients (38%) underwent an unsuccessful therapeutic procedure prior to admission to the Thoracic unit. In the unit, 58 patients received closed intercostal drainage (31 of which required further intervention), five patients were treated with repeated thoracentesis and 8 patients were subjected to fibrinolytic therapy. The majority of patients underwent a surgical procedure like rib resection (7), decortication (23), thoracoplasty (3) and other procedures in the first instance with only 4 patients requiring further surgery. Majority of patients (97/105, 92.4%) were cured of their disease. The hospital mortality was 7.6%. CONCLUSION: Multiple therapeutic options exist for the treatment of thoracic empyema. Optimal therapy requires selection of the most appropriate first procedure for each patient with post procedure imaging to avoid inordinate delays between interventions. Early referral of all empyema patients to thoracic units for definitive therapy is recommended.

Adolescent↗
PubMedDate not supplied

Clindamycin in the treatment of anaerobic lung abscess.

A case of anaerobic lung abscess who had treatment failure after 4 weeks of supervised parenteral penicillin and oral metronidazole is described. Anaerobic pathogens resistant to one or the other of the above drugs were isolated. The patient had a striking clinical response to subsequent therapy with oral clindamycin. Failure of therapy should alert physicians to the possibility of infection with resistant anaerobic pathogens and in such situations, clindamycin is considered as an effective alternative.

Adult↗
PubMedDate not supplied

Serodiagnosis of tuberculosis using purified mycobacterial proteins.

With a view to detect specific M. tuberculosis infection, mycobacterial proteins were purified initially by ammonium sulphate precipitation followed by ion-exchange chromatography. Out of the three fractions, namely P1, P2 and P3 precipitated with increasing concentrations (0-25%, 26-65% and 66-100% respectively) of ammonium sulphate, P2 fraction was found to be more immunoreactive. P2 fraction proteins were further fractionated into five fractions by salt gradient using DEAE-cellulose DE-52 ion-exchange chromatography. Immunoreactivity against tuberculous patients sera of all the fractions was assessed using ELISA test. The last fraction (DE-V) eluted with high salt concentration was found to have a more specific immunoreactive set of proteins within the range of 55 kD to 67 kD molecular weight. Multiple non-specific proteins were distributed in all the other fractions. ELISA test using P2 fraction proteins against tuberculous patients sera showed significantly higher (p less than 0.01) titre even in the absence of any other bacteriological evidence. DE-V fraction of P2 proteins was found to have a significantly high specificity for detecting M. tuberculosis infection in clinically confirmed and suspected tuberculous patients indicating its application in the diagnosis of the disease.

Antigens, Bacterial↗
PubMedDate not supplied

Chronic anaerobic pneumonitis.

A case of chronic anaerobic pneumonitis, without any predisposing factors, nor the classical features often associated with it, which masqueraded as pulmonary tuberculosis is described. Therapy with metronidazole resulted in striking improvement.

Adult↗
PubMedDate not supplied

Fibrebronchoscopy in pulmonary sarcoidosis--an Indian experience.

Twenty-four patients suspected to have sarcoidosis were subjected to fibrebronchoscopy. Histopathological support for the diagnosis was ultimately obtained in 20 patients. Fibrebronchoscopy provided the diagnosis in 17 patients, while histopathological confirmation was obtained from extrapulmonary biopsy sites in 3 patients. Transbronchial lung biopsy, attempted without fluoroscopic guidance, revealed non-caseating granulomata in 15 patients. The only complication encountered was a small pneumothorax, not requiring intervention, in one patient. Lack of fluoroscopic guidance did not compromise the diagnostic yield or increase the complication rate of the procedure. Bronchial biopsy confirmed the diagnosis in 2 patients with a non-specific lung biopsy. It was positive in 6 of 8 patients with an abnormal appearing mucosa and in 5 of 12 patients with a normal bronchial tree. Random bronchial biopsy in all patients, irrespective of mucosal changes, made an important contribution to the yield of fibrebronchoscopy. Fibrebronchoscopy confirmed the diagnosis of tuberculosis in 2 patients with an atypical radiological picture, thereby differentiating the two conditions which occasionally mimic each other.

Biopsy↗
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Comparative study of colorimetric DNA hybridization method and conventional culture procedure for detection of Salmonella in foods.

A second generation nucleic acid hybridization assay has been developed and evaluated against the conventional culture method for detection of salmonellae in foods. The assay involves a liquid hybridization with Salmonella-specific oligonucleotide probes, capture of probe:target hybrids onto a solid support (plastic dipstick), and a colorimetric end point detection. The assay can be completed in 2.5 h, following approximately 44 h of culture enrichment. One thousand samples representing 20 food types were analyzed in parallel by both methods. Samples included uninoculated test product, and product inoculated with Salmonella at 2 levels. Eighteen Salmonella serotypes were used as inocula. The data demonstrate that the colorimetric hybridization method and the conventional culture method are equivalent in their ability to detect Salmonella contamination of foods.

Animals↗
PubMedDate not supplied

Dose-dependent pharmacokinetics of ibuprofen in the rat.

The linearity of the pharmacokinetics of ibuprofen was examined in male Sprague-Dawley rats given iv bolus doses of 10, 20, and 50 mg/kg ibuprofen. Plasma and urine concentrations of ibuprofen and its two major metabolites, OH-ibuprofen and COOH-ibuprofen, were determined by HPLC and the binding of ibuprofen to plasma proteins was measured by an ultrafiltration technique. The systemic plasma clearance (CLtot) of ibuprofen was dose-dependent and decreased from 0.29 to 0.14 liter/hr/kg primarily as a result of a 65% decrease in the partial metabolic clearance to OH-ibuprofen while the average mean residence time (MRTtot) increased approximately 35% over the 10-50 mg/kg dosage range. Since there were no dose-dependent changes in the apparent steady state volume of distribution (Vss,tot), the mean harmonic half-life increased from 1.7-2.8 hr over the dosage range studied. The binding of ibuprofen to plasma proteins was relatively independent of concentration up to 90 mg/liter (mean free fraction approximately 5.5%), but became markedly concentration-dependent thereafter (free fraction up to 25.4% at 411 mg/liter). The mean recovery of total ibuprofen in the urine over 24 hours at 10 mg/kg was 62.1% and decreased by 24% and 40% at 50 and 20 mg/kg, respectively. This dose-dependent decrease in the percentage excreted in the urine was primarily due to a reduction in the recovery of OH-ibuprofen slightly offset by a small, but significant, increase in the urinary excretion of COOH-ibuprofen between 10 and 50 mg/kg. The apparent pharmacokinetic parameters based on free, unbound concentrations of ibuprofen were also dose-dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
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Evaluation of nerve function deficit. Its improvement by nerve decompression or corticosteroid therapy.

An attempt has been made to use the protocol for evaluation of nerve damage prepared at a "Workshop on Neuritis" held at Schiefflein Leprosy Research and Training Centre, Karigiri in three cases of ulnar nerve decompression, three cases of median nerve decompression and three cases of ulnar neuritis on corticosteroid therapy. The nerve function deficit did show an improvement. The problems and suggestions are presented with a view to encourage the use of the said protocol to enable comparison of data amongst different centres and different therapy.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Post decompression ulnar claw and its recovery.

There are no reports on the ulnar claw hand developing immediately after the nerve decompression although the possibility exists. A case report is presented in which the decompression for ulnar neuritis was complicated by the ulnar claw developing on the next day. Such complication can prove embarrassing to the surgeon and worry some for the patient. However, it improved in six months along with recovery of other modalities of sensation and voluntary motor power.

Adult↗