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Biomedical subjects

F A Khan

Publications and source records attributed to F A Khan.

At least 127 records · Page 7Linked to original sources

A review of 6978 consecutive admissions to the recovery room at a university hospital.

Recovery from anaesthesia is a time of potential danger to the surgical patients. A retrospective audit of all recovery room admissions over a period of 18 months was carried out at the Aga Khan University Hospital. During this period 6978 patients were admitted to the recovery area and 695 had one or more complications. The complications were recorded by the recovery room nursing staff in a recovery log book. The breakdown of complications according to different physiological systems is discussed. Several surveys have reviewed complications in the western population, but in contrast, no study is available in Pakistani patients. It is recommended that since one in ten patients is likely to have a problem in the early post-operative period, the local hospitals should provide adequate facilities meeting the criteria laid down for the recovery rooms in modern anaesthetic practice.

Adult↗

The effects of suxamethonium and pancuronium on the haemodynamic response to endotracheal intubation.

The pharmacological effects of suxamethonium and pancuronium on the cardiovascular system may vary and therefore alter the haemodynamic response to intubation. The arterial blood pressure, the heart rate and the rate pressure product were measured as parameters of haemodynamic change in forty adult ASA. I and II patients undergoing laryngoscopy and endotracheal intubation in a randomised controlled study. The patients were induced with either thiopentone/suxamethonium (Group A) or thiopentone/pancuronium (Group B). There was no significant difference between the groups on comparison of systolic and diastolic blood pressure changes. Pancuronium, however, caused a significantly higher rise in the heart rate after endotracheal intubation compared to suxamethonium. In both groups the maximum rate pressure product occurred one minute after intubation, rising by 56% in the suxamethonium group and 64% in the pancuronium group compared to control values. In conclusion, there were significant and statistically similar increases in systolic and diastolic blood pressures and rate pressure product following intubation in both groups with values significantly above baseline until three minutes post intubation but the increase in heart rate in group A was significantly less than that in group B.

Adolescent↗

Patterns of accidental fractures and dislocations in Saudi Arabia.

A study of 4320 confirmed cases of accidental fractures and dislocations was conducted. The aims were to study and analyse the patterns of fractures and dislocations, age and sex distribution, and the cause of injury. It was found that dislocations are relatively uncommon, upper limb injuries are more frequent than lower limb and axial skeleton injuries, and the radius and ulna were the most commonly fractured bones. A young adult male was found to be the person most at risk of an injury, and children of both sexes were the second age group most commonly involved. The overall results showed that road traffic accidents accounted for 14 per cent of the cases, but this incidence increased in the young adult and the over 40 years age group, and this cause was more evident with the more serious fractures, such as those of the axial skeleton and lower limbs.

Accidents↗

Total intravenous anaesthesia with propofol and buprenorphine.

A combination of propofol infusion and two bolus doses of buprenorphine, 2.5 or 5.0 micrograms/kg were evaluated in a total intravenous anaesthesia technique in 36 patients of ASA grade 1 or 2 undergoing cholecystectomy. Additional boluses of propofol were given intravenously if needed. Systolic blood pressure after tracheal intubation increased significantly only in those who received the smaller dose of buprenorphine. Patients in both groups remained haemodynamically stable throughout surgery with minimal side effects. Recovery was fast even with prolonged infusions and without major side effects. No patient reported awareness on postoperative questioning.

Adult↗

A comparison of buprenorphine and pethidine in analgesic supplemented anaesthesia.

A randomized trial comparing 2.5 and 5 micrograms/kilogram body weight of buprenorphine and 0.8 milligram/kilogram pethidine, intravenously for intraoperative use in a balanced anaesthetic technique, and for postoperative analgesia was carried out. Compared with pethidine, buprenorphine was shown to be a satisfactory analgesic for preoperative and postoperative use with little difference in the incidence of unwanted effects and much longer duration of action. Increasing the dose of buprenorphine did not give any significant advantage.

Adult↗

Branhamella infections. An increasingly common respiratory illness.

Branhamella catarrhalis is an important cause of acute sinusitis and otitis media in children and of acute tracheobronchitis in older persons with underlying chronic lung disease or a suppressed immune system. Clinical presentation of B catarrhalis infection varies from a mild, self-limiting disease to severe pneumonia, but most cases are mild to moderate in severity. Infection occurs sporadically, and endogenous spread from the oropharynx is the likely mechanism. The keys to diagnosis are a high index of clinical suspicion, correct interpretation of Gram's stain of sputum, and subsequent confirmation on culture. Because most strains of B catarrhalis produce beta lactamase, antibiotics that resist beta-lactamase production, eg, amoxicillin-clavulanic acid (Augmentin), erythromycin, ciprofloxacin (Cipro), are recommended. Mild infections can be self-limiting and may not require antibiotic therapy.

Bacterial Infections↗

Effect of buprenorphine on the cardiovascular response to tracheal intubation.

The effects of buprenorphine on the haemodynamic responses to tracheal intubation were studied in a placebo-controlled double-blind trial in 40 patients who had elective surgery. In one group saline was administered intravenously 8 minutes before induction, whereas the others received buprenorphine 2.5 micrograms/kg intravenously. Anaesthesia was induced in both groups with thiopentone 4 mg/kg followed by suxamethonium 1.5 mg/kg after 90 seconds. In the buprenorphine group, the maximum increase in systolic and diastolic arterial blood pressures, heart rate and rate pressure product were significantly lower compared to the control group. It is concluded that buprenorphine is partially effective in attenuating the cardiovascular response to laryngoscopy and intubation, but does not obliterate it.

Adolescent↗

Sequential intravenous-oral administration of ciprofloxacin vs ceftazidime in serious bacterial respiratory tract infections.

The efficacy and safety of sequential intravenous/oral ciprofloxacin in moderate to severe respiratory tract infections (RTI) were compared with those of ceftazidime in a prospective clinical trial. Sixty-six patients received IV ciprofloxacin (200 to 300 mg twice daily), followed by oral ciprofloxacin (500 mg twice daily). Fifty-six patients received intravenous ceftazidime (1 to 2 g two to three times daily). Ciprofloxacin was as effective as ceftazidime and produced a 91 percent clinical cure rate. Significantly more pretreatment bacterial isolates were susceptible to ciprofloxacin, and ciprofloxacin had a significantly higher rate of sputum bacterial eradication than did ceftazidime. Ciprofloxacin showed broad in vitro antibacterial activity with particularly low minimal inhibitory concentrations for Gram-negative organisms. Ciprofloxacin was well tolerated; there were few adverse effects. Ciprofloxacin was an effective and well-tolerated treatment for severe RTI that had the advantages of broad in vitro antibacterial activity, twice-daily dosing, and sequential availability in an intravenous and oral formulation.

Administration, Oral↗

Acute sporadic hepatitis non A non B clinical features and biochemical profile.

Hepatitis Non A Non B is the commonest type of sporadic hepatitis in Pakistan. To document its clinicopathological pattern, one hundred consecutive cases were studied. The clinical presentation indicates that it is a disease of mild severity presenting with anorexia and dark coloured urine. The rise in serum bilirubin transaminases and alkaline phosphatase is moderate. Monophasic pattern of transaminase elevation is seen. Chronic sequelae do not occur. The disease shows certain differences from western countries and Japan. It resembles hepatitis A. The possibility that it is caused by a closely related virus may have to be considered.

Acute Disease↗

Common complications in critically ill patients.

Patients in intensive care units (ICUs) are subject to many complications connected with the advanced therapy required for their serious illnesses. Complications of ventilatory support include problems associated with short-term and long-term intubation, barotrauma, gastrointestinal tract bleeding, and weaning errors. Cardiac tachyarrhythmias can arise from a patient's intrinsic cardiac disease, as well as from drug therapy itself. Hemodynamic monitoring is crucial to careful patient management, but it is associated with technical complications during insertion such as pneumothorax, as well as interpretive errors such as those caused by positive end-inspiratory pressure. Acute renal failure can develop as a result both of therapy with drugs such as aminoglycosides and hypotension of many etiologies, as well as the use of contrast media. Nosocomial infection, which is a dreaded complication in ICU patients, usually arises from sources in the urinary tract, bloodstream, or lung. Complications frequently can arise if the interactions of drugs commonly used in the ICU are not recognized. Further, the ICU patient is subject to nutritional complications, acid base problems, and psychological disturbances. This monograph deals with the frequency, etiology, and prevention of these common ICU complications.

Acid-Base Imbalance↗

Root growth responses of Anagallis arvensis L., primulaceae to air pollution.

The root growth response to air pollution in populations of Anagallis arvensis growing about 0.5, 2, 6, 12 and 20 km leeward from a power plant complex varied with the level of pollution, age of the stand and meteorological conditions. The roots were more affected by the pollutants at a young stage and the loss in net primary productivity was proportional to the pollution level. The populations up to 2 km from the source of pollution completed their life cycle quickly. The coal consumption rate at the power plant, relative humidity, wind direction and other environmental factors were found to influence the degree of growth response to air pollution.

Journal Article↗

Solubilized glycosyltransferases and biosynthesis in vitro of glycolipids.

The assembly of most of the ceramide-linked glycolipids (GSLs) in eukaryotic cells occurs in Golgi bodies. At least 18 different glycolipid:glycosyltransferases (GSL:GLTs) have been characterized, 10 of which have been solubilized. These GLTs can be classified into 2 distinct groups: 1) GLTs dedicated to either Dol-P-P-sugar(s) or ceramide-linked sugar(s); and 2) GLTs with dual loyalties (i.e., they compete with glycolipid- and glycoprotein-bound oligosaccharides). Studies with solubilized and purified GalNAcT-1 and GalNAcT-2 from embryonic chicken brains prove that GalNAcT-1 (UDP-GalNAc:GM3 beta 1-4GalNAcT) is specific for GSL, whereas GalNAcT-2 (UDP-GalNAc:Gb3 beta 1-3GalNAcT) can transfer to an oligosaccharide containing the alpha-linked terminal galactose. Similarly, GalT-3 (UDP-Gal:GM2 beta 1-3GalT) is more specific for ganglio-oligosaccharide and GalT-4 (UDP-Gal:Lc3 beta 1-4GalT) can transfer galactose to N-acetylglucosamine linked to p-nitrophenol, glycolipid or glycoprotein. Both GalT-3 and GalT-4 have been separated and purified from embryonic chicken brains. Studies with solubilized SAT-4 and SAT-3, from bovine spleen and embryonic chicken brains, respectively, suggest the existence of 2 different gene-expressed alpha 2-3SATs. The newly discovered FucT-3 (GDP-Fuc:NeuGc-iLc6-alpha 1-3FucT) from human colon carcinoma (Colo-205) has also been solubilized and separated from other GSL:GLTs. Using a new activity gel-Western blot combined technique, the molecular mass of this FucT-3 was determined to be 105 kDa.

Animals↗

Controlled, comparative study of ciprofloxacin versus ampicillin in treatment of bacterial respiratory tract infections.

The efficacy and safety of ciprofloxacin in bacterial bronchitis were compared with those of ampicillin in a double-blind, prospective clinical trial. Eighty-seven patients received either oral ciprofloxacin (750 mg twice daily) or oral ampicillin (500 mg four times daily). Ciprofloxacin was as effective as ampicillin and produced a 98 percent clinical cure rate. Significantly more pretreatment bacterial isolates were susceptible to ciprofloxacin (p less than 0.05), and ciprofloxacin had a significantly higher rate of sputum sterilization than did ampicillin (p less than 0.05). Ciprofloxacin showed broad in vitro antibacterial activity with particularly low minimal inhibitory concentrations for gram-negative organisms. Ciprofloxacin was well tolerated; there were few adverse effects, and patients had a significantly lower incidence of diarrhea with ciprofloxacin than with ampicillin (p less than 0.05). Ciprofloxacin was an effective and well-tolerated treatment for bacterial bronchitis that had the advantages of broad in vitro antibacterial activity and twice-daily dosing.

Adult↗