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Biomedical subjects

F M Khan

Publications and source records attributed to F M Khan.

At least 37 records · Page 2Linked to original sources
PubMed1994

Comparative studies on the composition of two indigenously produced varieties of jaman (eugenia jambolana) fruits.

Eugenia Jambolana (Syzigium Cumini) locally known as Jaman, is being used in the indigenous Medicinal system for treatments of various ailments including some related to nutrition. No study appears to have been made previously regarding the composition of these native varieties produced in Northern Pakistan. Two varieties of fruits have been analyzed for physico chemical characteristics and their values compared. The findings indicate that both varieties contain adequate amount of nutrients and minerals; in general, variety I being richer in the former and II in the latter.

Journal Article↗
PubMed1993

Report of the Cancer Therapy Evaluation Program monitoring plan for secondary acute myeloid leukemia following treatment with epipodophyllotoxins.

BACKGROUND: Recent reports have documented the occurrence of treatment-related acute myeloid leukemia (AML) following therapy with epipodophyllotoxins. These reports have led to growing concern among oncologists, which could lead to premature abandonment of these agents at a time when the relationship between cumulative dose of epipodophyllotoxin and risk of treatment-related AML has not been determined. PURPOSE: Because of the increasingly important role of epipodophyllotoxins in the treatment of several types of adult and pediatric tumors, the Cancer Therapy Evaluation Program (CTEP) of the National Cancer Institute (NCI) has developed a monitoring plan to obtain reliable estimates of the risk of treatment-related AML following epipodophyllotoxin treatment. METHODS: We identified 12 NCI-supported Cooperative Group clinical trials in which patients with solid tumors are being treated with epipodophyllotoxins at different cumulative doses. One trial is using a moderate dose of teniposide (900 mg/m2), and 11 trials are using etoposide at a low dose (< 1500 mg/m2), a moderate dose (1500-3999 mg/m2), or a high dose (> or = 4000 mg/m2). Cases of treatment-related AML and treatment-related myelodysplastic syndrome (MDS) (hereafter referred to as treatment-related AML/MDS) occurring in these trials are reported to CTEP, with initial analysis for each cumulative dose group triggered by the reporting of four cases of treatment-related AML/MDS in that group. For each analysis, total patient follow-up for the group is determined and cumulative 6-year incidence rate is calculated. RESULTS: Three cases of treatment-related AML and one case of treatment-related MDS (with documented monosomy 7) were reported in a group of 207 patients who received etoposide at a low cumulative dose. The calculated 6-year rate of development of treatment-related AML/MDS was 3.2% (95% upper confidence interval bounded by 7.2%). CONCLUSIONS: The 6-year cumulative rate of treatment-related AML/MDS (3.2%) is within the range previously reported for alkylator-based regimens that did not include epipodophyllotoxins. IMPLICATIONS: Previous reports have suggested that higher cumulative doses of alkylators are associated with increased risk of treatment-related AML, and a critical goal of the monitoring plan is to determine whether a similar relationship exists for the epipodophyllotoxins. Estimates will be developed for leukemogenic risk for the moderate- and high-cumulative-dose groups when four cases of treatment-related AML/MDS have been identified within each group.

Acute Disease↗
PubMed1992

Beta irradiation of recurrent ptergia: results and complications.

Although postoperative beta irradiation for prevention of pterygium recurrence is widely used, its complication rate has not been widely appreciated. Thirty-six patients underwent pterygium excision followed by irradiation with 90Sr to between 1600 and 5300 cGy (median 2400) in two to four fractions over 7 to 27 days. A median of three fields were used in each treatment course (range two to 10). Most patients had undergone previous treatment for their pterygia, including surgery alone (25 patients), or both surgery and irradiation (5 patients). Overall, recurrences developed in 10 eyes (28%). Recurrence occurred in one eye after re-irradiation (20%), compared to 9 of 31 (29%) previously non-irradiated eyes (p greater than 0.1). There was no association with number of excisions and recurrences, although all but 6 patients had undergone more than one excision. Thirteen patients (36%) developed complications including: epithelial defect or corneal thinning (3), symblepharon (5), cataract (4) and corneal ulceration (1). Complications developed in 4 of the 5 (80%) re-irradiated eyes compared to 9 of 31 (29%) previously non-irradiated eyes (p less than 0.05). The power of the statistical analysis was limited by sample size, but no significant association was observed between the development of complications or recurrences and total dose, number of abutting fields, number of previous surgical excisions or patient age, even when re-irradiated patients were excluded. Recently described calibration uncertainties with the 90Sr applicator may explain in part these complications. Alternatively, technical factors such as the number of fields or volume treated may play a role. Excessive complications and recurrences with the use of postoperative beta irradiation in this series emphasize the danger of re-treatment and the need for alternative safe and effective therapies.

Adolescent↗
PubMed1992

Double-blind comparison of etodolac SR and diclofenac SR in the treatment of patients with degenerative joint disease of the knee.

An on-going multi-centre, double-blind, parallel-group study is being carried out to compare the efficacy and tolerability of sustained-release (SR) formulations of etodolac and diclofenac in patients with degenerative joint disease (osteoarthritis) of the knee. An interim analysis of the findings has been made for 64 patients from two centres which have now completed their part in the study. Thirty-two patients were randomly assigned to receive 600 mg etodolac SR once daily for 4 weeks; the remaining 32 patients received 100 mg diclofenac SR. Primary efficacy assessments rated on a 5-point categorical scale were patient and physician overall assessments of the patient's condition, night pain and pain intensity. Secondary efficacy parameters included weight-bearing pain, stiffness duration, joint tenderness on pressure, degree of swelling and erythema, degree of knee flexion and time to walk 15 metres. The results showed that for both etodolac SR and diclofenac SR treatment groups there was an improvement from baseline in all efficacy parameters at the last visit and no statistically significant difference was observed between treatments. However, although not statistically significant, the improvement rate in the patient's condition at Week 2 was slightly greater in the etodolac SR treatment group, suggesting that improvement may occur more rapidly with etodolac SR than with diclofenac SR. With regard to tolerability, 5 patients in the etodolac SR treatment group and 3 in the diclofenac SR group withdrew from the study because of adverse reactions. Two events (dyspepsia and mouth ulceration) in the etodolac SR group and 4 events (headache, glossitis, depression and insomnia) in the diclofenac SR group were considered to be definitely drug-related. Dyspepsia was reported by 3 patients (1 withdrawal) treated with etodolac SR and by 4 patients (2 withdrawals) treated with diclofenac SR. A statistically significant decrease was observed in haemoglobin and haematocrit values after 4 weeks of treatment in the diclofenac SR group, but this was not considered to be clinically important. In addition, there were no clinically significant changes in blood chemistry and urinalysis for either treatments. In conclusion, the results of the present study indicate that 600 mg etodolac SR once daily for 4 weeks is effective in the treatment of patients with degenerative joint disease of the knee, as is 100 mg diclofenac SR. In addition, both drugs have comparable tolerability profiles.

Aged↗
PubMed1991

Are heat stroke patients fluid depleted? Importance of monitoring central venous pressure as a simple guideline for fluid therapy.

During pilgrimage season (Hajj) in Saudi Arabia 34 patients with heat stroke (HS) were centrally cannulated to assess their state of hydration and fluid requirement during cooling period. Central venous pressure (C.V.P.) measurements indicated that most victims of heat stroke had normal C.V.P. on arrival at heat stroke centres and may not be fluid depleted. Twenty-two patients (64.7%) had normal or above normal C.V.P. Twelve patients (35.3%) had zero or below zero C.V.P. Six patients (17.6%) had above 10 cmH2O (range 10-26 cmH2O) and could have developed acute congestive heat failure and pulmonary edema if they had been transfused at the standard recommended rate of 3-4 litres of fluid during an average cooling time of 1 h as has been practiced in the heat stroke centres to date. This study also showed that heat stroke patients should not be briskly transfused because the heart may be affected by heat stroke per se and an unmonitored challenge by brisk i.v. therapy during cooling (which on its own increases preload on the heart due to peripheral vasoconstriction) can lead to acute overload problems. An average of 1 litre of normal saline or Ringer's lactate (crystalloids) was sufficient to normalize C.V.P. during the cooling period and to restore an optimal state of hydration without predisposing to congestive cardiac failure and pulmonary edema--the potential to develop disastrous adult respiratory distress syndrome and disseminated intravascular coagulopathy.

Central Venous Pressure↗
PubMed1991

Border separation for adjacent orthogonal fields.

Field border separations for adjacent orthogonal fields can be calculated geometrically, given the validity of some important assumptions such as beam alignment and field uniformity. Thermoluminescent dosimetry (TLD) measurements were used to investigate dose uniformity across field junctions as a function of field separation and, in particular, to review the CCSG recommendation for the treatment of medulloblastoma with separate head and spine fields.

Cerebellar Neoplasms↗
PubMed1991

Tracheal soiling with blood during intranasal surgery--comparison of two endotracheal tubes.

Sixty adult patients, ASA Classes I & II, were involved in a study to compare the effectiveness of Mallinckrodt Hi-Lo-Evac tube and Portex blue line tube in preventing soiling of the lower airways during intranasal surgery. The Hi-Lo-Evac tube with and without pack was significantly more effective than the Portex tube with pharyngeal pack (P less than 0.002) and (P less than 0.01 respectively). There was no significant difference when the Hi-Lo-Evac tube was used with or without a pack (P greater than 0.2). The more effective protection of the lower airways by the Hi-Lo-Evac tube is attributed to the facility of subglottic aspiration during surgery. It is suggested that the Hi-Lo-Evac tube could be used with safety during intranasal surgery in order to reduce postoperative morbidity associated with the use of pharyngeal pack.

Adolescent↗
PubMed1989

An afterloading brachytherapy device utilizing thermoplastic material.

An afterloading brachytherapy device for treatment of residual cancer in an enucleated orbit with two cesium-137 sources was designed using a thermoplastic material, Aquaplast. The device consists of a face-mask support held in place with elastic bands around the head and an acrylic afterloading applicator. The device is very easy to make, holds the sources firmly in place, allows full mobility of the patient, and gives excellent dose distribution to the target area. It was easily tolerated by a 7-year-old child during the 50 h of treatment.

Brachytherapy↗
PubMed1989

Total skin electron arc irradiation using a reclined patient position.

Several techniques for the treatment of the total skin of the patient using electron beams have been described in the literature. However, most techniques presuppose that the patient is capable of maintaining a standing position for the duration of the treatment. For patients either weakened by disease or those suffering from a loss of limbs, this is often an unrealistic expectation. We will describe a total skin electron irradiation technique that allows the patient to remain in a reclined position without sacrificing dose uniformity. This technique uses two symmetric +/- 48 degrees arc electron beams to provide a field uniformity of +/- 5% over a range of approximately 250 cm X 45 cm. Six patient positions are used to provide a uniform dose around the periphery of the patient. A description of the treatment technique along with details of the dosimetry are given.

Electrons↗
PubMed1988

Quality control of custom-made compensators.

This paper describes a method for routinely checking the accuracy of individual cerrobend compensators made for use with the Varian Clinicomp-100. The Reduction Ratios (for a given beam energy) are provided for select depth of compensation and field size. It is important to check each compensator before commencing treatment to identify possible operation error and ensure proper filling of the styrofoam with cerrobend. This verification process involves: (1) choosing several points at which the tissue deficit is known; (2) exposing a ready-pack film (Kodak XV-2) in a polystyrene phantom at a suitable depth, both with and without the compensator in place (the dose to which the film is exposed is within the initial linear range of the H and D curve); (3) determining the optical density at the above chosen points; and (4) comparing the O.D. ratios corresponding to the compensated and uncompensated conditions to the Tissue Maximum Ratios (TMRs) for the proper depths at these points. The method of this technique is also incorporated into the quality control check of other compensators, for example, acrylic, brass c-wedges, etc.

Humans↗
PubMed1988

Oculocardiac reflex during excision of periorbital tumor--a case report.

The occurrence of oculocardiac reflex causing severe bradycardia and hypotension during the excision of a large, hemorrhagic, periorbital tumor in a 66 year old male is presented. The reflex occurred despite complete destruction of the eye by the tumor. Intravenous atropine, 0.5 mg, restored both the heart rate and blood pressure and prevented further occurrence of the reflex during the rest of the operation.

Aged↗
PubMed1985

Gas exchange during microsurgery of the larynx using Foley catheter insufflation technique--preliminary results.

The technique of insufflating anesthetic gases via oro-tracheal Rusch type Foley catheter with spontaneous ventilation for microsurgery of the larynx is described. Fifteen unselected patients were used to assess the adequacy of gas exchange with this technique. Arterial blood gas analysis was carried out 5 minutes and 25 minutes after induction of anesthesia. The results at 25 minutes indicate adequate gas exchange. There was a significant increase in the PaO2 at 25 minutes but the decrease in PaCO2 at 25 minutes was insignificant. The technique also provided very satisfactory conditions for surgery with only minimal risk of gross tracheal soiling. No dysrhythmias were encountered and there was hemodynamic stability in all cases.

Adolescent↗