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Biomedical subjects

H Ismail

Publications and source records attributed to H Ismail.

At least 37 records · Page 2Linked to original sources
PubMed2003

Use of intravenous tranexamic acid to reduce allogeneic blood transfusion in total hip and knee arthroplasty: a meta-analysis.

Total hip or knee arthroplasty is associated with significant blood loss. Techniques such as the use of antifibrinolytics or desmopressin, or normovolaemic haemodilution have been used to reduce the need for allogeneic blood transfusion. Tranexamic acid has been used to reduce blood loss and transfusion requirement for total hip and knee arthroplasty, with variable results. This meta-analysis aims to evaluate whether intravenous tranexamic acid, when compared with placebo, reduces blood loss and transfusion requirement in total hip and knee joint replacement surgery and whether it might increase the risk of thromboembolic complications. The literature search was based on MEDLINE, EMBASE, Cochrane Controlled Trials Register, and information from the pharmaceutical company that produces tranexamic acid (Pharmacia-Upjohn). We identified 15 clinical trials and 12 were considered suitable for detailed data extraction. Tranexamic acid reduces the proportion of patients requiring allogeneic blood transfusion (OR 0.16, 95% CI: 0.09-0.26), total amount of blood loss (WMD 460 ml, 95% CI: 274-626 ml), and the total number of units of allogeneic blood transfused (WMD 0.85 unit, 95% CI: 0.36-1.33). Tranexamic acid does not increase the risk of thromboembolic complications such as deep vein thrombosis, pulmonary embolism, thrombotic cerebral vascular accident, or myocardial infarction (OR 0.98, 95% CI: 0.45-2.12). Intravenous tranexamic acid appears effective and safe in reducing allogeneic blood transfusion and blood loss in total hip and knee arthroplasty.

Antifibrinolytic Agents↗
PubMed2002

Identification and characterization of a 26- to 28-kDa circulating antigen of Fasciola gigantica.

As a disease of domestic ruminants, fascioliasis is of considerable economic importance. Although serological tests are available for the diagnosis of the disease, they are of generally low specificity because of cross-reactivity with antigens from other parasites. There is a need to identify other Fasciola antigens on which more specific tests could be based. In the present study, a specific rabbit anti-serum and western-blot analyses were used to demonstrate the presence of a highly reactive antigen of 26-28 kDa not only in an extract of adult F. gigantica but also in the excretory/secretory products of the worms and in the bile secretions and sera of cattle that were naturally infected with this parasite. The 26- to 28-kDa antigen was isolated from preparative polyacrylamide gels, by electro-elution. The purified antigen showed a single peak at 5.8 min when analysed by capillary zone electrophoresis. It was characterized as protein containing 47.5% hydrophilic and 29.3% hydrophobic amino acids. Immunostaining demonstrated that the target epitope was located in the gut and tegument of adult F. gigantica and within the bile ducts, the portal tracts of the livers and the mucosa and muscularis of the gallbladders of infected cattle. A simple and rapid dot-ELISA technique based on the specific rabbit anti-serum was 100% specific when tested on the sera from nine cattle infected with F. gigantea and 27 uninfected cattle. In conclusion, the 26- to 28-kDa Fasciola antigen may be a promising candidate for the immunodiagnosis of fascioliasis.

Amino Acids↗
PubMed2001

Case of the month

Each month, we will present a challenging Case of the Month for Green Journal readers, who must use their clinical acumen to arrive at the correct answer. We will also post the case each month on the Journal's web site (http://www.ajmselect.com). Several possible answers may be consistent with the case presentation; use your best judgment. Please send your answer (one per respondent) to The Green Journal at editors@amjmed.org or via FAX to (415) 447-2799. Indicate the case to which you are responding and include your complete address. The correct answer will appear in the next issue of the Journal. The first five persons who submit correct answers will receive a free one-year subscription to the Journal. Because of the volume of answers we receive, neither correct nor incorrect answers can be individually acknowledged. Colleagues of Drs. Ismail H and Bhat at Kasturba Medical College in Mangalore are not eligible for this month's case. If you would like to contribute a case, please submit a brief synopsis (<250 words) to the editorial office.

Journal Article↗
PubMed2001

Volatiles, color, and lipid oxidation of broiler breast fillets irradiated before and after cooking.

Chicken breast fillets were equally divided into three groups. One group was vacuum packaged, cooked in a water bath (cooked-in-bag) at 82 C for 25 min, and then irradiated at 0 or 3 kGy with a linear accelerator (V-C-I). The other two groups were irradiated at 0 or 3.0 kGy in vacuum packaging (V-I-C) or aerobic packaging (A-I-C). After 3 d of storage at 4 C, the irradiated meats were cooked in a water bath (cooked-in-bag) at 82 C for 25 min. After being cooked, meats were repackaged under vacuum and stored at 4 C. Breast fillets were analyzed at 0 and 21 d after cooking and analyzed for lipid oxidation, color, and volatiles. Irradiation accelerated lipid oxidation of breast fillets. Three days of storage of raw meat in aerobic conditions after irradiation had only minor influences on lipid oxidation after cooking. However, irradiation had a significant effect on the volatile production in meat. Dimethyl disulfide, related to irradiation odor, was significantly higher in irradiated fillets than in nonirradiated fillets for V-C-I and V-I-C, whereas it was only slightly higher for A-I-C. Other volatiles, such as 3-methyl butanal and 2-methyl butanal, were also produced in significant amounts after irradiation, especially in V-C-I and V-I-C. These results showed that irradiating cooked meat induced slightly more changes in volatiles than irradiating raw meat and then cooking. The amount of dimethyl disulfide between irradiated and nonirradiated samples for A-I-C was not different, because the dimethyl disulfide produced by irradiation disappeared during the 3 d in aerobic storage before cooking. Color a* value of irradiated fillets was higher than that of nonirradiated fillets. Irradiation also induced color L* and b* value changes. After 3 d of aerobic storage after irradiation of raw meat, the influence of irradiation on color after cooking was reduced. No significant lipid oxidation occurred during storage as shown by the low values for TBA-reactive substances.

Aldehydes↗
PubMed2001

Rapid deposition of wheat cell wall structural proteins in response to Fusarium-derived elicitors.

Two novel cell wall structural proteins of spring wheat (Triticum aestivum L. em Thell.). undergo rapid deposition in the cell wall matrix in a H(2)O(2)-dependent reaction after the elicitation of cultures with Fusarium graminearum (L.)-derived elicitor. The amino acid compositions of these proteins were remarkably similar and indicated that they were highly acidic (pI 3.8). These proteins contained 13--17% each of Gly, Glx and Ser with lesser amounts (6--8%) of Ala, Asx and Thr, and it has been suggested that they are known as glycine- and serine-rich proteins (GSRPs). SELDI-MS ionization spectra demonstrated that these proteins have low molecular masses of 8590 and 4292 Da. These results are discussed in relation to the possible role of these novel proteins in rapid, cell wall defensive reactions to pathogenic attack.

Amino Acids↗
PubMed1999

Vaccination against Schistosoma mansoni infection using 74 kDa Schistosoma protein antigen.

An IgG2a anti-Schistosoma mansoni mouse monoclonal antibody was shown to passively protect Swiss mice. The 74 kDa target antigen was isolated from antigenic extracts of S. mansoni adult worms. Swiss and C57 BL/6J mice were immunized with 30, 50, 100 and 200 microg antigen/mouse doses with and without Freund's adjuvant. Sera of immunized mice showed high reactivity against 74 kDa antigen. The highest protection level (76.6% in Swiss mice and 50.1% in C57 BL/6J mice) was obtained using the 50 microg antigen dose with and without Freund's adjuvant. A marked reduction in granuloma number and intensity of collagen and reticular granuloma fibers was observed. The 74 kDa antigen has the ability to protect mice of different strains and to modulate the host immune system.

Adjuvants, Immunologic↗
PubMed1999

Induction of resistance against Schistosoma mansoni infection by passive transfer of an IgG2a monoclonal antibody.

Monoclonal antibodies can confer resistance to schistosome infections. This has led to identification of several protective antigens. An IgG2a monoclonal antibody designated BRL4 mAb identified a 74-kDa antigen in antigenic extract of Schistosoma mansoni adult worms. The target antigen was localized in gut and tegument. In 3 passive transfer experiments, the BRL4 mAb conferred 51.6, 41.9 and 53.8% protection levels into female Swiss mice. Histopathological examination revealed a marked decrease in number, size, collagen and reticular fibers of the liver granulomas. Further experiments using purified 74-kDa-target antigen as a candidate vaccine will be performed.

Animals↗
PubMed1999

Treatment of progressive familial intrahepatic cholestasis: liver transplantation or partial external biliary diversion.

Progressive intrahepatic familial cholestasis (PFIC), previously called Byler's disease, is a syndrome in which children develop severe cholestasis progressing to biliary cirrhosis and chronic liver failure, usually during the first decade of life. Clinical features include jaundice, hepatomegaly, splenomegaly, growth retardation and severe pruritus. Laboratory tests demonstrate elevated bilirubin and bile acids, without an increase in serum gamma-glutamyl-transpeptidase or cholesterol. This study was performed to evaluate our experience with medical therapy as well as two types of surgical treatment used in children with PFIC, particularly partial external biliary diversion (PEBD) as an alternative method of therapy to liver transplantation (OLTx). Between 1979 and 1998 we have treated 46 children with PFIC (27 boys and 19 girls), aged 10 months to 19 yr (at the time of this study). Medical treatment with ursodeoxycholic (UDCA) was used in 39 patients for the period between 6 and 82 months. PEBD (cholecysto-jejuno-cutaneostomy) was performed in 16 patients, OLTx in eight children (including one after unsuccessful PEBD). Retrospective analysis of the clinical course and selected laboratory tests (bilirubin, ASPAT, ALAT, bile acids), and histopathological examinations were performed. Results of treatment were assessed by means of influence of the type of treatment on clinical symptoms, laboratory tests, progress of liver cirrhosis and hepatic failure, as well as physical development and survival. Medical therapy was effective in the long term in four (10%) of the patients resulting in clinical and biochemical normalization. Both surgical methods of therapy of PFIC, PEBD and OLTx, resulted in an 80% success rate and therefore should be used as complementary therapies. In patients before established liver cirrhosis, PEBD should be the first choice of treatment. Patients presenting with cirrhosis or after ineffective PEBD should qualify for OLTx. With this strategy most children with PIFC can be cured.

Adolescent↗
PubMed1999

Rapid detection of a Schistosoma mansoni circulating antigen excreted in urine of infected individuals by using a monoclonal antibody.

Schistosoma circulating antigens were used to indicate the infection intensity and to assess cure. An immunoglobulin G2a (IgG2a) mouse monoclonal antibody was used in a fast dot-enzyme-linked immunosorbent assay (ELISA; FDA) for rapid and simple diagnosis of schistosomiasis in the field. Seven hundred Egyptians were parasitologically examined for Schistosoma mansoni and other parasitic infections. A rectal biopsy was done as a "gold standard" for individuals showing no S. mansoni eggs in their feces. Egg counts were obtained by the Kato smear method for only 100 of 152 individuals with eggs in their feces. Specific anti-schistosome IgG antibodies were evaluated in sera by ELISA. Urine samples from the 700 individuals were tested by FDA for detection of the circulating antigen. The assay showed a sensitivity of 93% among 433 infected individuals and a specificity of 89% among 267 noninfected individuals. FDA showed the highest efficiency of antigen detection (91%) compared with the efficiency of antibody detection by ELISA (75%) and stool analysis (60%). In addition, FDA detected infected patients with 20 eggs/g of feces. Also, the sensitivity of FDA ranged from 90 to 94% among samples from patients with different clinical stages of schistosomiasis. All the assay steps can be completed within 30 min at room temperature for 96 urine samples. The monoclonal antibody identified a 74-kDa antigen in different antigenic extracts of S. mansoni and Schistosoma haematobium and in the urine of infected individuals. In addition, a 30-kDa degradation product was identified only in the urine samples. On the basis of these results, FDA should be used as a rapid tool for the sensitive and specific diagnosis of Schistosoma infection.

Adolescent↗
PubMed1999

Stroke in Saudi children.

This study reports the clinical features and neuroimaging correlates of stroke in Saudi children seen over a 5-year period at the King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. During the study period, 31 (18 boys, 13 girls; mean age, 26.2 months) of the 20,895 children seen had stroke; the annual stroke incidence was 29.7 per 100,000 in the pediatric population. Ischemic strokes accounted for 90% and hemorrhagic 10% of the cases, respectively. The boys-to-girls ratio for ischemic stroke was 2:1. Cranial computed tomographic scans and magnetic resonance imaging findings were abnormal in 82% and 91%, respectively. The etiologic factor was undetermined in 65% of the cases. Our results suggest that stroke is uncommon in Saudi children. However, further studies evaluating a larger population in different clinical settings are required to provide a more comprehensive picture of stroke in children in this area.

Cerebrovascular Disorders↗
PubMed1999

Immunochemical characterization and diagnostic potential of a 63-kilodalton Schistosoma antigen.

Schistosoma circulating antigens were used for the detection of active infection. Anti-S. mansoni IgG2a monoclonal antibody (MAb) designated C5C4 was generated. The target epitope of this MAb was detected in adult worms, eggs, and cercariae antigenic extracts of S. mansoni and S. haematobium, had a molecular size of 63 kD, and was not detected in Fasciola hepatica and Ascaris. In addition, a 50-kD degradation product was identified only in the urine of infected individuals. Analysis by high-performance liquid chromatography of the purified antigen demonstrated only one peak. The 63-kD antigen was characterized as a protein containing 40.4% hydrophobic, 7.5% acidic, and 8.8% basic amino acids. The C5C4 MAb was used in a Fast Dot-ELISA for rapid and simple diagnosis of human schistosomiasis. The 63-kD circulating antigen was detected in 92% of urine samples from 330 S. mansoni-infected individuals, with 16% false-positive results among 130 noninfected individuals.

Adolescent↗
PubMed1998

Immunochemical purification and characterization of a 74.0-kDa Schistosoma mansoni antigen.

A polypeptide antigen of 74.0 kDa molecular weight was detected in the antigenic extracts of the 3 developmental stages of Schistosoma mansoni (eggs, cercariae, and adult worms) by western blotting using BRL4 monoclonal antibody (mAb) that significantly protected mice at the levels of 51.6%, 42%, and 53.8% against challenge S. mansoni infection in 3 separate experiments. This antigen was isolated and purified from crude soluble worm antigen preparation by immunoaffinity chromatography using CNBr-activated sepharose-4B beads coupled with the BRL4 mAb. The purified antigen showed a single peak when analyzed by both high-performance liquid chromatography and high-performance capillary electrophoresis. The 74-kDa antigen was characterized as a protein in nature with 56.9% hydrophilic amino acids and 43.1% hydrophobic amino acids. This antigen was detected in 93% of urine samples from infected cases with specificity of 89% among noninfected cases using an enzyme immunoassay-fast dot-enzyme-linked immunosorbent assay based on BRL4 mAb.

Adolescent↗
PubMed1997

Primary vascular thrombosis after renal transplantation in children.

The aim of the study was to assess the incidence, causes, diagnostic and treatment modalities, and outcome of vascular thrombosis after kidney transplantation in children. Between 1984 and 1995 we performed 176 kidney transplants in pediatric recipients aged 1 to 18 years. Vascular thrombosis followed 7 transplants, 4 were renal vein and 3 arterial thromboses. Venous thromboses occurred 2 to 12 days after transplantation. All of the patients with a renal vein thrombosis lost their grafts. Arterial thrombosis developed in 2 cases of double renal arteries which were separately anastomosed into the recipient vessels. One graft was lost, but the other was saved by thrombolytic therapy (streptokinase). One child experienced intrarenal segmental artery thrombosis during acute vascular rejection, which resolved following combined anti-rejection and thrombolytic (intra-arterial streptokinase) treatment with full recovery of graft function. In all, vascular thrombosis complicated 7 out of 176 transplants (4.0%), and was the cause of 5 graft losses (2.8%). The incidence of vascular thrombosis was not increased in grafts with vascular anomalies (3/34 v. 4/142; p>0.05, chi sq.). We conclude that acute tubular necrosis, rejection and unstable volemia may predispose to vascular thrombosis. In selected cases, early diagnosis of vascular thrombosis may enable graft salvage by surgical or thrombolytic treatment.

Adolescent↗
PubMed1997

Fast-Dot ELISA using urine, a rapid and dependable field assay for diagnosis of schistosomiasis.

The fast dot-enzyme linked immunosorbent assay (FD-ELISA) was used as a field applicable tool for rapid diagnosis of schistosomiasis. Seven hundreds faecal specimens were parasitologically examined for detection of S. mansoni eggs and other parasitic infection. Egg count was done for 100 infected patients. Rectal biopsies (394) were taken from individuals with no S. mansoni egg in their stool where it was used as a golden standard for diagnosis of schistosomiasis. Cross-reactivity with other parasites was studied. Serum samples were tested by ELISA technique for detection of human IgG anti-schistosomal antibodies. Seven hundreds urine samples (433 S. mansoni infected patients and 267 healthy individuals) were tested by FD-ELISA for detection of a schistosomal antigen excreted in urine using BRLF4 mouse monoclonal antibody. FD-ELISA results were compared with ELISA detecting antischistosomal IgG and stool analysis where, it showed highest efficiency (91%), compared with 81% and 60% for ELISA and stool analysis respectively. The sensitivity of FD-ELISA was high ranging from 90-94% in the four different clinical stages of schistosomiasis (Simple intestinal. Hepatosplenomegaly, Shrunken liver & Splenomegaly, and Shrunken liver-splenomegaly & ascites). FD-ELISA was highly sensitive, detecting infection cases with 20 eggs/gm faeces and its specificity was 89%. The antigen was characterized as a protein with a molecular weight of 74 KDa using western blot technique.

Adolescent↗
PubMed1996

Diagnosis and monitoring of cytomegalovirus infection after liver transplantation in children.

Cytomegalovirus infection (CMV) complicated the posttransplant course in 9 of 24 children after liver transplantation. We found specific antibodies (IgG and IgM) to be of very low value in diagnosis and monitoring of CMV infection after liver transplantation. Detection of CMV-DNA by PCR method in the blood or urine was very useful for diagnosis, but less for monitoring of the course of disease and its treatment. Measurements of early immediate CMV antigen (IEA), in peripheral blood leucocytes allowed for very early diagnosis of CMV infection and correlated well with the course of disease and response to treatment of the patient.

Antibodies, Viral↗
PubMed1995

Food intake, nutrient utilization and water turnover in the lesser mouse-deer (Tragulus javanicus) given lundai (Sapium baccatum).

Voluntary food intake, digestibility and water turnover were determined in adult Malaysian lesser mouse-deer (Tragulus javanicus) given unlimited access to lundai foliage (Sapium baccatum). Daily dry matter (DM) intake was 42.4 g/kg metabolic live mass (M0.73) or 3.7% M. Digestible energy intake was 853 kJ/day (571 kJ metabolisable energy per M0.73), calculated to be used with 79% efficiency. Apparent digestibility (%) of organic matter was 83.8, crude fibre 63.7, acid detergent fibre 60.5, neutral detergent fibre 72.1 and crude protein 65.0. Urinary excretion of the purine derivative, allantoin, was 0.05 mg/g digestible DM intake suggesting rumen microbial yield efficiency may be lower than in other ruminant species. Total water intake was 182 ml/M0.82. The body-water content of the fed mouse-deer, from tritiated water dilution, was 77% M, consistent with a very lean carcass. Turnover of body water was 17% per day. The mouse-deer produced relatively dry, well-defined faecal pellets.

Allantoin↗