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Biomedical subjects

H Qureshi

Publications and source records attributed to H Qureshi.

At least 73 records · Page 4Linked to original sources

Giardia lamblia in patients undergoing upper G.I. endoscopy.

To determine the frequency of giardiasis in patients undergoing upper G.I. endoscopy for dyspepsia and other upper G.I. disorders, duodenal aspirates were collected in 200 patients and simultaneous duodenal biopsies in 163 patients. Nine percent aspirates and 1.8% duodenal biopsies showed Giardia lamblia trophozoites. Giardia as a cause of dyspepsia should be considered in patients with negative endoscopy and in those who remain symptomatic inspite of adequate treatment for known upper G.I. disorders.

Adolescent↗

Can diagnosis of Helicobacter pylori be rapid and yet sensitive?

Diagnostic accuracy of 5 tests viz., endoscopy, rapid urease, 24 hours urease, culture and histology, were evaluated in the detection of Helicobacter pylori (H. pylori) infection in 50 patients undergoing upper G.I. endoscopy. Endoscopic evidence of gastritis to predict H. pylori infection was 50% specific and 46% sensitive. Rapid and 24 hours urease test and culture were 100% specific when compared with histology and their sensitivity was 71%, 62% and 21% respectively. Of the three 100% specific tests, rapid urease test yields results within 15 minutes; therefore this test being easy, rapid and sensitive should be used for screening of H. pylori infection; followed by histology for further confirmation.

Endoscopy, Gastrointestinal↗

Differentiation of cirrhotic Vs idiopathic portal hypertension using 99mTc-Sn colloid dynamic and static scintigraphy.

Thirty-seven cases of portal hypertension with endoscopically proven oesophageal varices underwent liver biopsy to determine the etiology of portal hypertension. Of the total, 19 had cirrhosis and 18 idiopathic portal hypertension (IPH). Later all these patients underwent Tc99mSn colloid, static and dynamic scintigraphy of the liver and spleen. Ratios of the area and of the integral and slope of the integral for liver and spleen were calculated to see if any of these ratios can differentiate cirrhotics from IPH. Significant difference (P less than 0.001) was noted in the ratio of the area (L/S) in both patients and controls, but the ratios of the integral and the slope of the integral were not only significantly different (P less than 0.001) in the patients and controls but also in the two groups of patients (cirrhosis and IPH). The sensitivity of this test when compared with the histology was 58% for both cirrhosis and IPH but when compared with clinical diagnosis it was 76% for cirrhosis and 62% for idiopathic group. Therefore by adding the above mentioned test in the routine study of liver scintigraphy in patients with portal hypertension, further differentiation of cirrhotic group can be done from the idiopathic group.

Adolescent↗

Transhiatal oesophagectomy for carcinoma oesophagus. Early experience.

Over a period of eighteen months, (June, 89 to Dec, 90) 19 patients underwent Transhiatal Oesophagectomy for carcinoma. Thirteen were males and 6 females, age varying from 32 to 80 years with an average of 48.6 years. Dysphagia was present in all patients, the duration varied from 1.5 to 6 months, average 3.5 months. Pre-operative endoscopy and biopsy was done in all cases. Lesion was located in upper thoracic oesophagus in 6, middle 9 and lower 4. Histology revealed squamous cell carcinoma in 18 and adenocarcinoma in one. Transhiatal oesophagectomy without thoracotomy and cervical oesophagogastric anastomosis was carried out. The stomach was placed in the posterior mediastinum in 13 and retrosternal in 6 cases. Liver metastasis were present in 3, palpably enlarged nodes in 7 and the tumor was adherent to tissues in the mediastinum in 6 cases. Four patients died in hospital, 2 due to myocardial infarction, one due to massive haemetemesis, and the cause of death could not be established in one. Satisfactory relief of dysphagia was achieved in all cases. Oesophagectomy without thoracotomy is safe and better tolerated than the traditional trans-thoracic operations. The experience of one surgical unit is presented.

Adenocarcinoma↗

Efficacy of oral propranolol and injection sclerotherapy in the long-term management of variceal bleeding.

Three treatment regimens were tried in 145 portal hypertensives with bleeding oesophageal varices to test the efficacy of each regimen in the prevention of rebleeding. Forty-seven cases received oral propranolol, 57 sclerotherapy, while 41 who did not receive any treatment except conservative management served as controls. Patients were followed up at 6 weeks, 6 months, 1 and 2 years to see the frequency of bleeding with each regimen. No significant difference was seen at 6 weeks with either of the three regimens but at 6 months and 1 year the frequency of bleeding was significantly less (p less than 0.05) in the propranolol group than in the other two groups while at 2 years results were significantly better with both propranolol (p less than 0.05) and sclerotherapy (p less than 0.001) than in controls. Efficacy of propranolol when compared with sclerotherapy showed similar results. The results of the present study are different from most of the western reports where sclerotherapy was found to be superior to propranolol. Variations in the results are likely to be due to differences in the etiology of portal hypertension in different countries.

Administration, Oral↗

Site of duodenal ulcer and its influence on the mode of presentation and prognosis.

Two hundred and forty-five endoscopically proven or surgically treated duodenal ulcers were retrospectively evaluated to see if the site of ulcer has any influence on the clinical presentation, and healing and relapse rates. Anterior wall ulcer was present in 42%, posterior wall in 33%, lesser curve side of the cap in 12% and greater curve side in 13% cases. Ulcer site showed no correlation to age, sex, duration of illness, analgesic intake or smoking habits. Bleeding (116 cases) and perforation (15 cases) were the major complications encountered; of these perforation was invariably found on the anterior wall, while bleeding was more frequent in ulcers present on the lesser curve side of the cap. Better healing and high relapse rates were seen in ulcers situated on the greater curve, and low healing and relapse rates in lesser curve duodenal ulcers.

Adult↗

Association of Helicobacter pylori with acid peptic disease in Karachi.

The prevalence of H. pylori infection in 200 dyspeptic patients undergoing upper G.I. endoscopy was investigated by histology and rapid urease test. H. pylori was associated with 86% cases of chronic gastritis, 84.6% cases of duodenal ulcers and 78.5% of gastric ulcers. None of the 15 histologically normal gastric biopsies showed H. pylori.

Adolescent↗

Pattern of duodenal ulcer in Karachi.

Seven hundred and twenty cases of endoscopically proven peptic ulcer were seen at PMRC Research Centre, Jinnah Postgraduate Medical Centre, during the last 13 years (June 1976-June 1989). Duodenal to gastric ulcer ratio was 5:1. Duodenal ulcer was predominantly seen between 3rd and 5th decade of life, with a male to female ratio of 5. 7:1. Seventy five percent cases were skilled persons. Places of origin showed 50% to be migrants; mostly from India while the rest belonged to various provinces of Pakistan. Sixty percent patients were smokers/tobacco chewers and 3% were simultaneously taking alcohol. History of NSAID intake was present in 5% cases only. Majority (85%) of the patients presented with pain, 42% had upper G.I. bleeding, 11% perforation and 1% pyloric stenosis.

Adult↗

A placebo controlled trial of bismuth salicylate in Helicobacter pylori associated gastritis.

In a placebo controlled prospective clinical trial of bismuth salicylate in helicobacter pylori associated gastritis, 52 adult patients were randomly allocated to treatment with bismuth salicylate or placebo. Helicobacter pylori were totally cleared in 77% patients in bismuth group but none in placebo group (P less than 0.001). Resolution of gastritis (P less than 0.001) and improvement of symptoms (P less than 0.01) were significantly better in patients where H. pylori infection cleared as compared to patients where the infection persisted.

Adolescent↗

Perforated duodenal ulcer--a long term follow-up.

Retrospective analysis of 115 cases of perforated duodenal ulcer was done to determine the long term prognosis of patients managed by suture plication. Male to female ratio was 7.8:1. Males were younger than females with a median age of 35 and 50 years respectively. Highest frequency was noted in the 4th decade. Thirty-eight percent cases were smokers and 8.7% were pan/tobacco chewers. Blood group O was predominant (36.5%). Ninety-five percent perforations were in the anterior wall of the Cap and 5% prepyloric. Of the 48 (42%) cases followed, 28 (58%) relapsed during a 15 year follow-up. The cumulative relapse rate increased with the increase of follow-up period. Patients who relapsed had a longer duration of symptoms prior to perforation (P less than 0.05) than those who did not relapse.

Adolescent↗

Clinical features, course, viral markers and follow-up in young versus adult nonalcoholic cirrhotics--a retrospective study.

To determine the presenting features and prognosis of nonalcoholic cirrhosis, retrospective analysis was done in 145 cases. Of the total, 48 patients (33%) belonged to the young (less than or equal to 35 years), and 97 (67%) to the adult age group (greater than 35 years) with no predominance of either sex. The etiology of cirrhosis and the positivity of viral markers were similar in both groups. Adults had on presentation a higher frequency of anorexia while hematemesis was more frequent in the young group (p less than 0.001). During a mean follow-up (+/- SE) of 31.7 +/- 5.5 and 16.3 +/- 2.2 months in the young and adult group, respectively, 68 and 63% cases survived 5 years. Liver failure (53.8 and 44.4%) and variceal bleeding (23 and 11.1%) were the main causes of death in both groups, accounting for 27% mortality in each group.

Adult↗

Serum thyroid hormone levels in liver cirrhosis.

Levels of thyroid hormones, serum thyroxine, triiodothyronine (T3), free thyroxine (FT4), free triiodothyronine (FT3) and thyrotropin (TSH) were measured in 55 patients with liver cirrhosis using radioimmunoassay techniques. Results were compared with 78 controls. The mean serum concentration of T3, FT3 and FT4 were significantly decreased in cirrhotics, while no significant change was noted in serum T4 and TSH levels. T3/T4 ratio was also lower than the normal. This indicates an impaired liver conversion of T4 to T3 in peripheral tissues. Serum T3 and FT3 showed an inverse correlation with serum bilirubin and a positive correlation with serum albumin. T3, FT3 and T3/T4 ratios were significantly low in patients who had ascites as compared to those who had no ascites. This study confirms the presence of abnormalities in serum thyroid hormone levels in cirrhosis of liver. Alteration in serum T3 and FT3 levels correlate well with the disease severity and may be useful in assessing the course and prognosis in cirrhotic patients.

Adolescent↗

A single nocte dose of famotidine in the treatment of duodenal ulcer.

Fifty three patients with duodenal ulcer were treated with 40 mg of famotidine at bed time. Repeat endoscopy showed healing rates of 69.8% and 83% at 4 and 6 weeks respectively. Seven patients were kept on a maintenance dose of 20 mg nocte for one year, of these one had a relapse despite taking the drug regularly. No appreciable side effects were observed with the drug (JPMA 39:104, 1989).

Adolescent↗