Biomedical subjects

Irfan Ahmad

Publications and source records attributed to Irfan Ahmad.

16 recordsLinked to original sources

PubMed2026

miRNA-mediated control of TLR-NLR interplay in the uterus: A hidden corner of recurrent pregnancy loss.

Toll-like receptors (TLRs) and NOD-like receptors (NLRs) are crucial pattern recognition receptors that initiate inflammatory responses and immunological activation upon detecting pathogen- or damage-associated molecular patterns (PAMPs/DAMPS) in the female reproductive tract, thereby maintaining homeostasis and supporting pregnancy success. Their signaling pathways play a significant role in reproductive disorders by mediating the immune response to various pathogenic stimuli. Recurrent pregnancy loss (RPL), defined as the natural ending of two or more pregnancies before 24 weeks of gestation, approximately half of these patients remain idiopathic without precise prognostic, diagnostic, and therapeutic plans. Emerging data point that microRNAs are essential for immunological control in the female reproductive tract. MicroRNAs (miRNAs) are non-coding RNAs that regulate gene expression by binding to mRNA and preventing translation into protein. miRNAs play a role in many biological processes, including the development and differentiation of trophoblasts, the activation and implantation of embryos, immune tolerance, and the receptivity of the endometrium during implantation. Given their capacity to regulate up to 30 % of the human genome, miRNAs offer a promising avenue for understanding the immunopathogenesis of pregnancy complications. Recent research has detected differential expression of specific miRNAs in reproductive system pathologies. This review focuses on microRNAs and their association with idiopathic recurrent miscarriage, a condition characterized by considerable heterogeneity. Future studies identifying the precise mechanisms linking miRNA-mediated immune dysregulation in RPL immunopathogenesis could open the way for novel personalized therapeutic and diagnostic strategies.

Female↗

PubMed2006

Influence of a single course of antenatal betamethasone on the maternal-fetal insulin-IGF-GH axis in singleton pregnancies.

OBJECTIVE: We examined the hypothesis that a single course of antenatal betamethasone influences the maternal-fetal insulin-IGF-GH axis. DESIGN: A prospective, observational, pilot study consisting of four groups of pregnant women: (I) received betamethasone and delivered <2 weeks post treatment; (II) received betamethasone and delivered >2 weeks post treatment; (III) untreated women who delivered <37 weeks (preterm controls); (IV) untreated women who delivered >37 weeks (term controls). Maternal and mixed umbilical cord blood was collected at delivery and analyzed for insulin, glucose, IGF-I, IGF-II, IGFBP-1, IGFBP-3, GH, and GHBP. RESULTS: Betamethasone increased maternal insulin, glucose and IGF-I levels without affecting IGFBPs. In the fetal compartment, betamethasone treatment was associated with a delayed suppressive effect on GH and a sustained suppressive effect on IGF-II levels. There were no differences in infant size or neonatal morbidities between patients who delivered <2 weeks or >2 weeks post betamethasone treatment. In Group IV, birth weight correlated positively with cord IGF-I levels (r2=0.41, p=0.0098) and negatively with cord IGFBP-1 levels (r2=0.51, p=0.0039), and ponderal index correlated negatively with cord IGFBP-1 levels (r2=0.27, p<0.05). CONCLUSIONS: A single course of antenatal betamethasone influences the maternal-fetal insulin-IGF-GH axis, particularly fetal IGF-II levels, without measurable anthropometric changes at birth. Whether these effects have implications beyond the neonatal period remains to be determined.

Betamethasone↗

PubMed2006

Investigation of diarrhoeic faecal samples for enterotoxigenic, Shiga toxin-producing and typical or atypical enteropathogenic Escherichia coli in Kashmir, India.

Three hundred and twenty-six Escherichia coli isolates recovered from 326 human faecal specimens from sporadic cases of diarrhoea in Kashmir valley, India, were investigated for the presence of stx(1), stx(2), eaeA, hlyA and lt virulence genes. None of the samples was positive for stx genes or Shiga toxins by PCR or enzyme-linked immunosorbent assay. Twenty-three E. coli isolates showed the presence of the eaeA gene, whereas three isolates harboured the lt gene. Enteropathogenic E. coli (EPEC) belonged to 10 different serogroups. Out of 23 EPEC isolates, the majority (78.26%) were atypical while five (21.73%) were typical. Only one of the typical EPEC harboured the EAF plasmid. Subtyping of the eaeA gene showed the presence of eaeA-alpha(1), eaeA-beta, eaeA-xi and eaeA-eta in one, two, four and two isolates, respectively. None of the E. coli isolates possessed eaeA-delta, eaeA-epsilon and eaeA-zeta. This study further upholds the opinion that Shiga toxin-producing E. coli do not pose a major threat to human health in India and eaeA-alpha(1), eaeA-beta, eaeA-xi and eaeA-eta could be common EPEC subtypes prevalent in humans with diarrhoea in India. The present study appears to be the first report of subtype analysis of the eaeA gene from India and also records the isolation of EPEC with the eaeA-xi gene from humans.

Adhesins, Bacterial↗

PubMed2006

Predictors of fatal outcome in fulminant hepatic failure.

OBJECTIVE: To determine prognostic indicators for morbidity and mortality in patients with fulminant hepatic failure. DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Gastroenterology and Hepatology, Shaikh Zayed Postgraduate Medical Institute, Lahore, from April 2003 to June 2005. PATIENTS AND METHODS: Forty five patients with confirmed diagnosis of fulminant hepatic failure were included in this study. They were investigated for acute viral serology, complete blood count, liver function tests, renal function tests, serum electrolytes, arterial blood gases, initially daily and then on alternate days. Patients were followed in high dependency/ICU at the Shaikh Zayed Postgraduate Medical Institute. Data were analyzed by logistic regression analysis to identify predictors of mortality and morbidity. RESULTS: Of the 45 subjects, 31 were males and 14 females. Twenty four patients were positive for acute hepatitis E. Twenty patients recovered fully, whereas 25 died with mortality rate of 55.6 %. Variables i.e. presence of non-A non-B viral hepatitis, serum creatinine > 2.0 mg/dl, serum phosphate > 3.5 mg/dl and sepsis were found to have significant association with mortality on linear correlation. Only serum creatinine more than 2.0 mg/dl, serum phosphate > 3.5 mg/dl and development of sepsis were found to predict the outcome after multivariate analysis. CONCLUSION: Patients with serum creatinine > 2.0 mg/dl, serum phosphate > 3.5 mg/dl and sepsis showed adverse prognosis for survival.

Adult↗

PubMed2006

A study of colorectal polyps.

OBJECTIVE: To determine various features of colorectal polyps and to evaluate the safety of colonoscopic polypectomy. DESIGN: Case series. PLACE AND DURATION OF STUDY: The Department of Gastroenterology and Hepatology, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore, from January 1987 to January 2004. PATIENTS AND METHODS: This study was based on data analysis of 393 patients who underwent colonoscopic polypectomy at our institution during 17 years from January 1987 to January 2004. Presenting complaints of patients were noted. Polyps were evaluated in terms of size, site, number and histopathology. RESULTS: Among 393 patients, 268 were male and 125 female. Presenting complaints were bleeding per rectum in 339 patients, diarrhea with blood in 34 and without blood in 6 patients, and lower abdominal pain in 12 patients. Two patients were being investigated for iron deficiency anemia. Two hundred and sixty-four patients had juvenile polyps, 39 had adenomatous polyps, 39 hyperplastic polyps, 39 inflammatory polyps, 3 malignant polyps and 2 patients had familial polyposis. Histopathological reports were not available in 7 patients. Size of the polyps ranged from 0.3 cm to 3.0 cm. Left colon was involved in 353 patients, transverse colon in 15, right colon in 8 patients and diffuse involvement of colon found in 17 patients. Bleeding following polypectomy occurred in 2% of the patients. No other procedure related complication occurred. CONCLUSION: Juvenile polyps were the commonest variety of polyps in our study. Colonoscopic polypectomy has very low complication rate.

Colonic Polyps↗

PubMed2006

Serum alanine aminotransferase level and response to interferon-ribavirin combination therapy in patients with chronic hepatitis C.

OBJECTIVE: To determine the difference in sustained virological response to interferon-ribavirin combination therapy between patients with normal ALT and those with raised ALT in chronic hepatitis C. DESIGN: Quasi-experimental study. PLACE AND DURATION OF STUDY: Department of Gastroenterology and Hepatology, Shaikh Zayed Postgraduate Medical Institute, Lahore, from February 2004 to June 2005. PATIENTS AND METHODS: Patients with positive HCV RNA by PCR and compensated liver disease were included and divided in two groups. One group with ALT below upper normal limit (UNL= 65U/L) and second group with raised ALT (> 1x UNL). After treatment with standard interferon alpha 2a and ribavirin, both groups were checked for sustained viral response (SVR) six months after end of treatment and compared for response to therapy with Chi square test. RESULTS: Of the 70 patients included, 25 had normal ALT (< 1 x upper normal limit UNL) and 45 had ALT above upper normal limit (> 1 x UNL). Of these, 63 patients completed treatment. Sustained viral response (SVR) was seen in 13 of 22 patients with normal ALT who completed therapy and 22 of 41 patients with raised ALT who completed treatment. Difference in SVR in two groups was not significant (p 0.679). When patients with raised ALT were sub-classified, significantly better response was seen in patients with ALT > or = 2 times the upper normal limit (p 0.021). CONCLUSION: Patients with normal baseline ALT respond equally well to combination therapy as is seen in patients with raised ALT.

Adult↗

PubMed2005

Non-endoscopic prediction of presence of esophageal varices in cirrhosis.

OBJECTIVE: To identify hematological, biochemical and ultrasonographic predictors of esophageal varices in patients of cirrhosis. DESIGN: Cross-sectional, analytical study. PLACE AND DURATION OF STUDY: Department of Gastroenterology, Shaikh Zayed Postgraduate Medical Institute, Lahore, from September 2003 to March 2004. PATIENTS AND METHODS: One hundred and one patients with established cirrhosis and no history of variceal bleed underwent physical examination, hematological, biochemical tests and abdominal ultrasound examination. Esophagogastroduodenoscopy (EGD) was carried out in all patients. Presence of varices on EGD was correlated with hematological, biochemical and ultrasonographic variables by regression analysis. RESULTS: Esophageal varices were seen in 65 patients while 36 patients had no varices. High grade varices were seen in 15 patients and 50 patients had low grade varices. Serum albumin less than 2.95 g/dl, platelet count less than 88 x 103/muL and portal vein diameter more than 11 mm were associated with presence of varices. High grade varices were predicted by serum albumin < 2.95 g/dl and portal vein diameter more than 11 mm. CONCLUSION: Patients with serum albumin < 2.95 g/dl, platelet count < 88 x 103/muL and portal vein diameter > 11 mm are more likely to have high grade varices. These patients are candidates for surveillance endoscopy.

Adult↗

PubMed2005

High prevalence of C-reactive protein elevation with normal triglycerides (100-149 mg/dL): are triglyceride levels below 100 mg/dL more optimal in coronary heart disease risk assessment?

BACKGROUND: The National Cholesterol Education Program defines a fasting triglyceride level below 150 mg/dL as normal. However, observational data suggest that triglyceride levels above 100 mg/dL may predict coronary heart disease (CHD) events. METHODS: To determine the prevalence of systemic inflammation with a normal triglyceride level (100-149 mg/dL), data obtained from the population-based cross-sectional study of 4412 men and women in the third National Health and Nutrition Examination Survey were reviewed. Measurements included fasting lipids and lipoproteins and serum C-reactive protein (CRP) level measured using a Behring Nephelometer Analyzer System. RESULTS: High CRP level was equally prevalent whether the designated triglyceride cutpoint was greater than or equal to 100 (unadjusted OR, 2.0; 95% CI, 1.7-2.3) or greater than or equal to 150 (unadjusted OR, 1.9; 95% CI, 1.6-2.2). After adjustment for other covariates, the triglyceride range of 100 to 149 mg/dL remained independently associated with elevated CRP level (OR, 1.3; 95% CI, 1.02-1.67). In addition, an approximately fivefold higher likelihood of elevated CRP level was observed with triglyceride levels between 100 and 149 mg/dL and normal body mass index (BMI; 24-24.9) compared with lower triglyceride level (<65 mg/dL) and BMI (<22) (P < 0.0001). CONCLUSIONS: These data indicate that "normal" triglyceride levels (100-150 mg/dL) are associated with systemic inflammation and that lower fasting triglyceride levels (eg, <100 rather than <150 mg/dL) may be a more optimal cutpoint in CHD risk assessment.

Adult↗

PubMed2005

Precut papillotomy outcome.

OBJECTIVE: To determine the success and complications of precut papillotomy using needle knife technique in common bile duct cannulation. DESIGN: Quasi interventional. PLACE AND DURATION OF STUDY: The Department of Gastroenterology and Hepatology, Federal Postgraduate Medical Institute, Sheikh Zayed Hospital, Lahore from April 2001 to August 2003. MATERIALS AND METHODS: From April 2001 to August 2003, a total of 347 ERCPs were performed at our institution. During this period, precut papillotomy was carried out in 79 patients. The data of these patients was evaluated for the success of the procedure and occurrence of short-term complications. Other parameters such as age and gender of patients, appearance of ampulla, and the diagnoses were also recorded. RESULTS: Forty-five patients were women and 34 men. The mean age was 52 years (range 12-80 years). Precut helped to cannulate common bile duct in 67 patients at first attempt and in further 5 patients at second attempt with an overall success rate of 91.14%. Complications occurred in 8 (10.1%) patients. These include hemorrhage in 5 (6.3%) patients and pancreatitis in 3 (3.8%). All complications were managed conservatively. CONCLUSION: Precut papillotomy is an effective technique in cannulating common bile duct in difficult cases with margin of safety, dependent on expertise.

Adolescent↗

PubMed2005

A historical perspective of synthetic ceramic and traditional feldspathic porcelain.

UNLABELLED: Ceramics were invented by the Chinese during the T'ang Dynasty, where they quickly became a precious commodity. By the early 18th Century, ceramics found its way into dentistry due to its high strength, biocompatibility, and malleability. Today, ceramic materials are a staple in dentistry, available in both naturally based and partially synthetic formulas. Most recently they have become available as quartz-glass synthetic materials manufactured under controlled conditions to eliminate the inconsistencies and impurities inherent in the naturally based counterpart. LEARNING OBJECTIVES: This article details the discovery of porcelain and its role as a precious substance throughout the world and time, from its initial use as ornamental earthenware to its practical application in modern dentistry. Upon reading this article, the reader should: Understand the historical significance of porcelain. Recognize the fundamental constituents and physical properties of both natural feldspathic porcelains and fully synthetic ceramics used in dentistry.

Aluminum Silicates↗

PubMed2003

Evaluating dentin bonding agents: an update.

Technological and material advancements in contemporary adhesive protocols have resulted in the development of several generations of bonding agents. Acid-etching procedures coupled with restorative materials that demonstrate improved aesthetics, bond strength, and durability have led to increased interest in the use of multi-component, single-component, and self-etching adhesives for everyday protocols. Micromechanical retention has significantly evolved into a more predictable science through the incorporation of various dentin bonding agents. This article reviews current literature and discusses current concepts on routine adhesion during placement of indirectly fabricated restorations.

Crowns↗

PubMed2002

Restitution of maxillary anterior aesthetics with all-ceramic components.

This paper discusses the use of four types of ceramics; zirconia, leucite reinforced glass, densely-sintered pure aluminium oxide and a low fusing porcelain, for the restitution of anterior aesthetics. Recent advances in dental ceramic technology have made this scenario a reality, which only a decade ago, was thought elusive. While ceramics offer obvious advantageous properties of enhanced appearance, they also need to satisfy functional and longevity criteria to be considered viable restorative materials. Numerous studies have cited data to fulfil these criteria, including sustained function and survival rates similar to porcelain fused to metal (PFM) restorations. This discussion will focus on current dental ceramic advances, and present a clinical case study using all ceramic constituents to rectify a deteriorating dentition.

Computer-Aided Design↗

PubMed2002

Salvaging fractured porcelain crowns with a direct composite repair technique.

Fractures of porcelain crowns, particularly on anterior teeth, require a rapid resolution. While repair can be achieved with relative ease using a composite resin material, detailed investigation of the cause of the fracture is mandatory to avoid repetition, and to safeguard longevity of both the affected restoration and abutment tooth. Treatment of fractured prostheses should not be implemented unless thorough evaluation is performed to determine potential damage to abutment and surrounding teeth. The ensuing discussion highlights etiology, clinical presentations, and guidelines for repairing fractured restorations.

Adhesiveness↗

PubMed2002

Synaesthetic restorations: a psychological perspective for surpassing aesthetic dentistry.

Dentistry is often described as a fusion of art and science. While the scientific aspect is well documented, the artistic component is nebulous and often subject to interpretation. The use of the word "aesthetic" as a description of artistic dentistry is essentially flawed. While it forms part of artistic concepts, aesthetics is not the quintessential description of what constitutes art or its perception by the human brain. This article redresses this balance by emphasizing the artistic nature of dentistry and rationalizing the criteria that constitute artistic perception.

Adult↗

PubMedDate not supplied

Light dynamic properties of a synthetic, low-fusing, quartz glass-ceramic material.

Significant material advancements have resulted in the increased application of porcelain materials as an ideal restorative substitute for tooth enamel and dentin. This discussion introduces a synthetic, low-fusing, quartz glass-ceramic system for the fabrication of fixed dental prostheses. This article evaluates and compares the properties of this ceramic system with regard to its applicability for use in contemporary dental practices. The theoretical aspects are supplemented by clinical case studies that highlight examples of the authentic results achievable using the low-fusing restorative material.

Adult↗

PubMedDate not supplied

Effect of band ligation on portal hypertensive gastropathy and development of fundal varices.

BACKGROUND: Use of endoscopic therapies for esophageal varices has resulted in increased prevalence of fundal varices and severe portal hypertensive gastropathy. This study was meant to compare the effect of band ligation and sclerotherapy on development of fundal varices and portal hypertensive gastropathy. METHODS: Patients with esophageal varices presenting in the endoscopy unit of Shiakh Zayed Hospital, with at least one previous endoscopy were included. Patient's past record was reviewed for findings and type of treatment given for varices during first endoscopy, number of endoscopies till date, number of esophageal varices band ligation (EVBL) or sclerotherapy sessions. All patients underwent upper GI endoscopy and findings were recorded. Type of treatment patient rendered during first endoscopy either EVBL or sclerotherapy was correlated to the presence of fundal varices and severity of portal hypertensive gastropathy observed on present endoscopy, using Chi square test (chi2). RESULTS: Eighty one patients were included. Mean age of patients was 48.70 +/- 12.63. Esophageal varices band ligation was carried out during first endoscopy in 49 (60.5%) patients and sclerotherapy in 31 (38.2%) patients. On fresh endoscopy, fundal varices were seen in 25 (30.8%) patients. Severe portal hypertensive gastropathy was found in 26 (32.1%) and mild in 54 (66.7%) patients. Severity of portal hypertensive gastropathy and presence of fundal varices in recent endoscopy was significantly more in patients with EVBL in first endoscopy. CONCLUSION: Band ligation of esophageal varices is associated with more frequent development of fundal varices and worsening of portal hypertensive gastropathy compared to sclerotherapy.

Esophageal and Gastric Varices↗