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Biomedical subjects

M A Halim

Publications and source records attributed to M A Halim.

32 records · Page 2Linked to original sources
PubMed1993

Chronic non-A, non-B hepatitis complicated by end-stage renal failure treated with recombinant interferon alpha.

Chronic non-A, non-B hepatitis occurs in 50% of Saudi patients with end-stage renal failure and requires long-term hemodialysis since it is a contraindication to renal transplantation. Thirteen patients with biochemical and histological documented chronic non-A, non-B hepatitis (11 with HCV antibodies) entered a double-blind placebo controlled cross-over study, in which Roferon A 3 MU or placebo were administered subcutaneously 3 times weekly after hemodialysis for 6 months. The mean ALT fell significantly from pretreatment levels of 74.7 (95% confidence interval (CI) 54.7, 92.5) (13 patients in the 6-month run-in period) and 66.8 (CI 47.7, 85.8) (7 patients in the run-in period + 6 patients in the placebo period) (difference NS) to 37.6 (CI 21.0, 54.2) during interferon treatment (P < 0.005). In 10/13 patients (77%) ALT levels became normal. In the 6-month follow-up period immediately after therapy, the mean ALT was 45.2 (CI 28.0, 62.0). Although this change was not significant (P = 0.49), only 7 of these 10 patients sustained biochemical remission in the 6-month follow-up period. The corresponding total Histological Activity Index improved from 8.9 (CI 7.5, 10.3), 8.9 (CI 7.2, 10.7) (difference NS) to 6.2 (CI 3.9, 8.5) (P < 0.05; P = 0.052, respectively). Intralobular inflammation and periportal inflammation showed the most significant changes. Five of 13 (39%) and 2/13 patients (15%) had complete resolution of piecemeal necrosis and intralobular inflammation, respectively. Toxic effects of interferon were mild, early and self-limiting.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Successful treatment of visceral leishmaniasis with allopurinol plus ketoconazole in a renal transplant recipient after the occurrence of pancreatitis due to stibogluconate.

A case of a renal transplant recipient who developed pancreatitis during stibogluconate treatment for visceral leishmaniasis and who was successfully treated with a combination of allopurinol and ketoconazole is reported. The features of this case are compared with those of the three previously reported cases of pancreatitis during stibogluconate treatment. Complete cure was achieved during the follow-up period of 15 months. If stibogluconate is used for treatment of renal transplant recipients, we advise extreme caution with close observation and combination therapy to be considered instead.

Adult↗
PubMed1992

Efficacy of ciprofloxacin for treatment of Brucella melitensis infections.

The effectiveness of treatment of human brucellosis caused by Brucella melitensis with ciprofloxacin alone was investigated in a prospective nonrandomized study. Subjects with central nervous system involvement, endocarditis, or severe renal dysfunction; children under 16 years of age; and pregnant women were excluded from the study. Of 19 patients, 16 completed the study; 7 were diagnosed as having acute systemic brucellosis, and 9 had acute brucella arthritis-diskitis. A rapid response to ciprofloxacin was seen in all 16 patients, but the blood cultures of 1 patient remained positive and the treatment was changed. During a 104-week follow-up period, 4 of the 15 responding patients relapsed or were reinfected within 8 to 32 weeks after completion of therapy. We conclude that treatment with ciprofloxacin alone, although effective for the acute symptoms, is associated with an appreciable rate of relapse; therefore, it should be given with other agents for treatment of brucellosis.

Administration, Oral↗
PubMed1991

Diagnostic dilemma and therapeutic non-compliance in a case of intracranial tuberculoma.

A case of extensive intracranial tuberculoma is presented. The patient had been treated for 5 years with a standard antituberculosis regimen but she had been grossly non-compliant. This had led to emergence of multi-resistant Mycobacterium tuberculosis producing progressive disease and extensive cranial nerve damage and proptosis. The unusual CT and angiographic appearances cast doubt on the original diagnosis and a brain biopsy was necessary. Mycobacterium tuberculosis resistant to isoniazid, rifampicin, ethambutol, ethionamide, pyrazinamide, clofazimine and PAS was cultured from the brain biopsy specimen and from an associated groin abscess. A novel regimen of isoniazid, cycloserine, amikacin and ciprofloxacin produced clinical improvement of symptoms and radiological resolution.

Adult↗
PubMed1990

Beta-adrenergic receptor blockade in the management of pregnant women with mitral stenosis.

Twenty-five pregnant women with symptomatic mitral valve stenosis (mean valve area, 1.1 +/- 0.25 cm2) were managed by initiation or modification of beta-adrenergic receptor blockade with the use of either propranolol or atenolol. Significant improvement of symptoms occurred in 23 patients (92%) (p less than 0.01); the mean maternal heart rate was reduced significantly from 86 +/- 4 to 78 +/- 5 beats/min (p less than 0.0001). The overall fetal heart rate ranged between 130 to 150 beats/min during treatment. Only two patients required urgent closed mitral valvotomy, after pulmonary edema developed as a result of poor compliance to beta-blockade. All patients were safely delivered of infants at term. Fetal heart rates ranged between 120 to 140 beats/min at delivery. There was no maternal or fetal death. Pregnant woman with symptomatic mitral valve stenosis can be safely managed with beta-blockade, giving significant reduction in the incidence of pulmonary edema with no unwanted neonatal side effect.

Adrenergic beta-Antagonists↗
PubMed1987

Brucella endocarditis.

Brucella endocarditis is an underdiagnosed, fatal complication of human brucellosis. Four successfully treated cases of Brucella endocarditis are reported. The development of a new valvar lesion and bulky vegetations seen on echocardiography helped to identify Brucella endocarditis occurring during systemic brucellosis. The aortic valve was affected in all four patients, and in one the mitral valve was also affected. Medical treatment did not cure the patients and all needed valve replacement--for haemodynamic deterioration in three and because a further embolism was feared in one. Antibiotics were continued for six to nine months after operation. There was no early or late mortality and no recurrence after a follow up of 15 months.

Adult↗
PubMed1985

Endarterectomy of the left coronary system. Analysis of a 10 year experience.

Between January, 1971, and June, 1981, 278 patients undergoing coronary artery bypass grafting had additional endarterectomy to the left coronary system. This constitutes 28% of all patients undergoing bypass grafting. Additional endarterectomy of the left anterior descending was performed in 250 and of the circumflex in 75 (an average of 1.2 endarterectomies to the left coronary system per patient). Five hundred thirty-six additional grafts to other vessels were performed, for a total of 861 grafts (three grafts per patient). There were 11 (4%) early and 29 (10%) late deaths. The actuarial survival rate was 93% at 3 years and 80% at 6 years. The incidence of perioperative myocardial infarction was 12%. Of the survivors, 94% were either asymptomatic or improved. Two hundred forty-three grafts (75%) were restudied early (2 weeks to 1 year). The early patency rate of the grafts to the left anterior descending was 83% (156/188) and to the circumflex 75% (41/55). In 75 patients (81 grafts), restudied 1 year or more after operation, the patency rate was 75% (61/81). The runoff of grafts to the left coronary system was judged to be good in 76%, moderate in 14%, and poor in 10%.

Adult↗
PubMed1983

Late results of mitral valve replacement using unstented antibiotic sterilised aortic homografts.

Three hundred and seventy nine patients who had undergone mitral valve replacement using unstented antibiotic sterilised aortic homografts were followed up for 52 to 138 months (mean 102 months). Patients requiring additional aortic valve replacement were excluded. The commonest cause was rheumatic heart disease (321 patients). There were 37 early deaths (9.8%) and 97 late deaths (28%). The actuarial survival of operative survivors was 83% at three years, 75% at five years, and 55% at nine years. Technical valve failure occurred in six patients (1.6%), infective endocarditis in 19 (5%), and degeneration of the valve in 43 (12.5%). The cumulative probability of freedom from endocarditis was 96% at three years, 94% at five years, and 91% at nine years, while that of freedom from valve degeneration was 97% at five years and 48% at 10 years. There were no early embolic episodes, but late embolism occurred in five patients (1.5%).

Adolescent↗
PubMed1982

Early and late results of combined endarterectomy and coronary bypass grafting for diffuse coronary disease.

Between October 1969 and December 1979, a total of 440 patients who had diffuse coronary artery disease were treated with combined endarterectomy and coronary bypass grafting. This constitutes 42 percent of all patients operated on at the same institution during this period. Six hundred eight endarterectomies were performed, 329 on the right coronary artery, 227 on the left anterior descending coronary artery and 52 on the left circumflex coronary artery. The early mortality rate was 4.3 percent and the late mortality rate 9 percent during a mean follow-up period of 47 months. The perioperative infarction rate was 15 percent. Ninety-five percent of survivors were asymptomatic or in improved condition. Only 11 patients were lost to follow-up study. Three hundred fourteen patients (71 percent) were reinvestigated with coronary and graft arteriography 1 month to 8 years postoperatively. The early patency rate of grafts to the endarterectomized vessels was 85 percent and the late patency rate (1 year or more) was 77 percent. The runoff was good in 79 percent, fair in 14 percent and poor in 7 percent of grafts. Endarterectomy is a valuable additional procedure in the management of patients with diffuse coronary artery disease.

Adult↗
PubMedDate not supplied

Left atrial systolic antegrade flow in patients with mitral regurgitation: a pulsed Doppler sign displayed by color flow imaging.

Twenty-two patients with severe mitral regurgitation were observed to have turbulent systolic antegrade flow on pulsed Doppler mapping of the left atrium. All were studied by color flow imaging to delineate the mechanism of this peculiar flow. Pulsed Doppler findings of an eccentric regurgitant flow in one side, an antegrade systolic flow with slightly delayed onset in the other side, and a low velocity flow near the posterior wall, were consistant with the theory of a large eccentric regurgitant jet swirling in the left atrium. Color flow imaging confirmed this mechanism in all patients. Nineteen patients had flail mitral valve with a positive predictive value of 86%. The other three patients had deformed rheumatic mitral valve. The severity of mitral regurgitation was confirmed in all 16 patients studied by left ventricular cineangiography. We have shown that the antegrade systolic left atrial flow is the result of the swirling of a large regurgitant eccentric jet, is commonly observed with flail mitral valve, can occur in patients with deformed rheumatic mitral valve without flail leaflet, and most significantly indicates the presence of severe mitral regurgitation.

Adolescent↗
PubMedDate not supplied

Antibacterial activity of azithromycin against Brucella melitensis.

In vitro antibacterial activity of the new macrolide azithromycin was tested against 116 strains of Brucella melitensis, isolated from 115 patients in a major tertiary care referral center. Eighty-seven percent of the strains were inhibited by 1.0 mg/l and all the 116 strains by 2.0 mg/l of azithromycin. Comparison was made with tetracycline, gentamicin, trimethoprim-sulfamethoxazole, rifampicin and ciprofloxacin. All the isolates were susceptible to gentamicin, tetracycline, trimethoprim-sulfamethoxazole, rifampicin. One hundred and fifteen of the 115 strains were also susceptible to ciprofloxacin.

Anti-Bacterial Agents↗