Search PubMed⌕ Search

Biomedical subjects

M H Khan

Publications and source records attributed to M H Khan.

At least 37 records · Page 2Linked to original sources
PubMed1999

Randomized trial of ligation versus combined ligation and sclerotherapy for bleeding esophageal varices.

BACKGROUND: Endoscopic band ligation combined with sclerotherapy has been postulated to be superior to ligation alone for the treatment of esophageal variceal bleeding. METHODS: A randomized trial of ligation versus combined ligation and sclerotherapy was designed to determine whether combined therapy results in faster eradication of varices compared to ligation alone. Sixty patients were randomized to undergo band ligation or ligation combined with injection of 1 to 2 mL of polidocanol (1%) into each variceal column immediately proximal to the previously placed bands. Therapy was repeated at 1- or 2-week intervals until variceal eradication was achieved. Follow-up endoscopy was performed at 3 months and then at 6-month intervals. RESULTS: The demographic and clinical characteristics of the 31 patients who underwent ligation were similar to those of the 29 who received combined treatment. Sixty percent of the patients had cirrhosis due to viral hepatitis. No significant differences were found between the combined and ligation alone groups in arresting active bleeding [9 of 9 (100%) vs. 6 of 7 (86%)], units of blood transfusion (3 +/- 0.8 vs. 2 +/- 0.6), number of sessions required to eradicate varices (3.8 +/- 0.5 vs. 3.6 +/- 0.4), treatment failure [2 (17%) vs. 4 (14%)], esophageal varix recurrence [6 (21.%) vs. 2 (6%)], gastric varices formation [4 (14%) vs. 1 (3%)], stricture [1 (3%) vs. 0 (0%)], recurrent bleeding [5 (17%) vs. 7 (23%)], other complications [10 (34%) vs. 9 (29%)], or death [3 (10%) vs. 7 (23%)] during a follow-up period of up to 36 months. CONCLUSIONS: Combined ligation and sclerotherapy does not reduce the number of endoscopic treatment sessions required for variceal eradication and offers no benefit over ligation alone. Because of the lack of benefit, the added procedure time, and the cost, we do not advocate combination therapy, and ligation alone remains the best endoscopic treatment.

Combined Modality Therapy↗
PubMed1999

Cross-bred cattle protected against Hyalomma anatolicum anatolicum by larval antigens purified by immunoaffinity chromatography.

Antigens from larvae of Hyalomma anatolicum anatolicum were extracted and purified by immunoaffinity chromatography using immunoglobulin ligands from cross-bred animals immunized with soluble larval antigen. Affinity-purified antigen (Aff-TLE) and a total larval extract (TLE) were used to immunize cross-bred (Bos indicus x Bos taurus) cattle. The group immunized with Aff-TLE rejected 71.6% of larvae and 77.3% of nymphs. However, the rejection percentages were lower in the TLE-immunized group. No significant changes in the feeding period, moulting percentages or moulting period of engorged larvae and nymphs were recorded. There was, however, a significant decrease in the number of resultant nymphs p < 0.01) and adults (p < 0.01) in the ticks fed on the Aff-TLE-immunized group. The Aff-TLE antigen was 93.3% purified. SDS-PAGE analysis identified a 39 kDa protein, reported for the first time, as the antigen responsible for the induction of resistance in the host.

Animals↗
PubMed1999

Risk factors for development of hepatocellular carcinoma among Australians with hepatitis C: a case-control study.

BACKGROUND: Older patients with cirrhosis due to hepatitis C are at risk of developing hepatocellular carcinoma (HCC), but additional risk factors may vary between countries. AIM: In the present study, we sought to identify additional risk factors for HCC among a cohort of Australian patients with chronic hepatitis C. METHODS: Case-control study of patients with advanced fibrosis stage hepatitis C who developed HCC during five-year follow up at a referral liver clinic. Cases were compared to twice the number of age-matched patients with chronic hepatitis C of similar fibrotic severity who did not develop HCC over a similar interval, using conditional logistic regression analysis (CLRA) and multivariate analysis. The main outcome measures were demographic and disease-related variables at first presentation in relation to the development of HCC. RESULTS: HCC developed in 17 cases, an annual incidence among those considered to be at risk of 2%. The duration of follow up since first assessment was comparable among the cases and 34 selected age-matched controls (4.1 and 5.2 years respectively, p=0.5). Cases were more often male (p=0.03), born in Asia (p=0.05), and had poorer liver function as indicated by serum albumin concentration (p=0.02). Anti-hepatitis B core-antibody (anti-HBc) was detected in 59% (ten/17) of cases, compared to 21% (seven/34) of the controls (p=0.01). No patient with a sustained response to interferon developed HCC during follow up. There were no significant differences in the mode of HCV transmission, HCV genotype, alcohol exposure, serum bilirubin level or prothrombin time between the cases and the controls. Although the data set was small, multivariate CLR analysis identified serum albumin < or = 35 g/L and anti-HBc positivity to be independent risk factors for development of HCC. CONCLUSIONS: Among older Australian patients (over the age of 40 years) with advanced fibrosis stage hepatitis C, the annual incidence of HCC is about 2%. Those who have low serum albumin and evidence of previous exposure to hepatitis B virus (anti-HBc positivity) appear to have the highest risk of developing HCC during follow up, but males and those born in Asia could also be at increased risk.

Aged↗
PubMed1999

Management of reproductive tract infections in rural Bangladesh.

This study was undertaken to identify existing reproductive tract infection (RTI) treatment practices of the government family planning (FP) paramedics in rural Bangladesh. It also assessed the knowledge and perceptions of the clients about RTIs as well as the service-seeking behaviour of the clients and their husbands. Data on paramedic treatment practices were collected by observing paramedic-client interactions at the family welfare centres (FWCs) and satellite clinics (SCs). One hundred clients seeking RTI treatment were observed. The same clients were interviewed at departure from the health-care facility to assess their knowledge and perceptions about RTIs as well as service-seeking behaviour of the clients and their husbands. Twenty-four village practitioners were also interviewed to assess their knowledge on the subject. Results of the study showed that in the treatment of RTI, paramedics of government FP services commonly: (i) did not do a physical examination, (ii) used a substandard dosage of drugs, and (iii) made no attempt to notify or treat male partners. Thirty-one of the 97 clients reported that their husbands had some kind of genital problem. It was revealed from the study that as an alternative to the government FP services, the clients and their husbands often seek RTI treatment from the village practitioners though the village practitioners' knowledge concerning RTI is poor. Based on the findings of this study, it is recommended that the knowledge and skills of the paramedics and village practitioners for RTI treatment be strengthened. Prevention of RTI through awareness campaigns is essential for the control of RTIs, and especially of STDs.

Bangladesh↗
PubMed1999

Immunization of cattle against Hyalomma anatolicum anatolicum using larval antigens.

Development of immunity in cross-bred (Bos taurus x Bos indicus) calves against Hyalomma anatolicum anatolicum, vector of bovine tropical theileriosis, was studied using larval antigen (LS) in Freund's complete adjuvant (FCA). Calves immunized with LS + FCA showed significant rejection of larvae (57.25 +/- 6.8) and nymphs (45.75 +/- 5.16). Abnormally fed larvae (11.4 +/- 0.8) and nymphs (8.25 +/- 1.2) were also recovered from immunized calves. This abnormal feeding may possibly be attributed to their inability to gain access to the blood vessels owing to the host immunological reactions. Consequently, feeding of extravascular fluid leads to white colour of fed ticks. Sera from all immunized calves after a week of immunization were positive for anti-LS antibodies in ELISA. The investigation indicates that LS in FCA enhanced anti-tick immunity.

Animals↗
PubMed1998

Hepatocellular proliferation and development of hepatocellular carcinoma: a case-control study in chronic hepatitis C.

Patients with hepatitis C have an increased risk of developing hepatocellular carcinoma (HCC). This is related to the stage of chronic liver disease, as characterized histologically by hepatic fibrosis and architectural distortion, but it is unclear whether histological markers can define the risk of developing HCC. We conducted a case-control immunohistochemical study of Ki-67, a marker for hepatocellular proliferation, in livers of 18 patients who had developed HCC more than 2 years after the biopsy specimen had been taken. Using conditional logistic regression analysis, the results were compared with 18 selected controls, who were age-matched patients with hepatitis C of similar histological stage who had not developed HCC. We also examined livers for cellular dysplasia, p53 mutations, and bcl-2 overexpression, and assessed whether the results could be correlated with demographic and disease-related variables, such as gender, region of birth, alcohol consumption, severity of liver disease, HCV genotype, and markers of hepatitis B virus (HBV) infection. Livers from patients who developed HCC were more often positive for Ki-67 (13 of 18 [72%] v 9 of 18 [50%]; P = .06) and tended to have higher mean Ki-67 scores (6 +/- 7.5 v 3 +/- 4.4; P = .10) compared with control cases. In the HCC-predisposed group, three livers showed large cell dysplasia, two were positive for p53 mutations, and two for bcl-2 overexpression. In contrast, in the non-HCC group, only one case had dysplasia, and none were positive for immunostaining for p53 or bcl-2 mutations. With the exception of one case, all livers with large cell dysplasia or p53 mutations and bcl-2 overexpression were also positive for Ki-67. Twelve (55%) of the 22 Ki-67-positive cases were anti-HBc-positive in the serum, in contrast to 2 of 14 (14%) patients in the Ki-67-negative group (P = .01). Patients with evidence of past infection with HBV were more often Ki-67 positive than those who had no evidence of past infection (85% [11 of 13] v 45% [10 of 22]; P = .02). There were no other associations between demographic or disease-related variables and Ki-67 expression. Increased hepatocellular proliferative activity, as assessed by Ki-67 expression, may be one factor indicative of an increased risk of developing HCC among patients with chronic hepatitis C. Furthermore, past infection with HBV appears to be an important correlate of increased hepatocellular proliferation in hepatitis C.

Adult↗
PubMed1998

How much does alcohol contribute to the variability of hepatic fibrosis in chronic hepatitis C?

In order to determine the contribution of alcohol intake to the severity of hepatic fibrosis in patients with chronic hepatitis C, we studied associations between various levels of alcohol intake, other demographic variables and semiquantitative liver histology in 434 cases of chronic hepatitis C. Clinical, demographic and disease-related data were entered into a relational database. Liver histology was scored according to Scheuer. The average daily alcohol intake for the year preceding liver biopsy (recent exposure) and for earlier periods (past exposure) was categorized into five levels of intake. One-third of patients gave a history of alcohol intake that had exceeded 40 g/day for at least 5 years. By univariate analysis, age, but not recent or past alcohol intake or other baseline variables, was associated with portal score (r = 0.14, P = 0.004), fibrosis score (r = 0.46, P < 0.001), total Scheuer score (r = 0.35, P < 0.001). However, by multivariate analysis, age (P < 0.001), past (but not present) alcohol intake (P < 0.001) and birth in Egypt (P = 0.006) were independently associated with fibrosis score. Age, past alcohol and birth place in Egypt contributed 27% to total variance of the hepatic fibrosis score, while age alone accounted for 23%. Age also independently predicted portal activity (P = 0.02) and total Scheuer score (P < 0.001), whereas past alcohol intake correlated with total Scheuer score (P = 0.002) but not with other histological indices. A separate multivariate analysis was performed on a more homogeneous subgroup of 196 patients who acquired hepatitis C by injection drug use. In this subgroup, age (P < 0.05) and past alcohol (P < 0.05) were independently associated with fibrosis score. In both the overall and subgroup analyses, there was a threshold level of past alcohol intake (>80 g/day) beyond which the risk of fibrosis increased significantly. It is concluded that toxic levels of alcohol exposure for at least 5 years accentuate hepatic fibrosis in hepatitis C but the influence of alcohol appears to be minor compared with age and other variables and is exerted only at toxic levels of intake.

Adult↗
PubMed1998

Molecular epidemiology of hepatitis C in Australia.

The aim of this study was to determine the distribution of hepatitis C virus (HCV) genotypes in Australian patients with hepatitis C and to identify factors associated with particular genotypes. Serum isolates of HCV-RNA were genotyped using a commercial oligonucleotide hybridization (line probe) assay. Relationships between demographic factors, mode of HCV transmission and HCV genotype were assessed by logistic regression analysis. Among 463 patients with hepatitis C, 425 tested positive for HCV-RNA and a single HCV genotype was identified in 420 cases. The patients' places of birth were Australia or New Zealand (62%), Asia (13%), Europe (12%), Mediterranean (6%), Middle East (6%) and other countries (< 1%). The most common genotypes were type 1 (52%) or type 3 (32%); type 2 (9.3%), type 4 (5.5%) and type 6 (1.7%) were less common. Patients with genotype 1b were older (48 +/- 13 years, P< 0.001) and patients with genotype 3 were younger than the remaining patients (37 +/- 11 years vs 42 +/- 12 years, P< 0.001). Among type 1 isolates, 1b was more common for patients born outside Australia compared with those born in Australia (50% vs 13%, P< 0.001) whereas non-1b subtypes were more common among Australian-born patients. Likewise, 21 of 23 (91%) patients with type 4 were from Egypt and six of seven (86%) with type 6 were from Vietnam. The relative importance of parenteral risk factors for HCV also varied according to geographic origin. Thus, a definite risk factor for HCV acquisition was identified in > 95% of Australian-born patients, but in only 33% of Asian or Mediterranean-born patients. Logistic regression analysis indicated that region of birth and risk factor (intravenous drug use or not) would allow 98% of type 4 cases and 76% of type 1b cases to be identified correctly. In summary, region of birth, patterns of migration over time and risk factors for transmission of HCV interact to determine the distribution of HCV genotypes in a multi-racial community like Australia.

Adult↗
PubMed1998

Immune response in rabbits against Rhipicephalus sanguineus.

Rabbits immunised with homogenates of unfed larvae and nymphs of the tick R. sanguineus developed significant level of protective immunity to infestation with all the stages of the species. The acquisition of resistance was based on feeding and developmental performance parameters (rejection, moulting percentages and feeding period) of larvae and nymphs. The acquisition of resistance against adults was also measured by feeding and reproductive performance of female ticks viz., rejection percent, engorged female and egg mass weights, engorgement, preoviposition and oviposition periods and efficiency of female ticks in converting their food reserve to eggs and larvae. Sera from larval extract (RLAg) immunised rabbits were strongly positive for anti-RLAg antibodies after 3 weeks of immunisation while nymphal extract (RNAg) immunised rabbits were positive for anti-RNAg antibodies after 2 weeks of immunisation in enzyme linked immunosorbent assay. The immunised rabbits were also positive for immediate type hypersensitivity (ITH) reaction on Intradermal inoculation of RLAg and RNAg.

Animals↗
PubMed1998

Immunization of rabbits against Hyalomma anatolicum anatolicum using homogenates from unfed immature ticks.

Antigens were prepared from unfed larvae and nymphs of H. a. anatolicum as homogenised antigens (HLAg and HNAg, respectively). Five rabbits each were inoculated, s.c. with 8.56 mg HLAg and 9.34 mg HNAg in 3 divided doses. Following immunisation rabbits developed significant level of protective immunity to infestation with adults of this species. Significant reduction in engorged percentage and weights of engorged females and egg masses were observed in females fed on immunized rabbits, compared to that of female ticks fed on control rabbits. The engorgement period was also increased significantly. However, conversion efficiency indices remained unaffected. Larval antigen immunized rabbits showed significant antibody level from 28-126 days while with HNAg elevated antibody levels were recorded up to 112 days. Further, the rabbits immunized with HLAg had elevated level of antibodies against HLAg, HNAg, and adult antigen in ELISA. But HNAg immunized rabbits had lower levels of antibodies against HLAg and HAAg as compared to values recorded against HNAg. Anti-HLAg and anti-HNAg sera recognised common antigenic bands of 97.4, 85, 66, 47.3, 42 and 31 kDa in homogenates of larvae, nymphs and adults.

Animals↗
PubMed1995

Lead poisoning--a hazard of traffic and industries in Pakistan.

We measured blood lead level, hemoglobin, and urinary amino-levulinic acid (ALA) in industrial workers and in individuals exposed to vehicle smoke. Industrial workers and people exposed to traffic smoke had comparatively higher blood lead levels than the controls (p < 0.0001). Similarly, urinary ALA was 3.82 mg/dL in industrial subjects, 3.68 mg/dL in traffic-exposed people, and 0.8 mg/dL in control subjects (p < 0.001). The hemoglobin level was lower in the industrial group and in the traffic exposure group compared with the control group (p < 0.01). Traffic smoke-exposed persons, such as traffic police staff, had higher blood lead level than those handling lead material, Government Transport Service (GTS) workshop staff. The length of exposure showed no relationship with the lead levels. However, a positive correlation was observed between the duration of exposure and urinary ALA in both sample groups. The major signs and symptoms of the population studied included headache, generalized body pain, hypertension, and depression.

Adult↗
PubMed1992

Stromal cellular response in breast tumours and allied lesions.

Histopathological study for stromal cellular response was made on 200 cases of benign and dysplastic lesions and malignancy of breast. Infiltrations with lymphocytes and plasma cells were observed in 64% cases of fibroadenoma, 66.6% cases of giant fibroadenoma, 61% cases of mammary dysplasia and 33.3% cases of gynaecomastia. While mast cell infiltration was not observed in giant fibroadenoma, its presence was observed in 92% cases of fibroadenoma, 77.8% cases of mammary dysplasia and 33.3% cases of gynaecomastia. Lymphocytes and plasma cells infiltrations were observed in 100% of cases of invasive duct carcinoma, medullary carcinoma and fibrosarcoma. Comedocarcinoma showed infiltration with these cells in 75% of cases while that for colloid carcinoma and Paget's disease of breast were observed in 50% of cases of each. Infiltrations with mast cells were observed in 92.3% cases of invasive duct carcinoma, 75% cases of comedocarcinoma and 25% cases of medullary carcinoma. Other malignant conditions of breast did not show mast cell infiltration. Degree of infiltration with lymphocytes and plasma cells was mainly of low grade in benign and dysplastic lesions compared to high degree of infiltration in malignancy. Mast cell infiltration was of low degree in both the types of lesions.

Adenofibroma↗
PubMed1989

Clinical profile of 100 cases of liver abscess.

One hundred patients with liver abscess were studied for clinical features and complications. They were diagnosed by radiography, ultrasonography, serology and by needle aspiration. A variety of interesting clinical, haematological and ultrasonographic findings were observed. Literature on liver abscess was reviewed and results compared.

Adult↗
PubMed1989

Serodiagnosis of amoebic liver abscess by IHA method.

Serological test based on IHA (Indirect Haemagglutination Method) was performed in 100 cases of hepatic abscess. The test was 100% sensitive and 94% specific. The cut off point of antibody titer between normal population and patients with invasive amoebiasis was 1:128. Antibody titer in amoebic liver abscess was 1:5242 +/- 2795. A significant (P less than 0.001) correlation was found between total leucocyte count and antibody titer.

Adult↗