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Biomedical subjects

M Irshad

Publications and source records attributed to M Irshad.

87 records · Page 5Linked to original sources
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Role of fibronectin and complement in immunopathogenesis of acute and subacute hepatic failure.

The present study describes the plasma levels of soluble fibronectin (FN), C3d, the breakdown product of C3 complement and Ba, the breakdown product of properdin factor B, in 30 patients of uncomplicated acute viral hepatitis (AVH), 64 patients of fulminant hepatic failure (FHF) and 29 patients of subacute hepatic failure (SAHF) with different hepatitis viral infections. Aetiological analysis of these patients demonstrated hepatitis B, hepatitis C and hepatitis non-A, non-B, non-C (NANB-NC) infections in 6.7, 13.3 and 80% cases, respectively, of the AVH group; 18.8, 42.2. and 39.0% cases, respectively, of the FHF group; and 31.0, 34.5 and 34.5% cases of the SAHF group. None of them had hepatitis A infection. The analysis of data showed that the plasma FN level was significantly reduced in patients with FHF and SAHF as compared to AVH patients and healthy persons. Fibronectin levels in AVH was comparable to that in the healthy group. Further, the FN level was not dependent on the nature of aetiological virus. The level of C3d in plasma was significantly high in all patients of FHF and SAHF, irrespective of their viral aetiology, compared to the AVH group and the healthy group. Like FN, the C3d level was comparable in the AVH and healthy groups. However, the Ba level was comparable to the normal value in all types of infections including the AVH, FHF and SAHF groups. These findings were used to explain the possible roles of fibronectin and complement in the immunopathogenesis of liver injury in patients of acute liver failure of viral aetiology.

Adult↗
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HBV--status in professional blood donors in north India.

Present study demonstrates the efficacy and significance of routine screening assays used for HBsAg testing in donor blood in different blood banks of Delhi city. Blood from professional donors already screened in blood banks were cross checked using micro-ELISA technique developed at All India Institute of Medical Sciences and the results were compared. HBsAg carrier rate in these professional donors was found to be 11.7% by micro ELISA as against only 6% reported in blood banks using RPHA and latex agglutination assays. Thus, assays used in blood banks were found to be missing nearly 50% HBsAg positive cases as compared to micro-ELISA. A small group of professional donors was also screened for anti-HBs and results explained in comparison of normal values.

Blood Banks↗
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Prevalence of hepatitis B virus infection in healthy persons in North India.

BACKGROUND: There is scant information on the main methods through which hepatitis B virus infection is transmitted in India. We, therefore, studied the prevalence of hepatitis B surface antigen and antibody to hepatitis B surface antigen in voluntary blood donors as well as in those healthy groups who have a high risk of contracting this infection. METHODS: The groups at risk studied included commercial sex workers (635), eunuchs (28), truck drivers (217), professional blood donors (1117) and health care workers (1313). In addition, 20,435 voluntary blood donors were also studied. RESULTS: Hepatitis B surface antigen (and its antibody) was positive in 2.6% (14%) of voluntary blood donors, 3.6% (19%) of commercial sex workers, 5% (16%) of truck drivers, 12% (9%) of professional donors, 1.4% (19%) of health care workers and none (18%) of the eunuchs. Except professional donors and truck drivers, none of these groups had a higher positivity than the normal population (2.6%). CONCLUSIONS: Our results indicate that in India the so-called high risk groups, other than truck drivers and professional blood donors, are unlikely to represent major sources of infection.

Adult↗
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Chronic hepatitis in a large Indian hospital.

BACKGROUND: In developed countries as well as in Southeast Asia, the hepatitis B and C viruses are the main causes of chronic hepatitis. In India, however, there have been no major investigations on the aetiology of chronic hepatitis. (The hepatitis E virus which is responsible for half the sporadic and most of the epidemic cases of acute viral hepatitis in India does not cause chronic disease.) We, therefore, studied the profile of chronic hepatitis in India. METHODS: The clinical presentation, aetiology, serology and histological changes were studied prospectively in 48 patients with chronic hepatitis admitted to the All India Institute of Medical Sciences, New Delhi. Of these, 44 (92%) had chronic active hepatitis, 3 (6.3%) had chronic persistent hepatitis and 1 (2%) had chronic lobular hepatitis. RESULTS: The hepatitis B virus was the aetiological agent in 24 (50%) of these patients, the hepatitis D virus in association with hepatitis B virus in 10 (21%), the hepatitis C virus in 7 (15%) and the non-A, non-B viruses other than the hepatitis C virus in 6 (13%). One patient (2.0%) had autoimmune chronic active hepatitis. Jaundice at presentation was seen in 33 (69%) patients and more than half had hypoalbuminaemia (< 3 g/dl) with a prolonged prothrombin time. Alanine aminotransferase levels were less than 5 times above normal in over two-thirds of the patients. The highest alanine aminotransferase values were observed in patients with hepatitis D virus infection whereas the lowest were seen in patients with non-A, non-B related chronic active hepatitis. Histological examination revealed bridging necrosis in 40 (91%) patients with chronic active hepatitis indicating a severe form of disease. Replication of the hepatitis B virus was seen in 13 patients with chronic hepatitis, 5 of whom had hepatitis D virus-induced chronic hepatitis. Patients with hepatitis B virus replication had higher alanine aminotransferase values and more severe bridging necrosis than patients who did not have replicating viruses. Higher alanine aminotransferase values, ascites and oesophageal varices were encountered more frequently in patients with hepatitis B and D virus than in those with non-A, non-B related chronic hepatitis. CONCLUSION: Chronic hepatitis is not uncommon in India. It presents with evidence of severe disease and, as elsewhere, is most frequently caused by the hepatitis B virus.

Adult↗
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Plasma lipid profile in gallstone patients from North India.

One hundred and thirty five patients with gallstones along with eighty nine matched controls were studied ultrasonographically to look for any association with hyperlipidemias. Plasma cholesterol and triglycerides were estimated by colorimetric methods and lipoproteins were classified according to Beaumont's classification. Male to female ratio in gallstone patients was 1:3. Mean plasma cholesterol and triglyceride values were higher in male gallstones patients as compared to controls (166.40 +/- 54.21 vs 40.26 +/- 32.80 mg/dl, p <0.01 and 182.65 +/- 84.49 vs 133.18 +/- 52.37 mg/dl, p <0.01 respectively). In female gallstone patients, on the other hand, only plasma triglyceride levels were raised as compared to control (182.65 +/- 84.49 vs 133.18 +/- 52.32 mg/dl, p <0.01). Prevalence of type IIb and type IV was 24.32% and 29.72% in male gallstone patients and 13.2 and 39.70% respectively in female gallstone patients. Thus, more than half of our gallstone patients had hyperlipidemia, the commonest types amongst them being type IIb and type IV.

Adult↗
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Hepatitis E virus: a global view of its seroepidemiology and transmission pattern.

Hepatitis E virus (HEV) infection causes epidemic outbreaks as well as sporadic disease in many parts of the world. It has been detected in travellers from endemic regions and also in native citizens of developed countries. In contrast to epidemics where predominantly adults are infected, HEV is found to be a common cause of acute sporadic hepatitis in children as well. A high incidence of HEV infection has been noted in pregnant ladies. Further, HEV has an association with other hepatotropic viruses and induces fulminant hepatic failure both with and without the simultaneous presence of other viruses. Transmission of HEV occurs predominantly by the faeco-oral route. However, the parenteral route has also been implicated. There is evidence to suggest vertical transmission of HEV via the intrauterine and perinatal routes. However, a number of questions remain unanswered. The available data do not explain the occurrence of HEV infection predominantly in adults during epidemics, possibility of contact transmission and means of protection against this infection. More detailed studies are needed to provide the actual status of HEV epidemiology in different parts of the world.

Female↗