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Biomedical subjects

M Saleem

Publications and source records attributed to M Saleem.

At least 109 records · Page 6Linked to original sources

Laryngeal inflammation mimicking laryngeal carcinoma.

A case of severe inflammation with an exuberant granulation lesion of the larynx that mimicked laryngeal tumour is presented. A patient who was a chronic smoker, with a history of hoarse voice underwent multiple endoscopies and biopsies, confirmed histopathologically as acute and, subsequently, as chronic inflammation. The tumour-like tissue in the larynx responded dramatically to prolonged antibiotic treatment. We emphasize the importance of histological confirmation before embarking on removal of an essential organ or part of the body which could lead to physical or emotional scarring.

Aged↗

Bone marrow involvement in Hodgkin's disease: the significance of non-infiltrative changes.

We have tried to elucidate the significance of so called non-infiltrative changes in order to find their place in the staging procedure particularly in countries where facilities for elaborate clinical staging are not available. Seventy nine out of 88 patients were classified into 3 groups depending upon the histological findings in their bone marrow trephine biopsies. Bone marrow in Group-I (n = 20) patients was essentially normal. The established criteria of bone marrow involvement were fulfilled in Group III patients (n = 25); while bone marrow in Group-II patients (n = 34) showed non-infiltrative changes. The clinical presentation, peripheral blood parameters and LDH levels of the 3 groups of patients were compared. There was progressive anaemia, neutrophilic leucocytosis and increase in ESR from Group I to III. The change was statistically significant when Group I was compared with Group II or Group III but non-significant when Group II was compared with Group III. It is, therefore, postulated that both Groups II and III reflect the bone marrow involvement although the changes observed in Group II do not satisfy the previously established criteria for this purpose.

Adolescent↗

Ketamine for bone marrow aspiration and trephine biopsy in children.

To make bone marrow aspiration and trephine biopsy less painful and more acceptable in children a short acting anaesthetic ketamine was used in a dose of 1-2 mg/kg body weight intravenously or 4-5 mg/kg intramuscularly. One hundred cases aged 2 to 13 years were studied. The actual procedure time ranged between 20 seconds and 3 minutes, adequate samples were obtained in 80% of children on first attempt. Vomiting was the only side effect noted in two children. Ketamine is safe and recommended in all children undergoing bone marrow aspiration and trephine biopsies.

Adolescent↗

Attempts to demonstrate indirect T cell allorecognition of donor MHC peptides in transplant patients.

Indirect T cell allorecognition has been shown to play an important role in the rejection of allografts in experimental animals. Although there has been much speculation as to its role in clinical transplantation, especially with regard to chronic rejection, indirect T cell allorecognition has been difficult to demonstrate in transplant patients. In this paper, we looked for in vitro T cell proliferation to synthetic peptides corresponding to donor HLA-A and HLA-B incompatible antigens. Twelve 15 amino acid peptides corresponding to the hypervariable regions of six of the most common HLA class I alleles in Caucasian populations (A1, A2, A3, B7, B8 and B44) were studied. Blood was taken from 12 adult patients following one or more episodes of acute kidney graft rejection, and from three pediatric patients undergoing chronic rejection of heart/lung transplants. The donor-recipient combinations were selected such that at least one of the six HLA antigens above was present in the donor and absent in the recipient. Peripheral blood mononuclear cells from these patients responded strongly in proliferation assays to phytohemagglutinin. However, none responded to the incompatible donor HLA peptides. Compartmentalization of responding T cells, the effects of immunosuppression, and assay sensitivity are discussed as possible explanations for the negative results.

Adult↗

Molecular genetics of beta-thalassaemia in Pakistan: a basis for prenatal diagnosis.

Thalassaemia is the most common inherited disorder in Pakistan and there are very inadequate treatment facilities for over 4000 homozygotes born each year. Prevention of these disorders therefore forms an essential part of the management of this enormous health problem. We have characterized 1216 beta-thalassaemia alleles from the five major ethnic groups of Pakistan. The complete spectrum comprised 19 different mutations. There are important ethnic and regional differences in the prevalence of mutations. The five most common mutations, IVSI-5 (G-C) (37.3%), Fr 8-9 (+G) (25.9%), del 619 (7.0%), Fr 41-42 (-TTCT) (6.7%) and IVSI-1 (G-T) (5.4%), constitute 82.3% of the total. Fr 8-9 (+G) is the most common mutation in Northern Pakistan (41.3%), whereas IVSI-5 (G-C) is the most frequent mutation in Southern Pakistan (52.2%). Six subjects with transfusion-dependent thalassaemia major showed only a single mutant allele. One subject with transfusion-dependent thalassaemia major showed a novel 17 bp deletion involving Cd126-131. Our findings provide a comprehensive basis for carrying out prenatal diagnosis of thalassaemia in a geographical area where it is found in high frequency.

Base Sequence↗

Disseminated intravascular coagulation in acute leukaemias at first diagnosis.

Haemorrhagic diathesis is the commonest cause of morbidity and mortality in acute leukaemias (AL). It is most commonly due to thrombocytopenia resulting from bone marrow failure. However, in a significant number of cases, disseminated intravascular coagulation (DIC) plays an important part. Previously it was thought that this mechanism was mainly confined to acute promyelocytic leukaemia (APL), but recently it has also been reported to occur in other subtypes of acute leukaemia. We report the results of a study carried out to find the incidence of DIC in various types of AL at the time of first diagnosis and in the absence of other recognisable causes. DIC was observed in 14(13.4%) cases out of 104 cases of AL studied. Nine out of 49(18.4%) cases of AML and 5 out of 55(9.1%) cases of acute lymphoblastic leukaemia (ALL) showed coagulation abnormalities consistent with DIC. Out of the 9 cases of AML showing DIC, 63 (66.67%) belonged to APL (FAB ME) subtype. Three (60%) out of 5 cases of ALL with DIC had T-cell immunophenotype. The results indicate that DIC may also occur in types of AL other than APL, particularly in T-ALL, and should be looked for.

Adolescent↗

Serum ferritin levels in carriers of beta-thalassaemia trait.

Hypochromic and microcytic red cell morphology is the most commonly encountered abnormality in a clinical laboratory. Most of such cases have iron deficiency anaemia. However, in Pakistan about 5% of the individuals with a hypochromic and microcytic blood picture have the beta-thalassaemia trait. These individuals are more than often in a positive iron balance. However iron deficiency (being common) may be associated with the beta-thalassaemia trait. This study of serum ferritin levels was carried out on 135 confirmed cases of the beta-thalassaemia trait. A ferritin assay was done by a radioimmunoassay technique. The results show that the level of serum ferritin in 100 (74%) cases was within normal limits, in 17 (12.6%) cases it was above the normal range, whereas in 18 (13.4%) cases the level was lower than normal. The importance of serum ferritin estimation in carriers of the beta-thalassaemia trait is highlighted.

Adolescent↗

Blood lead levels and anemia in lead exposed workers.

The effects of lead on haematological parameters were studied in 51 occupationally exposed individuals comprising of 27 lead furnace workers, 24 lead pellet handlers and 20 healthy age and service matched controls. Blood lead levels were estimated by atomic absorption spectrometer AAS-180-80 and haematological parameters by Technicon H.1 system. The lead furnace workers had highest blood lead levels (median 71.20 ug/dl, range 21.2-171.10 ug/dl) and low Hb (median 106 g/l, range 73-144 g/l) as compared to healthy subjects (median lead levels 29.80 ug/dl, range 10.20-54.10 ug/dl and Hb median 135 g/l, range 101-153 g/l). The workers handling pellets had moderately increased blood lead levels (median 45.50 ug/dl, range 8.50-130.6 ug/l) and low Hb (median 114 g/l, range 74-158 g/l). The furnace exposed workers had higher blood lead levels and low Hb compared to the lead pellet handlers. TRBC, Hct, MCV, MCH and MCHC did not reveal any significant difference in all groups. It is concluded that chronic lead exposure causes normocytic normochromic anaemia and shows a dose response relationship between lead levels and severity of anemia.

Adult↗

Evaluation of M/H ratio for screening of beta thalassaemia trait.

This study was done to evaluate the efficiency of M/H ratio between the percentages of microcytic and hypochromic cells as a screening procedure for thalassaemia trait in Pakistani population. A total of 150 subjects, were included in this study. The analysis of results revealed that M/H ratio is a very sensitive index for beta thalassaemia trait. The sensitivity, predictive value and diagnostic accuracy of the M/H ratio for beta thalassaemia trait was 100%, 90.4% and 90.4% respectively. It also picked up all cases of beta thalassaemia trait with co-existent iron deficiency. It is therefore concluded that M/H ratio is an easy, reliable and sensitive index which can be used for mass screening of beta thalassaemia trait, particularly in a population where iron deficiency is also prevalent.

Adolescent↗

Antibodies to the extractable nuclear antigens (ENA) in Pakistani patients with systemic rheumatic disease.

Autoantibodies to the saline extracts of cells are being used as diagnostic and prognostic markers in the investigation of patients with suspected systemic rheumatic disease. These are also called antibodies to the extractable nuclear antigens or anti ENA antibodies. We used saline extracts of human spleen cells and rabbit thymus extract to detect six subtypes of anti ENA antibodies, namely anti SSA (anti Sjogren's syndrome A), anti SSB (anti Sjogren's syndrome B), anti RNP (anti Ribonucleoprotein), anti Sm (anti Smith), anti Jo-1 (anti Jo-1) and anti Scl 70 (anti Systemic sclerosis 70) antibodies. Two hundred and thirty-seven patients' sera were screened in the department of Immunology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, over a period of 16 months. Fifty-seven were positive for auto antibodies, of which 26 had anti SSA antibodies, 12 anti SSA+ anti RNP+ anti Sm antibodies, 7 anti RNP+ anti Sm antibodies, 6 anti SSA+ anti SSB antibodies, 5 anti SSA+ anti RNP antibodies while one patient showed only anti RNP antibody. The detection of the anti ENA antibodies was specially helpful in diagnosing patients with systemic lupus erythematosis presenting with atypical features and with mixed connective tissue disease.

Adolescent↗

Granulocytic sarcoma in patients with chronic myeloid leukaemia.

Granulocytic sarcoma is an unusual variant of myeloid malignancy most commonly encountered in the course of chronic or acute myeloid leukaemia. Of 60 patients of chronic myeloid leukaemia studied over 21 months, we encountered 6 (10%) cases of granulocytic sarcoma. Four of these had granulocytic sarcoma on their first presentation. All those who were receiving hydroxyurea did not fare well but one who was put on DAT (daunorubicin, cyftosine arabinocide, 6 thioguanine)regimen went into remission with complete disappearance of lesions.

Adolescent↗

Prevalence of antibody to hepatitis C virus in Pakistani thalassaemics by particle agglutination test utilizing C 200 and C 22-3 viral antigen coated particles.

Exposure to hepatitis C virus (HCV) and its effect on ALT levels was studied in 35 transfusion dependent cases of thalassaemia major. Twenty-one (60%) cases were anti HCV positive and also showed raised Alanine Transaminase (ALT) levels. Of 14 anti HCV negative, Hepatitis B Surface Antigen (HBs Ag) negative seven showed raised ALT levels, indicating the chances of acute viraemia. Thus there is an urgent need to start anti HCV screening on all blood donations.

Adolescent↗

Design and structural requirements of potent peptidomimetic inhibitors of p21ras farnesyltransferase.

Cysteine farnesylation of the ras oncogene product, p21ras, on its carboxyl-terminal CA1A2X box (C = cysteine, A = aliphatic, and X = methionine or serine) is required for its transforming activity. p21ras farnesyltransferase (FTase), the enzyme responsible or this important posttranslational modification can be inhibited by simple CA1A2X peptides. We have synthesized a family of CA1A2X peptidomimetics where the central 2 aliphatic amino acids are replaced by a variety of spacer groups with different shapes and conformational characteristics to investigate the structural requirements of these inhibitors. The biological activities of CA1A2X peptidomimetics, where the dipeptide "A1A2" is replaced by 3- or 4-aminomethylbenzoic acid (AMBA) and 3- or 4-aminobenzoic acid (ABA), are evaluated in a p21ras FTase inhibitory assay. Peptidomimetics Cys-4-ABA-Met and Cys-3-AMBA-Met contain spacers that provide good distance correspondence of the carboxylate and ammonium separation with that of the parent KB p21ras tetrapeptide, Cys-Val-Ile-Met, and are as potent FTase inhibitors (IC50 values of 50 and 100 nM, respectively). In contrast, replacing the central dipeptide with 4-AMBA reduced FTase inhibitory activity by 17-fold whereas replacement by 3-ABA reduces inhibitory activity of the peptidomimetics by 43-fold. Cys-4-ABA-Met (IC50 = 50 nM) is 128 times more potent as a p21ras FTase inhibitor than Cys-3-ABA-Met (IC50 = 6400 nM), yet these two peptidomimetics differ only in the substitution pattern around the phenyl ring. These results coupled with computer modeling studies demonstrate that the interaction between FTase and the peptidomimetics requires precise structural and conformational characteristics; in particular, correct positioning of the Cys and Met must be respected. Furthermore, Cys-3-AMBA-Met and Cys-4-ABA-Met are true inhibitors of p21ras FTase since they are not farnesylated by this enzyme, in contrast to Cys-Val-Ile-Met, which inhibits the enzyme by acting as alternative substrate. Computer modeling studies of the potent FTase inhibitor Cys-4-ABA-Met show that a folded conformation, where the thiol and carboxylate groups are close, is not possible. Therefore a beta-turn conformation that would result in the simultaneous coordination of the Cys-thiol and Met-carboxylate to zinc ion is not important for inhibition of p21ras FTase, as previously suggested.

Alkyl and Aryl Transferases↗

Screening for chronic lead poisoning in lead factory workers.

One hundred and forty-nine lead factory workers comprising of 46 fume exposed, 78 handling lead materials and 25 controls were screened for chronic lead poisoning. Blood lead level was determined by atomic absorption spectrometery and urinary ALA by ion-exchange chromatography. Fume exposed workers had significantly higher (P < 0.01) blood lead (median 61.20 micrograms/dl, range 21.20-171.10 micrograms/dl) and urinary ALA levels (median 4.10 mg/l, range 01.0-22.9 mg/l) than workers handling lead materials and controls. Urinary ALA was found to be a more sensitive and specific test for lead poisoning than estimation of blood lead levels.

Adult↗