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Biomedical subjects

R Malik

Publications and source records attributed to R Malik.

At least 19 recordsLinked to original sources

Adsorption of malachite green on groundnut shell waste based powdered activated carbon.

In the present technologically fast changing situation related to waste management practices, it is desirable that disposal of plant waste should be done in a scientific manner by keeping in view economic and pollution considerations. This is only possible when the plant waste has the potential to be used as raw material for some useful product. In the present study, groundnut shell, an agricultural waste, was used for the preparation of an adsorbent by chemical activation using ZnCl2 under optimized conditions and its comparative characterisation was conducted with commercially available powdered activated carbon (CPAC) for its physical, chemical and adsorption properties. The groundnut shell based powdered activated carbon (GSPAC) has a higher surface area, iodine and methylene blue number compared to CPAC. Both of the carbons were used for the removal of malachite green dye from aqueous solution and the effect of various operating variables, viz. adsorbent dose (0.1-1 g l(-1)), contact time (5-120 min) and adsorbate concentrations (100-200 mg l(-1)) on the removal of dye, has been studied. The experimental results indicate that at a dose of 0.5 g l(-1) and initial concentration of 100 mg l(-1), GSPAC showed 94.5% removal of the dye in 30 min equilibrium time, while CPAC removed 96% of the dye in 15 min. The experimental isotherm data were analyzed using the linearized forms of Freundlich, Langmuir and BET equations to determine maximum adsorptive capacities. The equilibrium data fit well to the Freundlich isotherm, although the BET isotherm also showed higher correlation for both of the carbons. The results of comparative adsorption capacity of both carbons indicate that groundnut shell can be used as a low-cost alternative to commercial powdered activated carbon in aqueous solution for dye removal.

Adsorption↗

Introducing Vi polysaccharide typhoid fever vaccine to primary school children in North Jakarta, Indonesia, via an existent school-based vaccination platform.

OBJECTIVES: To report results on coverage, safety and logistics of a large-scale, school-based Vi polysaccharide immunization campaign in North Jakarta. METHODS: Of 443 primary schools in North Jakarta, Indonesia, 18 public schools were randomly selected for this study. Exclusion criteria were fever 37.5 degrees C or higher at the time of vaccination or a known history of hypersensitivity to any vaccine. Adverse events were monitored and recorded for 1 month after immunization. Because this was a pilot programme, resource use was tracked in detail. RESULTS: During the February 2004 vaccination campaign, 4828 students were immunized (91% of the target population); another 394 students (7%) were vaccinated during mop-up programmes. Informed consent was obtained for 98% of the target population. In all, 34 adverse events were reported, corresponding to seven events per 1000 doses injected; none was serious. The manufacturer recommended cold chain was maintained throughout the programme. CONCLUSIONS: This demonstration project in two sub-districts of North Jakarta shows that a large-scale, school-based typhoid fever Vi polysaccharide vaccination campaign is logistically feasible, safe and minimally disruptive to regular school activities, when used in the context of an existing successful immunization platform. The project had high parental acceptance. Nonetheless, policy-relevant questions still need to be answered before implementing a widespread Vi polysaccharide vaccine programme in Indonesia.

Antigens, Bacterial↗

Recrudescent cryptococcosis, caused by Cryptococcus gattii (molecular type VGII), over a 13-year period in a Birman cat.

A 17-year-old desexed male Birman cat presented with a fleshy mass protruding from the left ear canal. A culture from the mass revealed a heavy growth of Cryptococcus gattii (molecular type VGII, serotype B). The lesion resolved with antifungal therapy over 8 weeks. Itraconazole was continued indefinitely due to persistent high serum cryptococcal antigen titres. The cat was euthanased 12 months later due to the acute development of hindlimb ataxia and collapse which may or may not have been attributable to cryptococcosis. This cat had first presented when 4 years of age with a 3-week history of inappetance, sneezing and serous nasal discharge. Culture of swabs from both nostrils were positive for C. gattii (VGII). Fluconazole therapy produced steady improvement over a 6 month period, at which time therapy was discontinued. The cat presented 9 months later for sneezing, again with a positive culture of C. gattii from the nasal cavity. Antifungal therapy was continued for 8 months, after which time cultures were negative and symptoms resolved. Three episodes of cryptococcosis in a cat over a 13-year period were thus documented. Importantly, the two C. gattii isolates, obtained 13 years apart, were identical using DNA fingerprinting and random amplification of polymorphic DNA (RAPD) analysis.

Animals↗

Nocardia infections in cats: a retrospective multi-institutional study of 17 cases.

OBJECTIVE: To record 17 cases of nocardiosis in cats from eastern Australia and to compare this series with cases previously reported. DESIGN: Retrospective/prospective study. RESULTS: Nocardia spp infections were diagnosed in 17 cats over 14 years from the three eastern states of Australia. There were no isolates from dogs during this period, but one isolate from a koala and two from dairy cows. The majority of cats presented with spreading lesions of the subcutis and skin associated with draining sinus tract(s). Early cutaneous lesions consisted of circumscribed abscesses. Infections spread at a variable rate, generally by extension to adjacent tissues. Lesions were generally located in regions subjected to cat bite or scratch injuries, including limbs, body wall, inguinal panniculus and nasal bridge. In some other cases, lesions were situated on distal extremities. The clinical course was variable, from chronic, indolent, initially localised infections to acute fulminating disease. Of the 17 cats, 14 were domestic crossbreds and three were purebreds. There was a preponderance of male cats (12 castrated, 1 entire young adult, 1 entire kitten). Nine of 17 cats were 10 years or older. Interestingly, the majority of infections were attributable to N nova. Immediate and/or predisposing causes could be identified in all cases, and included: renal transplantation [one cat]; chronic corticosteroid administration [three cats]; catabolic state following chylothorax surgery [one cat]; fight injuries [seven cats]; FIV infections [three of seven cats tested]. Of the 17 cats, three were apparently cured. Four were thought to be cured, but infection recurred after several months. Three cats responded partially but were euthanased, while another was improving when it died of unrelated complications. Two died despite treatment and two were euthanased without an attempt at therapy. For two cats there were either insufficient records or the patient was lost to follow up. CONCLUSION: Nocardiosis is a rare, serious disease. Currently it is more common in cats than dogs. Nocardial panniculitis may be clinically indistinguishable from the syndrome caused by rapidly growing mycobacteria. Although the prognosis is guarded, patients with localised infections caused by N nova often respond to appropriate therapy. If definitive treatment is delayed because of misdiagnosis, the disease tends to become chronic, extensive and refractory. Insufficient duration of therapy leads to disease recurrence.

Animals↗

Tachycardia-induced cardiomyopathy in a young Boxer dog with supraventricular tachycardia due to an accessory pathway.

A 1-year-old male Boxer dog presented with sustained supraventricular tachycardia and tachycardia-induced cardiomyopathy. Conversion to sinus rhythm was achieved initially with intravenous lignocaine and subsequently with oral procainamide. Oral procainamide treatment was relatively successful in maintaining normal sinus rhythm with no side effects apart from a reversible change in coat colour. Electrophysiological studies demonstrated the presence of an accessory pathway connecting the right atrium to the right ventricle and confirmed the diagnosis of orthodromic atrioventricular reciprocating tachycardia. Radiofrequency catheter ablation of the accessory pathway led to permanent resolution of the supraventricular tachycardia and for 9.5 years the dog has had no further signs of cardiac disease. The successful treatment of this condition highlights the importance of differentiating tachycardia-induced cardiomyopathy from dilated cardiomyopathy.

Animals↗

Long-term outcome of therapy for 59 cats and 11 dogs with cryptococcosis.

OBJECTIVE: To determine the outcome of therapy in cats and dogs with naturally occurring cryptococcosis. Design Retrospective study of 59 cats and 11 dogs at the University Veterinary Centre Sydney from 1986 to 2004. METHOD: Following detailed analysis of case notes potential associations between patient characteristics, cryptococcal species, retroviral status (cats), disease severity and type of therapy were examined in relation to duration and success of therapy. Treatment protocols based on amphotericin B, fluconazole and itraconazole were compared. RESULTS: Seventy-six percent of feline patients were successfully treated. For cats, the presence of central nervous system disease was the only factor found to influence outcome. Cats with neurological involvement, disseminated disease or refractory disease treated with amphotericin B containing protocols did as well, on average, as cats with less severe disease treated with azole monotherapy. Amphotericin B was thus an effective agent for treating severe cases of cryptococcosis. The median cumulative dose of amphotericin B for cats cured at the first attempt was 16 mg/kg (range 7 to 23 mg/kg). The median duration of treatment required to effect a cure at first attempt was significantly shorter for fluconazole (4 months; range 1 to 8 months) than for itraconazole (9 months; range 3 to 24 months; P = 0. 0191; Mann Whitney U test). The success rate for treatment of canine cases was 55%. No factor appeared to influence disease outcome in dogs. Large cumulative doses of amphotericin B could be administered via the subcutaneous route in both species and generally with minimal nephrotoxicity. Recrudescence occurred in a significant proportion of animals, in some cases despite a reduction of serum latex cryptococcal antigen agglutination test to zero. CONCLUSION: Although the prognosis of cryptococcosis should be described as guarded, a majority of the canine and especially feline patients can be expected to be cured, although treatment is protracted and expensive.

Amphotericin B↗

Seroprevalence study of feline coronavirus in owned and feral cats in Sydney, Australia.

OBJECTIVES: i) To establish the seroprevalence of Feline Coronavirus (FCoV) infection in two defined groups of cats in Sydney: owned and feral cats; ii) to identify factors associated with an increased risk of infection with FCoV; and iii) to establish the seroprevalence and FCoV antibody titres of owned cats with immunohistochemically confirmed feline infectious peritonitis (FIP). DESIGN: Prospective multi-institutional cross sectional study. Procedure Serum samples from owned cats presented to three inner city veterinary clinics in Sydney and feral cats from a colony in South Western Sydney over an 11-month period were tested for FCoV antibodies using the Immunocomb test kit. The relationship between serological score and six major factors (breed, age, gender, number of cats per household, living environment and health status) in the owned cat sample population was analysed and compared to cats with FIR RESULTS: The seroprevalence of FCoV infection in the sample population of owned and feral cats was 34% and 0%, respectively. The median Immunocomb scores of DSH, Persian, Siamese and Devon Rex cats were significantly lower than that of Burmese, BSH, Abyssinian, Birman, Ragdoll and Russian Blue. The median lmmunocomb score of pedigree cats less than 2 years-of-age was significantly higher than for pedigree cats greater than 2 years-of-age. This distinction was not evident in DSH cats in these age groups. The number of cats per household at the time of blood collection had a strong positive association with Immunocomb score. The median Immunocomb score of cats with immunohistochemically confirmed FIP was significantly higher than cats in the sample population of owned cats but there was sufficient overlap between these two groups to make definitive diagnosis of FIP by serology impossible. CONCLUSION: This represents the first seroprevalence study of FCoV in Australia. The major determinants of antibody score of owned cats identified in this study were breed, age and the number of cats per household. The significant relationship between the breed of the cat and the FCoV antibody titre further supports the notion, proposed previously by the authors, that breed related differences exist in the immunological response to FCoV infection.

Age Factors↗

Naturally-occurring chronic renal disease in Australian cats: a prospective study of 184 cases.

OBJECTIVE: To describe cases of naturally occurring feline chronic renal disease (CRD) in a defined population of Sydney. DESIGN: Prospective case series. METHODS: The inclusion criteria were the presence of a serum creatinine concentration above the reference range with either inadequately concentrated urine (urine specific gravity < or = 1.035), necropsy findings consistent with CRD, renal proteinuria or persistent azotaemia despite rehydration. Cats were excluded if a specific aetiology was identified ante or post mortem. Patients were divided into two categories (renal insufficiency or renal failure) on the basis of history, physical findings and serum creatinine concentration. The gender and age of cats with CRD was compared to an estimated Australian urban pet cat population. The breeds of cats with CRD were compared to the breeds of cats visiting the respective veterinary hospital where possible. Breed and gender comparisons were made using Fisher's exact tests. Age comparisons were made using Mann-Whitney U tests. The age at which cats were diagnosed with CRD was compared between veterinary hospitals using a Kruskal-Wallis test. RESULTS: One hundred and eighty-four (99 female; 85 male) cats fulfilled the inclusion criteria. Amongst cats with CRD, males (median 12 years) were significantly younger than females (median 15 years; p = 0.001). The overall proportion of male and female cats with CRD was similar to that of the reference urban cat population (p = 0.41), however, between the ages of 9 and 11 years, male cats with CRD were over-represented (p = 0.038). Patients diagnosed with renal insufficiency (123 cats; median age 15 years) were significantly older than patients diagnosed with renal failure (61 cats; median age 11 years; p = 0.0001). The age at diagnosis of cats with CRD differed significantly between veterinary hospitals (p = 0.002). CONCLUSION: Male cats with CRD were significantly younger than female cats with CRD. Younger cats were more likely to be diagnosed at an advanced stage of disease than older cats. The age at which cats were diagnosed with CRD was influenced by the clinic the cats attended. Whether these differences reflect differences in the aetiology of CRD or in the rate of disease progression warrants further investigation. Breed did not appear to play a significant role in the development of CRD in this survey.

Age Factors↗

The Bristol cataract listing survey: profile of listed patients with visual acuity 6/12 or better.

INTRODUCTION: The aim of this study was to assess the vision-related quality of life (VR-QOL) in patients with good distance Snellen visual acuity (VA) who are listed for cataract surgery. METHODS: An observational cross-sectional prospective study of patients listed for cataract surgery. VA and VR-QOL data using the VCMI questionnaire were collected on patients attending preoperative assessment during June 2002. RESULTS: A total of 397 cataract patients were listed during this month. Following exclusions there were 378 eligible individuals, 210 (56%) of whom had a VA of 6/12 or better in the eye scheduled for surgery. Of these, 40% patients had only mild VR-QOL impairment. More than half of the patients with good VA (6/12 or better) in the surgery eye and mild VR-QOL impairment described their vision as poor in this eye. However, most of these patients were not dissatisfied with their overall level of vision. CONCLUSION: A significant number of patients listed for cataract surgery with VA of 6/12 or better had only mild VR-QOL impairment and were not dissatisfied with their overall level of vision. The decision to list a patient for surgery may have been based on the patient's perception of monocular vision rather than their quality of life.

Aged↗

Clinicopathological findings associated with feline infectious peritonitis in Sydney, Australia: 42 cases (1990-2002).

OBJECTIVES: To review the clinicopathological findings in naturally-occurring, histopathologically confirmed cases of feline infectious peritonitis in client-owned cats in Sydney, Australia, with the purpose of identifying factors assisting in the diagnosis of this complex disease syndrome and to characterise the disease as it occurs in this region. DESIGN: Retrospective clinical study: the clinical records of all cats with histopathologically confirmed feline infectious peritonitis at the University Veterinary Centre Sydney and a private cat hospital in Sydney between 1990 and 2002 were reviewed for signalment, history, physical findings, diagnostic test results and the distribution of histological lesions throughout the body at necropsy. RESULTS: Forty-two cats met the inclusion criteria. Significant features of this study that unique to the contemporary literature are i) the over-representation of certain breeds (Burmese, Australian Mist, British Shorthaired, and Cornish Rex) and the under-representation of other breeds (Domestic Shorthaired, Persian); ii) the overrepresentation of males; iii) the tendency for effusive disease in Australian Mist cats and non-effusive disease in Burmese; iv) the even age distribution of disease seen in cats older than 2 years-of-age; and v) the presence of fulminant immune-mediated haemolytic anaemia in two cats in this study. CONCLUSION: The study highlights the diverse range of clinical manifestations and the complexities experienced by clinicians in diagnosing this fatal disease. Some aspects of the epidemiology and clinical manifestations of feline infectious peritonitis appear different to the disease encountered in Europe and North America, most notably the over-representation of specific breeds and the presence of immune-mediated haemolytic anaemia.

Age Factors↗

Improving seizure control in dogs with refractory epilepsy using gabapentin as an adjunctive agent.

OBJECTIVE: To assess whether there is a change in seizure activity in dogs with refractory epilepsy that are receiving appropriate doses of phenobarbitone and/or potassium bromide, when gabapentin is added to the therapeutic regimen. DESIGN: A prospective study of 17 dogs with a refractory seizure disorder, 16 of which have idiopathic epilepsy. PROCEDURE: Patients were stabilised using phenobarbitone and/or potassium bromide to produce tolerable therapeutic serum concentrations and dosed additionally with gabapentin at 35 to 50 mg/kg/d (divided twice or three times daily) for 4 months. Owners recorded seizure activity and side effects during this period in a standardised diary. Patients underwent monthly physical examinations and venepuncture to assess selected serum biochemical analytes, as well as phenobarbitone and bromide concentrations. Patients were further monitored for long-term response to adjunctive gabapentin therapy. RESULTS: There was no significant decrease in the number of seizures over the study period for the entire cohort, however three dogs stopped seizuring completely. There was a significant increase in the number of patients who showed an increase in the interictal period (P > 0.001). Serum alkaline phosphatase activity and triglyceride concentrations were elevated at baseline. There were no significant changes in biochemical analytes during the course of the study period. Side effects observed initially on addition of gabapentin included sedation and hind limb ataxia. The former resolved spontaneously after a few days; the latter after a slight reduction in bromide dose. Long-term, a further two patients became seizure free and ten patients remained on gabapentin indefinitely. No long-term side effects have become apparent. CONCLUSION: Addition of gabapentin to phenobarbitone and/or potassium bromide increased the interictal period and shortened the post-seizure recovery in some canine epileptics. In some dogs, seizures were prevented completely, while in others there was an increase in interictal period. The short-half life of gabapentin has advantages for seizure control, however its present high cost may prohibit therapy in large dogs.

Amines↗

Pneumonia due to Mycobacterium abscessus in two domestic ferrets (Mustelo putorius furo).

Two ferrets were diagnosed with pneumonia due to Mycobacterium abscessus. Both cases were treated successfully using clarithromycin after positive cultures were obtained via unguided bronchoalveolar lavage. This is the first time M abscessus has been isolated in our laboratory and the first report of this organism causing disease in companion animals in Australia. Underlying respiratory tract disease was thought to be an important factor in the development of the infections. Thorough investigation of chronic lower respiratory tract disease in ferrets is recommended as this species appears predisposed to atypical infections.

Animals↗

Prescription pattern of benzodiazepines for inpatients at a tertiary care university hospital in Pakistan.

OBJECTIVE: To determine the point prevalence of benzodiazepine prescriptions for inpatients at a tertiary care university hospital in Pakistan and to correlate it with prescription patterns of various specialties, indications and demographic variables of the patients. METHODS: This 24-hours point prevalence study was done at The Aga Khan University Hospital, Karachi. By convenient random sampling, 208 inpatients were interviewed. Patients' files were also studied to record the drugs administered. Data was entered into questionnaires and analyzed by SPSS 10.0. RESULTS: The point prevalence of the benzodiazepines was 21.2%. It was higher among males than females and among surgical than non-surgical patients. Midazolam was the most commonly used benzodiazepine, followed by Alprazolam and Lorazepam. Pre-anesthesia and psychiatric symptoms were the two most common indications. Oral route was used in 84% patients for drug administration and mean Valium equivalent dosage was 4.86 mg/day. Mean length of prescription was 3 days. Longer duration of hospitalization was a significant predictor of the requirement of benzodiazepine prescription (p-value = 0.020). CONCLUSION: Prescription pattern of benzodiazepines at a tertiary care university hospital is similar to that reported in the developed countries through monitoring at various levels by physicians, clinical pharmacist and nursing staff. Data regarding the prescription pattern of benzodiazepines is scarce, and it needs to be expanded to formulate clear guidelines regarding their prescription.

Adult↗

Concurrent Fusarium chlamydosporum and Microsphaeropsis arundinis infections in a cat.

A 7-year-old cat was presented initially with multiple draining sinuses on the metatarsal region of its right hindlimb. Another lesion had appeared at the same time on the fifth proximal interphalangeal joint of the left forelimb. Histopathological examination of a biopsy from the right hindlimb lesion revealed chronic pyogranulomatous inflammation associated with yeast-like bodies and septate mycelia; a fungus was cultured on conventional media but not identified further. Culture of a swab collected from the left forelimb lesion demonstrated a pigmented fungus, also not characterised further. Although there was initially a favourable response to ketoconazole (Nizoral, Janssen-Cilag Pty. Ltd) and beta-lactam therapy, the infection in the hind limb relapsed subsequently, and Fusarium chlamydosporum was cultured from deep biopsy specimens. Clinical improvement followed debridement and itraconazole (Sporanox, Janssen-Cilag Pty. Ltd; 100 mg orally once daily), however amputation of the limb represented the best chance for a cure. The cat made an uncomplicated recovery following surgery and remained well for five months until the lesion on the left forelimb recurred. Amputation of the distal fourth digit was then performed, and the resected tissue submitted for culture. The dematiaceous fungus Microsphaeropsis arundinis was subsequently cultured. The cat remained well for several months, until a further F. chlamydosporum infection developed on the body wall. This was excised 7 months ago, and no lesions have recurred in this area. Importantly, this is the first reported case of M. arundinis infection in a mammalian host.

Animals↗