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Biomedical subjects

S H Shah

Publications and source records attributed to S H Shah.

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

Immunohistochemical evaluation of small round cell tumors of childhood.

OBJECTIVE: This study was done to evaluate the pediatric undifferentiated small round cell tumors with immunohistochemical staining. SETTING: The present study included consecutive cases of small round cell tumors which were diagnosed in children (< 15 years) in the section of Histopathology at the Aga Khan University Hospital, Karachi during the period of two years. METHODS: The group of undifferentiated small round cell tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, formalin fixed, paraffin embedded tissue blocks. RESULTS: The category of undifferentiated small round cell tumors included rhabdomyosarcoma (23.2%), primitive neuroectodermal tumor (17.9%), non-Hodgkin's lymphoma (16.1%), neuroblastoma (14.2%), Ewing's sarcoma (10.7%) in order of frequency. Osteosarcoma (Small cell variant), retinoblastoma and medulloblastoma comprised 1.8% each. In seven cases (12.5%), the immunohistochemical analysis was inconclusive. CONCLUSION: Immunohistochemistry is a very valuable diagnostic tool which helps in distinguishing the undifferentiated tumors especially small round cell tumors. The immunohistochemical staining needs to be performed routinely for undifferentiated tumors in diagnostic histopathology.

Adolescent↗
PubMed1999

Clinico-morphological pattern and frequency of bone cancer.

OBJECTIVE: The present study was done to find out the frequency of malignant tumors of bone and to categorize the prevalence of various histological types of osseous malignancies with respect to age, sex and site of origin. SETTING: This study included consecutive cases of malignant bone tumors, which were diagnosed in the department of pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997). METHODS: These tumors were initially evaluated on H & E stained section from paraffin embedded tissue blocks. Special stains and immunohistochemical analysis was performed whenever required. RESULTS: A total of 169 malignant bone tumors were diagnosed during the study period. Metastatic tumors accounted for 28.4% of all malignant tumors of bone. Osteogenic sarcoma (27.2%) was the most frequent primary tumor of bone followed by Ewing's sarcoma (12.4%), Non-Hodgkin's lymphoma (10.6%), Chondrosarcoma (8.3%), Plasma Cell Myeloma (8.3%) and other rare entities (4.8%) in order of frequency. CONCLUSION: The most common malignant neoplasm diagnosed in osseous biopsies was metastatic tumors. Osteogenic sarcoma was the most frequent primary bone tumor in this series. The bone tumors were relatively more prevalent in males. The frequency of malignant bone tumor was relatively high as compared to developed countries.

Adolescent↗
PubMed1999

Morphological pattern and frequency of thyroid tumors.

OBJECTIVE: The present study was done to evaluate the frequency of thyroid cancer and to find out the prevalence of histological types of thyroid tumor with respect to age and sex group. SETTING: This study included consecutive cases of malignant tumors of thyroid gland, which were diagnosed in the Department of Pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997). METHODS: These cases were evaluated on H & E stained sections from paraffin embedded 10% buffered formalin fixed tissue blocks. Special stains and immunohistochemical analysis were performed whenever required. RESULTS: A total of 8541 malignant tumors were diagnosed in a period of 3 years which included 103 (1.2%) cases of thyroid cancer. Thyroid tumors were more prevalent in females with female to male ratio of 2.6:1. Papillary carcinoma (69%) was the most common histological type of thyroid tumors, followed by follicular carcinoma (11.6%), medullary carcinoma (9.7%), anaplastic carcinoma (5.9%), non-Hodgkin's lymphoma (2.9%) and unclassified tumors (0.9%) in order of frequency. CONCLUSION: Thyroid cancer was more common in females. Papillary carcinoma was the most common histological type of thyroid tumors in females as well as in males. Papillary carcinoma was more prevalent in third, fourth and fifth decades of life while follicular and anaplastic carcinomas were more frequent after the fourth decade of life.

Adult↗
PubMed1998

Diagnostic evaluation of fine needle aspiration cytology in the management of palpable breast lesions.

A total of 113 fine needle aspirates of the breast masses were evaluated in which the subsequent biopsy or mastectomy specimen were also available for histological examination. The age ranged from 16 to 80 years with a mean of 42 years. In benign conditions the mean age was 34.7 years while in malignant cases it was 48 years. The cytological diagnoses were compared with the histological results which revealed that the specificity and sensitivity of fine needle aspiration cytology in the palpable breast lesions was 86.1% and 89.2% respectively with a positive predictive value of 93% and efficiency of 88.2%. Similar statistics from other series in which the cytological results of breast lesions were compared with histological results, revealed almost same results which suggest that fine needle aspiration cytology is an effective and accurate technique for the diagnosis and management of palpable breast lumps.

Adolescent↗
PubMed1997

Duodenal erosions and ulcers in patients with pancreatobiliary obstruction.

In order to determine whether obstructive pancreatobiliary lesions increase the risk of duodenal erosions and ulcers, the duodenal mucosa of patients with these lesions were prospectively examined before endoscopic retrograde cholangiopancreatography (ERCP). During the study period, 133 patients underwent ERCP for various reasons in the Department of Medicine, The Aga Khan University Hospital. One hundred and twenty-three patients were eligible for final analysis. Sixty-five patients with bilirubin > or = 35 mumol/L and alkaline phosphatase > or = 2.5 times normal levels along with radiological evidence of pancreatobiliary obstruction were included in the obstruction group. Fifty-eight patients who did not fulfil these criteria were used in the control group. Acid peptic lesions, which included erosions and ulcers, were seen in 16 patients of the obstruction group and four patients of the control group (P = 0.016, odds ratio (OR) = 4.41). Patients with carcinoma of the pancreas had a greater number of lesions than the rest of the obstruction group (P = 0.001, OR = 8.75). Individual variables like age, sex, serum bilirubin, alanine aminotransferase, alkaline phosphatase, amylase levels, and duration of jaundice did not increase the vulnerability to acid peptic injury. The degree of obstruction multiplied by duration of jaundice (alkaline phosphatase x days) increased the susceptibility for duodenal disease (P = 0.047). From this data it was concluded that patients with obstructive pancreatobiliary lesions are more prone to acid peptic duodenal lesions.

Adolescent↗
PubMed1996

Efficacy of octreotide in diarrhoea due to Vibrio cholerae: a randomized, controlled trial.

Although octreotide, a long-acting analogue of somatostatin, is currently used in the treatment of chronic secretory diarrhoea due to various causes, its role in the management of acute secretory diarrhoea is not well established. In the present study, therefore, the therapeutic value of octreotide in the management of cholera, a classical example of acute secretory diarrhoea, was investigated. During an outbreak of cholera, patients admitted with acute secretory diarrhoea of < or = 24 h duration and a purging rate > 100 ml/h were enrolled on the study and randomly assigned to octreotide (N = 17) and control (N = 16) groups. All 33 patients received intravenous fluid replacement and antibiotic treatment (200 mg ofloxacin twice daily for 3 days, by mouth). Each patient in the octreotide group was also given a subcutaneous injection containing 100 micrograms octreotide every 8 h for a maximum of six doses. The stool output of each patient was recorded every hour until there had been none for an hour, which was taken as the endpoint. Mean (S.D.) total stool output was lower [6.56 (3.7) v. 9.7 (6.5) litres] and the mean (S.D.) duration of diarrhoea after admission was shorter [32.9 (15.6) v. 47.8 (22.3); P < 0.05] in the octreotide group than in the control group. However, as both groups generally had similar purging rates, the higher volume of stools from the control group was simply the result of the longer period of diarrhoea in this group. Octreotide therefore only decreased the duration of diarrhoea in the cholera patients.

Adult↗
PubMed1996

Measurement of spleen size and its relation to hypersplenism and portal hemodynamics in portal hypertension due to hepatic cirrhosis.

AIMS: Splenomegaly is common in portal hypertension due to hepatic cirrhosis, but there are little data comparing different methods of spleen measurement. We have compared ultrasound with radionuclide imaging in measuring splenomegaly. The relation of splenomegaly to hypersplenism and portal hemodynamic factors was also studied. RESULTS: Ultrasound and radionuclide measures of spleen volume gave comparable results (r = 0.95, p < 0.0001). Phagocytic activity of the spleen measured by radionuclide uptake increased as the volume of the spleen increased (r = 0.46, p < 0.03) but was not related to diminishing liver phagocytic activity. Spleen volume was correlated negatively with leukocyte counts (r = 0.43, p < 0.05) but not with hemoglobin or platelet counts. Spleen radionuclide uptake was negatively correlated with hemoglobin (r = 0.48, p < 0.04) and leukocyte counts (r = 0.46, p < 0.04) but not with platelet counts. Spleen volume was related to portal vein cross-sectional area (r = 0.91, p < 0.0001) and portal vein blood flow volume (r = 0.57, p < 0.008) but not to portal vein blood flow velocity, portal pressure gradient, or azygos blood flow. CONCLUSIONS: Spleen size measured by ultrasonography and radionuclide studies gives comparable results. Spleen phagocytic activity in cirrhosis increases as the spleen enlarges but not in relation to decreased hepatic phagocytic activity. Spleen phagocytic activity probably contributes to anemia and leukopenia in the splenomegaly of cirrhosis, but other factors must contribute to thrombocytopenia. Portal hemodynamics are probably important in the splenomegaly, but the interrelation is complex.

Female↗
PubMed1995

Transcranial magnetic stimulation: cortical motor maps in acute spinal cord injury.

This investigation examined the motor pathways of four, C5-6 spinal cord injured (SCI) patients within 6-17 days of injury. Mapping of the motor cortex was achieved by transcranial magnetic stimulation (TMS) applied to the scalp. Motor evoked potentials were recorded from target muscle groups (Biceps brachii and Abductor pollicis brevis m.). Evidence of an expanded cortical map of the preserved contralateral biceps muscle was demonstrated in these patients as early as 6 days. These findings suggested that early motor re-organization may occur following acute cervical spinal cord injury in man.

Adult↗
PubMed1995

Visceral leishmaniasis--a study of 38 cases on the basis of geographical distribution.

Geographical distribution of thirty-eight cases of visceral leishmaniasis (VL), who were diagnosed in the department of Pathology, Rawalpindi Medical College and two private laboratories in Rawalpindi and Islamabad is presented. Majority (84.2%) came from Azad Kashmir, especially from areas around Poonch (e.g., Rawlakot-28.9%; Bagh-23.7%; Dirkot-5.3% and Pallandari-2.6%) and areas around Muzaffarabad (e.g., Chakothi-13.2% and Punja Sharif-5.3%). Only two patients (5.3%) belonged to Gilgit agency. Four cases came from villages around Murree, Rawalpindi and Abbottabad. These places are not known as endemic areas of VL. It is proposed that epidemiological studies for VL should be carried out in areas of Azad Kashmir, especially concentrating on the places from where patients keep on presenting for treatment in various hospitals of Rawalpindi and Islamabad.

Adolescent↗
PubMed1995

The pattern of bone marrow infiltration in non-Hodgkin's lymphomas.

The pattern of bone marrow infiltration in 40 consecutive cases of non-Hodgkin's lymphomas (NHLs) having marrow involvement is presented. For histological break-up, working formulation of NHLs was used. Low grade NHLs (50%) were the commonest, followed by intermediate (32.5%) and high grade NHLs (17.5%), respectively. Histologically, small lymphocytic type (32.5%) was the commonest, followed by diffuse small cleaved cell (15%) type; follicle small cleaved cell, diffuse mixed small and large cell as well as lymphoblastic types were equally frequent (12.5% each). Other histological types were less common. The pattern of infiltration of the bone marrow was diffuse in 76.7% of intermediate, 70% of low and 100% of high grade NHLs. It was focal random (non-paratrabecular) in 15% of low grade and 15.4% of intermediate grade NHLs. Focal paratrabecular pattern was evident in 15% of low grade and 7.7% of intermediate grade NHLs.

Adolescent↗
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↗
PubMed1994

A morphological pattern of 234 cases of leukemias.

Morphological pattern of 234 consecutive cases of various types of leukemias is presented. Acute leukemias (62.8%) were commoner than chronic (37.2%). Amongst acute leukemias, myeloid leukemias (AML) were more frequent as compared to lymphoblastic (ALL). AML:ALL ratio was 2.57:1 in adults and 1:3 in children. Amongst AML cases, M4 was the commonest, followed by M2, M1, M3 and M4 and M6 and M7 respectively. In ALL patients, L1 was the commonest, followed by L2 and L3 respectively. Amongst chronic leukemias, myelocytic leukemia (CML) was more common than lymphocytic leukemia (CLL) with a CML:CLL ratio of 3.1:1. In a total of 60 CML cases, two had juvenile CML, four were between 10 and 15 years of age and the remaining 54 were adults. Hairy cell leukemia (2 cases) and lymphoma/leukemia syndrome (5 cases) were uncommon.

Acute Disease↗
PubMed1993

New schedule of intramuscular iron administration for pregnant women.

Pregnant women between 14 and 20 weeks were randomly recruited in 2 groups, 50 to each. One group received iron with folic acid orally, other group was given 5 injections of iron dextran spaced 4 weekly. Mean haemoglobin was same for both the groups at the beginning (p > 0.05). At 36 weeks intramuscular group has shown statistically more haemoglobin rise than oral group (p < 0.001). This new intramuscular schedule is found to be convenient, cheap and acceptable to pregnant women. It also assures at least 5 antenatal checkups to a pregnant woman.

Administration, Oral↗
PubMed1993

Antibody to hepatitis-C virus in multi-transfused thalassaemics--Indian experience.

Twelve out of 72 (16.7%) multi-transfused patients with thalassemia major (age range: 7-22 years) were found to be positive for antibody to hepatitis-C virus (anti-HCV). Nine (75%) of these 12 cases were positive for hepatitis B core antibody (anti-HBc) and/or hepatitis B surface antibody (anti-HBs). Out of the remaining 60 patients (83.3%), 27 patients (45%) were positive for anti-HBc and/or anti-HBs, while six (10%) were HBsAg positive Anti-HCV positive patients had significant higher levels of liver enzymes than those who were negative (p < 0.01). S. Ferritin was also significantly higher in those with seropositivity for anti-HCV than those who were negative (p < 0.01). It is concluded that HCV (besides HBV) is a major problem in multi-transfused thalassemia major patients and routine pre-transfusion screening of blood for anti-HCV must be introduced in the blood banks.

Adolescent↗