Biomedical subjects
Publications and source records attributed to S J Zuberi.
Retrospective analysis of 300 children with various liver diseases, seen at two major teaching hospitals of Karachi indicates that acute viral hepatitis and its sequelae are the commonest of all hepatic ailments. Their frequency, clinical presentation, biochemical findings and outcome are presented.
Two hundred and forty-five endoscopically proven or surgically treated duodenal ulcers were retrospectively evaluated to see if the site of ulcer has any influence on the clinical presentation, and healing and relapse rates. Anterior wall ulcer was present in 42%, posterior wall in 33%, lesser curve side of the cap in 12% and greater curve side in 13% cases. Ulcer site showed no correlation to age, sex, duration of illness, analgesic intake or smoking habits. Bleeding (116 cases) and perforation (15 cases) were the major complications encountered; of these perforation was invariably found on the anterior wall, while bleeding was more frequent in ulcers present on the lesser curve side of the cap. Better healing and high relapse rates were seen in ulcers situated on the greater curve, and low healing and relapse rates in lesser curve duodenal ulcers.
The prevalence of H. pylori infection in 200 dyspeptic patients undergoing upper G.I. endoscopy was investigated by histology and rapid urease test. H. pylori was associated with 86% cases of chronic gastritis, 84.6% cases of duodenal ulcers and 78.5% of gastric ulcers. None of the 15 histologically normal gastric biopsies showed H. pylori.
Seven hundred and twenty cases of endoscopically proven peptic ulcer were seen at PMRC Research Centre, Jinnah Postgraduate Medical Centre, during the last 13 years (June 1976-June 1989). Duodenal to gastric ulcer ratio was 5:1. Duodenal ulcer was predominantly seen between 3rd and 5th decade of life, with a male to female ratio of 5. 7:1. Seventy five percent cases were skilled persons. Places of origin showed 50% to be migrants; mostly from India while the rest belonged to various provinces of Pakistan. Sixty percent patients were smokers/tobacco chewers and 3% were simultaneously taking alcohol. History of NSAID intake was present in 5% cases only. Majority (85%) of the patients presented with pain, 42% had upper G.I. bleeding, 11% perforation and 1% pyloric stenosis.
In a placebo controlled prospective clinical trial of bismuth salicylate in helicobacter pylori associated gastritis, 52 adult patients were randomly allocated to treatment with bismuth salicylate or placebo. Helicobacter pylori were totally cleared in 77% patients in bismuth group but none in placebo group (P less than 0.001). Resolution of gastritis (P less than 0.001) and improvement of symptoms (P less than 0.01) were significantly better in patients where H. pylori infection cleared as compared to patients where the infection persisted.
Retrospective analysis of 115 cases of perforated duodenal ulcer was done to determine the long term prognosis of patients managed by suture plication. Male to female ratio was 7.8:1. Males were younger than females with a median age of 35 and 50 years respectively. Highest frequency was noted in the 4th decade. Thirty-eight percent cases were smokers and 8.7% were pan/tobacco chewers. Blood group O was predominant (36.5%). Ninety-five percent perforations were in the anterior wall of the Cap and 5% prepyloric. Of the 48 (42%) cases followed, 28 (58%) relapsed during a 15 year follow-up. The cumulative relapse rate increased with the increase of follow-up period. Patients who relapsed had a longer duration of symptoms prior to perforation (P less than 0.05) than those who did not relapse.
A study of the immunogenicity and safety of 20 micrograms recombinant DNA yeast derived hepatitis B vaccine was conducted in 153 Pakistani adults. All participants were in good physical condition, had negative hepatitis B serological markers (HBsAg, anti-HBs, anti-HBc) and normal ALT. Anti-HBs developed in 33%, 81% and 98% of subjects one month after the first, second and third dose respectively. Minor systemic and local side-effects were observed in 39% of individuals. We conclude that yeast derived hepatitis B vaccine is safe, effective and immunogenic in Pakistani adults.
Explore the source record for details and available documents.
Gastric cellular and humoral immune response investigated by immunoperoxidase staining of 53 antral biopsies showed significant differences in Campylobacter pylori-associated gastritis as compared with non-bacterial chronic gastritis and normal controls. IgA, secretory component, and complement C3 coated bacilli were seen in all cases of active chronic gastritis. C3 was always associated with coating by IgA, IgM, or both, which were rarely seen in gastritis without polymorphonuclear neutrophil infiltration. Intraepithelial mononuclear cellular infiltration was seen in 18 of 26 cases of C. pylori-associated chronic gastritis. The intraepithelial mononuclear cells stained positively for T cells and histiocytes.
To determine the presenting features and prognosis of nonalcoholic cirrhosis, retrospective analysis was done in 145 cases. Of the total, 48 patients (33%) belonged to the young (less than or equal to 35 years), and 97 (67%) to the adult age group (greater than 35 years) with no predominance of either sex. The etiology of cirrhosis and the positivity of viral markers were similar in both groups. Adults had on presentation a higher frequency of anorexia while hematemesis was more frequent in the young group (p less than 0.001). During a mean follow-up (+/- SE) of 31.7 +/- 5.5 and 16.3 +/- 2.2 months in the young and adult group, respectively, 68 and 63% cases survived 5 years. Liver failure (53.8 and 44.4%) and variceal bleeding (23 and 11.1%) were the main causes of death in both groups, accounting for 27% mortality in each group.
Serum proteins, albumin and globulin in 456 (274 males and 182 females) subjects were within the normal range and showed uniform distribution. Mean protein levels were low in infants under 0-1 year of age. No significant change was noted with age and sex in other groups. These values were considered to be normal for our population as all protein values fell within 2.5 and 97.5 percentile (95% of the total population) irrespective of age and sex except babies under 0-1 year. The average intake of protein/kg body weight was almost upto the recommended allowances.
Explore the source record for details and available documents.
The radiological report of gall bladder contraction 60 minutes after fatty meal, was compared with the computed volume and contraction of gall bladder using Siffert's technique. Of 46 oral cholecystograms, 34 were reported to be normal and 12 as poor contraction. On computation only 14 were found to be normal and 32 showed poor contraction. The difference was statistically significant.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Fifty three patients with duodenal ulcer were treated with 40 mg of famotidine at bed time. Repeat endoscopy showed healing rates of 69.8% and 83% at 4 and 6 weeks respectively. Seven patients were kept on a maintenance dose of 20 mg nocte for one year, of these one had a relapse despite taking the drug regularly. No appreciable side effects were observed with the drug (JPMA 39:104, 1989).
Postprandial sera of seventy patients with liver disease (hepatitis 30, cirrhosis 19, liver cancer 21) were analysed for total serum bile acids. The mean values observed in hepatitis (169.0 mumol/L), cirrhosis (112.15) and liver cancer (86.44) were significantly higher (p less than 0.001) than in normal (19.45). The frequency of abnormal bile acids was greater than that of the standard liver function tests except for alkaline phosphatase in liver cancer.
Explore the source record for details and available documents.