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T Mozaffar

Publications and source records attributed to T Mozaffar.

13 recordsLinked to original sources
PubMed2002

Predictors of mortality in brain abscess.

OBJECTIVE: Brain abscess carries significant morbidity and mortality. Our objective was to elucidate the clinical presentation of brain abscess and to assess predictors of mortality in these patients. METHODS: All patients with a brain abscess presenting to the Aga Khan University Hospital, a tertiary care referral center in Karachi, Pakistan, were studied retrospectively. Statistical analysis involved univariate analysis and a logistic regression model. RESULTS: Among the 66 patients analyzed, a distant metastatic focus of infection was the most commonly identified predisposing factor (29%). Otogenic infection was the commonest contiguous source and sinusitis was noticeably absent. Multiple abscesses were frequent (35%). Streptococci were the most common isolates (39%). Lumbar puncture was performed in 44% and steroids administered in 33%. Treatment was surgical in 58%. Most comatose patients were treated conservatively. Overall mortality was 29%. Univariate analysis identified comatose presentation and identification of a distant focus of infection as predictors of mortality. The logistic regression model, however, identified a distant focus of infection as the only independent predictor. CONCLUSION: Age greater than 30 years, corticosteroid use, multiple abscesses, performance of lumbar puncture and conservative management had no affect on outcome.

Adolescent↗
PubMed2001

Brain abscess.

Explore the source record for details and available documents.

Brain Abscess↗
PubMed2000

Myopathy with anti-Jo-1 antibodies: pathology in perimysium and neighbouring muscle fibres.

OBJECTIVE: To evaluate muscle pathology and clinical characteristics in patients with a myopathy and serum antibodies to the Jo-1 antigen (histidyl t-RNA synthetase). BACKGROUND: Anti-Jo-1 antibodies occur in syndromes that may include muscle weakness and pain, Raynaud's phenomenon, interstitial lung disease, arthritis, and a skin rash different from that seen in dermatomyositis. The muscle pathology is not well defined. METHODS: Case series. Review of charts, muscle biopsies, and laboratory records. Features of myopathology in 11 patients with anti-Jo-1 antibody associated myopathies were compared with other types of inflammatory myopathies. RESULTS: Myopathology in patients with anti-Jo-1 antibodies consistently included fragmentation of, and macrophage predominant inflammation in, perimysial connective tissue. Perifascicular myopathic changes, including atrophy, regenerating muscle fibres, and some muscle fibre necrosis, were most common in regions near the connective tissue pathology and were most prominent in patients with more severe weakness. Unlike many other inflammatory myopathies, inflammation in endomysial and perivascular regions was uncommon. By contrast with dermatomyositis, capillary density was normal. CONCLUSIONS: Myopathological changes in the anti-Jo-1 antibody syndrome include perimysial connective tissue fragmentation and inflammation, with muscle fibre pathology in neighbouring perifascicular regions. Myositis with anti-Jo-1 antibodies may result from an immune mediated disorder of connective tissue.

Adolescent↗
PubMed1999

Chronic subdural haematoma presenting with transient ischaemic attacks--a case report.

We report a middle-aged man who presented with repeated episodes of transient ischaemic attacks (TIA) in the setting of a chronic subdural haematoma. This case report discusses the various pathophysiologic mechanisms whereby such TIA may occur in chronic subdural haematoma. We also highlight the importance of cranial imaging in cases of TIA.

Chronic Disease↗
PubMed1998

Clinical correlates of granulomas in muscle.

We evaluated the clinical and myopathological features of all patients with granulomas in muscle biopsy specimens identified over a 5-year period (1992-1996) at the Washington University Medical Center. Ten patients were found to have granulomas in their muscle biopsy specimens. Of these, eight patients had myopathic changes. Seven had dysphagia as a major functional difficulty during the course of their disease. None had elevated levels of serum creatine kinase (CK). Four of the patients with myopathy had systemic sarcoidosis and relatively severe proximal weakness with functional disability. Treatment with corticosteroids was followed by marked improvement in strength and functional disability. The four other patients with myopathy had no systemic signs of sarcoidosis. Weakness was especially prominent distally in three of these patients. The two patients in this group treated with corticosteroids did not improve. The final two patients, who had granulomas in muscle but no myopathic changes, had clinical syndromes of mononeuritis multiplex and eosinophilic fasciitis (Shulman syndrome). We conclude that granulomatous myopathy, in the presence or absence of systemic sarcoidosis, is commonly associated with dysphagia (87%) and a normal serum CK. Clinical features in patients with sarcoidosis included severe proximal weakness with functional disability that often responded to corticosteroid treatment. Granulomatous myopathy without systemic sarcoidosis was associated with milder, but more predominantly distal weakness.

Adult↗
PubMed1998

Paraneoplastic necrotizing myopathy: clinical and pathological features.

OBJECTIVE: To characterize the clinical features and muscle pathology of paraneoplastic necrotizing myopathy. BACKGROUND: Paraneoplastic syndromes involving many levels of the nervous system are well described, but there are only rare case reports of a necrotizing myopathy associated with cancer. DESIGN: Case series. RESULTS: We identified four patients with paraneoplastic necrotizing myopathy from muscle biopsies done at Washington University over a 10-year period. The patients (aged 38 to 76 years) presented with subacutely evolving, symmetric, proximal weakness. Tumor types included gastrointestinal adenocarcinoma (2 of 4), transitional cell carcinoma, prostatic carcinoma, and non-small cell lung carcinoma. Two patients died. Two others improved after treatment that included corticosteroids and tumor resection. Muscle pathology showed numerous necrotic fibers (8 to 100%) and intense alkaline phosphatase staining of the muscle connective tissue, but little inflammation. CONCLUSIONS: Paraneoplastic necrotizing myopathy is characterized by a rapidly progressive, symmetric, predominantly proximal weakness that produces severe disability. Muscle pathology demonstrates prominent necrosis with alkaline phosphatase staining of connective tissue and little inflammation. Evaluation for cancer is indicated in patients with these clinical and pathologic findings.

Adult↗