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Biomedical subjects

Z Abbas

Publications and source records attributed to Z Abbas.

At least 19 recordsLinked to original sources
PubMed2006

Comparison of biopsy-based methods for the detection of Helicobacter pylori infection.

Various biopsy-based methods for the detection of Helicobacter pylori are evaluated to determine their sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), followed by polymerase chain reaction (PCR) for the 16S ribosomal RNA (rRNA) gene of H. pylori (16S PCR) to confirm the results. Seventyfive patients (65% [49] males, age range: 17-77 years, mean 42+/-14.6 years) with dyspeptic symptoms are included in the study. Gastric antrum biopsy specimens collected during endoscopy are tested using a urea agar base enriched with 40% urea solution (eUAB, Oxoid)), a commercial rapid urease test (Pronto Dry, Medical Instrument Corp, Switzerland), histopathology and 16S PCR. The eUAB test showed 97% sensitivity, 86% specificity, 84% PPV, 97% NPV and 91% accuracy when the diagnosis of H. pylori infection was made with positive Pronto Dry and histopathology. Pronto Dry showed 100% sensitivity, 82% specificity, 80% PPV, 100% NPV and 89% accuracy when the diagnosis of H. pylori infection was made on positive histopathology and eUAB. Thus, the eUAB can be used as a rapid urease test. It is economical and has a sensitivity and specificity comparable to a commercially available rapid urease test to detect urease activity of H. pylori in gastric biopsy.

Costs and Cost Analysis↗
PubMed2005

Pill-induced esophageal injury: endoscopic features and clinical outcomes.

BACKGROUND AND STUDY AIMS: Pill-induced esophageal injury is a common but under-reported problem. The purpose of this study was to explore the clinical and endoscopic features, and the outcome of pill-related esophageal injury. PATIENTS AND METHODS: Endoscopy records for the period from January 1997 to June 2003 were searched for reports of esophageal pathology. The records of patients with pill-induced esophageal injury were evaluated. RESULTS: A total of 92 patients with pill-induced esophageal injury were identified (33 men, 59 women; mean age 59, range 25-87). Common symptoms were odynophagia (n = 69, 75 %), chest pain (n = 55, 60 %), vomiting (n = 53, 58 %), dysphagia (n = 31, 33 %), and hematemesis (n = 14, 15 %). The endoscopic findings in the esophagus were: erythema in 76 patients (83 %), erosions in 53 patients (58 %), ulcers in 24 patients (26 %), seven of which were "kissing" ulcers, esophageal ulcer with bleeding in 17 patients (18 %), and esophageal strictures in seven patients (8 %). The causative pills were nonsteroidal anti-inflammatory drugs in 38 patients (41 %), tetracyclines in 20 patients (22 %), potassium chloride tablets in nine patients (10 %), alendronate in eight patients (9 %), and other drugs in 17 patients (18 %). Underlying diseases included diabetes in 60 patients (65 %), ischemic heart disease in 39 patients (42 %), and hypothyroidism in four patients (4 %). The mean hospital stay was 1.94 days; 14 patients (15 %) required injection of epinephrine 1 : 10,000 to control bleeding; and two patients died. CONCLUSIONS: Pill-induced injury may present as erosions, kissing ulcers, and multiple small areas of ulceration with bleeding, mainly in the middle third of the esophagus. Advanced age, female gender, diabetes, and ischemic heart disease were common associations. The majority of patients made an uneventful recovery.

Aged↗
PubMed2005

Concurrent malaria and enteric fever in Pakistan.

INTRODUCTION: The precise incidence of concurrent malaria and enteric fever in most geographical areas is largely unknown, and no data on such an association exists in Asia. Because both malaria and enteric fever are hyperendemic in Pakistan, we sought to determine the frequency, epidemiology, and clinical and laboratory features of dual malaria and enteric fever in a tertiary care setting. METHODS: We conducted a retrospective case-control study of 1,891 patients hospitalised with malaria over a ten-year period and identified 21 patients with concurrent culture-proven enteric fever. RESULTS: Cases with dual infection had significantly more gastrointestinal symptoms at the time of admission, including nausea, vomiting, abdominal pain, and/or diarrhoea compared to matched control subjects with uncomplicated malaria (p-value is less than 0.006). Cases were more likely to have a continuous rather than intermittent fever (p-value is less than 0.0001), delayed defervescence in response to antimalarial treatment (p-value is less than 0.006), normal or low white blood cell counts (p-value is less than 0.04), relatively higher platelet counts among cases versus control (p-value is less than 0.05) and serum haemoglobin (p-value is less than 0.06), elevated alanine aminotransferase levels (p-value is less than 0.02), and a prolonged hospital stay (p-value is less than 0.03). The negative predictive values for gastrointestinal symptoms, continuous fever pattern and delayed defervescence were 80 percent, 72 percent and 74 percent, respectively. CONCLUSION: Patients with malaria who have marked gastrointestinal symptoms, continuous pattern of fever and persistence of fever for more than 24 hours after appropriate antimalarial therapy, should be investigated or empirically treated for concurrent enteric fever. The absence of the above clinical features in patients with uncomplicated malaria should reassure physicians that there is no concurrent typhoid fever.

Adolescent↗
PubMed2004

Improving kidney and live donation rates in Asia: living donation.

Organ transplantation started with organs donated by living subjects. Increasing demands brought cadaveric organ donation. The brain-death law, mandatory for this procedure, is prevalent in all countries involved in organ transplantation except Pakistan. Spain is the leading country in cadaveric organ donation (32.5 pmp). Despite the sources of living and cadaveric organs, both heart-beating and non-heart-beating, the gap between the demand and supply has widened. An example is the United States, where the numbers of patients on the waiting list for kidney transplantation have risen from 30,000 in 1988 to more than 116,000 in 2001. This has caused a resurgence in living donors all over the world. These can be related, unrelated, spousal, marginal, or ABO-incompatible donors. Family apprehensions, medical care costs, and nonexistent social security can be barriers to this form of organ donation. Unrelated organ donation can open the doors to commercialism. To make this process more successful, transplantation should be made reachable by all sectors of the population. This is possible when transplantation is taken to the public sector institutions and financed jointly by the government and community. To increase living organ donation especially in Asian countries, which face barriers of low literacy rates, ignorance, and cultural and religious beliefs, more efforts are needed. Public awareness and education play an important role. Appreciation and supporting the donors is necessary and justified. It is a noble act and should be recognized by offering job security, health insurance, and free education for the donor's children.

Cadaver↗
PubMed2004

Thymosin alpha 1 in combination with interferon alpha and ribavirin in chronic hepatitis C patients who are non-responders or relapsers to interferon alpha plus ribavirin.

OBJECTIVE: Interferon alpha (IFN-alpha) with or without ribavirin is an approved therapy for patients with chronic hepatitis C. However, a sustained response is achieved in less than 40% of all treated cases. Retreatment of relapsers or non-responders usually fails. Thymosin alpha 1 (Ta-1) is a polypeptide with immunomodulatory properties that has been suggested to increase response rates in patients with chronic hepatitis C. The aim of present study was to evaluate the efficacy of a novel triple regimen which includes Ta-1 for relapsers and non-responders to the combination of TA-1 and ribavirin. METHODS: In the present study, 11 patients who relapsed (n=5) or did not respond (n=6) to previous INF-alpha-based therapy were retreated with combination Ta-1, INF-alpha and ribavirin for 12 months, and followed up for a further six months. RESULTS: Four out of five relapsers had a sustained response. One of the non-responders cleared the HCV RNA during the post-treatment follow-up. Minor adverse effects were observed during treatment with this combination therapy and no dose reduction or discontinuations were needed. CONCLUSION: This data suggests that thymosin alpha 1 may add to the efficacy of INF-alpha plus ribavirin in the retreatment of relapsers or non-responders to previous INF-alpha-based hepatitis C therapy.

Adjuvants, Immunologic↗
PubMed2003

Interleukin (IL) 1beta and IL-10 gene polymorphism in chronic hepatitis C patients with normal or elevated alanine aminotransferase levels.

OBJECTIVE: To evaluate the frequency of cytokine gene single nucleotide polymorphisms (SNP) of IL-1beta and IL-10 at promoter sites -115 and -1082 respectively and their association with hepatocellular injury as suggested by alanine aminotransferase (ALT) level. METHODS: Fifty six patients (31 males, 25 females) positive for HCV antibody were studied. Their mean age was 37.5 +/- 12.0 years (range 16-62). Fifty one were HCV RNA positive; 14 had normal and 37 elevated ALT levels. Type 3 was the predominant genotype. For cytokine polymorphism DNA was extracted from the whole blood. After amplification with polymerase chain reaction, biallelic polymorphisms of IL-1beta at -115 and IL-10 at -1082 promotor site were determined using sequence specific oligonucleotide primers. RESULTS: IL-1beta-15 C allele was present in 49 (87.5%) and -115 T in 30 (53.6%) patients. Genotype CC was present in 26 (46%), TC 23 in (42%), and TT in 07 (12%). IL-10 -1082 A allele was seen in 50 (89.3%) and -1082 G in 35 (62.5%). Genotype AG in 29 (52%), AA in 21(37%), and GG in 06 (11%). Though greater number of HCV RNA positive patients with normal ALT had IL-10 -1082 AG genotype (10 out of 14), no statistically significant difference could be found in the genotype profile of the above promoter sites of IL-1beta and IL-10 in patients with normal or elevated ALT. CONCLUSION: IL-1beta-115 C and IL-10 -1082A are the more frequent alleles in our patients. Genotypes L-1beta -115 CC and TC, and IL-10 -1082AG and AA are common while -115 TT and -1082 GG are less common. Any effect of IL-1beta and IL-10 gene polymorphism on the degree of hepatocellular injury may not be apparent by the ALT levels.

Adolescent↗
PubMed2001

Prevalence of histological reflux oesophagitis in H. pylori positive patients: effect of density of H. pylori and activity of inflammation.

OBJECTIVE: Recently there has been a great interest in the role of Helicobacter pylori in gastroesophageal reflux disease. Many studies do not show any significant difference in the overall prevalence of H. pylori in patients with endoscopic oesophagitis and controls. In this prospective study we assessed the influence of H. pylori density and activity of inflammation in different parts of stomach on histological oesophagitis. METHODS: One Hundred and forty consecutive patients undergoing endoscopy for dyspepsia and heartburn were evaluated. Three biopsies were taken from antrum and two each from corpus, cardia and lower oesophagus. Urease test (CLO test) was performed. Density and activity of infection was assessed in a semi-quantitative way. RESULTS: One Hundred and Fourteen (81%) patients from the 140 endoscoped, were positive for H. pylori and had H. pylori positive antral gastritis. Of these 114 cases, H. pylori were detectable in 104 (91%) of biopsies taken from corpus and 96 (84%) of biopsies from cardia. There was a strong correlation of density of H. pylori (0-3) in antrum with body and of body with cardia by Spearman correlation tests (p = 0.000). But H. pylori were more dense in antrum as compared to corpus and in corpus as compared to cardia (p = 0.0000 and 0.0003 respectively by Wilcoxon's rank test). Neutrophil activity and degree of mononuclear infiltrate were also greater in antrum as compared to corpus (p = 0.000 and 0.059). The activity and degree of inflammation was not significantly different in corpus-cardia pair. Out of 114 H. pylori positive patients, 75 had histological oesophogitis (p = 0.855). After excluding cases of hiatal hernia (H.H) and gapping lower oesophageal sphincter (LOS), number of H. pylori positive patients decreased to 73, out of these 50 had histological oesophagitis (p = 0.103). In all H. pylori positive patients with histological oesophagitis, H. pylori density (1-3) in antrum correlated with severity of oesophagitis (P = 0.011). Neutrophil activity in antrum and corpus also correlated with the severity of histological oesophagitis (P = 0.024 and 0.035 respectively). Correlation further improved after excluding cases of HH and gapping LOS (P = 0.002 for H. pylori density and 0.026 and 0.004 for activity in antrum and corpus). No correlation could be found of density and activity of infection in cardia with histological oesophagitis. CONCLUSION: Our H. pylori positive patients had more dense and severe infection in antrum. Those who had histological oesophagitis in addition showed a positive correlation of the density of H. pylori in antrum and neutrophil activity in antrum and corpus with the severity of histological oesophagitis.

Adolescent↗
PubMed2000

Triple therapy with clarithromycin, omeprazole, and amoxicillin for eradication of Helicobacter pylori in duodenal ulcer patients in Asia and Africa.

BACKGROUND: Studies assessing the efficacy of triple therapy containing clarithromycin and amoxicillin for the eradication of Helicobacter pylori infection and healing of duodenal ulcers in Asian and African countries are limited. AIM: To determine the efficacy and safety of 1-week triple therapy with omeprazole, amoxicillin and clarithromycin for eradicating H. pylori infection in patients with active duodenal ulcer living in Asian and African regions. METHODS: This was an open-label, multicentre study in 11 centres in Asia and Africa. Patients with endoscopy-proven duodenal ulcer and who were H. pylori-positive were treated with clarithromycin 500 mg, omeprazole 20 mg, and amoxicillin 1000 mg, all given twice daily for 7 days. Upper endoscopy was repeated at week 6 to check for ulcer healing and H. pylori status. RESULTS: A total of 117 patients were recruited. H. pylori eradication rates were 85% by per protocol analysis and 80% by intention-to-treat analysis. Ulcer healing was found in 94% of subjects (per protocol analysis). Clinical success, measured by change of pre-treatment ulcer symptoms, was strongly supported by complete resolution or improvement in 100% of the evaluable patients (per protocol analysis). Since treatment-related adverse events, when present, were largely mild or moderate, the triple therapy regimen was considered safe. CONCLUSION: Seven-day triple therapy with omeprazole, amoxicillin, and clarithromycin was efficacious for treating Asian and African patients with duodenal ulcer disease associated with H. pylori infection, and the treatment regimen was well-tolerated.

Amoxicillin↗
PubMed2000

Effect of Helicobacter pylori density on inflammatory activity in stomach.

AIM: To assess the relationship of H. pylori density on inflammatory activity in different parts of stomach. MATERIALS AND METHODS: Endoscopic biopsies were taken from gastric antrum, corpus and cardia of 150 dyspeptic patients in a prospective analysis. A semiquantitative scoring was done according to updated Sydney system in accordance with the variables like H. pylori density, neutrophil activity and mononuclear cell infiltrate. Glandular atrophy and intestinal metaplasia was also noted. Statistical analysis was done using Spearman rank correlation test. RESULT: One hundred and fifty patients, 94 males and 56 females (with a mean age of 35.4) were analyzed. Morphologically within stomach 82.7% of antral, 74% of corpus and 68% of cardia biopsies were positive for H. pylori. Correlation coefficient of H. pylori density and neutrophil activity was 0.542, 0.644 and 0.729 for antrum, corpus and cardia respectively (P = 0.00); while the correlation coefficient of mononuclear cell infiltrate with H. pylori density was 0.173, 0.245 and 0.326 for antrum, corpus and cardia respectively (P = 0.035, 0.003, 0.000). H. Pylori density in corpus and cardia was proportional to its density in antrum. CONCLUSION: Density of H. pylori is more in the antrum due to its alkaline pH and the neutrophil activity shows a direct association with H. pylori density (JPMA 50:148, 2000).

Adolescent↗
PubMed1998

Prevalence of Helicobacter pylori antibodies in endoscopy personnel and non-medical volunteers of Karachi.

Prevalence of Helicobacter pylori (Hp) is high in developing countries. As endoscopy personnel are at greater risk of exposure to gastric secretions, they are apparently at higher risk of acquiring this infection. The aim of this study was to determine prevalence of Hp antibodies in endoscopy staff and compare it with non-medical volunteers and assess any additional risk of occupational exposure to Hp in the former group. Thirty-three subjects working in endoscopy suites of different hospitals of Karachi and 33 non-medical volunteers were investigated for the prevalence of Hp antibodies by using a commercially available rapid qualitative test (FlexPack HP; Abbott). The two groups were comparable in mean age, sex and social class. Twenty-six of 33 (79%) of the endoscopy personnel and 19/33 (58%) of the non-medical volunteers were positive for Hp serology (p = 0.06 R.R 1.37). Among the endoscopy personnel 13/14 (93%) of endoscopy assistants were positive and this subgroup had a significantly higher prevalence of Hp antibodies as compared to the control group (p = 0.019). No correlation could be found between the positive serology and symptoms of dyspepsia.

Adult↗