Biomedical subjects

Z Ali

Publications and source records attributed to Z Ali.

At least 19 recordsLinked to original sources

PubMed2006

Evaluation of polymerase chain reaction and adenosine deaminase assay for the diagnosis of tuberculous effusions in children.

AIM: To evaluate and compare the utility of polymerase chain reaction (PCR) for the diagnosis of tuberculous effusions in children. METHODS: PCR, adenosine deaminase (ADA) activity and absolute lymphocyte count (ALC) were evaluated in the fluid of 31 tuberculous (20 pleural, 8 ascites and 3 pericardial) and 24 non-tuberculous (10 transudtative ascites, 8 empyema thoracis, 3 malignant pleural and 3 pyopericardium) effusions. RESULTS: Fluid PCR for Mycobacterium tuberculosis was positive in 74% of tuberculous effusions, whereas it was falsely positive in 13% of the non-tuberculous group. The mean fluid ADA and ALC values were significantly higher in tuberculous effusions than in non-tuberculous effusions (p<0.001). The sensitivity and specificity of PCR, ADA (> or =38 IU/l) and ALC (> or =275/mm3) were 74% and 88%, 81% and 75%, and 90% and 83%, respectively, in diagnosing tuberculous effusions. The sensitivity of PCR, ADA and ALC was 100%, 100% and 88%, respectively, for confirmed tuberculous effusions. When the two tests were combined (either/or positive), the sensitivity increased (90-100%) at the expense of specificity. When both the tests were positive, then the specificity markedly increased (92-96%), but sensitivity of the tests decreased. CONCLUSION: Fluid PCR alone should not be relied on as a single test; rather, combined analysis with either ADA or ALC could be more useful in the diagnosis of tuberculous effusions in children.

Adenosine Deaminase↗

PubMed2006

Craniotomy with prosthetic heart valves: a clinical dilemma.

The authors report two cases of spontaneous intracranial haemorrhage after elective craniotomy for resection of cerebral tumour. Both patients had mechanical aortic valve prostheses and were on regular warfarin therapy. In both cases, warfarin therapy was discontinued 5 days prior to surgery and unfractionated heparin administered intravenously until 12 h before surgery. Both patients were re-anticoagulated with subcutaneous low molecular weight heparin within the first week postcraniotomy-both developed life-threatening intracranial haemorrhage requiring urgent evacuation. The authors emphasize the risk of re-anticoagulation without postoperative imaging and the disadvantages of therapeutic dose, low molecular weight heparin in the postoperative period.

Anticoagulants↗

PubMed2005

A comparison of the objective structured clinical examination results across campuses of the University of the West Indies (2001 and 2002).

OBJECTIVE: To compare the performance of medical students in the Objective Structured Clinical Examination (OSCE) of thefinal MBBS Examination across the four campuses of The University of the West Indies, over a two-year period DESIGN AND METHODS: All final examination results of the Medicine and Therapeutics OSCE were collectedfrom the Faculty of Medical Science at the four campuses of The University of the West Indies and analyzed using both parametric (t-tests and ANOVAs) and non-parametric tests (chi-squared tests). RESULTS: Results indicated that students achieved significantly higher mean scores in the 2002 examination than in 2001 (t = 3.85, df = 415, p = 0.000). There were no significant differences between campuses with regards to the mean corrected score in 2001. Also in 2001, in adult stations, all campuses achieved significantly higher scores than Jamaica. However, in Jamaica, mean child health station scores were significantly higher than all other campuses and, the mean score in Trinidad and Tobago was higher than the Bahamas and Barbados. In 2002, all other campuses achieved significantly higher scores than Trinidad and Tobago and females performed significantly better than males with regards to overall mean scores (t = 2.814, df = 189, p = 0.005). Also in 2002, Barbados achieved significantly higher mean corrected scores than Trinidad and Tobago (F = 4.649, df = 3191; p = 0.004) and Barbados and Trinidad and Tobago both obtained significantly higher mean child health station scores than Jamaica. CONCLUSIONS: The important conclusion from this study is that the OSCE scores in Medicine and Therapeutics are generally uniform across the four campuses of the University, thereby confirming the consistency of the approach to teaching and helping to validate the efficacy and veracity of the medical graduate being produced by The University of the West Indies.

Adult↗

PubMed2004

Immune status with empyema thoracis.

OBJECTIVE: To evaluate the humoral and cell mediated immune status of children with empyema thoracis. METHODS: Serum IgG, IgA, IgM, Complement C3 assay and cell mediated immunity (CMI) tests were performed in 33 patients of empyema thoracis, and 14 healthy age matched controls. RESULTS: The mean serum IgG and IgA levels in empyema thoracis and its subgroups were significantly raised as compared to controls. The overall values of IgG and IgA were 104% (p<0.001) and 114% (p<0.01) of normal mean, respectively. The mean serum IgM and complement C3 levels did not differ significantly in both the groups. The frequency of negative skin reaction to purified protein derivative (PPD) was significantly higher in children with empyema thoracis as compared to controls (p<0.05). The mean absolute lymphocyte count (ALC) was significantly decreased and serum adenosine deaminase (ADA) activity was significantly raised in empyema thoracis in comparison to controls. The overall ALC was 76.1% (p<0.01) and serum ADA activity was 169.4% (p<0.001) of normal mean, respectively. No significant differences were observed in the mean levels of immunoglobulins, complement C3 and CMI tests between pyothorax and pyopneumothorax and pleural fluid culture positive and negative cases. CONCLUSIONS: Thus, both humoral and cell mediated immunity were affected in empyema thoracis patients. However, CMI demonstrated more pronounced change in comparison to humoral immunity.

Adenosine Deaminase↗

PubMed2004

Neonatal Group B streptococcal infection at the Mount Hope Women's Hospital, Trinidad.

OBJECTIVE: To determine the incidence of early onset Group B streptococcal (GBS) infection in neonates at the Mount Hope Women's Hospital, Trinidad over the period 1996-97. DESIGN AND METHODS: This retrospective study included all babies with a positive blood culture for GBS during the study period. RESULTS: There were 9866 live births (LB) of whom 29 were diagnosed as early onset GBS disease. The incidence was 2.9/1000 LB. 37.9% of babies were preterm and 65.5% were delivered to primiparous women. Rupture of amniotic membranes occurred within 12 h of delivery in 55% of infected babies. Four of the 29 infected babies died and all were preterm. CONCLUSION: The incidence of early onset neonatal GBS sepsis was five to six times higher in this series than that reported in the USA and UK. An intervention policy to control this preventable disease is urgently needed.

Adult↗

PubMed2003

First human experiments with a novel non-invasive, non-optical continuous glucose monitoring system.

This paper describes a non-invasive continuous glucose monitoring system based on impedance spectroscopy. Changes in the glucose concentrations can be monitored by varying the frequency in the radio band over a range, optimised to measure the impact of glucose on the impedance pattern. A number of clinical-experimental studies (hyperglycaemic excursions) were performed with healthy subjects in order to prove the applicability of this approach. The sensor used in these experiments is the size of a wristwatch and holds an open resonant circuit coupled to the skin and a circuit, performing an impedance measurement. In most cases, the experiments showed a good correlation between changes in blood glucose and the sensor recordings. A detailed description of the trials is presented. The results of this first series of experiments can be considered as a proof of concept for this novel non-invasive monitoring approach. Nevertheless, partly due to the indirect measurement, a considerable number of questions remain to be clarified.

Blood Glucose↗

PubMed2003

Pathological effects of formalin (37% formaldehyde) mixed in feed or administered into the crops of White Leghorn cockerels.

This study compared the adverse effects of formalin administered by two different methods. Formalin mixed with the feed (2.5, 5.0 and 10 ml/kg) was given to 10-week-old White Leghorn cockerels for a period of 8 weeks. Simultaneously in other groups, a 3% solution of formalin was administered into the crops (5, 10, 15 and 20 ml/bird/day). Total amount of formalin utilized during the experiment in the feed of individual bird of groups given 2.5, 5 and 10 ml/kg was 6.25, 3.9 and 1.6% higher than those administered 5, 10 and 20 ml of 3% formalin into crop, respectively. Body mass and feed intake in all feed-mixed groups and those given 5 and 10 ml formalin (3%) into the crop were not significantly different from control. Administration of 15 and 20 ml formalin (3%) into crop resulted in depression, delayed onset of crowing, significantly decreased feed intake, lower body mass, decreased mass and volume of testes, ulceration in crops, sloughing of mucosa and petechial haemorrhages in proventriculus. All the groups given formalin had significantly smaller diameters of seminiferous tubules. Kidneys of the birds administered formalin into crop exhibited pyknotic nuclei of epithelial cells in proximal tubules. Non-significant differences in different parameters and lesser degree of pathological changes in birds given formalin-mixed feed than their corresponding crop-administered groups suggested that formalin present in the feed had partially evaporated. Therefore, birds ingested less amount of formalin than that originally mixed in the feed.

Administration, Oral↗

PubMed2003

Cerebrospinal fluid lysozyme level for the diagnosis of tuberculous meningitis in children.

Lysozyme activity was assayed in the cerebrospinal fluid (CSF) of 32 tuberculous meningitis (TBM), 17 bacterial meningitis, 10 partially treated bacterial meningitis, 18 encephalitis and 18 control subjects. The mean CSF lysozyme activity was significantly raised (p < 0.001) in TBM patients compared with other study groups. A cut-off CSF lysozyme level of > or = 26 U/l had a sensitivity and specificity of 93.7 and 84.1 per cent, respectively for the diagnosis of TBM. Overall, it was found to be a better test than any other single test and thus can be used for rapid and early diagnosis of TBM in children.

Case-Control Studies↗

PubMed2003

Acute respiratory disorders in the newborn at the Mount Hope Women's Hospital, Trinidad.

This retrospective study was undertaken to determine the incidence of acute respiratory disorders (ARD) in newborns delivered at the Mount Hope Women's Hospital (MHWH) from January 1 to December 31, 1994. The study also examined the relationships between incidence rate of ARD and maternal and neonatal parameters. Hyaline membrane disease (HMD), transient tachypnoea of the newborn (TTN), meconium aspiration syndrome (MAS), persistent fetal circulation (PFC) and pulmonary infection (PI) were identified as ARDs among 5062 live newborns using standard diagnostic criteria. Overall, 174/5062 neonates were diagnosed with ARD to give an incidence of 3.4% (104 males and 70 females). The most common ARD was PI (39%) followed by HMD (29%). The incidence of ARD in preterm infants was 20.6% (100/486) and 1.1% (48/4363) in term neonates. Hyaline membrane disease occurred mainly in the preterm and low birthweight babies. Transient tachypnoea of the newborn and PI were found in all gestational age groups. Asphyxia was present in 10.9% (19/174) at five minutes of age. It was more common in babies who developed HMD and PFC. Forty-one per cent (71/174) of babies with ARD required assisted ventilation. There were 58/174 (33%) deaths. More than a half of those ventilated died (39/71 or 55%); 2/3 of those with airleaks and all those with intraventricular haemorrhage died. Mortality was significantly associated with asphyxia at both one and five minutes of age. There was significantly greater mortality among neonates with HMD as compared to the other ARDs.

Acute Disease↗

PubMed2002

Value of routine long bone radiographs in management of babies with a positive VDRL at the Mount Hope Women's Hospital.

This retrospective study examined the records of 44 mothers and 44 babies with a positive blood VDRL test and/or who showed symptoms of congenital syphilis at the Mount Hope Women's Hospital (MHWH), Trinidad, between June 1, 1996 and September 30, 1998. Long bone radiographs of 40/44 (91%) babies were assessed independently by two radiologists for signs of congenital syphilis and the data were analysed using frequency tables. Of the 44 mothers in the study, 34 (77%) were VDRL positive and the rest were either negative or unknown. Maternal age ranged from 14 to 39 years and most (92%) had antenatal care. Fourteen of the 34 (41%) VDRL positive mothers received treatment antenatally. All mothers were asymptomatic and none had any clinical features of syphilis. In 35/44 babies, the VDRL test was positive and in nine, the test was either negative or unknown. Twenty-six of the babies had signs suggestive of congenital syphilis and in 12, (46%) long bone radiographs revealed changes compatible with the diagnosis of congenital syphilis. Radiographic abnormalities were present only in infants with VDRL titres > 1:8.

Adolescent↗

PubMed2001

Application of the California mastitis test in intramammary Streptococcus agalactiae and Staphylococcus aureus infections of camels (Camelus dromedarius) in Kenya.

A study was conducted on 207 lactating camels in six herds in Kenya to evaluate the California mastitis test (CMT) for the detection of intramammary infections (IMIs) caused by Streptococcus agalactiae and Staphylococcus aureus and to investigate the prevalence of both the pathogens in the camel udder. IMI with S. agalactiae was found in 12% of all camels sampled. IMI with S. aureus was present in 11% of all camels sampled. The herd-level prevalence of IMI varied between 0 and 50% for S. agalactiae and between 0 and 13% for S. aureus. Longitudinal observations over 10-12 months confirmed persistent infections for both pathogens. Observations in one herd suggested that camel pox was a contributing factor in spreading and exacerbating S. agalactiae udder infections.The CMT had quarter-level sensitivities of 77 and 68% for S. agalactiae and S. aureus in camels, respectively. The CMT specificities were 91% for both the pathogens.

Animals↗

PubMed2001

Phenolics and physico-chemical characteristics of persimmon during post-harvest storage.

Garden picked mature but unripe fresh persimmon fruits were unipackaged in different thicknesses of polyethylene (PE) and stored at room (18.5-30 degrees C) and refrigerated temperature (6 +/- 1 degrees C). Maximum mean methanol extractable sinapine (0.168%), catechin (1.51%), and leucoanthocyanidine (10.94 delta A550/g) were recorded in the unipackaged samples kept at room temperature during 6 weeks storage, whereas the minimum values for water extractable phenolics (sinapin, catechin and procyanidin) were recorded in unipackaged samples under refrigerated temperature. The mean maximum weight loss of 12.58 and 7.90% was recorded in control samples kept at room temperature and low temperature, respectively. The weight loss for unipackaged in different thicknesses of PE ranged between 0.93-0.96% and 0.43-0.45% for samples kept at room and low temperature, respectively. Changes in texture values were significantly faster in control than unipackaged samples (P < 0.05). Low temperature combined with unipackaging in PE film performed better for the maintenance of overall fruit quality during post-harvest storage.

Biflavonoids↗

PubMed2001

Inadequacy of colonoscopy revealed by three-dimensional electromagnetic imaging.

INTRODUCTION: It is generally accepted that clinicians performing colonoscopy should reach the cecum in at least 90 percent of examinations. However, little attention has been paid to whether the endoscopist correctly estimates the amount of colon actually seen. METHODS: During colonoscopy, endoscopists were asked to state how far they had reached. This was compared with the amount of colon actually seen, as assessed by a novel electromagnetic imaging device that recorded a three-dimensional position of the scope within a magnetic field pervading the patient's abdomen. If electromagnetic imaging showed that the cecum had not been reached, the endoscopist was asked to use the electromagnetic imaging system to determine whether it helped advance the colonoscope further. RESULTS: In 119 patients undergoing colonoscopy, clinical assessment of position reached was correct in only 92 (77.3 percent). When the endoscopists stated that cecal landmarks had been seen (n = 85), the scope was distal to the cecum in seven cases (8.2 percent). When cecal landmarks had not been seen (n = 34), the endoscopist's assessment of the position of the scope was accurate in only 14 (41.2 percent). The use of electromagnetic imaging in this latter group assisted passage to the cecum in 26 cases (76.5 percent). CONCLUSION: Despite assumed visualization of the cecum, inadequate colonoscopy highlights the potential for missing significant pathology in the right colon.

Adult↗

PubMed2001

Maternal repression of the human GRB10 gene in the developing central nervous system; evaluation of the role for GRB10 in Silver-Russell syndrome.

The GRB10 gene encodes a growth suppressor and maps to human chromosome 7p11.2-p13. Maternal duplication (matdup) of this region has recently been associated with Silver-Russell syndrome (SRS), which is characterised by pre- and postnatal growth restriction, craniofacial dysmorphism and lateral asymmetry. Maternal uniparental disomy for chromosome 7 (mUPD7) occurs in approximately 7% of SRS patients. Exposure of a recessive allele due to isodisomy has been ruled out in five mUPD7 cases, suggesting genomic imprinting as the basis for disease. Assuming SRS patients with matdup of 7p11.2-p13 and mUPD7 share a common aetiology, this would implicate a maternally expressed gene from this interval, which is involved in growth inhibition. Murine Grb10 was identified as a maternally expressed gene by subtractive hybridisation using normal and androgenetic mouse embryos. Grb10 maps to the homologous region of proximal mouse chromosome 11, for which mUPD incurs reduced birthweight. A role for GRB10 in SRS was evaluated by determining its imprinting status in multiple human foetal tissues using expressed polymorphisms, and by screening the coding region for mutations in 18 classic non-mUPD7 SRS patients. Maternal repression of GRB10 was observed specifically in the developing central nervous system including brain and spinal cord, with biallelic expression in peripheral tissues. This is in contrast to mouse Grb10, and represents the first example of opposite imprinting in human and mouse homologues. While a role for GRB10 in mUPD7 SRS cases can not be ruled out on the basis of imprinting status, no mutations were identified in the patients screened.

Abnormalities, Multiple↗

PubMed2001

A rapid, non-destructive method for the determination of Staphylococcus epidermidis adhesion to surfaces using quartz crystal resonant sensor technology.

AIMS: To investigate the use of quartz crystal resonant sensor (QCRS) technology to determine the adhesion of Staphylococcus epidermidis to fibronectin-coated surfaces. METHODS AND RESULTS: QCRS sensors (14 MHz) with 4 mm gold electrodes were coated with fibronectin and exposed for 15 min to suspensions of Staph. epidermidis ranging in concentration from 1 x 10(2) to 1 x 10(6) cfu ml(-1). Changes in resonant frequency were recorded and showed a linear relationship with the logarithm of cell concentration over the range tested. CONCLUSIONS: QCRS technology was shown to be a rapid, sensitive and non-destructive method for measuring the adhesion of bacteria to surfaces. SIGNIFICANCE AND IMPACT OF THE STUDY: This report demonstrates that QCRS technology has the potential to be used for a range of applications requiring measurement of bacteria on surfaces. In particular, it may be used for the real-time monitoring of bacterial biofilm formation.

Bacterial Adhesion↗

PubMed2001

TGFbeta and PTHrP control chondrocyte proliferation by activating cyclin D1 expression.

Exact coordination of growth plate chondrocyte proliferation is necessary for normal endochondral bone development and growth. Here we show that PTHrP and TGFbeta control chondrocyte cell cycle progression and proliferation by stimulating signaling pathways that activate transcription from the cyclin D1 promoter. The TGFbeta pathway activates the transcription factor ATF-2, whereas PTHrP uses the related transcription factor CREB, to stimulate cyclin D1 promoter activity via the CRE promoter element. Inhibition of cyclin D1 expression with antisense oligonucleotides causes a delay in progression of chondrocytes through the G1 phase of the cell cycle, reduced E2F activity, and decreased proliferation. Growth plates from cyclin D1-deficient mice display a smaller zone of proliferating chondrocytes, confirming the requirement for cyclin D1 in chondrocyte proliferation in vivo. These data identify the cyclin D1 gene as an essential component of chondrocyte proliferation as well as a fundamental target gene of TGFbeta and PTHrP during skeletal growth.

Activating Transcription Factor 2↗

PubMed2001

Open-label phase I clinical study to assess the safety of intravenous eptifibatide in patients undergoing internal carotid artery angioplasty and stent placement.

OBJECTIVE: Eptifibatide, a competitive platelet glycoprotein IIb-IIIa receptor inhibitor with high selectivity and a short half-life, has been demonstrated to reduce the risk of ischemic events associated with coronary interventions. However, its role in neurointerventional procedures needs to be analyzed. We report the results of an open-label Phase I study to evaluate the safety of the use of eptifibatide during carotid angioplasty and stent placement. METHODS: Each study patient received eptifibatide administered intravenously as a 135-microg/kg single-dose bolus, then a 0.5-microg/kg/min infusion for 20 to 24 hours during carotid angioplasty and stent placement. The primary efficacy end point was the 30-day composite occurrence of death, cerebral infarction, transient ischemic attack, and unplanned or urgent surgical intervention, thrombolysis, or subsequent percutaneous revascularization. The primary safety end point was bleeding. Bleeding complications were classified as major (hemoglobin decrease >5 g/dl), minor (hemoglobin decrease 3-5 g/dl), or insignificant. RESULTS: Ten patients (mean age, 73 yr; four men) were treated by use of the study protocol. One patient developed a minor stroke postprocedurally (National Institutes of Health Stroke Scale score of 21 at 24 h that improved to 1 at 7 d). Three patients underwent scheduled coronary artery bypass graft surgery 4 to 12 days after undergoing carotid angioplasty and stent placement. At 1-month follow-up, no new ischemic events were observed. Major or minor bleeding was not observed in any patient. Insignificant bleeding was observed in two patients. CONCLUSION: The use of eptifibatide as an adjunct to carotid angioplasty and stent placement seems to be safe. Further studies are required to analyze the effectiveness and role of eptifibatide in neurointerventional procedures.

Aged↗

PubMed2001

Intra-arterial third-generation recombinant tissue plasminogen activator (reteplase) for acute ischemic stroke.

OBJECTIVE: We prospectively evaluated the safety and recanalization efficacy of intra-arterially administered reteplase, a third-generation recombinant tissue plasminogen activator, for treating ischemic stroke in patients considered poor candidates for intravenously administered alteplase therapy. METHODS: Patients were considered poor candidates for intravenously administered therapy because of severity of neurological deficits, interval from onset of symptoms to presentation of 3 hours or more, or recent major surgery. We administered a maximum total dose of 8 U of reteplase intra-arterially in 1-U increments via superselective catheterization. Adjunctive angioplasty of the occluded artery was performed in seven patients. Angiographic evidence of perfusion and thrombus was graded by use of modified Thrombolysis in Myocardial Infarction (TIMI) criteria. Neurological examinations were performed before and 24 hours and 7 to 10 days after treatment. RESULTS: Sixteen consecutive patients were treated (mean age, 64.1 +/- 16.4 yr; seven were men). Initial National Institutes of Health Stroke Scale scores ranged from 10 to 26. Time from onset of symptoms to treatment ranged from 2 to 9 hours. Occlusion sites were the cervical internal carotid artery (n = 4), intracranial internal carotid artery (n = 4), middle cerebral artery (n = 6), and vertebrobasilar artery (n = 2). Complete or near-complete perfusion (TIMI Grade 3 or 4) was achieved in the arteries in 14 patients (88%), with partial recanalization (TIMI Grade 2) or minimal response (TIMI Grade 1) in the arteries in one patient each. Neurological improvement (defined as decrease of four or more points in National Institutes of Health Stroke Scale score) was observed in 7 (44%) of the 16 patients at 24 hours. Symptomatic intracerebral hemorrhage occurred in one patient; three other patients experienced intracerebral hemorrhages that did not result in neurological worsening. The overall mortality during hospitalization was 56%, related to massive ischemic stroke (n = 7), withdrawal of care at the family's request after the development of aspiration pneumonia and renal failure (n = 1), and a combination of intracerebral hemorrhage and massive ischemic stroke (n = 1). CONCLUSION: In this study, intra-arterially administered reteplase in doses up to 8 U with or without angioplasty resulted in a high rate of recanalization. This strategy should be considered in treating patients considered poor candidates for intravenous thrombolysis.

Acute Disease↗