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Deivanayagam N, Mala N, Nedunchelian K, Ashok TP, Ahmed SS. Age for assessment of trivalent oral polio vaccination coverage: is there a need for revision in India. Indian Pediatr 1991; 28:665-8. [PMID: 1748517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Deivanayagam N, Vasudevan S, Ashok TP, Ahmed SS. Potency of oral polio vaccine stored at distribution centers in Madras. Indian J Pediatr 1990; 57:757-61. [PMID: 2131305 DOI: 10.1007/bf02722269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study was done with the objective to measure, monitor, and document the potency of oral polio vaccine and the storage conditions in the city of Madras for a period of one year from May 88. The Corporation of Madras which takes care of indenting and supplying the vaccine has 87 centers for storage and distribution. We took 12 samples a month from these centers by stratified random sampling technique adopting proportionate sampling. The samples were coded and sent to the laboratory. The investigator noted the storage conditions in a specially designed data card. Results were notified to the managers concerned. 122 samples were tested out of which 28 (23%) showed loss of potency (less than log 10(5.84]. The loss of potency is statistically significant in centers not having dial thermometer and where inappropriate carrier was used for transport of vaccine. It was least in Maternity and Child Health Centers probably due to the orientation of the personnel. The frequency of loss of potency was more in the beginning of the study and decreased as the study progressed. Monitoring of storage conditions and potency of vaccine along with periodic training and reorientation of health personnel are stressed.
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Deivanayagam N, Ramamurthy N, Krishnamurthy PV, Shankar VJ, Ashok TP, Nedunchelian K, Mala N, Ahmed SS. Age for measles immunization seroconversion after measles vaccination at 6-8 months of age--a randomized controlled trial. Indian Pediatr 1990; 27:1171-6. [PMID: 2081639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The objective of the study was to compare the effectiveness of measles vaccine by seroconversion in vaccinated children with non-vaccinated children of 6 to 8 months age group in a city slum community so as to study the feasibility of advancing the age of immunization. Live attenuated lyophilized Schwartz strain of measles vaccine was used. Hemagglutination inhibition (HI) antibody was estimated. Seroconversion was defined as either the conversion of negative to positive or a two fold rise in titre. One hundred and thirty two children completed the study. There was no difference in the age, sex and nutritional status between vaccinated and non-vaccinated groups (p greater than 0.7). The seroconversion rate in the vaccinated group was 65% and in the non-vaccinated group was 26%. The age, sex and nutritional status did not significantly affect the seroconversion. Our data suggest that immunization with measles vaccine may be effective as early as 6 months of age. Immunization at 6 months may be needed at least for children in densely populated areas like cities and towns.
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Deivanayagam N, Vasudevan S, Krishnamurthy PV, Shankar VJ, Ashok TP, Nedunchelian K, Mala N, Ahmed SS. Prevalence of placentally transmitted antibodies for measles in infants 3 to 11 months old in an urban slum community. Indian Pediatr 1990; 27:919-23. [PMID: 2286435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Upto 35% of infants aged between 6 and 11 months are infected with measles in India with its associated high morbidity and mortality. The objective of the study is to know the waning pattern of placentally transmitted antibodies (PTA) for measles so that the age at which children are likely to become susceptible to measles infection could be identified. A cross-sectional serological survey of children aged 3 to 11 months in one of the Integrated Child Development Service (ICDS) area in Madras city slums was done. Venous blood from 376 children was collected and was tested for Hemagglutination Inhibition (HI) antibodies by standard microtitration technique. Titre greater than or equal to 1:8 has been considered as protective. The proportion of children with immune level and the Geometric Mean Titre (GMT), declined to the least by 5 months which denotes that most of the infants become susceptible to measles infection from as early as 5 months of age. There is no significant difference in the waning pattern between different age groups, sex and nutritional status. A community study for effectiveness of measles vaccine at 6-8 months of age is needed to know the feasibility of immunization earlier than 9 months of age.
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Ahmed SS, Kaji S, Samesima K, Tsuruta J, Namba K. Osteoarthropathy in hereditary sensory radicular neuropathy. A case report. ACTA ORTHOPAEDICA SCANDINAVICA 1990; 61:92-4. [PMID: 2336963 DOI: 10.3109/17453679008993078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A young man had hereditary sensory radicular neuropathy with relapsing ulcer of the foot and, in addition to previously known clinical features, osteoarthropathy with hallux valgus, metatarsus primus varus, exostosis, and pes planus.
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Fournier G, Baghdadi H, Ahmed SS, Paris M. Contribution to the Study of Cotula cinerea Essential Oil. PLANTA MEDICA 1989; 55:580. [PMID: 17262490 DOI: 10.1055/s-2006-962109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
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Abstract
Chronic cigarette use is common in persons who habitually use other cardioactive agents that have been causally associated with heart disease. This study was undertaken to determine if cigarette use intensifies the abnormalities of myocardial function and composition observed in experimental alcoholism over an 18-month period. Young adult male beagles with tracheostomy were divided into four groups. There were 10 controls (group 1); 9 smoked seven cigarettes per day (group 2); 7 were fed ethanol as 20% of calories (group 3), and 6 received both ethanol and cigarettes (group 4). After a period of 18 months, left ventricular function was assessed under anesthesia. Heart rate, left ventricular end-diastolic pressures, and volumes (indicator dilution) did not differ in the four groups. An index of contractility derived by normalizing peak dP/dt for pre- and afterload was reduced significantly below the level of 2.41 +/- 0.7 cm/s in controls to 1.41 +/- 0.35 in group 2, 1.19 +/- 0.38 in group 3, and 1.28 +/- 0.17 in the ethanol cigarette group (each p less than 0.002). Arterial pressures were moderately elevated above group 1 in all three experimental groups without evidence of left ventricular hypertrophy. In contrast to smoking, which elicited no abnormalities of myocardial cation composition, ethanol reduced myocardial potassium and sodium in group 3 without a gain of water content. In group 4, no further decline of tissue cations was observed. Thus, cigarette use when combined with ethanol over a relatively long period produced no greater myocardial abnormalities than ethanol alone and may not be essential to the genesis of cardiomyopathy in alcoholics.
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Ahmed SS, Howard M, ten Hove W, Leevy CM, Regan TJ. Cardiac function in alcoholics with cirrhosis: absence of overt cardiomyopathy--myth or fact? J Am Coll Cardiol 1984; 3:696-702. [PMID: 6693642 DOI: 10.1016/s0735-1097(84)80245-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Cardiomyopathy in alcoholics is considered to be associated with a low incidence of hepatic cirrhosis. To evaluate cardiac hemodynamics in alcoholic liver disease, left ventricular function in 37 patients with hepatic cirrhosis (group II) was compared with that in 13 normal subjects (group I) matched for age, sex and cardiac size. These groups were contrasted with group III, comprising 32 alcoholics without cirrhosis who had cardiac symptoms but no cardiomegaly or heart failure. Patients with cirrhosis as a group did not differ from normal subjects (group I) in terms of left ventricular filling pressure and cardiac muscle and pump function (cardiac index). However, subgroup IIA (n = 21) had a stroke index significantly less than normal, while subgroup IIB had a significantly increased stroke index and myocardial cardial contractility with a diminished systemic arterial resistance. Similar hepatic abnormalities were present in both subgroups. In group III, left ventricular end-diastolic and aortic mean pressures were significantly elevated compared with values in normal subjects, while cardiac index and indexes of ventricular contraction and relaxation were abnormal. Further examination of patients with cirrhosis indicated that the responses to volume or pressure increments in terms of the level of stroke work for a given filling pressure were most abnormal in group IIA, approximating those of group III. Thus, although overt cardiomyopathy is infrequent in patients with cirrhosis, asymptomatic myocardial disease may assume clinical importance during volume or pressure overload.
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Ahmed SS, Regan TJ. Are pressure-volume relations at end-systole a reflection of left ventricular myocardial contractility? Angiology 1983; 34:137-48. [PMID: 6824196 DOI: 10.1177/000331978303400208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The pressure-volume relation at end-systole is reportedly altered by changes in contractility. To explore the potential of this ratio in man 185 subjects including 23 normals (Group I) were studied. In 35 patients of Group II (16 with mitral stenosis, 7 with atrial septal defect, and 12 with cor pulmonale) ESP/ESV like an index of contractility measuring force-velocity-length rela tionship (Cy Ix) was insignificantly different from Group I (ESP/ESV and Cy Ix in I = 1.73 ± .31 mmHg/sec, 1.46 ± .09 cm/sec/cm vs 1.44 ± .10, 1.31 ± .05 in II respectively.) With significantly reduced Cy Ix (1.03 ± .04, P<0.00001) ESP/ ESV was likewise reduced (1.16 ± .07, P<0.007) in 108 patients with compen sated LV disease (34 with alcoholic cardiomyopathy, 16 coronary artery dis ease, 30 aortic valve disease, 8 hypertension and 16 with other heart muscle disease.) Like the Cy Ix (0.70 ± .05, P<0.001) ESP/ESV was even lower (0.84 ± .13, P<0.05) in 14 patients with decompensated LV (Group IV). It was insensitive to changes in pressure (angiotensin and volume (dextran). However unlike the Cy Ix it did not vary with acute changes in inotropy (exercise and pacing). The correlations between ESP/ESV and ejection fraction and contractility index in the entire series though weak, were significant (r = .50 and .20 respectively, each P<0.006). Exclusion of patients with aortic valve disease and hypertension in the analysis tended to improve the relationship between the contractility and end-systolic pressure-volume parameters. In the latter two subgroups neither the ESV nor the ESP/ESV ratio related to the contractil ity index, both parameters however did correlate significantly with the ejection fraction. These results indicate that end-systolic pressure-volume relations provide useful measures of LV performance in man, though not expressing the contractility either in all patients or under all situations.
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Ahmed SS, Haider B, Regan TJ. Silent left coronary artery-cameral fistula: probable cause of myocardial ischemia. Am Heart J 1982; 104:869-70. [PMID: 7124600 DOI: 10.1016/0002-8703(82)90024-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
Bleeding, thrombocytopenia, and osteopenia are recognized as the side effects of heparin administration. We recently noted occurrence of pulmonary edema in a patient with myelofibrosis with myeloid metaplasia being treated with heparin for pulmonary embolism. The hypertensive episodes preceding left ventricular failure were considered related to serotonin released from the immunologically mediated lowering of platelets.
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Ahmed SS. Effect of angiotensin on left ventricular function in man. Chest 1981; 79:122. [PMID: 7449491 DOI: 10.1378/chest.79.1.122a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Ahmed SS, Regan TJ. Assessment of left ventricular contractile performance from isovolumic relaxation phase in man. Cardiology 1981; 68:1-18. [PMID: 7248999 DOI: 10.1159/000173259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The rate of left ventricular (LV) pressure fall (dP/dtmin) is reportedly altered by contractility and LV stress. To explore the possibility that the ratio of dP/dtmin to dicrotic notch pressure (DTES) measures contractility, 243 subjects including 23 normals (group I) were studied. In 35 patients of group II (16 with mitral stenosis, 7 with atrial septal defect, and 12 with cor pulmonale) DTES, as an index of contractility (Cy Ix) measuring force-velocity-length relationship, was insignificantly different from group I (DTES and Cy Ix in group I = 21.6 +/- 0.6 s-1 and 1.34 +/- 0.04 muscle lengths/s/cm and 18.8 +/- 1.8 s-1 and 1.55 +/- 0.24 muscle lengths/s/cm in group II, respectively). With significantly reduced Cy Ix (1.05 +/- 0.04, p less than 0.01), DTES was likewise reduced (19.0 +/- 0.5, p less than 0.01) in 163 patients with compensated LV disease (47 with alcoholic cardiomyopathy, 24 coronary artery disease, 48 valve disease, 10 hypertensives and 34 with other heart muscle diseases). Like the Cy Ix (0.70 +/- 0.05, p less than 0.001), DTES was even lower (13.3 +/- 0.6, p less than 0.001) in 15 patients with decompensated LV (group IV). Like Cy Ix, this ratio changed significantly with acute changes in inotropy (exercise and pacing), but not with preload (dextran infusion). Basal heart rate, preload and afterload did not influence DTES. Furthermore, DTES correlated significantly in all groups and subgroups with two indices of contractility, VCE (velocity of contractile element) at peak isometric stress, and Cy Ix (r = 0.68 and 0.70, respectively, each p less than 0.001) measured in this study. These results indicate that DTES provides a simple, reliable, and useful measure of the contractile state of LV myocardium in man, independent of preload and afterload.
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Bagdasarian A, Wheeler J, Stewart GJ, Ahmed SS, Colman RW. Isolation of alpha 1-protease inhibitor from human normal and malignant ovarian tissue. J Clin Invest 1981; 67:281-91. [PMID: 6161137 PMCID: PMC371598 DOI: 10.1172/jci110025] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Proteolytic enzymes are associated with normal and neoplastic tissues. Therefore protease inhibitors might also be involved in the control of cell function. alpha 1-protease antigen and antitryptic activity have been found in normal and neoplastic human ovarian homogenate. The inhibitor has been localized to ovarian stromal cells or tumor cells by immunoperoxidase staining. The protein was purified to apparent homogeneity as judged by alkaline gel and sodium dodecyl sulfate (SDS) gel electrophoresis. Immunochemical studies revealed antigenic similarity of plasma alpha 1-protease inhibitor by double immunodiffusion and similar mobility on immunoelectrophoresis and two-dimensional electroimmunodiffusion. The molecular weight was similar to that described for plasma alpha 1-protease inhibitor: 60,000 by gel filtration and 53,500 by SDS electrophoresis. Furthermore, the phenotypic pattern as determined by acid starch gel electrophoresis and immunoprecipitation was PiMM, which is the predominant genetic variant in normal plasma alpha 1-protease inhibitor. An inhibitor ws isolated and purified from an ovarian carcinoma that exhibited functional, immunochemical, and physical similarity to the normal ovarian alpha 1-protease inhibitor. alpha 1-protease inhibitor from normal and malignant ovaries competitively inhibited bovine pancreatic trypsin at incubation times of 5 min at 30 degrees C. Inhibition constant (Ki) values were calculated at 0.67 and 0.51 inhibitory units, respectively. The alpha 1-protease inhibitor in malignant cells may be a factor in the control of proliferation in this tissue. Since ovulation is in part a proteolytic event, the alpha 1-protease inhibitor in ovarian cells may play a role in the control of this specialized tissue. Persistance of this protein in malignant ovarian tissue may be a vestige of its differentiated origin.
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Lee WK, Haider B, Ahmed SS, Oldewurtel HA, Lyons MM, Regan TJ. Cell sodium and the induction of myocardial injury after adrenaline. Cardiovasc Res 1980; 14:661-70. [PMID: 7226176 DOI: 10.1093/cvr/14.11.661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Accumulation of calcium in cardiac cells during catecholamine induced injury is considered a major pathogenetic factor but its mechanism has not been defined. During initiation of injury in an intact canine model, cell sodium was enhanced fourfold in myocardium after a local infusion of epinephrine via the left anterior descending coronary artery for a 60 min period. Tissue calcium was enhanced and a major role for the Na-Ca carrier system is suggested. Regional myocardial function, blood flow and electrocardiogram responses to toxic levels of the catecholamine have been contrasted with ischaemic injury.
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Ahmed SS, Levinson GE, Fiore JJ, Regan TJ. Spectrum of heart muscle abnormalities related to alcoholism. Clin Cardiol 1980; 3:335-41. [PMID: 6449341 DOI: 10.1002/clc.4960030408] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Ahmed SS, Moschos CB, Oldewurtel HA, Regan TJ. Myocardial effects of long-term cigarette smoking: relative roles of carbon monoxide and nicotine. Am J Cardiol 1980; 46:593-8. [PMID: 7416019 DOI: 10.1016/0002-9149(80)90508-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Regan TJ, Ahmed SS. The heart in diabetes mellitus. COMPREHENSIVE THERAPY 1979; 5:36-42. [PMID: 445989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Ahmed SS, Brancato RR. Transmural versus nontransmural myocardial infarction. Influence of location on clinical features and mortality. Angiology 1979; 30:240-8. [PMID: 443589 DOI: 10.1177/000331977903000403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Ahmed SS, Lee CH, Oldewurtel HA, Regan TJ. Sustained effect of glucose-insulin-potassium on myocardial performance during regional ischemia. Role of free fatty acid and osmolality. J Clin Invest 1978; 61:1123-35. [PMID: 659587 PMCID: PMC372632 DOI: 10.1172/jci109027] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
To evaluate the influence of glucose infusate administered with insulin and potassium on left ventricular function during 4 h of ischemia, as well as mechanism of action, four groups of intact anesthetized dogs were studied. Acute regional ischemia was induced with a balloon tip catheter in the left anterior descending artery and infusates were begun after 20 min of ischemia. A threefold increase of plasma glucose concentration was associated with improved left ventricular function during ischemia, compared to animals receiving isovolumic saline. There was a significant decline of left ventricular end-diastolic pressure associated with elevation of stroke volume and ejection fraction to control levels, as determined by indicator dilution. In a separate subgroup studied by cineangiography, shortening of the ischemic anterior wall, after an initial decline, was increased in response to glucose but there was no evidence of extension of injury. Ischemic tissue exhibited a smaller gain of water as well as Na+ per gram dry weight as compared to ischemic controls. On precordial electrocardiogram mapping there was a significant decrease in the sigmaST (sum of ST elevation) as well as NST (number of ST segment elevations), but the reduction of R wave amplitude was not different from controls. To further evaluate long-term effects, eight controls and six treated animals underwent myocardial ischemia and were sacrificed after 4 mo. Calculated area and weight of scar, as well as degree of wall thinning, were similar in both groups. The glucose-treated animals had a significant decrease of plasma FFA in contrast to controls which manifested a significant rise. To examine the postulate that the decrease in FFA was important to therapeutic action, a third group was infused with Intralipid (Cutter Laboratories, Inc., Berkeley, Calif.) and heparin, simultaneously with the glucose infusate, to effect an elevation of plasma FFA during ischemia. Changes in myocardial function and electrolyte composition, as well as precordial electrocardiogram mapping, were similar to that of animals receiving glucose alone. Because serum osmolality was increased approximately 40 mosmol during the glucose infusion, the potential role of hyperosmolality was assessed by infusion of 20% mannitol during acute ischemia in a fourth group. After a transient small increase, there was a moderate decline in function by 4 h, suggesting that the response to glucose is not dependent upon extracellular osmolality. Thus, it is concluded that during the initial hours after the onset of myocardial ischemia the glucose infusate improves ventricular performance without evidence of arrhythmia induction or intensification of ischemic injury. Evolution of irreversible necrosis appears to be delayed rather than prevented under the circumstances of this study.
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Ettinger PO, Wu CF, De La Cruz C, Weisse AB, Ahmed SS, Regan TJ. Arrhythmias and the "Holiday Heart": alcohol-associated cardiac rhythm disorders. Am Heart J 1978; 95:555-62. [PMID: 636996 DOI: 10.1016/0002-8703(78)90296-x] [Citation(s) in RCA: 365] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Ahmed SS, Rozefort R, Brancato R. Incidence of acute myocardial infarction among Blacks in an urban community. THE JOURNAL OF THE MEDICAL SOCIETY OF NEW JERSEY 1977; 74:1058-60. [PMID: 271230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Nathan MP, Haider B, Ahmed SS, Regan TJ. Spontaneous heart rate, ventricular tachycardia, and the response to procainamide during acute ischemia. Am Heart J 1977; 94:627-32. [PMID: 910701 DOI: 10.1016/s0002-8703(77)80133-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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