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Akhtar S, Burke FD. A technique to facilitate symmetrical and atraumatic placement of the core suture during flexor tendon repair. J Plast Reconstr Aesthet Surg 2007; 60:447-9. [PMID: 17349605 DOI: 10.1016/j.bjps.2006.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2006] [Revised: 04/23/2006] [Accepted: 04/25/2006] [Indexed: 10/24/2022]
Abstract
We present a technique aiding symmetrical accurate and atraumatic placement of the core suture during tendon repair. This technique facilitates a neat repair and avoids unnecessary contact with the tendon during the insertion of the core suture.
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Akhtar S, McElvanna N, Gardiner KR, Irwin ST. Bowel perforation caused by swallowed chicken bones--a case series. THE ULSTER MEDICAL JOURNAL 2007; 76:37-8. [PMID: 17288304 PMCID: PMC1940304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shah NN, Bhargava R, Ahmed Z, Pandey DK, Shameem M, Bachh AA, Akhtar S, Dar KA, Mohsina M. Unilateral bullous emphysema of lung. Lung India 2007. [DOI: 10.4103/0970-2113.44202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Akhtar S, Carpenter TE, Rathi SK. A chain-binomial model for intra-household spread of Mycobacterium tuberculosis in a low socio-economic setting in Pakistan. Epidemiol Infect 2007; 135:27-33. [PMID: 16740189 PMCID: PMC2870536 DOI: 10.1017/s0950268806006364] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2006] [Indexed: 11/07/2022] Open
Abstract
A simulation study using Greenwood's chain-binomial model was carried out to elucidate the spread and control of Mycobacterium tuberculosis among the household contacts of infectious pulmonary tuberculosis (TB) patients. Based on the observed data, the maximum-likelihood estimates (+/-S.E.) of chain-binomial probabilities of intra-household M. tuberculosis transmission from an index case in 3-person and 4-person households were 0.313+/-0.008 and 0.325+/-0.009 respectively. The chi2 goodness-of-fit test of observed and simulated mean expected frequencies of cases revealed good fit for 3-person (P=0.979) and 4-person (P=0.546) households. With the assumption of varying risk of M. tuberculosis transmission across the households under beta-distribution, goodness-of-fit tests of observed and mean simulated expected frequencies revealed the inadequacy of Greenwood's chain-binomial model both for 3-person (P=0.0185) and 4-person (P<0.001) households. Simulated M. tuberculosis control strategy comprising efficient diagnosis, segregation and prompt antibiotic therapy of index pulmonary TB patients showed a substantial reduction of new cases among the household contacts in both household sizes. In conclusion, segregation coupled with prompt antibiotic therapy of the index case, chemoprophylaxis of M. tuberculosis-exposed household contacts, and the assessment of household environmental risks to devise and implement an educational programme may help reduce the TB burden in this and similar settings.
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Akhtar S, Burke FD. Study to outline the efficacy and illustrate techniques for steroid injection for trigger finger and thumb. Postgrad Med J 2006; 82:763-6. [PMID: 17099099 PMCID: PMC2660508 DOI: 10.1136/pmj.2006.048330] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To outline the efficacy of a steroid injection in treating trigger finger. Our study defines the anatomy of the A1 pulley, and suggests methods for simple and safe flexor sheath injection for trigger finger and thumb. METHOD Systematic review of published literature on trigger finger and thumb and its treatment, particularly steroid injection. The use of the knowledge of the superficial landmarks of the A1 pulley with the techniques described were combined to provide a comprehensive guide to injecting steroids in patients with trigger finger and thumb. RESULTS Several studies are outlined, which provided evidence to suggest that a steroid injection into the flexor sheath of the affected digit is successful in treating most of the patients. Methods of identifying the superficial landmarks of the A1 pulley and of approaching the pulley without injury to surrounding structures are also outlined in the literature. Two different techniques used to infiltrate the flexor sheath were described. CONCLUSION Steroid injection in the flexor sheath at the level of the A1 pulley is an effective method of treating patients with trigger finger and should be considered as the preferred treatment. Specific anatomical landmarks and methods allow the procedure to be carried out without fear of inadvertent damage to surrounding structures.
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Abstract
Ageing changes occur in all the structures of the eye causing varied effects. This article attempts to review the parameters of what is considered within the "normal limits" of ageing so as to be able to distinguish those conditions from true disease processes. Improving understanding of the ageing changes will help understand some of the problems that the ageing population faces.
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Akhtar S, Demuth-Anderson L, Stoller M, Meyer M, Todd K. 194. Ann Emerg Med 2006. [DOI: 10.1016/j.annemergmed.2006.07.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Naqvi R, Akhtar S, Noor H, Saeed T, Bhatti S, Sheikh R, Ahmed E, Akhtar F, Naqvi A, Rizvi A. Efficacy of Isoniazid Prophylaxis in Renal Allograft Recipients. Transplant Proc 2006; 38:2057-8. [PMID: 16979998 DOI: 10.1016/j.transproceed.2006.06.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The efficacy of isoniazid (INH) prophylaxis in renal allograft recipients who are on long-term immunosuppression in a region highly prevalent for tuberculosis (TB) was studied. INH (300 mg/d in patients weighing more than 35 kg and 5 mg/kg/d in patients with <35 kg body weight) together with Pyridoxine 50 mg/d for 1 year was started in randomly assigned renal allograft recipients. Occurrence of clinical tuberculosis during the initial 2 years posttransplantation was observed in the risk group and patients at no risk. Risks were defined as acute rejection episodes and exposure to antirejection therapy, past history of TB completely or incompletely treated, radiological evidence of past tuberculosis, history of tuberculosis in close contacts. Among 480 patients registered in the study, INH prophylaxis was given to 219 randomly assigned renal allograft recipients. Results were compared among patients developing TB during the initial 2 years posttransplantation in both the groups. Risk factors were analyzed for comparison in both groups. No significant difference was observed in terms of past history of TB, TB in close contacts, episodes of acute rejection during the initial 3 months, and comorbidities such as cytomegalovirus infection, hepatitis C virus infection, and posttransplant diabetes. One patient from the INH group and 10 patients from the non-INH group developed TB during the initial 2 years posttransplantation (P < .0001). None of patients required discontinuation of INH. INH was observed to be safe and effective as a chemoprophylactic agent in renal allograft recipients.
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Shahzad K, Akhtar S, Mahmud S. Prevalence of and Factors Associated with Asthma in Adult Male Leather Tannery Workers of Karachi, Pakistan. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s213-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Naqi SA, Khan HM, Akhtar S, Shah TA. Femoral pseudoaneurysm in drug addicts--excision without revascularization is a viable option. Eur J Vasc Endovasc Surg 2006; 31:585-7. [PMID: 16466941 DOI: 10.1016/j.ejvs.2005.12.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2005] [Accepted: 12/10/2005] [Indexed: 11/26/2022]
Abstract
PURPOSE To present a series of patients presenting with femoral pseudoaneurysm. RESULTS Seventeen patients who presented with a femoral pseudoaneurysm during a 1 year period were included in this study. Parenteral drug abuse was the most common aetiological factor. The femoral artery was most commonly involved at its bifurcation. Sixteen patients (94%) had excision of the pseudoaneurysm with ligation of vessel and debridement without any revascularization and one patient (6%) had reverse saphenous grafting after excision and ligation of vessels. Four amputations (23%) were performed. Three (17%) were major limb amputations, which included one above knee and two below knee amputations. Four patients (23%) developed intermittent claudication. CONCLUSION Excision of the pseudoaneurysm with ligation of vessels and wide debridement without immediate revascularization in infected pseudoaneurysms is a safe and effective treatment.
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Wickramasuriya BPN, Casey A, Akhtar S, Zia R, Ehtisham S, Barrett TG, Shaw NJ, Kirk JMW. Factors Determining Patient Choice of Device for GH Therapy. Horm Res Paediatr 2006; 65:18-22. [PMID: 16357486 DOI: 10.1159/000090375] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2005] [Accepted: 10/19/2005] [Indexed: 11/19/2022] Open
Abstract
AIM To assess the factors determining patient choice of GH device, and whether offering free patient choice improves compliance with GH therapy. METHODS A prospective cross-sectional study performed on patients offered free choice of GH device in a regional growth clinic. In a subgroup having home delivery, GH compliance was assessed using ampoule counts. RESULTS 125 patients (74 (59%) male), median (range) 9.30 (1.0-18.3) years were commenced on GH from January 2001 to March 2004, and offered free choice of device. 68 (54%) chose a needled device, and 57 (46%) needle-free. There was no statistical difference in age, sex or diagnostic category between the two groups. Light blue devices were more likely to be chosen by males (p=0.056). Questionnaires giving reasons for choosing a device were available in 40, and a further 50 gave reasons for both choosing a specific device and not choosing others. Other than choice of needled/needle-free device, the factor most likely to determine choice was 'ease of use'. Only 6 (4.8%) subsequently changed device, and compliance remained high but unchanged at approximately 90%. CONCLUSIONS There are no specific features which determine what GH device a patient will choose. For those units offering free patient choice, a wide range of different devices should be made available.
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Akhtar S, Tbakhi A, Humaidan H, El Weshi A, Rahal M, Maghfoor I. ESHAP+fixed dose G-CSF as autologous peripheral blood stem cell mobilization regimen in patients with relapsed or refractory diffuse large cell and Hodgkin's lymphoma: a single institution result of 127 patients. Bone Marrow Transplant 2006; 37:277-82. [PMID: 16400345 DOI: 10.1038/sj.bmt.1705239] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
From 1996 to November 2004, 131 consecutive patients with relapsed or refractory diffuse large cell lymphoma (DLCL) and Hodgkin's lymphoma (HD) received ESHAP as mobilization chemotherapy before autologous peripheral blood stem cell transplant (ASCT). Patients received fixed dose G-CSF 300 microg SC bid starting 24-36 h after finishing mobilizing ESHAP. In all, four patients failed mobilization and are excluded. Characteristics of 127 patients: 68 males: 59 females. DLCL 49: HD 78. Initial stage I:II:III:IV:unknown was 15:34:33:42:3. Median age at ASCT 26 years. Median prior chemotherapy cycles were six [<6 (17 patients), 6-8 (90 patients), >8 (20 patients)]. Median ESHAP cycle used as mobilizer was third. Patients required 1, 2, 3, 4 apheresis were 93:25:8:1. Median total CD34+ cells/kg collected were 6.9 x 10(6) (DLCL 5.17 x 10(6) and HD 7.6 x 10(6)), patients weighing < or = 70 kg (93 patients) 6.54 x 10(6) and >70 kg (34 patients) 7.44 x 10(6) (P = 0.59), one apheresis (93 patients) 8.6 x 10(6)/kg and >1 apheresis (34 patients) 4.5 x 10(6) (P = 0.001). We conclude that ESHAP and G-CSF 300 microg SC bid is an effective mobilizing regimen even in patients >70 kg and most patients require only 1-2 apheresis.
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Akhtar S, Luby SP, Rahbar MH. Multivariate analysis of risk factors associated with genital ulcer disease among incarcerated males in Sindh. J PAK MED ASSOC 2006; 56:S34-9. [PMID: 16689482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To evaluate the potential risk behaviors associated with the lifetime risk of self reported genital ulcer disease (GUD) among prison inmates. SETTING Prison inmates from 14 prisons of Sindh Province. METHODS A cross-sectional study was conducted on 3395 prison inmates during July to December 1994. A questionnaire was used to assess the lifetime risk of self-reported GUD (whether or not the subject was ever affected with GUD up to present age) and to investigate demographic markers and risk behaviors for their possible association with lifetime risk of GUD using logistic regression analysis. RESULTS The reported lifetime risk of GUD in the study sample was 11.4% (386/3395). In final multivariate logistic regression model the sexual behaviors which were independently associated with GUD were having sexual intercourse with female (adjusted OR = 1.7; 95% CI: 1.3-2.3, P=0.0002), sexual intercourse with a prostitute (adjusted OR = 1.5; 95% CI: 1.2-2.0, P=0.0008), sexual intercourse with man (adjusted OR = 2.2; 95% CI: 1.7-2.7, P=<0.001) and sexual intercourse with man during current incarceration (adjusted OR = 1.9; 95% CI: 1.2-2.9, P=0.0071). CONCLUSION Health education needs to re-enforce monogamous relationship for high risk groups such as in our study. Although infrequent condom use was not a risk factor for GUD in this study, yet based on the results of previous studies, promotion of condom use should be the component of health education program (JPMA 50:115;2000).
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Hasham S, Akhtar S, Fourie LR. Persistent seroma following breast prosthesis explantation: a case report and review. EUROPEAN JOURNAL OF PLASTIC SURGERY 2005. [DOI: 10.1007/s00238-005-0011-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cantón I, Akhtar S, Gavalas NG, Gawkrodger DJ, Blomhoff A, Watson PF, Weetman AP, Kemp EH. A single-nucleotide polymorphism in the gene encoding lymphoid protein tyrosine phosphatase (PTPN22) confers susceptibility to generalised vitiligo. Genes Immun 2005; 6:584-7. [PMID: 16015369 DOI: 10.1038/sj.gene.6364243] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Vitiligo is an acquired hypomelanotic skin disorder resulting from the loss of functional melanocytes from the cutaneous epidermis and autoimmunity has been suggested to play a part in its pathogenesis. Recently, the missense R620W polymorphism in the PTPN22 gene, which encodes lymphoid protein tyrosine phosphatase (LYP), has been associated with susceptibility to autoimmune disorders. The objective of this study was to ascertain if the disease-associated 1858T allele was also associated with generalised (nonsegmental) vitiligo and so the frequencies of the PTPN22 1858C/T alleles were investigated in 165 English patients with generalised vitiligo and 304 ethnically matched control subjects. The results indicated that the 1858T allele was significantly over-represented in the vitiligo patient group compared with the control cohort. Of 330 vitiligo alleles, 48 (14.5%) encoded the Trp620 variant compared to 52 of 608 (8.6%) control alleles (P=0.006; odds ratio=1.82, 95% confidence interval=1.17-2.82). The results indicate that the LYP missense R620W polymorphism may have an influence on the development of generalised vitiligo and provide further evidence for autoimmunity as an aetiological factor with respect to this disease.
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Yousif MHM, Benter IF, Akhtar S. The role of tyrosine kinase-mediated pathways in diabetes-induced alterations in responsiveness of rat carotid artery. ACTA ACUST UNITED AC 2005; 25:69-78. [PMID: 15757506 DOI: 10.1111/j.1474-8673.2004.00333.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
1 G-protein-coupled receptor signalling, including transactivation of receptor tyrosine kinases (RTKs), has been implicated in vascular pathology. However, the role of specific RTKs in the development of diabetes-induced cardiovascular complications is not known. 2 We investigated the ability of a chronic administration of genistein, a broad-spectrum inhibitor of tyrosine kinases (TKs), AG1478, a specific inhibitor of epidermal growth factor receptor (EGFR) TK activity, and AG825, a specific inhibitor of Erb2, to modulate the altered vasoreactivity of isolated carotid artery ring segments to common vasoconstrictors and vasodilators in streptozotocin (STZ)-induced diabetes. 3 In diabetic carotid artery, the vasoconstrictor responses induced by noradrenaline (NE), endothelin-1 (ET-1), and angiotensin II (Ang II), were significantly increased whereas vasodilator responses to carbachol and histamine were significantly reduced. Inhibition of TKs, EGFR or Erb2 pathway did not affect the body weight or agonist-induced vasoconstrictor and vasodilator responses in the non-diabetic control animals. However, inhibition of TKs by genistein, EGFR TK by AG1478 or Erb2 by AG825 treatment produced a significant normalization of the altered agonist-induced vasoconstrictor responses without affecting blood glucose levels. Treatment with diadzein, an inactive analogue of genistein, did not affect the vasoconstrictor and vasodilator responses in the diabetic animals. 4 Treatment with genistein, AG1478 or AG825 resulted in a significant improvement in diabetes-induced impairment in endothelium-dependent relaxation to carbachol and histamine. 5 These data suggest that activation of TK-mediated pathways, including EGFR TK signalling and Erb2 pathway, are involved in the development of diabetic vascular dysfunction in the carotid artery.
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Akhtar S, Bron AJ, Qin X, Creer RC, Guggenheim JA, Meek KM. Gelatinous drop-like corneal dystrophy in a child with developmental delay: clinicopathological features and exclusion of the M1S1 gene. Eye (Lond) 2005; 19:198-204. [PMID: 15254496 DOI: 10.1038/sj.eye.6701453] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIMS Gelatinous drop-like corneal dystrophy (GDLD) is an early-onset, autosomal recessive condition characterised by amyloid deposits within the cornea. We report the histopathological and molecular genetic findings in a Caucasian child with GDLD who also exhibited global developmental delay. METHODS Bilateral lamellar keratoplasty was carried out at age 6 and 7 years. Tissue was fixed for light and electron microscopy, including immunoelectronmicroscopy. The coding region of the M1S1 gene was screened for mutations in the affected proband and available relatives, using DNA extracted from mouthwashes. RESULTS Nodular deposits, which were present subepithelially and in the central superficial stroma, stained typically for amyloid with PAS and Congo red. A nodular deposit of amyloid, together with large amounts of lactoferrin and sparse amounts of keratoepithelin (betaig-h3), was present in the central superficial stroma, causing destruction of Bowman's layer and elevation of the thinned, degenerate epithelium. Around the deposit zone, the stroma exhibited large numbers of thick filamentous proteoglycan deposits. While the affected child was homozygous for a novel A1133 C single-nucleotide polymorphism (SNP) that resulted in an aspartic acid to alanine substitution at position 173 of the M1S1 coding sequence, this polymorphism was also found at relatively high frequency in a sample of normal controls, enabling exclusion of the M1S1 gene as the disease locus. CONCLUSION Increased epithelial permeability in GDLD may be explained in part by an altered membrane permeability of the superficial epithelial cells. An association with developmental delay has not been reported previously.
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Akhtar S, Arenas Prat J, Sinha S. Neuropraxia of the palmar cutaneous branch of the ulnar nerve during carpal tunnel decompression. Ann R Coll Surg Engl 2005. [DOI: 10.1308/147870805x42635] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Deeba F, Tahseen HN, Sharad KS, Ahmad N, Akhtar S, Saleemuddin M, Mohammad O. Phospholipid diversity: Correlation with membrane–membrane fusion events. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2005; 1669:170-81. [PMID: 15893520 DOI: 10.1016/j.bbamem.2005.02.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2004] [Revised: 02/07/2005] [Accepted: 02/07/2005] [Indexed: 10/25/2022]
Abstract
The transport of various metabolically important substances along the endocytic and secretory pathways involves budding as well as fusion of vesicles with various intracellular compartments and plasma membrane. The membrane-membrane fusion events between various sub-compartments of the cell are believed to be mainly mediated by so-called "fusion proteins". This study shows that beside the proteins, lipid components of membrane may play an equally important role in fusion and budding processes. Inside out (ISO) as well as right side out (RSO) erythrocyte vesicles were evaluated for their fusogenic potential using conventional membrane fusion assay methods. Both fluorescence dequenching as well as content mixing assays revealed fusogenic potential of the erythrocyte vesicles. Among two types of vesicles, ISO were found to be more fusogenic as compared to the RSO vesicles. Interestingly, ISO retained nearly half of their fusogenic properties after removal of the proteins, suggesting the remarkable role of lipids in the fusion process. In another set of experiments, fusogenic properties of the liposomes (subtilosome), prepared from phospholipids isolated from Bacillus subtilis (a lower microbe) were compared with those of erythrocyte vesicles. We have also demonstrated that various types of vesicles upon interaction with macrophages deliver encapsulated materials to the cytosol of the cells. Membrane-membrane fusion was also followed by the study, in which a protein synthesis inhibitor ricin A (that does not cross plasma membrane), when encapsulated in the erythrocyte vesicles or subtilosomes was demonstrated to gain access to the cytosol.
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Akhtar S, Arenas Prat J, Sinha S. Neuropraxia of the palmar cutaneous branch of the ulnar nerve during carpal tunnel decompression. Ann R Coll Surg Engl 2005; 87:W1-2. [PMID: 16395819 PMCID: PMC1963910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Carpal tunnel syndrome is one of the most commonly encountered conditions in the hand clinic and carpal tunnel decompression is the most frequently performed procedure in hand surgery. It is an effective procedure for patients with carpal tunnel syndrome. However, there is a high risk of complications that can be avoided with an understanding of wrist anatomy, appropriate planning and execution. We highlight one such complication, a case of neuropraxia of the palmar cutaneous branch of the ulnar nerve that followed carpal tunnel decompression.
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Robertson JL, Akhtar S, Petrie JR, Brown FJ, Jones GC, Perry CG, Paterson KR. How do people with diabetes access information? ACTA ACUST UNITED AC 2005. [DOI: 10.1002/pdi.818] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Molloy R, Akhtar S. PEG insertion at the time of definitive surgery for oral malignancy. Int J Oral Maxillofac Surg 2005. [DOI: 10.1016/s0901-5027(05)81230-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Akhtar S, Younus M, Adil S, Jafri SH, Hassan F. Hepatitis C virus infection in asymptomatic male volunteer blood donors in Karachi, Pakistan. J Viral Hepat 2004; 11:527-35. [PMID: 15500553 DOI: 10.1111/j.1365-2893.2004.00518.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The objectives of this study were to assess the proportion of hepatitis C virus (HCV) reactors and to identify risk factors associated with HCV infection in volunteer blood donors in Karachi, Pakistan. Between 1 January 1998 and 31 December 2002, consecutive blood donations tested at two blood banks were used to assess the proportion of HCV sero-reactors donors. To evaluate the potential risk factors, a case-control study design was implemented to select cases and controls between 15 October 2001 and 15 March 2002. The overall seroprevalence of HCV in these blood donors was 1.8% (6349/35 1309). Trend analysis revealed a significant (P < 0.001) linear increase in proportions of HCV-seropositive donors from 1998 to 2002. Final multivariate logistic regression model showed that the cases were more likely than controls to have reported past hospitalization or to have received multiple injections. When a glass syringe was used to give therapeutic injections, it increased the adjusted odds of being HCV seropositive significantly more among cases than in controls and this relationship was stronger when injection was given by general medical practitioner than if the injection was given in hospital setting. Cases were more likely than controls to have reported sexual contact with multiple sexual partners. Primary prevention programmes focused on identified risk factors might help to curtail the spread of HCV infection in this community and in other similar settings in developing countries.
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Akhtar S, Husk G, Waxman D, Sonara P. Emergency department crowding: A national perspective. Ann Emerg Med 2004. [DOI: 10.1016/j.annemergmed.2004.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Waxman D, Husk G, Akhtar S, Krishnamurthy C. Hourly emergency department census: A simple measure of crowding. Ann Emerg Med 2004. [DOI: 10.1016/j.annemergmed.2004.07.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Raza SA, Akhtar S, Avan BI, Hamza H, Rahbar MH. A matched case-control study of risk factors for neonatal tetanus in Karachi, Pakistan. J Postgrad Med 2004; 50:247-51; discussion 251-2. [PMID: 15623963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Previous studies have identified various risk factors for neonatal tetanus (NNT) in rural areas of Pakistan. The present matched case control study was conducted to further evaluate these risk factors in an urban setting. AIM The study was carried out to identify risk factors for NNT in Karachi. MATERIALS AND METHODS Patients of NNT (n = 125) diagnosed from January 1998 to February 2001 were recruited through a surveillance system of Expanded Programme on Immunization (EPI). Two neighbourhood controls (n = 250) were matched for each case for gender and date of birth of the case. STATISTICAL ANALYSIS Conditional logistic regression was performed to assess the independent effect of factors associated with NNT. RESULTS The final multivariable model identified subsequent application of substances on the umbilical cord (adjusted matched odds ratio [adj. mOR] = 5.1 [2.7-9.7]), home delivery (adj. mOR = 1.8; 95% CI: 1.1- 3.1) and illiterate mother (adj. mOR = 1.6; 95% CI: 1.0- 2.0) as risk factors for NNT after adjusting for other variables in the model. Population attributable risk per cent (PAR %) for subsequent cord application was 69% and PAR % for home delivery was 31%. CONCLUSION Health planners, while formulating control strategies through immunization programmes should also take into account the impact of post-delivery practices, such as 'subsequent cord application' along with pre-delivery practices. Health awareness regarding appropriate post-delivery practices should be promoted and counselling of pregnant women for giving preference to health care setting for delivery is also crucial.
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Akhtar S, Coldewey J, Timmons MJ. Cellular neurothekeoma in the arm of a child. ACTA ACUST UNITED AC 2004; 57:572-4. [PMID: 15308407 DOI: 10.1016/j.bjps.2004.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2003] [Accepted: 02/16/2004] [Indexed: 11/21/2022]
Abstract
Soft tissue tumours of the limb in children are uncommon. We report a cellular neurothekeoma, which presented as a hard, irregular tumour in the upper arm of a 7-year-old child. The differential diagnosis of soft tissue tumours in the upper limbs of children is discussed.
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Ezzat A, Rahal M, Twegieri T, Akhtar S, Al Sayed A, Ajarim D, Tulbah A, Al Malik O, Al Shabanah M. Primary chemotherapy with doxorubicin followed by docetaxel-cisplatin in locally advanced breast cance. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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231
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Raja M, Akhtar S, El Weshi A, Maghfoor I. Extrapulmonary small cell carcinoma (EPSCC): Retrospective review from a single institution. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.6108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Akhtar S, Bron AJ, Meek KM, Voon LW. Clinical and ultrastructural findings in mare's tail lines of the corneal epithelium. Br J Ophthalmol 2004; 88:864-7. [PMID: 15205226 PMCID: PMC1772224 DOI: 10.1136/bjo.2003.033456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2003] [Indexed: 11/03/2022]
Abstract
AIMS Mare's tail lines are uncommon, grey, parallel, tapering epithelial lines, which may give rise to discomfort or to visual symptoms. The authors report the clinical and ultrastructural findings in two patients METHODS Therapeutic debridement was performed in two patients suffering from mare's tail disorder. The loosely attached epithelium was removed and fixed in glutaraldehyde containing cuprolinic blue and processed in a standard fashion for electron microscopy. RESULTS Ultrastructural studies showed an avascular, collagenous pannus extending under the whole of the excised epithelium in each case and separated from it by a thickened basal lamina like zone. The basal laminar material extended into the epithelium in folds, in keeping with the clinical features. Interesting ultrastructural features included: (1) a lack of hemidesmosomes in relation to the basal laminar material; (2) trapping of degenerate keratocytes within the invaginating basal laminar folds; (3) an unusual regularity and fine dimensions of the collagen fibrils and proteoglycans making up the subepithelial pannus. The basal laminar material contained proteoglycans and small fibres similar in appearance to long spacing collagen. CONCLUSIONS Mare's tail lines are caused by basal laminar material, assumed to be chiefly of epithelial origin, which invaginates the corneal epithelium. The presence of occasional keratocytes within the invaginating folds suggests that there may be a stromal contribution to the disorder. The visibility of mare's tail lines in the focal beam of the slit lamp is likely to be related to the thickness and light scattering properties of the invaginations and of the subepithelial deposits. Tractional forces, imposed by lid action, could explain their horizontal disposition.
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Ather MH, Noor MA, Akhtar S. The effect of intracalyceal distribution on the clearance of renal stones of ≥ 20 mm in children after extracorporeal lithotripsy. BJU Int 2004; 93:827-9. [PMID: 15049998 DOI: 10.1111/j.1464-410x.2003.04739.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the effect of the intracalyceal distribution of renal stones on clearance rates after treating paediatric nephrolithiasis with extracorporeal shock wave lithotripsy (ESWL). PATIENTS AND METHODS We assessed a retrospective case series of children (aged < or = 14 years) undergoing lithotripsy on an MPL 9000 (Dornier GmbH, Germany) echo-guided lithotripter. Patients were identified using an international coding and indexing system and ESWL registry. In all, 125 children were treated during 1990-2003, but 21 had stones of > or = 20 mm. Stone clearance was assessed at 1 and 3 months, the stone-free state being defined as no radiological evidence of stone or fragments of < or = 3 mm. Failed treatments were analysed to identify any correlation with stone site. RESULTS The overall stone-free rate was 81%; in four children the treatment failed (all girls) and subsequently they required ancillary procedures. Nineteen patients (90%) received up to three sessions of ESWL; two required four or more sessions. Of the four children in whom treatment failed, two had JJ stents; the stones were in the lower pole calyx in two, and the renal pelvis and lower pole calyx in two. The mean stone size in those where treatment failed was 25 mm, vs 21 mm in the stone-free group. The complication rate was 19%, but only one child required admission to hospital. CONCLUSIONS ESWL is very effective for renal stones in children, with minimal morbidity. Lower pole and partial staghorn stones with a major component in the lower pole calyx should preferably be treated by a percutaneous approach.
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Akhtar S, Juliano RL. Cellular uptake and intracellular fate of antisense oligonucleotides. Trends Cell Biol 2004; 2:139-44. [PMID: 14731968 DOI: 10.1016/0962-8924(92)90100-2] [Citation(s) in RCA: 162] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Antisense oligonucleotides with sequences complementary to a given genetic target can enter cells in sufficient quantities to selectively inhibit gene expression. Thus, they have a potential therapeutic use in preventing undesirable gene expression in diseases such as cancer and AIDS. However, it is remarkable that these molecules, which have high molecular weights and are often charged, gain entry to cells at all. In this article, we review the possible mechanisms by which oligonucleotides enter cells and their subsequent intracellular fates. We also discuss current approaches for improving cellular uptake and delivery of antisense nucleic acids to their intended targets.
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Abstract
Surveillance is a continuous and systematic process of collection, consolidation, analysis, interpretation and dissemination of relevant information on the occurrence of health problems. Data from surveillance can be used to calculate the incidence and prevalence of events, to categorise disease distribution by relevant characteristics, to guide investigations into the occurrence of epidemic and endemic disease, and to contribute essential information for the design and evaluation of effective disease prevention and control programmes. Disease surveillance systems should also respond to the information needs of government agencies, agribusiness, academia, producers and consumers. However, in most developing countries, including Pakistan, animal disease surveillance systems are not well developed, and do not produce a desirable quality of information on disease status and trends. In this paper, the authors describe various facets of a generic surveillance system and propose a structure for a surveillance system at district level. Such systems have been designed and implemented for public health surveillance in a number of countries, and may be developed to meet the needs of veterinary public health.
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Mascie-Taylor CGN, Karim R, Karim E, Akhtar S, Ahmed T, Montanari RM. The cost-effectiveness of health education in improving knowledge and awareness about intestinal parasites in rural Bangladesh. ECONOMICS AND HUMAN BIOLOGY 2003; 1:321-30. [PMID: 15463982 DOI: 10.1016/j.ehb.2003.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2003] [Revised: 08/08/2003] [Accepted: 08/08/2003] [Indexed: 05/15/2023]
Abstract
The impact of regular health education in improving knowledge, attitude and practices in the control of intestinal parasites was examined in four rural areas of Bangladesh; two areas received health education and the other two areas were controls. By the end of the 18-month study households receiving health education showed highly significant improvements in knowledge, water and sanitation facilities and personal hygiene compared with households in the control areas. Improving knowledge by 1% cost between US dollars 0.75 and 0.82 per household, while a 1% improvement in personal hygiene cost between US dollars 1.10 and 1.32 per household and water and sanitation between US dollars 1.39 and 1.52 per household.
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Usman HR, Akhtar S, Rahbar MH, Hamid S, Moattar T, Luby SP. Injections in health care settings: a risk factor for acute hepatitis B virus infection in Karachi, Pakistan. Epidemiol Infect 2003; 130:293-300. [PMID: 12729198 PMCID: PMC2869965 DOI: 10.1017/s0950268802008178] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A case control study was conducted to identify the association of therapeutic injections with acute hepatitis B virus (HBV) infection in Karachi, Pakistan. We enrolled 67 cases of acute HBV infection (IgM anti-HBc positive) and 247 controls (anti-HBc negative) from four hospitals of Karachi during July 2000-June 2001. Exposure to various risk factors during the period relevant to the incubation period of HBV was recorded both from cases and controls using a structured questionnaire. Multivariate logistic regression analysis of the data showed that cases were more likely to have received one injection (OR = 4.0; 95 % CI 1.4, 11.1), or more than one injection (OR = 6.3; 95 % CI 3.2, 12.4) compared to controls. The estimated population attributable risk (PAR) for therapeutic injections was 53%. Also the cases compared to controls were more likely to have household size of seven or more (OR = 1.9; 95 % CI 0.95, 3.9). This study showed that unsafe therapeutic injections appear to be the major risk factor for acute HBV infection and needs immediate focus from public health stand point.
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Akhtar S, De PP, De SK. Short fiber-reinforced thermoplastic elastomers from blends of natural rubber and polyethylene. J Appl Polym Sci 2003. [DOI: 10.1002/app.1986.070320530] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Yousif MHM, Benter IF, Akhtar S. Inhibition of calcium/calmodulin-dependent protein kinase II normalizes diabetes-induced abnormal vascular reactivity in the rat perfused mesenteric vascular bed. ACTA ACUST UNITED AC 2003; 23:27-33. [PMID: 14565535 DOI: 10.1046/j.1474-8673.2003.00282.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
1. Calcium/calmodulin-dependent protein kinase II (CaMKII) has an important function in mediating insulin release but its role in the development of diabetes-induced cardiovascular complications is not known. 2. We investigated the ability of a chronic administration of KN-93 (5 mg kg(-1) alt diem for 4 weeks), an inhibitor of CaMKII, to modulate the altered vasoreactivity of the perfused mesenteric bed to common vasoconstrictors and vasodilators in streptozotocin (STZ)-induced diabetes. 3. The vasoconstrictor responses induced by noradrenaline (NE), endothelin-1 (ET-1), and angiotensin II (Ang II), were significantly increased whereas, vasodilator responses to carbachol and histamine were significantly reduced in the perfused mesenteric bed of the STZ-diabetic rats as compared with non-diabetic controls. 4. Inhibition of CaMKII by KN-93 treatment did not affect blood glucose levels but produced a significant normalization of the altered agonist-induced vasoconstrictor and vasodilator responses. KN-93 did not affect agonist-induced responses in control animals. In addition, KN-93 significantly reduced weight loss in diabetic rats. 5. The present data suggest that CaMKII is an essential mediator in the development of diabetic vascular dysfunction and may also play an important role in signalling pathways leading to weight loss during diabetes.
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Akhtar S, Luby SP. Risk behaviours associated with urethritis and genital ulcer disease in prison inmates, Sindh, Pakistan. EASTERN MEDITERRANEAN HEALTH JOURNAL 2002. [DOI: 10.26719/2002.8.6.776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We evaluated the epidemiological differences with respect to demographics, drug use and sexual behaviours associated with lifetime risk of urethritis, genital ulcer disease [GUD] and urethritis and GUD together among 3395 male prisoners in Sindh. Factors associated with urethritis and GUD alone were sex with multiple females, sex with men, and ethnicity. Additional factors associated with urethritis alone were sex with prostitutes, sex with partners having multiple partners and sex with partners believed to be injecting drugs. Behaviours associated with lifetime risk for urethritis and GUD together were sex with multiple females, sex with prostitutes, sex with men, sex with partners believed to be injecting drugs and ethnicity. These relationships were consistently stronger compared to urethritis or GUD alone.
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Lewis S, Tarrier N, Haddock G, Bentall R, Kinderman P, Kingdon D, Siddle R, Drake R, Everitt J, Leadley K, Benn A, Grazebrook K, Haley C, Akhtar S, Davies L, Palmer S, Faragher B, Dunn G. Randomised controlled trial of cognitive-behavioural therapy in early schizophrenia: acute-phase outcomes. Br J Psychiatry 2002; 43:s91-7. [PMID: 12271807 DOI: 10.1192/bjp.181.43.s91] [Citation(s) in RCA: 267] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Cognitive-behavioural therapy (CBT) improves persistent psychotic symptoms. AIMS To test the effectiveness of added CBT in accelerating remission from acute psychotic symptoms in early schizophrenia. METHOD A 5-week CBT programme plus routine care was compared with supportive counselling plus routine care and routine care alone in a multi-centre trial randomising 315 people with DSM-IV schizophrenia and related disorders in their first (83%) or second acute admission. Outcome assessments were blinded. RESULTS Linear regression over 70 days showed predicted trends towards faster improvement in the CBT group. Uncorrected univariate comparisons showed significant benefits at 4 but not 6 weeks for CBT v. routine care alone on Positive and Negative Syndrome Scale total and positive sub-scale scores and delusion score and benefits v. supportive counselling for auditory hallucinations score. CONCLUSIONS CBT shows transient advantages over routine care alone or supportive counselling in speeding remission from acute symptoms in early schizophrenia.
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Kumar R, Wadhwa A, Akhtar S. The upside-down intubating laryngeal mask airway: a technique for cases of fixed flexed neck deformity. Anesth Analg 2002; 95:1454-8, table of contents. [PMID: 12401644 DOI: 10.1097/00000539-200211000-00066] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
IMPLICATIONS When the neck is fixed in extreme flexion, access to the windpipe becomes very difficult. The intubating laryngeal mask airway (ILMA) appears unsuitable for guiding the breathing tube into the windpipe in such cases because of its rigid, preformed shape. However, the ILMA introduced upside down may provide the answer, even if the mouth opening is smaller than normal.
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Akhtar S, Luby SP. Risk behaviours associated with urethritis and genital ulcer disease in prison inmates, Sindh, Pakistan. EASTERN MEDITERRANEAN HEALTH JOURNAL = LA REVUE DE SANTE DE LA MEDITERRANEE ORIENTALE = AL-MAJALLAH AL-SIHHIYAH LI-SHARQ AL-MUTAWASSIT 2002; 8:776-86. [PMID: 15568455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
We evaluated the epidemiological differences with respect to demographics, drug use and sexual behaviours associated with lifetime risk of urethritis, genital ulcer disease (GUD) and urethritis and GUD together among 3395 male prisoners in Sindh. Factors associated with urethritis and GUD alone were sex with multiple females, sex with men, and ethnicity. Additional factors associated with urethritis alone were sex with prostitutes, sex with partners having multiple partners and sex with partners believed to be injecting drugs. Behaviours associated with lifetime risk for urethritis and GUD together were sex with multiple females, sex with prostitutes, sex with men, sex with partners believed to be injecting drugs and ethnicity. These relationships were consistently stronger compared to urethritis or GUD alone.
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Rathi SK, Akhtar S, Rahbar MH, Azam SI. Prevalence and risk factors associated with tuberculin skin test positivity among household contacts of smear-positive pulnionary tuberculosis cases in Umerkot, Pakistan. Int J Tuberc Lung Dis 2002; 6:851-7. [PMID: 12365570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
STUDY POPULATION AND SETTING Household contacts of acid-fast bacilli (AFB) sputum smear-positive tuberculosis patients in the Umerkot Taluka, Sindh, Pakistan. OBJECTIVE To estimate the prevalence of and identify risk factors associated with tuberculin skin test (TST) positivity among household contacts of acid-fast bacilli (AFB) sputum smear-positive pulmonary tuberculosis cases. DESIGN A cross-sectional study of household contacts of AFB sputum smear-positive tuberculosis cases, registered at the Umerkot Anti-Tuberculosis Association clinic from August 1999 to September 1999. The contact's Mycobacterium tuberculosis infection status was assessed using TST. On the day of the TST, a pre-designed questionnaire was administered to collect data on putative risk factors for TST positivity among contacts. The data were analysed using a marginal logistic regression model by the method of generalised estimating equations (GEE) to determine risk factors independently associated with TST positivity. RESULTS The prevalence of TST positivity among household contacts of AFB sputum smear-positive index patients was 49.4%. The final multivariate GEE model showed that contact's age and sleeping site relative to the index case, the intensity of the index case's AFB sputum-smear positivity and the contact's BCG scar status were independent predictors of TST positivity among household contacts of AFB sputum smear-positive index cases. CONCLUSIONS The results suggest that the household contacts of AFB sputum smear-positive tuberculosis patients in a poor neighbourhood of rural Sindh had a high prevalence of M. tuberculosis infection as determined by TST. Poor housing conditions seem to contribute to the spread of M. tuberculosis infection. Early diagnosis of pulmonary TB through evaluation of TST-positive household contacts, followed by appropriate therapy, may prevent further spread of M. tuberculosis infection. We recommend an awareness programme to prevent household contacts from acquiring M. tuberculosis infection from smear-positive pulmonary TB cases.
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Jones LA, Akhtar S, Wann KT. Induction of Alzheimer phenotype in mouse skin fibroblasts. PROCEEDINGS OF THE WESTERN PHARMACOLOGY SOCIETY 2002; 44:177-80. [PMID: 11793974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Akhtar S, Moatter T, Azam SI, Rahbar MH, Adil S. Prevalence and risk factors for intrafamilial transmission of hepatitis C virus in Karachi, Pakistan. J Viral Hepat 2002; 9:309-14. [PMID: 12081609 DOI: 10.1046/j.1365-2893.2002.00350.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Household contacts of hepatitis C virus (HCV)-positive patients are considered at increased risk of HCV infection. This cross-sectional study during April through June 1999 assessed the prevalence and risk behaviours associated with HCV seropositivity among the household contacts of HCV seropositive thalassaemic children in Karachi, Pakistan. Among the 341 household contacts of 86 thalassaemic HCV seropositive children who were tested, 70 (20.5%) were positive for anti-HCV antibodies. The stratified analysis showed that HCV seroprevalence among the contacts did not differ significantly by the gender of the index patient and the type of relationship of contact with the index patient. However, HCV seroprevalences among the fathers and mothers of male index patients was substantially higher compared to those of female index patients. HCV RNA was recovered and genotyped from nine index patients and corresponding nine HCV-seropositive household contacts. HCV genotype 3a and 3b were found in 89% (8/9) and 11% (1/9) of the pairs, respectively. The final multivariable conditional logistic regression model revealed that after adjusting for the effect of ethnicity and past hospital admission history, the HCV-seropositive household contacts were more likely than HCV seronegative household contacts to have been bitten by the carrier [adjusted matched odds ratio (mOR)=2.6, 95% CI 1.3-5.2] or have shared a toothbrush with the carrier (adjusted mOR=8.2; 95% CI 1.56-43.5). Control efforts should focus on the risk behaviours.
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Thiruchelvam JK, Penfold CN, Akhtar S. Chronic eosinophilic pneumonia associated with T-cell lymphoma. Int J Oral Maxillofac Surg 2002; 31:112-4. [PMID: 11936394 DOI: 10.1054/ijom.2001.0112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A case of a woman presenting with a parotid swelling is described. She had chronic eosinophilic pneumonia (CEP) for approximately 2 years prior to presentation. After further investigation she had biopsy of her parotid, which proved to be T-cell lymphoma. This is a rare association, the diagnosis and the management of this condition is discussed.
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Eason RC, Archer HE, Akhtar S, Bailey CJ. Lipoic acid increases glucose uptake by skeletal muscles of obese-diabetic ob/ob mice. Diabetes Obes Metab 2002; 4:29-35. [PMID: 11874439 DOI: 10.1046/j.1463-1326.2002.00171.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIM Alpha-lipoic acid has been reported to increase glucose disposal in diabetic states. This study has examined the effect of alpha-lipoic acid on glucose uptake by cultured L6 muscle cells and different types of skeletal muscles in normal lean (+/+) and severely insulin-resistant, obese-diabetic (ob/ob) mice. METHODS Glucose uptake was measured in L6 muscle cells using the non-metabolized glucose analogue 2-deoxy-d-glucose (2DG), and in isolated muscles by glucose disappearance from the incubation medium. RESULTS In L6 muscle cells, short-term incubations (2-12 h) with 10(-3) m alpha-lipoic acid increased glucose uptake by 40-80%, approximately the same extent as 10(-6) m insulin. Combination of the two agents produced a slightly greater increase (120% at 12 h) than either alone. Red quadriceps (mainly type 1 fibres), diaphragm (similar proportions of type 1 and 2 fibres) and abdominal muscle (mainly type 2 fibres) from normal mice incubated with 10(-3) m alpha-lipoic acid showed increased glucose uptake to a similar extent as 10(-6) m insulin in each of the three muscles. Muscles from ob/ob mice, which showed little response to insulin, showed a substantial increase (approximately 300%, p < 0.05-0.01) in glucose uptake when 10(-3) m alpha-lipoic acid was added in the presence of insulin. The alpha-lipoic acid also increased glucose uptake in red quadriceps (approximately 300%, p < 0.01) from ob/ob mice without added insulin. CONCLUSION The results suggest that alpha-lipoic acid can increase glucose uptake by a range of normal muscle types and improve the response to insulin by insulin-resistant skeletal muscles of ob/ob mice.
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Manganas LN, Akhtar S, Antonucci DE, Campomanes CR, Dolly JO, Trimmer JS. Episodic ataxia type-1 mutations in the Kv1.1 potassium channel display distinct folding and intracellular trafficking properties. J Biol Chem 2001; 276:49427-34. [PMID: 11679591 DOI: 10.1074/jbc.m109325200] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Episodic ataxia type 1 (EA-1) is a neurological disorder arising from mutations in the Kv1.1 potassium channel alpha-subunit. EA-1 patients exhibit substantial phenotypic variability resulting from at least 14 distinct EA-1 point mutations. We found that EA-1 missense mutations generate mutant Kv1.1 subunits with folding and intracellular trafficking properties indistinguishable from wild-type Kv1.1. However, the single identified EA-1 nonsense mutation exhibits intracellular aggregation and detergent insolubility. This phenotype can be transferred to co-assembled Kv1 alpha- and Kv beta-subunits associated with Kv1.1 in neurons. These results suggest that as in many neurodegenerative disorders, intracellular aggregation of misfolded Kv1.1-containing channels may contribute to the pathophysiology of EA-1.
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