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Nickol JL, Malik SA, Yetman AT. Case Report of Loeys Dietz Syndrome Presenting with Coronary Artery Aneurysm. Eur Heart J Case Rep 2022; 6:ytac383. [PMID: 36237225 PMCID: PMC9552997 DOI: 10.1093/ehjcr/ytac383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/26/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Loeys Dietz syndrome is a heritable disorder that presents with thoracic aortic aneurysm and/or dissection caused by a mutation in one of the transforming growth factor- B (TGFR-B) receptor or ligand genes. It is associated with widespread familial arterial aneurysm and rupture.
Case Summary
We present a case of a 70 year old male with a family history of heritable thoracic aortic aneurysm disease (h-TAAD) who presented to the emergency department with chest pain. His presenting electrocardiogram was significant for ST elevation in the inferior leads with complete heart block. Computed tomography-angiography (CTA) was done to rule out aortic dissection, which was negative for aortic dissection but did reveal 3.9 cm infrarenal abdominal aortic aneurysm and 2.7 cm bilateral iliac artery aneurysms. He was then taken for invasive angiography and was found to have aneurysmal dilation of the entire right coronary artery (RCA) measuring up to 6 mm with 100% occlusion secondary to thrombus in the distal segment. He was found to have obstructive disease in the left anterior descending (LAD) artery and first and second obtuse marginals (OM). Genetic testing performed confirmed a pathogenic mutation in the TGFBRI gene (TGFBRI c.934G > A p.Gly312Ser) consistent with the diagnosis of Loeys-Dietz syndrome.
Discussion
Although Loeys-Dietz syndrome is known to cause arterial aneurysms throughout the arterial tree, there have been no other cases of primary coronary aneurysms reported in this patient population. This case represents the first description of a patient with genetically confirmed Loeys-Dietz syndrome presenting with coronary artery aneurysm.
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Affiliation(s)
- Jennifer L Nickol
- University of Nebraska Medical Center, Division of Cardiovascular Medicine 982265 Nebraska Medical Center Omaha, NE 68198-2265
| | - Shahbaz A Malik
- University of Nebraska Medical Center, Division of Cardiovascular Medicine 982265 Nebraska Medical Center Omaha, NE 68198-2265
| | - Anji T Yetman
- University of Nebraska Medical Center, Division of Cardiovascular Medicine 982265 Nebraska Medical Center Omaha, NE 68198-2265
- Children’s Hospital and Medical Center, Division of Pediatric Cardiology 8200 Dodge St, Omaha, NE 68114
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Malik SA, Goldsweig AM. Doing procedures for patients rather than to patients. Catheter Cardiovasc Interv 2022; 100:449-450. [PMID: 36084185 PMCID: PMC9544704 DOI: 10.1002/ccd.30374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Shahbaz A Malik
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Andrew M Goldsweig
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Abstract
The firing rate of some biological neurons such as neocortical pyramidal neurons is consistent with fractional order derivative, and the fractional-order neuron models depict the firing rate of neurons more accurately than other integer order neuron models do. For this reason, first, the dynamical characteristics of fractional order Hindmarsh Rose (HR) neuron are investigated, here and then a two coupled neuronal system based on Hindmarsh Rose neuron is presented. The results show several differences in the dynamical cha.racteristics of integer order and fractional order Hindmarsh Rose neuron model. The integer order model shows only one type of firing characteristics when the parameter of the model remained the same. The fractional-order model depicts several dynamical behaviors even for the same parameters as the order of the fractional operator is varied with the same parameter values. The firing frequency increases as the order of the fractional operator decreases. The fractional-order is therefore key in determining the firing characteristics of biological neuron models. A linearized model of HR neuron is also given for hardware resource minimizations and to implement this neuronal network on a large scale. A synchronized system of two fractional-order fractional Hindmarsh-Rose (HR) neurons in the presence of noise is also presented. The dynamical characteristics of the modified coupled neuron are determined by the parameters of the neuron model and the coupling function. The robustness of the network in the presence of noise is verified by both amplitude and phase synchronization techniques. A simplification of the coupling function is also presented to reduce the hardware cost. The synchronization results show that the model can produce the desired behavior with acceptable error.
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Malik SA, Gajanan G, Chatzizisis YS, O’Leary EL. What Knot to Do: Retrieval of a Kinked and Trapped Coronary Catheter. JACC Case Rep 2020; 2:1657-1661. [PMID: 34317028 PMCID: PMC8312086 DOI: 10.1016/j.jaccas.2020.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/10/2020] [Indexed: 11/29/2022]
Abstract
Diagnostic coronary artery catheter knotting and kinking are uncommon but potentially catastrophic complications. Our case emphasizes the importance of avoiding this problem and provides recommendations for catheter retrieval in the unlikely event of this complication. To our knowledge, the technique used in our case has not been described before. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Shahbaz A. Malik
- Cardiovascular Division, University of Nebraska Medical Center, Omaha, Nebraska
| | - Ganesh Gajanan
- Cardiovascular Division, University of Nebraska Medical Center, Omaha, Nebraska
| | | | - Edward L. O’Leary
- Cardiovascular Division, University of Nebraska Medical Center, Omaha, Nebraska
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Malik SA, Goldsweig AM. He said, she said: Sex differences in peripheral artery disease. Adv Med Sci 2020; 65:233-234. [PMID: 32172155 DOI: 10.1016/j.advms.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/25/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Shahbaz A Malik
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Andrew M Goldsweig
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
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Malik SA, Goldsweig AM. The Circle of Life: Vieussens' Arterial Ring. JACC Cardiovasc Interv 2019; 12:e73-e74. [PMID: 30772297 DOI: 10.1016/j.jcin.2018.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 12/11/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Shahbaz A Malik
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Andrew M Goldsweig
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
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Malik SA, Khole S, Mittal SPK, Urmode T, Kusurkar R, Ghaskadbi SS. Differential response of antioxidant defense in HepG2 cells on exposure of Livotrit ®, in a concentration dependent manner. J Tradit Complement Med 2019; 9:38-44. [PMID: 30671364 PMCID: PMC6335567 DOI: 10.1016/j.jtcme.2017.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 07/20/2017] [Accepted: 08/10/2017] [Indexed: 01/24/2023] Open
Abstract
Livotrit®, a polyherbal formulation (Zandu, India) is commonly prescribed for liver health. The present study was undertaken to elucidate possible mechanism of antioxidant potential of Livotrit®. Livotrit® exhibited concentration dependent radical scavenging activity, inhibition of lipid peroxidation as well as activation and gene expression of antioxidant enzymes. Interestingly, lower concentration of Livotrit® (0.05%) significantly increased activities and gene expression of catalase, Glutathione reductase (GR) and Gluthathione peroxidase (GPx), while higher concentration of Livotrit® (0.5%) significantly increased antioxidant enzyme Heme-oxygenase 1(HO-1) and not catalase (CAT), GR and GPx. Transcription factor, Nuclear factor erythroid 2-related factor 2 (Nrf2) required for expression of catalase, GR, GPx and HO-1 was efficiently translocated into the nucleus at both concentrations. Inspite of this, concentration dependent activation of these enzymes was found to be mediated through miRNAs involved in regulation of their gene expression.
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Affiliation(s)
- S A Malik
- Department of Zoology, Savitribai Phule Pune University, Ganeshkhind, Pune 411007, India
| | - S Khole
- Department of Zoology, Savitribai Phule Pune University, Ganeshkhind, Pune 411007, India
| | - S P K Mittal
- Department of Zoology, Savitribai Phule Pune University, Ganeshkhind, Pune 411007, India
| | - T Urmode
- Department of Chemistry, Savitribai Phule Pune University, Ganeshkhind, Pune 411007, India
| | - R Kusurkar
- Department of Chemistry, Savitribai Phule Pune University, Ganeshkhind, Pune 411007, India
| | - S S Ghaskadbi
- Department of Zoology, Savitribai Phule Pune University, Ganeshkhind, Pune 411007, India
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Koul PA, Hakim NA, Malik SA, Khan UH, Patel J, Gnatiuc L, Burney PGJ. Prevalence of chronic airflow limitation in Kashmir, North India: results from the BOLD study. Int J Tuberc Lung Dis 2018; 20:1399-1404. [PMID: 27725054 PMCID: PMC5019142 DOI: 10.5588/ijtld.15.0968] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Data on spirometrically defined chronic airflow limitation (CAL) are scarce in developing countries. OBJECTIVE: To estimate the prevalence of spirometrically defined CAL in Kashmir, North India. METHODS: Using Burden of Obstructive Lung Disease survey methods, we administered questionnaires to randomly selected adults aged ⩾40 years. Post-bronchodilator spirometry was performed to estimate the prevalence of CAL and its relation to potential risk factors. RESULTS: Of 1100 participants initially recruited, 953 (86.9%) responded and 757 completed acceptable spirometry and questionnaires. The prevalence of a forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio less than the lower limit of normal was 17.3% (4.5) in males and 14.8% (2.1) in females. Risk factors for CAL included higher age, cooking with wood and lower educational status. The prevalence of current smoking was 61% in males and 22% in females; most smoked hookahs. CAL was found equally in non-smoking males and females, and was independently associated with the use of the hookah, family history of respiratory disease and poor education. A self-reported doctor's diagnosis of chronic obstructive pulmonary disease was reported in 8.4/1000 (0.9% of females and 0.8% of males). CONCLUSION:Spirometrically confirmed CAL is highly prevalent in Indian Kashmir, and seems to be related to the high prevalence of smoking, predominantly in the form of hookah smoking.
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Affiliation(s)
- P A Koul
- Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - N A Hakim
- Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - S A Malik
- Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - U H Khan
- Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - J Patel
- National Heart & Lung Institute (NHLI), Imperial College, London, UK
| | - L Gnatiuc
- National Heart & Lung Institute (NHLI), Imperial College, London, UK
| | - P G J Burney
- Department of Respiratory Epidemiology and Public Health, NHLI, Imperial College London, London, UK
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Malik SA, Brilakis ES, Pompili V, Chatzizisis YS. Lost and found: Coronary stent retrieval and review of literature. Catheter Cardiovasc Interv 2018; 92:50-53. [DOI: 10.1002/ccd.27464] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/10/2017] [Accepted: 11/25/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Shahbaz A. Malik
- Division of Cardiovascular Medicine; University of Nebraska Medical Center; Omaha Nebraska
| | - Emmanouil S. Brilakis
- Center for Advanced Coronary Interventions, Minneapolis Heart Institute, Abbott Northwestern Hospital; Minneapolis Minnesota
| | - Vincent Pompili
- Division of Cardiovascular Medicine; University of Nebraska Medical Center; Omaha Nebraska
| | - Yiannis S. Chatzizisis
- Division of Cardiovascular Medicine; University of Nebraska Medical Center; Omaha Nebraska
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Kumar V, Malik SA, Sheikh M, Stys A. AngioVac System Used as an Adjunct Treatment for Intra-Cardiac Lead and Valvular Vegetations. S D Med 2018; 71:22-24. [PMID: 29439300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Infections are known complications of cardiovascular implantable electronic devices (CIEDs). We describe a case of a 62-year-old male who presented with pulseless electrical activity (PEA) cardiac arrest and respiratory failure. He had a history of cardiac resynchronization device and defibrillator (CRT-D) implantation for nonischemic cardiomyopathy. After resuscitation, he was found to have methicillin sensitive Staphylococcus aureus (MSSA) bacteremia on blood culture and large vegetations on the CRT-D lead and tricuspid valve found on echocardiography. The patient underwent extraction of the leads, but several large vegetations were present adherent to the tricuspid valve on intra-cardiac ultrasound (ICE). Due to comorbidities, the patient was not a candidate for surgical removal of these vegetations. Thus, he underwent percutaneous extraction of tricuspid and right atrial vegetations with the AngioVac device.
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Affiliation(s)
- Vishesh Kumar
- Department of Cardiology, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota
| | - Shahbaz A Malik
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota
| | - Maryam Sheikh
- Department of Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota
| | - Adam Stys
- Department of Cardiology, University of South Dakota Sanford School of Medicine
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11
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Malik SA, Porter TT, Pavlides G, Chatzizisis Y. Vasospastic Angina Presenting With Syncope and Chest Pain: A Case Report and Brief Literature Review. S D Med 2017; 70:498-502. [PMID: 29088521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 65-year-old male presented to the hospital with chest pain associated with recurrent syncope. He had a history of coronary artery disease and a long-standing history of smoking. While he was hospitalized, he had an episode of chest pain during which he was found to have transient ST segment elevation in the inferior leads. He was also noted to have a brief cardiac tachyarrhythmia. Coronary arteriography revealed vasospasm of the left anterior descending artery and right coronary artery, which were relieved to a significant extent after administration of intracoronary nitroglycerin. Subsequent angiograms and fractional flow reserve studies, demonstrated underlying non-obstructive coronary artery disease at the sites of spasm. No percutaneous coronary intervention was pursued. The patient was started on a calcium channel blocker on dismissal from the hospital. Upon follow up several months later, he remained free of symptoms that brought him to the hospital.
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Affiliation(s)
- Shahbaz A Malik
- Department of Internal Medicine, Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Thomas T Porter
- Department of Internal Medicine, Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Gregory Pavlides
- Department of Internal Medicine, Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Yiannis Chatzizisis
- Department of Internal Medicine, Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska
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12
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Aguirre AG, Malik SA, Rzepka A. The Use of Alternative Agents to Indigo Carmine During Cystoscopic Evaluation of Ureteral Patency. J Minim Invasive Gynecol 2015; 22:S155. [DOI: 10.1016/j.jmig.2015.08.585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ullah F, Malik SA, Ahmed J, Ullah F, Shah SM, Ayaz M, Hussain S, Khatoon L. Investigation of the Genetic Basis of Tetracycline Resistance in Staphylococcus aureus from Pakistan. TROP J PHARM RES 2013. [DOI: 10.4314/tjpr.v11i6.8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
Parkinson’s disease (PD) is a neurodegenerative disorder. COMT inhibitors, MOA-B inhibitors, Levodopa, Levodopa in combination with Dopa Decarboxylase (DDC) inhibitors, Entacapone, Tolcapone, Pramipexole, Ropinirole, Zonisamide, Cholinesterase inhibitors such as rivastigmine, galantamine and donepezil are used for treatment of Parkinson’s disease. Gene therapy of cellular and brain circuit pathways for the treatment of PD is under trials. Recently nuclear transfer embryonic stem cells or induced pluripotent stem derived cells can be used. The presence of Lewy bodies, reduced dopamine transporter and tyrosine hydroxylase expression within transplanted cells indicated that grafted cells are pathological. Adult and fetal neural stem cells are self-renewable.Journal of College of Medical Sciences-Nepal, 2011, Vol-7, No-2, 67-71DOI: http://dx.doi.org/10.3126/jcmsn.v7i2.6687
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Siddique N, Naeem K, Ahmed Z, Abbas MA, Farooq S, Malik SA. Isolation, identification, and phylogenetic analysis of reassortant low-pathogenic avian influenza virus H3N1 from Pakistan. Poult Sci 2012; 91:129-38. [PMID: 22184438 DOI: 10.3382/ps.2011-01530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
During routine avian influenza surveillance in Pakistan, a low-pathogenic avian influenza virus (LPAI) subtype H3N1 was isolated for the first time from domestic chickens. The higher seroprevalence of H3N1 was recorded in both commercial and domestic poultry in ecological zones of Pakistan where the geographical proximity with neighboring countries and attractive birding sites provide better opportunities for frequent movements of wild and migratory birds, and their intermingling with the local domestic and commercial poultry. Subsequent whole genome sequencing of this virus revealed a new introduction of a reassortant Eurasian avian strain, which was distinguishable from corresponding human and swine strains isolated elsewhere. Phylogenetically, the HA gene was mostly clustered with Nordic (Scandinavian) strains of influenza viruses, whereas the NA and PB1 genes showed a maximum nucleotide sequence homology with the Indian H11N1, and the PB2 gene was found to be closely related to the Altai H5N2. The Matrix and NP genes of H3N1 mostly clustered with the European avian influenza viruses (AIV), whereas its NS and PA genes showed maximum nucleotide homologies with the African (Egypt) AIV strains. A sequence and amino acid analysis revealed an LP motif, avian-like receptor specificity, potential glycosylation sites, and sensitivities to oseltamivir, zanamivir, and amantadine. Some point mutations possessed by this Pakistani AIV H3N1 were also found in human, equine, and swine H3 influenza viruses. This H3N1 isolate showed less nucleotide sequence homology with the previously known Pakistani AIV as compared with other Eurasian AIV strains.
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Affiliation(s)
- N Siddique
- National Reference Laboratory for Poultry Diseases, Animal Sciences Institute, National Agricultural Research Center, Park Road, Islamabad 45500, Pakistan.
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Pervaiz ZH, Turi NA, Khaliq I, Rabbani MA, Malik SA. Methodology: a modified method for high-quality DNA extraction for molecular analysis in cereal plants. Genet Mol Res 2012; 10:1669-73. [PMID: 21863559 DOI: 10.4238/vol10-3gmr1346] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Cereal crops that have rigid non-cellulose components in the cell wall tissues of leaves and high starch and protein content in grains face limitations in DNA extraction. Advanced molecular genetic techniques such as mapping and marker-assisted selection programs require pure and quick DNA extraction. In this study, we developed methods for isolating high-quality genomic DNA from leaves and seeds of major cereal crops with minor modifications. DNA yields ranged from 300 to 1800 ng for 0.01 g seed or leaf tissue.
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Affiliation(s)
- Z H Pervaiz
- Department of Biochemistry, Quaid-e-Azam University, Islamabad, Pakistan.
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17
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Abstract
PURPOSE The aim of our study was to analyze the pattern of injuries, hospital care, and outcome of the victims of suicide bomb attacks in Pakistan. METHODS This prospective, cohort study was conducted at the Combined Military Hospital Rawalpindi during the last 3 years. Seriously injured patients in the "immediate category" were resuscitated in the emergency operation theater adjacent to the emergency room and, after resuscitation, the patients were transferred to the main operation theaters, where consultant surgeons were available. RESULTS During the study period, 1,296 terrorist victims presented to the emergency department and (86.9%) were admitted, with a mean hospital stay of 8.2 ± 2.1 days. The majority of patients arrived by ambulance (91%) and only 38 (3%) were evacuated by air. Penetrating splinter injuries were the most prevalent (87%), and 29% patients also had associated injuries. Open bone fractures were found in 48% and 42% had injured hollow and solid viscous. Overall, 33% of patients had thoracic injuries and neuro-trauma was observed in 16% of the study population. Deafness was a feature in 33% patients, 121 had to undergo limb amputations, and mortality remained in 7% of patients. CONCLUSION Most of the problems encountered were logistic in nature. Early evacuation of the victims remains pivotal in saving lives. The major causes of death in peripheral patients was hypovolemic shock, sepsis, and hypothermia. Mortality and morbidity can be enhanced by ample fluid resuscitation, tetanus prophylaxis, and proficient first aid at the site of injury.
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Affiliation(s)
- M M A Yasin
- Department of General Surgery, Combined Military Hospital, Rawalpindi, 4600, Pakistan.
| | - G Nasreen
- Department of Gynecology and Obstetrics, Military Hospital Rawalpindi, Rawalpindi, 4600, Pakistan
| | - S A Malik
- Department of General Surgery, Combined Military Hospital, Rawalpindi, 4600, Pakistan
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18
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Rashid S, Naeem K, Ahmed Z, Saddique N, Abbas MA, Malik SA. Multiplex polymerase chain reaction for the detection and differentiation of avian influenza viruses and other poultry respiratory pathogens. Poult Sci 2009; 88:2526-31. [PMID: 19903950 DOI: 10.3382/ps.2009-00262] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S Rashid
- Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan 45320
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Naqvi GA, Malik SA, Jan W. Necrotizing fasciitis of the lower extremity: a case report and current concept of diagnosis and management. Scand J Trauma Resusc Emerg Med 2009; 17:28. [PMID: 19527519 PMCID: PMC2704167 DOI: 10.1186/1757-7241-17-28] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2009] [Accepted: 06/15/2009] [Indexed: 11/24/2022] Open
Abstract
Necrotizing fasciitis is a severe soft tissue infection characterized by rapidly progressing necrosis, involving subcutaneous tissues. This rare condition carries high mortality rate and require prompt diagnosis and urgent treatment with radical debridement and antibiotics. We describe a case of 21-year old man who presented with the history of trivial injury to the knee. Initially he was admitted and treated for septic arthritis but later was diagnosed as necrotizing fasciitis which was successfully treated with no ill effects what so ever from this devastating condition. This rare condition has been reported in literature but still early diagnosis, which is a key for successful treatment, remains a challenge.
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Affiliation(s)
- GA Naqvi
- Department of Orthopaedics, Our Lady of Lourdes Hospital, Drogheda, Republic of Ireland
| | - SA Malik
- Department of Orthopaedics, Our Lady of Lourdes Hospital, Drogheda, Republic of Ireland
| | - W Jan
- Department of Orthopaedics, Our Lady of Lourdes Hospital, Drogheda, Republic of Ireland
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20
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Pasha Q, Malik SA, Iqbal J, Shaheen N, Shah MH. Comparative distribution of the scalp hair trace metal contents in the benign tumour patients and normal donors. Environ Monit Assess 2008; 147:377-388. [PMID: 18214698 DOI: 10.1007/s10661-007-0127-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Accepted: 12/19/2007] [Indexed: 05/25/2023]
Abstract
The scalp hair samples of benign tumour patients (n = 77) and normal donors (n = 86) were analysed for selected trace metal contents using atomic absorption spectrophotometry. In the scalp hair of benign tumour patients, highest average levels were found for Ca (1,401 microg/g), followed by Na (476.9 microg/g), Mg (441.6 microg/g), Zn (438.3 microg/g), K (119.2 microg/g) and Fe (96.38 microg/g) while in comparison, the maximum mean levels in the scalp hair of normal donors were shown by Ca (556.5 microg/g), followed by Zn (154.2 microg/g), Mg (153.4 microg/g), Na (97.45 microg/g) and Fe (81.68 microg/g). Almost all metal levels revealed higher dispersion and asymmetry in the scalp hair of benign tumour patients compared with the normal donors. The average concentrations of Ca, Cd, Co, K, Mg, Mn, Na, Ni, Pb, Sb, Sr and Zn were significantly higher in the hair of benign tumour patients compared with the normal donors. Significant gender-based differences were also observed in the scalp hair metal contents of benign tumour patients. Strong positive correlations were found between Cd-Cr (0.547) and Cd-Co (0.507) in the hair of benign tumour patients whereas Ca-Mg, Mg-Sr, Co-Cd, Cr-Cd, Li-Cr, Li-Co, Li-Cd, Na-Cd, Na-Co and Na-Li exhibited strong relationships (r > 0.50) in the hair of normal donors. Cluster analysis (CA) and principal component analysis (PCA) were used for the source identification and apportionment of scalp hair trace metals in the two donor groups. The scalp hair of benign tumour patients and normal donors revealed six and five main clusters of trace metals, respectively. PCA extracted seven principal components of trace metals in the scalp hair of benign tumour patients while six principal components were observed in the case of normal donors. The study evidenced significantly different patterns of metal distribution in the hair of benign tumour patients in comparison with normal donors.
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Affiliation(s)
- Q Pasha
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, 45320, Pakistan
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21
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Mahmood K, Malik SA. Painful left index finger in a 37-year-old man. Clin Exp Dermatol 2008; 33:669-70. [PMID: 18801101 DOI: 10.1111/j.1365-2230.2007.02656.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K Mahmood
- Department of Dermatology, PAF Hospital, Islamabad, Pakistan.
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22
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Qadir MI, Malik SA. Plasma lipid profile in gynecologic cancers. EUR J GYNAECOL ONCOL 2008; 29:158-161. [PMID: 18459552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Lipids are associated with cancer because they play a key role in the maintenance of cell integrity. We studied the relationship of plasma lipids with gynecologic cancer. METHODS A total of 196 female individuals were included in the study. Of these 50 were normal subjects. The remaining were cancer patients: 80 breast cancer, 40 ovarian cancer and 26 patients with other gynecologic cancers. Plasma levels of triglycerides, total cholesterol, LDL-cholesterol and HDL-cholesterol were estimated by using spectrophotometer. RESULTS In breast cancer patients there is moderate increase in the plasma levels of triglycerides (18%) and cholesterol (21%), and a high increase in LDL-cholesterol (43%), while there is a moderate decrease in HDL-cholesterol levels (30%) when compared with normal subjects. In ovarian cancer patients, there is a high decrease in the plasma levels of triglycerides (31%) and HDL-cholesterol (39%), while a moderate decrease in cholesterol (28%) and LDL-cholesterol levels (11%) when compared with normal subjects. In gynecologic cancers other than breast and ovarian cancer, there is a moderate decrease in plasma levels of the triglycerides (25%), cholesterol (21%), and HDL-cholesterol levels (27%), while a non-significant decrease in LDL-cholesterol (6.2%) when compared with normal subjects. CONCLUSIONS Plasma lipid levels, except HDL-cholesterol, are raised in breast cancer and are decreased in other gynecologic cancers. HDL-cholesterol is decreased in all gynecologic cancers. As there is an alteration in the plasma lipid profile during gynecologic cancers, it may be helpful for diagnosis of the disease.
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Affiliation(s)
- M I Qadir
- Department of Biochemistry, Faculty of Biological Sciences, Quiad-i-Azam University, Islamabad, Pakistan.
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23
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Ahmad M, Hussain SS, Malik SA. Burns from a stove burst: analysis of 34 cases. Ann Burns Fire Disasters 2007; 20:173-175. [PMID: 21991092 PMCID: PMC3188091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Indexed: 05/31/2023]
Abstract
Burns continue to be a major environmental factor responsible for significant morbidity and mortality in developing countries and, in particular, burns due to stove bursts are a major problem. Two types of stoves are available in Pakistan: gas stoves and kerosene stoves. The state is considered of patients burned by stove bursts in general, and also with specific reference to 34 adult patients admitted with stove burns to our hospital in Pakistan. Various treatment options were used, and the patients' treatment and outcome are reported. The continued commercialization of such stoves, and especially of the gas stove, is is a cause of serious and permanent consequences that represent a danger for the population. Proper care should be observed when handling them because, as always, prevention is better than cure.
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Affiliation(s)
- M Ahmad
- Aesthetic Plastic Surgery, Chaklala, Rawalpindi, Pakistan
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24
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Ahmad M, Shahid Hussain S, Ibrahim Khan M, Malik SA. Experience of burn injuries at the pakistan institute of medical science, islamabad, pakistan*. Ann Burns Fire Disasters 2007; 20:7-10. [PMID: 21991058 PMCID: PMC3188041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/16/2006] [Indexed: 05/31/2023]
Abstract
The objective of this prospective study was to consider the demographical data of burn patients admitted to the Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. The study was carried out at PIMS from January 2002 to December 2003. Only admitted patients of either sex of age more than 12 yr were included. Patients below 12 yr were excluded. Patients requiring outpatient treatment were also excluded. A total number of 77 males and 65 females fulfilled the criteria. The mean age of the males was 32.2 yr and of the females 24.4 yr, while the male/female ratio was 1/1.18. Burns were commonest during the winter season (42.2%). In 6% of the patients, the burns were due to suicide attempts and in 15% to homicidal intent. The burns were accidental in 79% of cases. The major mechanism in females was stove burst (22%) and in males direct flame (18%). The kitchen was the commonest site of the accident in females (27%). Housewives were the most frequently affected (35%). More married males (39%) were burned than unmarried females (18%). Inhalational injury was present in 23% of the patients. Males had average total body surface area burned of 27.4% compared with 39.5% in females. Eighteen per cent of the deaths occurred among males and 16% among females. This study provides a comprehensive overview of hospitalized burn patients in Pakistan. Prevention is always the rule to be safe from burns but, once they occur, immediate and proper care should be given with aggressive treatment in order to minimize post-burn problems.
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Affiliation(s)
- M Ahmad
- Plastic, Reconstructive, and Hand Surgeon, Rawalpindi, Pakistan
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25
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Ahmad M, Shahid Hussain S, Ibrahim Khan M, Malik SA. Pattern of bacterial invasion in burn patients at the pakistan institute of medical sciences, islamabad. Ann Burns Fire Disasters 2006; 19:18-21. [PMID: 21991014 PMCID: PMC3188017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/22/2005] [Indexed: 05/31/2023]
Abstract
A prospective study was carried out in the Department of Plastic Surgery, Pakistan Institute of Medical Sciences, Islamabad, from January 2002 to December 2003. A total number of 142 patients were included in the study. The patients' mean age was 32.2 yr for males and 24.4 yr for females. The male/female ratio was 1.18:1.0. Micro-organisms from 86 patients were cultured for the first five days and in 77 patients from day 6 onwards. Staphylococcus aureuswas found in 24.4%, which decreased to 18.2% after the first week. Pseudomonas aeruginosawas found in 27.3% of patients. Methicillin-resistant Staphylococcus aureuswas observed in 11.7% of cases. No case of methicillin-sensitive Staphylococcus aureuswas found. Seven patients, after admission day 6, showed no growth. Eighteen per cent of males and 16% of females died during their stay in hospital. This study highlights the predominant bacterial pathogens among the infected burn wounds treated in our centre.
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Affiliation(s)
- M Ahmad
- Plastic Reconstructive and Hand Surgeon, Rawalpindi, Pakistan
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26
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Lyall V, Heck GL, Phan THT, Mummalaneni S, Malik SA, Vinnikova AK, Desimone JA. Ethanol modulates the VR-1 variant amiloride-insensitive salt taste receptor. II. Effect on chorda tympani salt responses. ACTA ACUST UNITED AC 2005; 125:587-600. [PMID: 15928404 PMCID: PMC2234074 DOI: 10.1085/jgp.200509264] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The effect of ethanol on the amiloride- and benzamil (Bz)-insensitive salt taste receptor was investigated by direct measurement of intracellular Na+ activity ([Na+]i) using fluorescence imaging in polarized fungiform taste receptor cells (TRCs) and by chorda tympani (CT) taste nerve recordings. CT responses to KCl and NaCl were recorded in Sprague-Dawley rats, and in wild-type (WT) and vanilloid receptor-1 (VR-1) knockout mice (KO). CT responses were monitored in the presence of Bz, a specific blocker of the epithelial Na+ channel (ENaC). CT responses were also recorded in the presence of agonists (resiniferatoxin and elevated temperature) and antagonists (capsazepine and SB-366791) of VR-1 that similarly modulate the Bz-insensitive VR-1 variant salt taste receptor. In the absence of mineral salts, ethanol induced a transient decrease in TRC volume and elicited only transient phasic CT responses. In the presence of mineral salts, ethanol increased the apical cation flux in TRCs without a change in volume, increased transepithelial electrical resistance across the tongue, and elicited CT responses that were similar to salt responses, consisting of both a phasic component and a sustained tonic component. At concentrations <50%, ethanol enhanced responses to KCl and NaCl, while at ethanol concentrations >50%, those CT responses were inhibited. Resiniferatoxin and elevated temperature increased the sensitivity of the CT response to ethanol in salt-containing media, and SB-366791 inhibited the effect of ethanol, resiniferatoxin, and elevated temperature on the CT responses to mineral salts. VR-1 KO mice demonstrated no Bz-insensitive CT response to NaCl and no sensitivity to ethanol. We conclude that ethanol increases salt taste sensitivity by its direct action on the Bz-insensitive VR-1 variant salt taste receptor.
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Affiliation(s)
- Vijay Lyall
- Department of Physiology, Division of Nephrology, Virginia Commonwealth University, Richmond, VA 23298, USA.
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27
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Malik SA, Khan WA. Relation of serum sialic acid with serum lipids in cardiac patients. Pak J Pharm Sci 2005; 18:71-3. [PMID: 16380349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Elevated serum sialic acid concentration is a risk factor for coronary heart disease in general population along with dyslipidemia. Sialic acid and lipid profile was determined in healthy subjects (Group A1 and A2) and sixty cardiac patients, divided into two groups, group B comprising of thirty male patients and group C comprising of thirty female patients. A highly significant increase was observed in the level of sialic acid and different variables of lipid profile except HDL-C in all patients. HDL-C showed a significant decrease in patients. An increase in the level of sialic acid in cardiac patients showing the implications of raised level of sialic acid in the development of cardiovascular complications.
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Lyall V, Heck GL, Phan THT, Mummalaneni S, Malik SA, Vinnikova AK, DeSimone JA. Ethanol modulates the VR-1 variant amiloride-insensitive salt taste receptor. I. Effect on TRC volume and Na+ flux. J Gen Physiol 2005; 125:569-85. [PMID: 15928403 PMCID: PMC2234079 DOI: 10.1085/jgp.200409213] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2004] [Accepted: 05/04/2005] [Indexed: 01/06/2023] Open
Abstract
The effect of ethanol on the amiloride- and benzamil (Bz)-insensitive salt taste receptor was investigated by the measurement of intracellular Na(+) activity ([Na(+)](i)) in polarized rat fungiform taste receptor cells (TRCs) using fluorescence imaging and by chorda tympani (CT) taste nerve recordings. CT responses were monitored during lingual stimulation with ethanol solutions containing NaCl or KCl. CT responses were recorded in the presence of Bz (a specific blocker of the epithelial Na(+) channel [ENaC]) or the vanilloid receptor-1 (VR-1) antagonists capsazepine or SB-366791, which also block the Bz-insensitive salt taste receptor, a VR-1 variant. CT responses were recorded at 23 degrees C or 42 degrees C (a temperature at which the VR-1 variant salt taste receptor activity is maximally enhanced). In the absence of permeable cations, ethanol induced a transient decrease in TRC volume, and stimulating the tongue with ethanol solutions without added salt elicited only transient phasic CT responses that were insensitive to elevated temperature or SB-366791. Preshrinking TRCs in vivo with hypertonic mannitol (0.5 M) attenuated the magnitude of the phasic CT response, indicating that in the absence of mineral salts, transient phasic CT responses are related to the ethanol-induced osmotic shrinkage of TRCs. In the presence of mineral salts, ethanol increased the Bz-insensitive apical cation flux in TRCs without a change in cell volume, increased transepithelial electrical resistance across the tongue, and elicited CT responses that were similar to salt responses, consisting of both a transient phasic component and a sustained tonic component. Ethanol increased the Bz-insensitive NaCl CT response. This effect was further enhanced by elevating the temperature from 23 degrees C to 42 degrees C, and was blocked by SB-366791. We conclude that in the presence of mineral salts, ethanol modulates the Bz-insensitive VR-1 variant salt taste receptor.
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Affiliation(s)
- Vijay Lyall
- Department of Physiology, Division of Nephrology, Virginia Commonwealth University, Richmond, VA 23298, USA.
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29
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Lyall V, Heck GL, Vinnikova AK, Ghosh S, Phan THT, Alam RI, Russell OF, Malik SA, Bigbee JW, DeSimone JA. The mammalian amiloride-insensitive non-specific salt taste receptor is a vanilloid receptor-1 variant. J Physiol 2004; 558:147-59. [PMID: 15146042 PMCID: PMC1664927 DOI: 10.1113/jphysiol.2004.065656] [Citation(s) in RCA: 208] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The amiloride-insensitive salt taste receptor is the predominant transducer of salt taste in some mammalian species, including humans. The physiological, pharmacological and biochemical properties of the amiloride-insensitive salt taste receptor were investigated by RT-PCR, by the measurement of unilateral apical Na+ fluxes in polarized rat fungiform taste receptor cells and by chorda tympani taste nerve recordings. The chorda tympani responses to NaCl, KCl, NH4Cl and CaCl2 were recorded in Sprague-Dawley rats, and in wild-type and vanilloid receptor-1 (VR-1) knockout mice. The chorda tympani responses to mineral salts were monitored in the presence of vanilloids (resiniferatoxin and capsaicin), VR-1 antagonists (capsazepine and SB-366791), and at elevated temperatures. The results indicate that the amiloride-insensitive salt taste receptor is a constitutively active non-selective cation channel derived from the VR-1 gene. It accounts for all of the amiloride-insensitive chorda tympani taste nerve response to Na+ salts and part of the response to K+, NH4+ and Ca2+ salts. It is activated by vanilloids and temperature (> 38 degrees C), and is inhibited by VR-1 antagonists. In the presence of vanilloids, external pH and ATP lower the temperature threshold of the channel. This allows for increased salt taste sensitivity without an increase in temperature. VR-1 knockout mice demonstrate no functional amiloride-insensitive salt taste receptor and no salt taste sensitivity to vanilloids and temperature. We conclude that the mammalian non-specific salt taste receptor is a VR-1 variant.
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Affiliation(s)
- Vijay Lyall
- Department of Physiology, Virginia Commonwealth University, Richmond, VA 23298-0551, USA.
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30
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Lyall V, Alam RI, Malik SA, Phan THT, Vinnikova AK, Heck GL, DeSimone JA. Basolateral Na+-H+ exchanger-1 in rat taste receptor cells is involved in neural adaptation to acidic stimuli. J Physiol 2004; 556:159-73. [PMID: 14724181 PMCID: PMC1664893 DOI: 10.1113/jphysiol.2003.057745] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The role of basolateral Na(+)-H(+) exchanger isoform-1 (NHE-1) was investigated in neural adaptation of rat taste responses to acidic stimuli, by direct measurement of intracellular pH (pH(i)) in polarized taste receptor cells (TRCs) and by chorda tympani (CT) taste nerve recordings. In TRCs perfused with CO(2)/HCO(3)(-)-free solution (pH 7.4), removal of basolateral Na(+) decreased pH(i) reversibly and zoniporide, a specific NHE-1 blocker, inhibited the Na(+)-induced changes in pH(i). The spontaneous rate of TRC pH(i) recovery from NH(4)Cl pulses was inhibited by basolateral zoniporide with a K(i) of 0.33microm. Exposure to basolateral ionomycin, reversibly increased TRC Ca(2+), resting pH(i), and the spontaneous rate of pH(i) recovery from an NH(4)Cl pulse. These effects of Ca(2+) on pH(i) were blocked by zoniporide. In in vivo experiments, topical lingual application of zoniporide increased the magnitude of the CT responses to acetic acid and CO(2), but not to HCl. Topical lingual application of ionomycin did not affect the phasic part of the CT responses to acidic stimuli, but decreased the tonic part by 50% of control over a period of about 1 min. This increased adaptation in the CT response was inhibited by zoniporide. Topical lingual application of 8-CPT-cAMP increased the CT responses to HCl, but not to CO(2), and acetic acid. In the presence of cAMP, ionomycin increased sensory adaptation to HCl, CO(2), and acetic acid. Thus, cAMP and Ca(2+) independently modulate CT responses to acidic stimuli. While cAMP enhances TRC apical H(+) entry and CT responses to strong acid, an increase in Ca(2+) activates NHE-1, and increases neural adaptation to all acidic stimuli.
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Affiliation(s)
- Vijay Lyall
- Department of Physiology, Virginia Commonwealth University, Sanger Hall 3002, 1101 E. Marshall Street, Richmond, VA 23298-0551, USA.
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31
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Vinnikova AK, Alam RI, Malik SA, Ereso GL, Feldman GM, McCarty JM, Knepper MA, Heck GL, DeSimone JA, Lyall V. Na+-H+ exchange activity in taste receptor cells. J Neurophysiol 2003; 91:1297-313. [PMID: 14602837 DOI: 10.1152/jn.00809.2003] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
mRNA for two Na(+)-H(+)-exchanger isoforms 1 and 3 (NHE-1 and NHE-3) was detected by RT-PCR in fungiform and circumvallate taste receptor cells (TRCs). Anti-NHE-1 antibody binding was localized to the basolateral membranes, and the anti-NHE-3 antibody was localized in the apical membranes of fungiform and circumvallate TRCs. In a subset of TRCs, NHE-3 immunoreactivity was also detected in the intracellular compartment. For functional studies, an isolated lingual epithelium containing a single fungiform papilla was mounted with apical and basolateral sides isolated and perfused with nominally CO(2)/HCO(3)(-)-free physiological media (pH 7.4). The TRCs were monitored for changes in intracellular pH (pH(i)) and Na(+) ([Na(+)](i)) using fluorescence ratio imaging. At constant external pH, 1) removal of basolateral Na(+) reversibly decreased pH(i) and [Na(+)](i); 2) HOE642, a specific blocker, and amiloride, a nonspecific blocker of basolateral NHE-1, attenuated the decrease in pH(i) and [Na(+)](i); 3) exposure of TRCs to basolateral NH(4)Cl or sodium acetate pulses induced transient decreases in pH(i) that recovered spontaneously to baseline; 4) pH(i) recovery was inhibited by basolateral amiloride, 5-(N-methyl-N-isobutyl)-amiloride (MIA), 5-(N-ethyl-N-isopropyl)-amiloride (EIPA), HOE642, and by Na(+) removal; 5) HOE642, MIA, EIPA, and amiloride inhibited pH(i) recovery with K(i) values of 0.23, 0.46, 0.84, and 29 microM, respectively; and 6) a decrease in apical or basolateral pH acidified TRC pH(i) and inhibited spontaneous pH(i) recovery. The results indicate the presence of a functional NHE-1 in the basolateral membranes of TRCs. We hypothesize that NHE-1 is involved in sour taste transduction since its activity is modulated during acid stimulation.
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Affiliation(s)
- Anna K Vinnikova
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, 23298, USA
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Abstract
Recently seven isolates of avian influenza virus (AIV) serotype H9N2 recovered from an outbreak of AI were analyzed on the basis of their biological and molecular characteristics. All the isolates belonged to the low-pathogenicity group of AIV. To further evaluate their pathogenic potential in association with other organisms, an isolate was inoculated experimentally in chickens using different routes and subsequently challenged with infectious bronchitis virus, Ornithobacterium rhinotracheale or Escherichia coli. The virus isolation and seromonitoring data revealed a significant role of Escherichia coli in aggravating the clinical condition of the birds earlier infected with AIV (H9N2). The AIV-antigen was detected in lung, trachea, kidney, and cloacal bursa among the infected birds, using immunofluorescent antibody technique. In another experiment, chickens that were immunosuppressed chemically showed high mortality when challenged with AIV H9N2. The results indicated that this low pathogenicity AIV (H9N2) isolate could produce severe infection depending on the type of secondary opportunistic pathogens present under field conditions. This may explain the severity of infection with the present H9N2 outbreak in the field. A prolonged antibacterial therapy in flocks infected with AIV H9N2 and use of oil-based vaccine at an early age in new flocks has helped to control this infection and the disease.
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Affiliation(s)
- S Bano
- Animal Health Laboratory, Animal Sciences Institute, National Agricultural Research Center, Park Road, Islamabad-45500, Pakistan
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Lyall V, Alam RI, Phan THT, Russell OF, Malik SA, Heck GL, DeSimone JA. Modulation of rat chorda tympani NaCl responses and intracellular Na+ activity in polarized taste receptor cells by pH. J Gen Physiol 2002; 120:793-815. [PMID: 12451050 PMCID: PMC2229570 DOI: 10.1085/jgp.20028656] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mixture interactions between sour and salt taste modalities were investigated in rats by direct measurement of intracellular pH (pH(i)) and Na(+) activity ([Na(+)](i)) in polarized fungiform taste receptor cells (TRCs) and by chorda tympani (CT) nerve recordings. Stimulating the lingual surface with NaCl solutions adjusted to pHs ranging between 2.0 and 10.3 increased the magnitude of NaCl CT responses linearly with increasing external pH (pH(o)). At pH 7.0, the epithelial sodium channel (ENaC) blocker, benzamil, decreased NaCl CT responses and inhibited further changes in CT responses induced by varying pH(o) to 2.0 or 10.3. At constant pH(o), buffering NaCl solutions with potassium acetate/acetic acid (KA/AA) or HCO(3)(-)/CO(2) inhibited NaCl CT responses relative to CT responses obtained with NaCl solutions buffered with HEPES. The carbonic anhydrase blockers, MK-507 and MK-417, attenuated the inhibition of NaCl CT responses in HCO(3)(-)/CO(2) buffer, suggesting a regulatory role for pH(i). In polarized TRCs step changes in apical pH(o) from 10.3 to 2.0 induced a linear decrease in pH(i) that remained within the physiological range (slope = 0.035; r(2) = 0.98). At constant pH(o), perfusing the apical membrane with Ringer's solutions buffered with KA/AA or HCO(3)(-)/CO(2) decreased resting TRC pH(i), and MK-507 or MK-417 attenuated the decrease in pH(i) in TRCs perfused with HCO(3)(-)/CO(2) buffer. In parallel experiments, TRC [Na(+)](i) decreased with (a) a decrease in apical pH, (b) exposing the apical membrane to amiloride or benzamil, (c) removal of apical Na(+), and (d) acid loading the cells with NH(4)Cl or sodium acetate at constant pH(o). Diethylpyrocarbonate and Zn(2+), modification reagents for histidine residues in proteins, attenuated the CO(2)-induced inhibition of NaCl CT responses and the pH(i)-induced inhibition of apical Na(+) influx in TRCs. We conclude that TRC pH(i) regulates Na(+)-influx through amiloride-sensitive apical ENaCs and hence modulates NaCl CT responses in acid/salt mixtures.
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Affiliation(s)
- Vijay Lyall
- Department of Physiology, Virginia Commonwealth University, Richmond, VA 23298-0551, USA.
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Lyall V, Alam RI, Phan DQ, Ereso GL, Phan TH, Malik SA, Montrose MH, Chu S, Heck GL, Feldman GM, DeSimone JA. Decrease in rat taste receptor cell intracellular pH is the proximate stimulus in sour taste transduction. Am J Physiol Cell Physiol 2001; 281:C1005-13. [PMID: 11502578 DOI: 10.1152/ajpcell.2001.281.3.c1005] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Taste receptor cells (TRCs) respond to acid stimulation, initiating perception of sour taste. Paradoxically, the pH of weak acidic stimuli correlates poorly with the perception of their sourness. A fundamental issue surrounding sour taste reception is the identity of the sour stimulus. We tested the hypothesis that acids induce sour taste perception by penetrating plasma membranes as H(+) ions or as undissociated molecules and decreasing the intracellular pH (pH(i)) of TRCs. Our data suggest that taste nerve responses to weak acids (acetic acid and CO(2)) are independent of stimulus pH but strongly correlate with the intracellular acidification of polarized TRCs. Taste nerve responses to CO(2) were voltage sensitive and were blocked with MK-417, a specific blocker of carbonic anhydrase. Strong acids (HCl) decrease pH(i) in a subset of TRCs that contain a pathway for H(+) entry. Both the apical membrane and the paracellular shunt pathway restrict H(+) entry such that a large decrease in apical pH is translated into a relatively small change in TRC pH(i) within the physiological range. We conclude that a decrease in TRC pH(i) is the proximate stimulus in rat sour taste transduction.
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Affiliation(s)
- V Lyall
- Department of Physiology, Virginia Commonwealth University, Richmond, Virginia 23298-0551, USA.
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35
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Gandapur AS, Malik SA. Reply: Tumor necrosis factor in falciparum malaria. Ann Saudi Med 1997; 17:567-8. [PMID: 17339796 DOI: 10.5144/0256-4947.1997.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- A S Gandapur
- Department of Basic Medical Sciences, Gomal University, Dera Ismail Khan, Pakistan, and Department of Biological Sciences, Quaid-I-Azam University, Islamabad, Pakistan
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Gandapur AS, Malik SA, Raziq F. Bone marrow changes in human malaria: a retrospective study. J PAK MED ASSOC 1997; 47:137-9. [PMID: 9230580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The bone marrow reports of 1966 patients admitted to a provincial teaching hospital between January, 1992 to April, 1995 were retrospectively analyzed. Twenty-six (1.3%) bone marrows showed the presence of malarial parasites. Sixteen (62%) patients had Plasmodium falciparum 9 (34%) Vivax malaria and one (4%) mixed infection. All these patients gave a history of prolonged illness and had low parasite counts. Plasmodium vivax malaria was not associated with any significant pathology in the bone marrow, except iron deficiency anaemia. The bone marrows with Plasmodium falciparum malaria showed myeloid hyperplasia, erythroid hyperplasia, megaloblastosis and hypoplasia in different proportions. No evidence of dyserythropoiesis was found in this series. The possible mechanisms producing these changes and the factors responsible for the discrepancy in bone marrow findings in different geographical areas are discussed.
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Affiliation(s)
- A S Gandapur
- Department of Basic Medical Sciences, Gomal University, Dera Ismail Khan
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Abstract
To investigate the relationship of TNFalpha levels to Plasmodium falciparum (PF) infection, plasma TFNalpha concentrations were measured in Pakistani adults and children with mind, severe, cerebral and chronic falciparum malaria and healthy (control) subjects. The initial geometric mean plasma concentrations of TFNalpha in adult patients with severe malaria (187.6 pg/mL) were significantly higher than mild malaria patients (87.1 pg/mL, P < 0.001). TNFalpha levels were not correlated to parasite density, cerebral malaria, young age, hypoglycemia or fatal outcome; however, they were associated with severe anemia, and hepatic and kidney dysfunction. TNFalpha levels were not significantly increased in 16 patients with hyperparasitemia and were significantly elevated (P < 0.02) in chronic malaria patients as compared to control subjects. TNFalpha levels were elevated independently in patients with anemia, hypoglycemia (P < 0.001, P < 0.05), and hepatic and kidney (P < 0.001 each) dysfuntion. In this study, high TNFalpha levels were associated with several manifestations of severe malaria and were not specific to cerebral malaria and hyperparasitemia.
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Affiliation(s)
- A S Gandapur
- Department of Basic Medical Sciences, Gomal University, Dera Ismail Khal, and Department of Biology, Quaid-Azam University, Islamabad
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38
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Khan AS, Malik SA. Haematological changes in falciparum malaria and tumor necrosis factor. J PAK MED ASSOC 1996; 46:198-201. [PMID: 8936985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Tumor necrosis factor and various haematological parameters were studied in 90 patients suffering from falciparum malaria. They were divided into three groups on the basis of haemoglobin level. The difference in haemoglobin level between group-1 (Hb < 7 gm/dl) and group-2 (Hb 7-10 gm/dl), as well as group-1 and group-3 was statistically significant. The geometric mean TNF alpha concentrations in group-1 (193.9 pg/ml) and group-2 (132.2 pg/ml) were higher as compared to group-3; however, the difference was statistically non-significant. The TNF concentration in group-2 correlated negatively with haemoglobin level (r = .43, p = .05). As a whole, 21% patients had leukocytosis, 3% leukopenia, 46% increased ESR and 26% elevated levels of fibrin degradation products. The platelet count was done only in 4 patients with bleeding problems. Twenty-five healthy subjects were included in the study as controls. The difference between TNF and haemoglobin level in group-1 and controls was statistically significant (p < .05, p < .001 each). The role of tumor necrosis factor in the production of these changes is discussed.
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Affiliation(s)
- A S Khan
- Department of Basic Medical Sciences, Gomal University
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39
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Naeem K, Niazi T, Malik SA, Cheema AH. Immunosuppressive potential and pathogenicity of an avian adenovirus isolate involved in hydropericardium syndrome in broilers. Avian Dis 1995; 39:723-8. [PMID: 8719205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The role of avian adenovirus isolate PARC-1 as an immunosuppressive agent was investigated using a Newcastle disease virus (NDV) vaccine immune response procedure. The immunosuppressive effect on the humoral immune response was investigated up to 21 days after inoculation with adenovirus. Infected chickens showed a serologic response to NDV that was reduced compared with that of the controls. To further investigate the effect of the virus on major lymphoid organs, the pattern of virus dissemination in various organs was studied at various time intervals after inoculation. Spleen, thymus, bursa of Fabricius, and cecal tonsils of broilers were examined using a dot-immunobinding assay. The virus was found to have a predilection for lymphoid organs, and virus from lymphoid organs was capable of producing disease when inoculated into healthy chickens. The relationship of virus predilection to its immunosuppressive effect also was studied.
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Affiliation(s)
- K Naeem
- Animal Health Laboratories, National Agricultural Research Centre, Islamabad, Pakistan
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40
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Malik SA, Khan C, Jabbar A, Iqbal A. Heroin addiction and sex hormones in males. J PAK MED ASSOC 1992; 42:210-2. [PMID: 1433805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
To investigate the effects of illicit heroin abuse on the endocrine system a study was carried out in North West Frontier Province (NWFP) where heroin addiction is prevalent. Sixty-eight subjects were included in this study. Thirty-three were untreated heroin addicts visiting "drug abuse treatment centres" in Peshawar and 35 age matched normal males. Urine samples of all addicts showed the presence of morphine. The serum concentrations of testosterone (T) in addicts was 228 ng/ml, leutinizing hormone (LH) 10.7 mlU/ml and folical stimulating hormone (FSH) 4.9 mlU/ml whereas the corresponding values for control males were T 630 ng/ml, LH 14.3 mlU/ml and FSH mlU/ml, respectively. Heroin exerts a depletion effect on T and FSH levels in more or less all the groups studied irrespective of age, amount of heroin intake per day and period of contact with heroin. LH levels remained affected and are within clinically accepted normal range.
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41
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Harfi HA, Malik SA. Chediak-Higashi syndrome: clinical, hematologic, and immunologic improvement after splenectomy. Ann Allergy 1992; 69:147-50. [PMID: 1510287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A 10-year-old boy with Chediak-Higashi syndrome in accelerated phase failed to respond to treatment with ascorbic acid, vincristine, and prednisone. Splenectomy resulted in clinical, hematologic, and immunologic improvement: his leukocyte chemotactic and phagocytic functions returned to normal. We suggest that splenectomy be considered in treatment of the accelerated phase of Chediak-Higashi syndrome unresponsive to other forms of therapy.
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Affiliation(s)
- H A Harfi
- Department of Pediatrics and Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
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42
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Say B, Hommes FA, Malik SA, Carpenter NJ. An infant with multiple congenital abnormalities and biochemical findings suggesting a variant of galactosialidosis. J Med Genet 1992; 29:423-4. [PMID: 1619639 PMCID: PMC1015996 DOI: 10.1136/jmg.29.6.423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A female newborn probably with a variant form of galactosialidosis is described. The patient, in addition to the common findings seen in early infantile forms of classical galactosialidosis, displayed an unusual combination of congenital malformations including complex cyanotic congenital heart disease with dextrocardia and situs inversus.
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Affiliation(s)
- B Say
- H Allen Chapman Research Institute of Medical Genetics, Children's Medical Center, Tulsa, OK 74135
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43
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Jabbar A, Khawaja SA, Iqbal A, Malik SA. Effect of malathion and methyl-parathion on rat liver enzymes. J PAK MED ASSOC 1990; 40:266-70. [PMID: 2126808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The effect of sub-lethal doses of Malathion and Methyl-parathion was studied on the rat liver enzymes. Intravenous administration of both insecticides at weekly interval for four weeks resulted in increase in heart and spleen weight. Short term (24 hr.) and long term (4 weeks) treatment with insecticides resulted in increased specific activities of liver enzymes, Acid phosphatase, Alkaline phosphatase, Glutamate dehydrogenase, Glutamate oxaloacetate transaminase and Glutamate pyruvate transaminase. The increase in enzyme activity was not as profound when the insecticide administration was spread over 4 weeks. Malathion had greater effect than Methyl-parathion on the biochemical parameters studied.
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Affiliation(s)
- A Jabbar
- Entomological Research Labs., National Agricultural Research Centre, Islamabad
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44
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Khan C, Malik SA, Iqbal MA. Testosterone suppression by heroin. J PAK MED ASSOC 1990; 40:172-3. [PMID: 2125664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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45
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Jabbar A, Khawaja SA, Iqbal A, Malik SA. Effect of malathion and methyl-parathion on rat liver enzymes. J PAK MED ASSOC 1990; 40:85-9. [PMID: 2126817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The effect of sub-lethal doses of Malathion and Methyl-Parathion was studied on the rat liver enzymes. Intravenous administration of both insecticides at weekly interval for four weeks resulted in increase in weight of various tissues, i.e., heart and spleen. Short term (24 hr) and long term (4 weeks) treatment with insecticides resulted in increased specific activities of liver enzymes, Acid phosphatase, Alkaline phosphatase, Glutamate dehydrogenase, Glutamate oxaloacetate transaminase and Glutamate pyruvate transaminase. The increase in enzyme activity was not as profound when the insecticide administration was spread over 4 weeks. Malathion had greater effect than Methyl-parathion on the biochemical parameters studied.
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Affiliation(s)
- A Jabbar
- Entomological Research Labs, National Agricultural Research Centre, Islamabad
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46
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Taylor GJ, Mikell FL, Moses HW, Dove JT, Katholi RE, Malik SA, Markwell SJ, Korsmeyer C, Schneider JA, Wellons HA. Determinants of hospital charges for coronary artery bypass surgery: the economic consequences of postoperative complications. Am J Cardiol 1990; 65:309-13. [PMID: 2105627 DOI: 10.1016/0002-9149(90)90293-a] [Citation(s) in RCA: 147] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This is a prospective study of 500 consecutive patients having coronary artery bypass surgery; mean hospital charge from time of surgery to discharge was +11,900 +/- 12,700. Multiple regression analysis was performed using preoperative variables and postoperative complications. No preoperative clinical feature was a significant predictor of higher average charge. Sternal wound infection (p = 0.0001), respiratory failure (p = 0.0001) and left ventricular failure (p = 0.017) were associated with higher average hospital charge. The absence of any complication predicted a lower average charge, and postoperative death (4.4 +/- 4.5 days after surgery) was also associated with lower average charge. A cost equation was developed: hospital charge equalled $11,217 + $41,559 of sternal wound infection, + $28,756 for respiratory failure, + $5,186 for left ventricular failure, - $1,798 for no complication and - $6,019 for death. Recognition of the influence of complications on charges suggests that low average charges can only be achieved by surgical programs with a low complication rate.
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Affiliation(s)
- G J Taylor
- Prairie Cardiovascular Center, Springfield, Illinois
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47
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Saleem M, Malik SA, Ahmed M, Saleem N. Isoniazid acetylation and polymorphism in humans. J PAK MED ASSOC 1989; 39:285-6. [PMID: 2516534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Phenotypes of slow and fast acetylators of isoniazid (INH) were determined in 157 subjects (80 normals and 77 patients with tuberculosis) from the twin cities of Rawalpindi and Islamabad. Plasma INH concentrations were determined chemically six hours after the drug ingestion. The findings indicate that 31.8% subjects were fast acetylators of the drug.
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48
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Taylor GJ, Malik SA, Colliver JA, Dove JT, Moses HW, Mikell FL, Batchelder JE, Schneider JA, Wellons HA. Usefulness of atrial fibrillation as a predictor of stroke after isolated coronary artery bypass grafting. Am J Cardiol 1987; 60:905-7. [PMID: 3661408 DOI: 10.1016/0002-9149(87)91045-9] [Citation(s) in RCA: 147] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- G J Taylor
- Prairie Cardiovascular Center, Southern Illinois University School of Medicine
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49
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Abstract
One hundred consecutive cases of cervicofacial sinuses are reviewed in terms of aetiology, diagnosis and subsequent management. One hundred and thirty-eight cases recorded in the world literature are reviewed for comparison.
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50
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Ozsoylu S, Malik SA. Incidence of alpha-thalassemia in Turkey. Turk J Pediatr 1982; 24:235-44. [PMID: 6926788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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