Medicine and Health Sciences Commons^™

Outcomes In Culture Positive And Culture Negative Ascitic Fluid Infection In Patients With Viral Cirrhosis: Cohort Study, Lubna Kamani, Khalid Mumtaz, Umair S. Ahmed, Ailia W. Ali, Wasim Jafri

Department of Medicine

Background: Ascitic fluid infection (AFI) in cirrhotic Patients has a high morbidity and mortality. It has two variants namely, spontaneous bacterial peritonitis (SBP) and culture negative neutrocytic ascites (CNNA). The aim of this study was to determine the outcome in cirrhotic Patients with culture positive (SBP) and culture negative neutrocytic ascites. Methods: We analyzed 675 consecutive hepatitis B and/or C related cirrhosis Patients with ascites admitted in our hospital from November 2005 to December 2007. Of these, 187 Patients had AFI, clinical and laboratory parameters of these Patients including causes of cirrhosis, Child Turcotte Pugh (CTP) score were recorded. Results: …

Response Of Imitanib Meysylate In Patients With Gastrointestinal Stromal Cell Tumour, Abdullah Ladha, Mohammad Usman Shaikh

Department of Pathology and Laboratory Medicine

In this study, the response of Imitanib Mesylate in patients with Gastro-intestinal stromal cell tumour (GIST) was assessed. GIST results from a mutation in one of the receptor protein tyrosine kinases. Imitanib Mesylate, a tyrosine kinase inhibitor, has emerged as a promising new treatment for GISTs. Total 16 cases were reviewed. Diagnosis was based on biopsy and immunohistochemistry. Response assessment was done using CT scans, at a median duration of 4 months. The median age of the patients was 52 years, Majority were male (n=14). Most common presenting complaint was abdominal pain (n=7). Commonest primary site was stomach (n=7), Liver …

Predictors Of Gastrointestinal Lesions On Endoscopy In Iron Deficiency Anemia Without Gastrointestinal Symptoms, Shahid Majid, Mohammad Salih, Rozina Wasaya, Wasim Jafri

Section of Gastroenterology

Background:Iron deficiency anaemia (IDA) due to occult gastrointestinal (GI) blood loss usually remains unnoticed until Patient become symptomatic. There is sparse data in IDA Patients without gastrointestinal symptoms. This study was designed to find out the frequency and predictors of endoscopic lesions in IDA without gastrointestinal symptoms. Cross-sectional study performed on a convenience sample of consecutive subjects.

Methods: Ninety five consecutive Patients with laboratory based diagnosis of IDA having no gastrointestinal symptoms were interviewed and their clinical and biochemical variables were recorded. All the study Patients underwent esophago-gastroduodenoscopy (EGD) and colonoscopy. Endoscopic findings were documented as presence/absence of bleeding …

Complete Resolution Of Gastric Amyloidosis After Autologous Stem Cell Transplantation., Dinu Cherian, Kristin Braun, Neal Flomenberg, Juan P. Palazzo, David Kastenberg

Division of Gastroenterology and Hepatology Faculty Papers

A 48-year-old female with multiple myeloma (MM) and amyloidosis presented with massive upper gastrointestinal (GI) bleeding one week after autologous stem cell transplantation (autologous-SCT). Esophagogastroduodenoscopy (EGD) demonstrated necrotic, purple, pigmented, friable lesions throughout the stomach (Figure 1a), along with a bleeding ulcer in the cardia (Figure 1b, Video 1) which was successfully treated with epinephrine (1:10,000) injections. Biopsies demonstrated nodular amyloid deposition (Figures 2) which was Congo red positive. The patient had no further hematemesis and was discharged home 4 days later. Ten months after autologous-SCT, EGD revealed a normal stomach (Figure 3, Video 2) with …

Pegylated Interferon 2a And 2b In Combination With Ribavirin For The Treatment Of Chronic Hepatitis C In Hiv Infected Patients., Ravinder Dhillon, Simona Rossi, Steven K Herrine

Department of Medicine Faculty Papers

Coinfection with hepatitis C virus (HCV) and HIV is an increasingly recognized clinical dilemma, particularly since the advent of highly active antiretroviral therapy. Several studies of this population have demonstrated both more rapid progression of liver disease and poorer overall prognosis compared to HCV monoinfected patients. Consensus guidelines, based primarily on the results of 4 major randomized trials, recommend treatment with peginterferon and ribavirin for 48 weeks in coinfected patients. However, this current standard of care is associated with lower response rates to therapy than those seen in monoinfected patients. Important predictors of response include HCV genotype, pretreatment HCV RNA …

Clinical Features And Management Of Autoimmune Hepatitis, Edward L. Krawitt

Dartmouth Scholarship

Autoimmune hepatitis (AIH) is a chronic hepatitis of unknown etiology which can progress to cirrhosis. Its clinical manifestations are highly variable and sometimes follow a fluctuating course. Diagnosis is based on characteristic histologic, clinical, biochemical and serological findings. Anti-inflammatory/immunosuppressive treatment frequently induces remission but long-term maintenance therapy is often required. Liver transplantation is generally successful in patients with decompensated cirrhosis unresponsive to or intolerant of medical therapy.

Predictive Factors For Early Aspiration In Liver Abscess, Rustam Khan, Saeed Hamid, Shahab Abid, Wasim Jafri, Zaigham Abbas, Mohammed Islam, Hasnain Shah, Shaalan Beg

Department of Medicine

Aim: To determine the predictive factors for early aspiration in liver abscess.

Methods: A retrospective analysis of all Patients with liver abscess from 1995 to 2004 was performed. Abscess was diagnosed as amebic in 661 (68%) Patients, pyogenic in 200 (21%), indeterminate in 73 (8%) and mixed in 32 (3%). Multiple logistic regression analysis was performed to determine predictive factors for aspiration of liver abscess.

Results: A total of 966 Patients, 738 (76%) male, mean age 43 17 years, were evaluated: 540 Patients responded to medical therapy while adjunctive percutaneous aspiration was performed in 426 Patients. Predictive factors for aspiration …

Increased Prevalence Of Helicobacter Pylori 23s Rrna Gene Mutations In, Javed Yakoob, Wasim Jafri, Z Abbas, Shahab Abid, Rustam Khan, Nida Jafri, Zubair Ahmad

Section of Gastroenterology

No abstract provided.

Analysis Of Sustained Virological Response To Pegylated Interferon & Ribavirin Treatment In Compensated Cirrhosis Due To Hepatitis C Virus, Genotype 3 Infection, Amna Subhan Butt, Wasim Jafri, Khalid Mumtaz, Saeed Hamid, Shahab Abid, Syed H Shah, Nida Jafri, Javed Yakoob, Zubair Ahmad

Section of Gastroenterology

No abstract provided.

High Prevalence Of Helicobacter Pylori Infections By Multiple Strains In Patients With Dyspepsia From A Developing Country, Shahab Abid, Javed Yakoob, Wasim Jafri, Khalid Mumtaz, Nida Jafri, Z Abbas, Syed H Shah, Saeed Hamid, Rashida Ahmed

Section of Gastroenterology

No abstract provided.

Gastric Juice For The Diagnosis Of H Pylori Infection In Patients On Proton Pump Inhibitors, Javed Yakoob, Shahid Rasool, Z Abbas, Wasim Jafri, Shahab Abid, Muhammad Islam, Zubair Ahmad

Section of Gastroenterology

Aim:To determine the efficacy of gastric juice polymerase chain reaction (PCR) for the detection of H pylori infection in comparison with histology and gastric antral biopsy PCR in Patients on a proton pump inhibitor (PPI).

Methods:

Eighty-five consecutive Patients with dyspeptic symptoms were enrolled. Gastric biopsies for histology, PCR and gastric juice were collected at endoscopy for PCR of the H pylori urease C gene (ure C). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, positive and negative likelihood ratio for PCR of gastric juice for the H pylori ure C gene was compared to histology …

Gastric Corpus Polyps Associated With Proton Pump Inhibitors Therapy, Javed Yakoob, Zaigham Abbas, Wasim Jafri, Zubair Ahmad

Section of Gastroenterology

The prevalence of Gastroesophageal Reflux Disease (GERD) is rapidly rising in Asia. We describe here a case of 51 years old man who had surgery for esophageal leiomyoma and received long-term therapy with Proton Pump Inhibitors (PPIs) for persisting reflux symptoms. On Esophago-Gastroduodenoscopy (EGD) several sessile polyps were seen in the gastric corpus. Earlier EGD done 15 years back had not demonstrated those polyps. Sections revealed polypoid fragments of glandular epithelium with dilated glands and negative histology for H. pylori. Polymerase chain reaction for 16S ribosomal RNA gene (16S rRNA PCR) of H. pylori was also negative. This is the …

An Open Study To Assess The Safety And Efficacy Of Heprovac-B Vaccine 10 Mcg-Dose For Adults, Hasnain Ali Shah, Wasim Jafri

Section of Gastroenterology

Heprovac B is a novel recombinant vaccine. There are many vaccines available in Pakistani market but Heprovac B claims to be immunogenic even at 10 meg dose. Aim of the study is to determine whether using 10 meg of Heprovac B vaccine is safe and effective in producing sufficient immunity in Pakistani population. One hundred and twenty five subjects, who fulfilled the Inclusion criteria, were enrolled for the study. Heprovac B was administered in a three-dose regimen given at 0, 1 and 6 months and adverse events were recorded. Immunogenicity was tested by measuring hepatitis B surface antibody one month …

Precipitating Factors And The Outcome Of Hepatic Encephalopathy In Liver Cirrhosis., Dileep K. Rohra, Jaipal, Ameer A. Khowaja, Khalid Mahmood, Kanya Lal Ahuja

Department of Medicine

No abstract provided.

Inhibition Of Signal Transducer And Activator Of Transcription 3 Expression By Rna Interference Suppresses Invasion Through Inducing Anoikis In Human Colon Cancer Cells, Yu Fan, You-Li Zhang, Ying Wu, Wei Zhang, Yin-Huan Wang, Zhao-Ming Cheng, Hua Li

Dartmouth Scholarship

AIM: To investigate the roles and mechanism of signal transducer and activator of transcription 3 (STAT3) in invasion of human colon cancer cells by RNA interference.

Conformational Changes And Flexibility In T-Cell Receptor Recognition Of Peptide–Mhc Complexes, Kathryn M. Armstrong, Kurt H. Piepenbrink, Brian M. Baker

Food for Health: Publications

A necessary feature of the immune system, TCR (T-cell receptor) cross-reactivity has been implicated in numerous autoimmune pathologies and is an underlying cause of transplant rejection. Early studies of the interactions of αβ TCRs (T-cell receptors) with their peptide–MHC ligands suggested that conformational plasticity in the TCR CDR (complementarity determining region) loops is a dominant contributor to T-cell cross-reactivity. Since these initial studies, the database of TCRs whose structures have been solved both bound and free is now large enough to permit general conclusions to be drawn about the extent of TCR plasticity and the types and locations of motion …

Detection And Molecular Epidemiological Analysis Of Acute Gastroenteritis Viruses In The South Of Ireland, Grainne Lennon

Theses

Rotavirus infections are considered to be the most common cause of severe gastroenteritis in children under the age of 5 years, and are responsible for up to 611,000 deaths annually, mainly in developing countries. From 1997 to 1999, 16 hospital laboratories in the Republic of Ireland reported to detection of 4,643 cases of rotaviral disease, while in 2004 and 2005 and increase of 1,600 and 2,251 rotavirus cases were reported. These rotavirus cases have a significant impact on the healthcare system with the minimum cost per case being €728.40. A large percentage of the infections were reported in neonates, suggesting …

Use Of Bioluminescent Imaging To Assay The Transplantation Of Immortalized Human Fetal Hepatocytes Into Mice., Moon Seok Choi, Andreea M Catana, Jian Wu, Young Seok Kim, Sang Jeong Yoon, Alexander D Borowsky, Sanjiv S Gambhir, Sanjeev Gupta, Mark A Zern

jian duan wu

Noninvasive serial monitoring of the fate of transplanted cells would be invaluable to evaluate the potential therapeutic use of human hepatocyte transplantation. Therefore, we assessed the feasibility of bioluminescent imaging using double or triple fusion lentiviral vectors in a NOD-SCID mouse model transplanted with immortalized human fetal hepatocytes. Lentiviral vectors driven by the CMV promoter were constructed carrying reporter genes: firefly luciferase and green fluorescence protein with or without herpes simplex virus type 1 thymidine kinase. Human fetal hepatocytes immortalized by telomerase reconstitution (FH-hTERT) were successfully transduced with either of these fusion vectors. Two million stably transduced cells selected by …