Diseases Commons^™

Effects Of Methylprednisolone And Its Liver-Targeted Dextran Prodrug On Ischemia–Reperfusion Injury In A Rat Liver Transplantation Model, Anjaneya Chimalakonda, Reza Mehvar

Pharmacy Faculty Articles and Research

Purpose. To evaluate the effectiveness of a liver-targeted dextran prodrug (DMP) of methylprednisolone ( MP) in cold preservation-warm reperfusion injury associated with liver transplantation.

Methods. The effects of donor pretreatment with single 5 mg/kg doses of MP or DMP on ischemia reperfusion damage to the liver were studied after 8 or 24 h of cold preservation in both isolated perfused rat liver (IPRL) and syngeneic orthotopic rat liver transplantation (OLT) models.

Results. In IPRL studies, donor pretreatment with DMP, and to a lesser degree MP, significantly improved the uptake of hyaluronic acid (HA), a marker of endothelial …

Noncommunicable Diseases And Injuries: Action Needed In South Asia Too, Ali Khan Khuwaja, Riaz Qureshi, Zafar Fatmi

Community Health Sciences

No abstract provided.

Hepatitis B And C: Prevalence And Risk Factors Associated With Seropositivity Among Children In Karachi, Pakistan, Wasim Jafri, Nadim Jafri, Javed Yakoob, Muhammad Islam, Syed Farhan Ali Tirmizi, Tazeen Jafar, Saeed Akhtar, Saeed Hamid, Hasnain Ali Shah, Sheikh Qamaruddin Nizami

Section of Gastroenterology

Background

Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) can lead to chronic liver disease and hepato-cellular carcinoma (HCC). This cross-sectional study estimated the prevalence and identified risk factors associated with Hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV) sero-positivity among children 1 to 15 years of age.

Methods

The study targeted the low to middle socioeconomic population that comprises 80% to 85% of the population. Consent was obtained from parents of the eligible children before administering questionnaire and collected a blood sample for anti-HCV and HBsAg serology.

Results

3533 children were screened for HBsAg and …

Physician And Patient Barriers To Adherence With Cholesterol Guidelines, Lynne J. Goebel, Asim J. Khattak, Fadl Ballony, Todd W. Gress

Internal Medicine

Several national studies have shown poor compliance with National Cholesterol Education Program II (NCEP) goals. A study we conducted of patients in the General Internal Medicine Clinic at the Marshall University Joan C. Edwards School of Medicine in Huntington showed that 46% of them were not at NCEP goals. We hypothesized that both patient and physician barriers were responsible for these findings so we administered two surveys about barriers to cholesterol management to 261 random patients identified with hypercholesterolemia and to all 50 residents and faculty at the clinic. We identified insufficient knowledge of low cholesterol foods as a patient …

Frequency Of Nsaid Induced Peptic Ulcer Disease, Saeed Hamid, Javed Yakoob, Wasim Jafri, Shanul Islam, Shahab Abid, Muhammad Islam

Section of Gastroenterology

Objective:

To determine the frequency of peptic ulcer disease in patients on nonsteroidal anti-inflammatory drugs (NSAID).

Methods:

Record of eight hundred and twenty consecutive patients undergoing upper gastrointestinal (GI) endoscopy; from January 1998 to December 2000 were reviewed. The endoscopic diagnosis varied from gastritis, peptic ulcer to duodenitis. The use of NSAID was documented by reviewing medical records of patients with peptic ulcer.

Results:

Peptic ulcers were found in 43% (353/820) patients. NSAID associated peptic ulcers were identified in 14.7% (52/353) patients. Diclofenac and aspirin were most common NSAIDs associated with peptic ulcers in 32.7% (17/52) and 30.7% (16/52) patients, …

Phloroglucinol In Irritable Bowel Syndrome, Wasim Jafri, Javed Yakoob, Sajjad Hussain, Nadim Jafri, Muhammad Islam

Section of Gastroenterology

Objective: To determine the efficacy and tolerability of phloroglucinol, an antispasmodic agent in the treatment of Irritable Bowel Syndrome (IBS). Methods: It was an open label (quasi interventional) study. One hundred patients coming to the gastroenterology clinics of Aga Khan University Hospital with IBS as defined by the Rome II criteria were enrolled between February 2004 and September 2004 to participate in the trial and were treated as outpatients. Phloroglucinol (Himont) 50mg orally three times daily was given for two months. Symptoms were assessed before and during treatment using a questionnaire. Results: One hundred patients were enrolled in the study. …

Attenuation Of Acute Rejection In A Rat Liver Transplantation Model By A Liver-Targeted Dextran Prodrug Of Methylprednisolone, Anjaneya Chimalakonda, Donald L. Montgomery, Jon A. Weidanz, Imam H. Shaik, Justin H. Nguyen, John J. Lemasters, Eiji Kobayashi, Reza Mehvar

Pharmacy Faculty Articles and Research

Background. The use of methylprednisolone (MP) and other corticosteroids for the treatment of acute liver allograft rejection is associated with severe toxicities in nontarget tissues. Therefore, selective delivery of NIP to the liver may improve its efficacy and alleviate its side effects. We investigated the effects of a novel liver-targeted dextran prodrug of MP (DMP) in an orthotopic rat liver transplantation (OLT) model.

Methods. The model consisted of a high responder rejection strain combination (Dark Agouti donors and Lewis recipients). Liver recipients were intravenously administered saline or a single subtherapeutic dose of MP (5 mg/kg) as the parent …

Giardiasis In Patients With Dyspeptic Symptoms, Javed Yakoob, Wasim Jafri, Shahab Abid, Nadim Jafri, Saeed Hamid, Hasnain Ali Shah, Lubna Rizvi, Muhammad Islam, Hizbullah Shaikh

Section of Gastroenterology

AIM:

To investigate the prevalence of giardiasis in patients with dyspeptic symptoms.

METHODS:

Clinical records of consecutive patients who attended Gastroenterology Department at Aga Khan University Hospital from January 2000 to June 2003 and had esophagogastroduodenoscopy (EGD) with duodenal biopsies and international classification of diseases 9th revision with clinical modifications (ICD-9-CM) coded with giardiasis were studied.

RESULTS:

Two hundred and twenty patients fulfilled the above criteria. There were 44% (96/220) patients who were giardiasis positive, 72% (69/96) of them were males and 28% (27/96) of them were females. There were 65% (81/124) males and 35% (43/124) females who were giardiasis …

Role Of Rapid Urease Test And Histopathology In The Diagnosis Of Helicobacter Pylori Infection In A Developing Country, Javed Yakoob, Wasim Jafri, Shahab Abid, Zaigham Abbas, Saeed Hamid, Muhammad Islam, Kashif Anis, Hasnain Ali Shah, Hizbullah Shaikh

Section of Gastroenterology

Background

The aim of this study was to determine the effect of commonly self-prescribed proton pump inhibitors (PPI) on the results of rapid urease test and histology for the diagnosis of H. pylori infection.

Methods

One hundred-nine consecutive patients with dyspeptic symptoms attending the endoscopy suite were enrolled in this study. Antrum biopsy specimens were collected at endoscopy for the rapid urease test (Pronto Dry, Medical Instrument Corp, France) and histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and like-hood ratio of a positive and negative of Pronto Dry test were compared against histology. The gold standard …

Frequency Of Irritable Bowel Syndrome In College Students., Wasim Jafri, Javed Yakoob, Nadim Jafri, Muhammad Islam, Qazi Masroor Ali

Section of Gastroenterology

Background:

This study was carried out to investigate the presence of irritable bowel syndrome (IBS) in college students and compare its distribution in the non-medical college and medical college students.

Methods:

We collected data from 508 students by inviting them to fill out a questionnaire based on Rome II criteria for the diagnosis of IBS from November 2001 to February 2004. Two major cities Karachi and Bahawalpur were selected and it was coordinated by the section of Gastroenterology, Department of Medicine, Aga Khan University Hospital and Quaid-e-Azam Medical College, Bahawalpur.

Results:

A total of 508 subjects with males 43 %(220/508) …

Requirements For Vibrio Cholerae Hapr Binding And Transcriptional Repression At The Hapr Promoter Are Distinct From Those At The Apha Promoter, Wei Lin, Gabriela Kovacikova, Karen Skorupski

Dartmouth Scholarship

Virulence gene expression in certain strains of Vibrio cholerae is regulated in response to cell density by a quorum-sensing cascade that influences the levels of the LuxR homolog HapR through small regulatory RNAs that control the stability of its message. At high cell density, HapR represses the expression of the gene encoding the virulence gene activator AphA by binding to a site between −85 and −58 in the aphA promoter. We show here that a second binding site for HapR lies within the hapR promoter from which it functions to repress its own transcription. This site, as determined by gel …

Trefoil Factor 2 (Tff2) Deficiency In Murine Digestive Tract Influences The Immune System, M. Baus- Loncar, J. Schmid, El-Nasir Lalani, I. Rosewell, R. A. Goodlad, H. G.W. Stamp, N. Blin, T. Kayademir

Department of Pathology and Laboratory Medicine

Background & Aims:

The gastrointestinal trefoil factor family (TFF1, TFF2, TFF3) peptides are considered to play an important role in maintaining the integrity of the mucosa. The physiological role of TFF2 in the protection of the GI tract was investigated in TFF2 deficiency.

Methods:

TFF2-/- mice were generated and differential expression of various genes was assessed by using a mouse expression microarray, quantitative real time PCR, Northern blots or immunohistochemistry.

Results:

On an mRNA level we found 128 differentially expressed genes. We observed modulation of a number of crucial genes involved in innate and adaptive immunity in the TFF2-/- mice. …

Identification Of A Tcpc-Tcpq Outer Membrane Complex Involved In The Biogenesis Of The Toxin-Coregulated Pilus Of Vibrio Cholerae, Niranjan Bose, Ronald K. Taylor

Dartmouth Scholarship

The toxin-coregulated pilus (TCP) of Vibrio cholerae and the soluble TcpF protein that is secreted via the TCP biogenesis apparatus are essential for intestinal colonization. The TCP biogenesis apparatus is composed of at least nine proteins but is largely uncharacterized. TcpC is an outer membrane lipoprotein required for TCP biogenesis that is a member of the secretin protein superfamily. In the present study, analysis of TcpC in a series of strains deficient in each of the TCP biogenesis proteins revealed that TcpC was absent specifically in a tcpQ mutant. TcpQ is a predicted periplasmic protein required for TCP biogenesis. Fractionation …

A Novel Triterpenoid Induces Transforming Growth Factor Β Production By Intraepithelial Lymphocytes To Prevent Ileitis, Laurie A. Minns, Dominique Buzoni-Gatel, Kenneth H. Ely, Nicolas Rachinel, Souphalone Luangsay, Lloyd H. Kasper

Dartmouth Scholarship

The loss of homeostasis is a hallmark of inflammatory bowel disease. Oral infection of susceptible mice with Toxoplasma gondii results in an acute lethal ileitis characterized by increased interferon γ, tumor necrosis factor α, and inducible nitric oxide synthase; homeostasis results from transforming growth factor β production by intraepithelial lymphocytes. The synthetic oleanane triterpenoid 2-cyano-3,12-dioxooleana-1,9-dien-28-oic acid (CDDO) is a potent anti-inflammatory molecule previously shown in vitro to suppress the de novo synthesis of inducible nitric oxide synthase and to induce the transcription and activation of genes from the transforming growth factor β signaling pathway. We evaluated the immune response in …

Helicobacter Pylori Infection And Micronutrient Deficiencies., Javed Yakoob, Wasim Jafri, Shahab Abid

Section of Gastroenterology

It is known that deficiencies of micronutrients due to infections increase morbidity and mortality. This phenomenon depicts itself conspicuously in developing countries. Deficiencies of iron, vitamins A, E, C, B12, etc are widely prevalent among populations living in the third world countries. Helicobacter pylori (H pylori) infection has a high prevalence throughout the world. Deficiencies of several micronutrients due to H pylori infection may be concomitantly present and vary from subtle sub-clinical states to severe clinical disorders. These essential trace elements/micronutrients are involved in host defense mechanisms, maintaining epithelial cell integrity, glycoprotein synthesis, transport mechanisms, myocardial contractility, brain development, cholesterol …

Candida Esophagitis: Risk Factors In Non-Hiv Population In Pakistan, Javed Yakoob, Wasim Jafri, Shahab Abid, Nadim Jafri, Muhammad Islam, Saeed Hamid, Hasnain Ali Shah, Akbar S. Hussainy

Section of Gastroenterology

AIM:

Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching hospital.

METHODS:

Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications' (ICD-9-CM), with candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were studied.

RESULTS:

Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34% of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and …

Irritable Bowel Syndrome In Health Care Professionals In Pakistan, Wasim Jafri, Javed Yakoob, Nadim Jafri, Mahesh Maloni, Saeed Hamid, Hasnain Ali Shah, Shahab Abid

Section of Gastroenterology

Objective: To evaluate the symptomatology of irritable bowel syndrome (IBS) among health care professionals attending an IBS symposium in a tertiary care university hospital. Method: A questionnaire designed to incorporate Manning and Rome II criteria was distributed among participants of an IBS symposium, most of them were health care professionals. A total of 100 questionnaires were distributed, 41 had symptoms fulfilling criteria of IBS. In these patients male: female ratio was 28:13 with age range 18-68. Results: The predominant symptom was abdominal pain 87.8 % (36/41) which was aggravated post-prandially 72.2% (29/41), relieved following defecation in 87 % (35/41) with …

Ccr5 Mediates Specific Migration Of Toxoplasma Gondii—Primed Cd8+ Lymphocytes To Inflammatory Intestinal Epithelial Cells, Souphalone Luangsay, Lloyd H. Kasper, Nicolas Rachinel, Laurie A. Minns

Dartmouth Scholarship

Toxoplasma gondii, an obligate intracellular parasite, can invade intestinal epithelial cells and elicit a robust Th1 immune response. In this model of intestinal inflammation, CD8⁺ intraepithelial lymphocytes (IELs) secrete transforming growth factor (TGF)-β, which appears necessary for the maintenance of homeostasis in the intestine. However, the mechanism responsible for the IEL migration to the inflamed intestine is still unclear.An in vitro coculture cell system was used to quantify the IEL attraction by an infected intestinal epithelial cell line (m-IC_cl2). We used CCR5-deficient mice to determine which chemokine receptor—chemokine interaction could be responsible for the recruitment of …

Association Of Iron Deficiency Anaemia In Children Of 1-2 Years Of Age With Low Birth Weight, Recurrent Diarrhoea Or Recurrent Respiratory Tract Infection - A Myth Or Fact?, Niloufer Sultan Ali, Rukhsana Wamiq Zuberi

Department for Educational Development

No abstract provided.

Mechanism Of Toxt-Dependent Transcriptional Activation At The Vibrio Cholerae Tcpa Promoter, Robin R. Hulbert, Ronald K. Taylor

Dartmouth Scholarship

The AraC homolog ToxT coordinately regulates virulence gene expression in Vibrio cholerae. ToxT is required for transcriptional activation of the genes encoding cholera toxin and the toxin coregulated pilus, among others. In this work we focused on the interaction of ToxT with the tcpA promoter and investigated the mechanism of ToxT-dependent transcriptional activation at tcpA. Deletion analysis showed that a region from −95 to +2 was sufficient for ToxT binding and activation, both of which were simultaneously lost when the deletion was extended to −63. A collection of point mutations generated by error-prone PCR revealed two small regions required …

Health And Development: Infectious Intestinal Diseases In A Transborder Region (United States-Mexico), Flavia Bianchi

Theses and Dissertations (Comprehensive)

Intestinal infectious diseases are considered the northern Mexican border’s most obvious challenge facing children. The Mexico-US Border region is a 200-kilometer border zone that extends 100 kilometers on either side of an imaginary borderline and stretches 3,141 kilometers from the Pacific Ocean to the Gulf of Mexico. In 2000, the Pan American Health Organization (PAHO), the World Health Organization’s representative for the Americas, published a study of the top causes of mortality between 1995 and 1997 to estimate the absolute burden of mortality in the primary Mexican and American border community, collectively known as the Sister Cities. Using the PAHO …

Morphological Pattern Of Salivary Gland Tumours, M. S. Gill, S. Muzaffar, I. N. Soomro, Naila Kayani, A. S. Hussainy, Shahid Pervez, S. H. Hasan

Department of Pathology and Laboratory Medicine

Objective: To delineate the spectrum of salivary gland tumors in our setup.

Setting: The Aga Khan University Medical Centre, Karachi.

Method: Tumors were analysed considering histological type, age and sex of the patients and anatomic location. The diagnosis of individual tumours was based on the 1991 World Health Organisation Classification.

Results: During the span of eight years (1991-1998), 379 cases of salivary gland tumours were diagnosed. Of these, 205 (65.7%) were male and 174 (34.3%) were female. The median age at the time of diagnosis was 35 years. The median age for patients with malignant lesions (44 years) was 12 …

Vibrio Cholerae H-Ns Silences Virulence Gene Expression At Multiple Steps In The Toxr Regulatory Cascade, Melinda B. Nye, James D. Pfau, Karen Skorupski, Ronald K. Taylor

Dartmouth Scholarship

H-NS is an abundant nucleoid-associated protein involved in the maintenance of chromosomal architecture in bacteria. H-NS also has a role in silencing the expression of a variety of environmentally regulated genes during growth under nonpermissive conditions. In this study we demonstrate a role for H-NS in the negative modulation of expression of several genes within the ToxR virulence regulon ofVibrio cholerae. Deletion of hns resulted in high, nearly constitutive levels of expression of the genes encoding cholera toxin, toxin-coregulated pilus, and the ToxT virulence gene regulatory protein. For the cholera toxin- and ToxT-encoding genes, elevated expression in an …

Gastric Carcinoma With Lymphoid Stroma: Association With Epstein Virus Genome Demonstrated By Pcr, Irshad N. Soomro, Samina Noorali, Syed Abdul Aziz, Suhail Muzaffar, Shahid Pervez, Akbar S. Hussainy, Tariq Moatter

Department of Pathology and Laboratory Medicine

No abstract provided.

Adenoma Characteristics At First Colonoscopy As Predictors Of Adenoma Recurrence And Characteristics At Follow-Up, Rosalind U. Van Stolk, Gerald J. Beck, John A. Baron, Robert Haile, Robert Summers

Dartmouth Scholarship

All patients with colorectal adenomas may not require identical follow-up. We aimed to determine if adenoma characteristics at initial colonoscopy could predict adenoma recurrence or characteristics at follow-up. The number of adenomas and the size, type, and degree of atypia in 479 patients in a polyp prevention trial were evaluated as predictors of the same characteristics at follow-up using odds ratios (ORs) with 95% confidence intervals (CIs). Multiple logistic regression analysis was performed to determine if several baseline characteristics were simultaneously associated with outcome.

A Change Of Il-2 And Il-4 Production In Patients With Helicobactor Pylori Infection, X. G. Fan, Javed Yakoob, X. J. Fan, P. W. N. Keeling

Section of Gastroenterology

Helicobactor pylori is the most common cause of gastroduodenal inflammation. However, the exact immune pathogenesis is not fully understood. To look for evidence of the immunological mechanism in H. pylori associated disease, we measured cytokine interleukin-2 (IL-2) and IL-4 levels produced by peripheral blood lymphocytes (PBL) and gastric biopsies in 20 subjects with or without H. pylori infection. H. pylori can stimulate IL-2 and IL-4 production from PBL in H. pylori negative as well as H. pylori positive individuals. The spontaneous IL-2 production by PBL and gastric biopsies was greater (p < 0.0025, <0.001)in H. pylori negative individuals than that in H. pylori infected patients. Increased IL-4 levels from PBL in H. pylori infected patients were found in the presence of H. pylori (p < 0.0025). An increased spontaneous production of IL-4 from gastric biopsies was also observed in H. pylori infected patients (p < 0.025). In conclusion, an enhanced type 2 cytokine production was observed in H. pylori infected patients, which may be responsible for H. pylori chronic infection.

Cavernous Hemangioma (Cavernoma) Of Ileum, J. Mark Cox

Medical Arts and Sciences: A Scientific Journal of the College of Medical Evangelists

Hemangioma of the small intestine is rare. A case of cavernoma of the ileum was discovered at the Riverside Sanitarium and Hospital at Nashville, Tennessee. This tumor was found during a laparotomy on a female patient who had complained of increasing severity of abdominal pain over a period of two years.

The symptom complex of griping lower abdominal pain in the midline and back, nausea, occasional blood in the stools, and midline abdominal tenderness should bring to mind the possibility of intestinal hemangioma.

The Gastric Cancer Problem, Clarence E. Nelson

Medical Arts and Sciences: A Scientific Journal of the College of Medical Evangelists

No abstract provided.

The Muscular Activity Of The Small Intestine During Acute Obstruction., Rudolph F. Antoncic

Electronic Theses and Dissertations

No abstract provided.