Hepatitis: Khan SA

Gomaa AI, Khan SA, Leen EL, Waked I, Taylor-Robinson SD. · Department of Hepatology and Gastroenterology, Division of Medicine, Imperial College London, St Mary's Hospital Campus, South Wharf Road, London W2 1NY, United Kingdom. · World J Gastroenterol. · Pubmed #19294759 links to  free full text

Abstract: Hepatocellular carcinoma (HCC) is one of the commonest cancers worldwide, particularly in parts of the developing world, and is increasing in incidence. This article reviews the current modalities employed for the diagnosis of HCC, including serum markers, radiological techniques and histological evaluation, and summarises international guidelines for the diagnostic approach to HCC.

Gomaa AI, Khan SA, Toledano MB, Waked I, Taylor-Robinson SD. · Department of Hepatology and Gastroenterology, Imperial College London, St Mary's Hospital Campus, Praed Street, London W2 1NY, United Kingdom. · World J Gastroenterol. · Pubmed #18666317 links to  free full text

Abstract: Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Given that the burden of chronic liver disease is expected to rise owing to increasing rates of alcoholism, hepatitis B and C prevalence and obesity-related fatty liver disease, it is expected that the incidence of HCC will also increase in the foreseeable future. This article summarizes the international epidemiology, the risk factors and the pathogenesis of HCC, including the roles of viral hepatitis, toxins, such as alcohol and aflatoxin, and insulin resistance.

Mandeville KL, Krabshuis J, Ladep NG, Mulder CJ, Quigley EM, Khan SA. · Department of Primary Care and Population Sciences, Centre for Infectious Diseases Epidemiology, University College London, Royal Free Hospital, London, United Kingdom. · World J Gastroenterol. · Pubmed #19533805 links to  free full text

Abstract: Developing countries shoulder a considerable burden of gastroenterological disease. Infectious diseases in particular cause enormous morbidity and mortality. Diseases which afflict both western and developing countries are often seen in more florid forms in poorer countries. Innovative techniques continuously improve and update gastroenterological practice. However, advances in diagnosis and treatment which are commonplace in the West, have yet to reach many developing countries. Clinical guidelines, based on these advances and collated in resource-rich environments, lose their relevance outside these settings. In this two-part review, we first highlight the global burden of gastroenterological disease in three major areas: diarrhoeal diseases, hepatitis B, and Helicobacter pylori. Recent progress in their management is explored, with consideration of future solutions. The second part of the review focuses on the delivery of clinical services in developing countries. Inadequate numbers of healthcare workers hamper efforts to combat gastroenterological disease. Reasons for this shortage are examined, along with possibilities for increased specialist training. Endoscopy services, the mainstay of gastroenterology in the West, are in their infancy in many developing countries. The challenges faced by those setting up a service are illustrated by the example of a Nigerian endoscopy unit. Finally, we highlight the limited scope of many clinical guidelines produced in western countries. Guidelines which take account of resource limitations in the form of "cascades" are advocated in order to make these guidelines truly global. Recognition of the different working conditions facing practitioners worldwide is an important step towards narrowing the gap between gastroenterology in rich and poor countries.

Nadeem A, Aslam M, Khan DA, Hussain T, Khan SA. · Department of Physiology, Army Medical College, Rawalpindi. · J Coll Physicians Surg Pak. · Pubmed #19208310 No free full text.

Abstract: OBJECTIVE: To determine the frequency of thyroid dysfunction in patients of chronic hepatitis C during treatment with interferon alpha-2b and ribavirin therapy. STUDY DESIGN: A cohort study. PLACE AND DURATION OF STUDY: Army Medical College and Military Hospital, Rawalpindi, from February 2006 to January 2007. METHODOLOGY: One hundred and sixty seven non-cirrhotic chronic hepatitis C patients were grouped into treatment group (n=107) and control group (n=60) awaiting treatment. Baseline serum(s.) Alanine Transferase (ALT) and S. Aspartate Transferase (AST) were measured by IFCC method. Serum Thyroid Stimulating Hormone (S. TSH), serum free thyroxine (S. Free T4) and serum total triiodothyronine (S.T3) level were determined by chemiluminescence. Study group patients underwent 24 weeks IFN and ribavirin therapy and were followed-up for thyroid dysfunction at weeks 0, 12 and 24. Control group patients underwent the same tests at weeks 0, 12 and 24. Statistical analysis was done on SPSS 15. RESULTS: Out of 107 patients of treatment group, 20 patients (18.69%) developed thyroid dysfunction. Females were at higher risk with Relative Risk (RR) of 11.25 and Attributable Risk (AR) of 91%. Hypothyroidism was more common than hyperthyroidism. CONCLUSION: Interferon-alpha and ribavirin therapy induces thyroid dysfunction in chronic hepatitis C patients. Hypothyroidism was more common. Females are at a higher risk of developing thyroid dysfunction.

Khan SA, Toledano MB, Taylor-Robinson SD. · Department of Hepatology and Gastroenterology, Imperial College London London UK. · HPB (Oxford). · Pubmed #18773060 links to  free full text

Abstract: Cholangiocarcinoma (CCA) is a fatal cancer of the biliary epithelium, arising either within the liver (intrahepatic, ICC) or in the extrahepatic bile ducts (extrahepatic ECC). Globally, CCA is the second most common primary hepatic malignancy. Several recent epidemiological studies have shown that the incidence and mortality rates of ICC are increasing. This review of the literature on the international epidemiological rates of CCA, both intra- and extrahepatic, explores possible explanations for the trends found. The possible role of epidemiological artifact in the findings is discussed and the known risk factors for CCA are summarized. These include primary sclerosing cholangitis, liver fluke infestation, congenital fibropolycystic liver, bile duct adenomas, and biliary papillomatosis, hepatolithiasis, chemical carcinogens such as nitrosamines, Thorotrast, chronic viral hepatitis, cirrhosis, chronic non-alcoholic liver disease and obesity. Potential pathways involved in the molecular pathogenesis of CCA are also summarized.

Rana A, Siddiqui N, Khan SA, Ehtaishamul Haque S, Bhat MA. · Hamdard University, Faculty of Pharmacy, Department of Pharmaceutical Chemistry, New Delhi 110 062, India. · Eur J Med Chem. · Pubmed #17826870 No free full text.

Abstract: A series of 1,3-benzothiazol-2-yl benzamides (11-30) were prepared in satisfactory yield and evaluated for their anticonvulsant, neurotoxicity, CNS depressant study and other toxicity studies. All the synthesized compounds were in good agreement with elemental and spectral data. Majority of the compounds were active in MES and scPTZ screen and showed the decrease in the immobility time. None of the compounds had shown neurotoxicity or liver toxicity.

Ahmad M, Afzal S, Roshan E, Mubarik A, Bano S, Khan SA, Hashmi SN. · Department of Pathology, Army Medical College, Rawalpindi. · J Pak Med Assoc. · Pubmed #15816692 No free full text.

Abstract: OBJECTIVE: To see the usefulness of liver biopsy in the diagnosis and to document the spectrum of paediatric liver diseases. METHODS: A retrospective, cross sectional survey at Histopathology Department of Army Medical College Rawalpindi from January 2000 to December 2003. The liver biopsies were taken with Menghini needle. The fixed tissues were processed under standard conditions. RESULTS: During four years period, a total of 100 cases with age range of 1.5 months to 16 years were studied. The most common histological findings in order of frequency were secondary haemochromatosis (30%), biliary atresia (20%), storage disorders (16%), cirrhosis of liver (10%) and neonatal hepatitis (10%). The less common entities were chronic hepatitis (6%), nonspecific reactive hepatitis (3%) and granulomatous hepatitis (1%). One case each of hepatoblastoma, haemophagocytic lymphohistiocytosis and congenital fibrosis was also noted. These findings have been compared with local and international histological studies. CONCLUSION: Liver biopsy is a useful diagnostic technique in the diagnosis of paediatric liver diseases. Biliary atresia, strorage disorders and neonatal hepatitis are the most common entities in our set up.

Stratford R, McKelvie ND, Hughes NJ, Aldred E, Wiseman C, Curtis J, Bellaby T, Bentley M, Hindle Z, Brennan FR, Chatfield SN, Dougan G, Khan SA. · Microscience Ltd., 540-545 Eskdale Rd., Winnersh Triangle, Wokingham, Berkshire RG41 5TU, United Kingdom. · Infect Immun. · Pubmed #15618173 links to  free full text

Abstract: Novel candidate live oral vaccines based on a Salmonella enterica serovar Typhi ZH9 (Ty2 DeltaaroC DeltassaV) derivative that directed the expression of either the B subunit of Escherichia coli heat-labile toxin or hepatitis B virus core antigen from the bacterial chromosome using the in vivo inducible ssaG promoter were constructed. The levels of attenuation of the two S. enterica serovar Typhi ZH9 derivatives were similar to that of the parent as assessed by measuring the replication of bacteria within human macrophage-like U937 cells. The expression of heterologous antigen in the respective S. enterica serovar Typhi ZH9 derivatives was up-regulated significantly within U937 cells compared to similar S. enterica serovar Typhi ZH9 derivative bacteria grown in modified Luria-Bertani broth supplemented with aromatic amino acids. Immunization of mice with these S. enterica serovar Typhi ZH9 derivatives stimulated potent antigen-specific serum immunoglobulin G responses to the heterologous antigens.

Ahmed B, Khan SA, Alam T. · Antihepatotoxic Research Laboratory, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi, India. · Pharmazie. · Pubmed #12685811 No free full text.

Abstract: Silymarin isolated from Silybum marianum is a mixture of three isomers, silybin (1), silydianin (2) and silychristin (3). Silybin is the most active antihepatotoxic agent, and contains a 1,4-dioxane ring in addition to a flavonoid moiety. Based on the skeleton of silybin, we prepared some flavones and coumarins containing the 1,4-dioxane ring system and evaluated them for antihepatotoxic activity against carbon tetrachloride induced hepatotoxicity in albino rats. The degree of protection was determined by measuring biochemical parameters such as serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvate transaminase (SGPT), alkaline phosphatase (ALKP), total protein (TP) and total albumin (TA). The compounds namely 3',4'(1",4"-dioxino) flavone (4f), and 3',4'(2-hydroxy methyl, 1",4"-dioxino) flavone (4g) were found to exhibit a significant activity comparable to standard drug silymarin (silybon-70). Other compounds also exhibited good activity. The structure activity relationship (SAR) was also studied, and where the flavonoid analogues containing a hydroxy methyl group at position-2" in the dioxane ring exhibited superior antihepatotoxic activity in comparison to coumarin derivatives.

Singhal A, Ghosh P, Khan SA. · Department of Elderly Care, Lister Hospital, Corey's Mill Lane, Stevenage, Hertfordshire SG1 4AB, UK. · Age Ageing. · Pubmed #12615569 links to  free full text

Abstract: Amiodarone is a commonly used anti-arrhythmic in elderly patients. Abnormal liver function is frequently reported with its use but clinically symptomatic disease is rare. Hepatomegaly, cholestasis, acute hepatitis and rarely fulminant liver failure have been recorded [1, 2], however amiodarone toxicity presenting with cirrhosis is exceedingly rare. Toxic effects of amiodarone are well described with higher dosage but severe hepatic toxicity and cirrhosis with low dose amiodarone has not been reported in the English language literature. We present a report on a patient with pseudo-alcoholic cirrhosis with low dose amiodarone.

Khan LA, Khan SA. · No affiliation provided · Saudi Med J. · Pubmed #11479651 No free full text.

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