Itrat Mehdi - Academia.edu (original) (raw)

Papers by Itrat Mehdi

PubMed, May 1, 2000

Aims: To compare the efficacy of 2 weeks of dual therapy of Lansoprazole and Amoxycilline with tr... more Aims: To compare the efficacy of 2 weeks of dual therapy of Lansoprazole and Amoxycilline with triple therapy of Lansoprazole, Amoxycilline and Roxythromycin for H. pylori eradication. Subjects: Twenty-five suffering from dyspepsia and found H. pylori positive (CLO) during upper GI endoscopy. Methods: Patients were divided into 2 groups, one group received Lansoprazole (30 mg) once a day, and amoxycilline (500 mg) three times a day (group I), while the second group received Lansoparazole and amoxycillin in similar dosage with the addition of Roxythromycin (150 mg) twice a day (group II). H. pylori status was confirmed on endoscopy using CLO test at entry to the protocol and then at 4 weeks. Results: H. pylori eradication was 57% in group I and 86% in group II with healing of lesions in all cases. Conclusion: Better response with triple therapy (group II) indicates enhanced eradication of the pathogens with triple therapy while using roxythromycin (JPMA 50:157, 2000).

PubMed, Dec 1, 2011

A 32 year Libyan male presented with the complaints of headache and diplopia. He was diagnosed wi... more A 32 year Libyan male presented with the complaints of headache and diplopia. He was diagnosed with a cavernous sinus meningioma on the basis of MRI findings but no initial biopsy was taken. Depending on the radiologic diagnosis the patient was treated with gamma knife surgery twice, abroad. During follow up he developed left ear deafness and left cervical lymph adenopathy. An ENT evaluation with biopsy from the nasopharynx and cervical lymph node was taken. The histopathologic diagnosis of the resected tumour showed a nasopharyngeal carcinoma with cervical lymph node metastasis (poorly differentiated lympho-epithelial carcinoma). The cavernous sinus tumour which was initially treated as a meningioma was in fact metastasis from the nasopharyngeal carcinoma, making this an interesting and rare occurrence.

PubMed, 2012

Renal Cell Carcinoma (RCC) is a malignant tumor occurring in 5th-6th decade of life with an incre... more Renal Cell Carcinoma (RCC) is a malignant tumor occurring in 5th-6th decade of life with an increasing incidence reported in the US but stable in Europe. The metastasis of RCC to head and neck region is infrequent and very rarely seen in larynx. Very few cases of RCC metastasizing to larynx are reported in literature. We report a case of RCC in a middle aged male with metastasis to larynx, 7 years after initial diagnosis and nephrectomy. These unusual tumor metastases have unique pathobiology and route of metastasis, and there can be a long interval from initial diagnosis of primary tumor. The diagnosis of metastatic RCC in unusual locations is often not easy. Treatment options include metastasectomy, radiotherapy and systemic chemotherapy but with a poor outcome. A differential diagnosis should always be considered in metastatic head and neck tumors. The need for prompt accurate diagnosis, risk stratification at initial primary diagnosis, surveillance, and long term regular follow up is emphasized.

Journal of Ayub Medical College Abbottabad, Oct 1, 2003

Background: The diagnosis of Helicobacter pylori infection was initially being made through invas... more Background: The diagnosis of Helicobacter pylori infection was initially being made through invasive methods but now non invasive methods have been developed to make the diagnosis easier. The present study was done to evaluate the diagnostic efficacy of a two non invasive tests i.e. Helicobacter pylori Stool antigen test (HpSA) and Helicobacter pylori IgG serology with an invasive method i.e. Campylobacter like organism (CLO) gel test. Methods. The study was conducted in the gastroenterology unit of Pakistan Medical Research Council Research Centre Karachi. Adult patients with gastroduodenal disease were selected for study and their medical history was recorded. Endoscopy was done on all patients and the antral biopsy sample was tested for H.pylori using CLO test. Serology (IgG) was done elsewhere using ELISA and titers of over 50 units were recorded as positive. HpSA was done to determine the presence of H.pylori antigen in stool. Results. Out of 43 patients 34 (79%) were males and 9 (21%) females. The main presenting symptom was epigastric pain in 74 % cases. Although H.pylori IgG antibody titers of over 50 were taken as positive but for this study titres of over 100 were taken as significant for comparison with other tests. CLO test was positive in 26 (60.5%) cases, H. Pylori antibody titers of over 100 IU were present in 33 (76.7%) cases and HpSA in 21 (48.8 %). Using CLO test as the gold standard the sensitivity of serology was 81 % and that of HpSA 65% with a 29% and 76 % specificity respectively. Conclusion. In our setting CLO test is still the best diagnostic test for H. Pylori detection. Both non invasive tests i.e. serology and stool HpSA are less sensitive than CLO but amongst each other both are equally sensitive.

PubMed, 1998

Malignant gastrointestinal tumours are amongst the commonest tumours exhibiting an annual increas... more Malignant gastrointestinal tumours are amongst the commonest tumours exhibiting an annual increase globally. There is a change in the morphological site of involvement observed over the years. In this study biopsy proven malignant gastrointestinal tumours seen at Jinnah Postgraduate Medical Centre, Karachi from 1961-1992 were analyzed with reference to age, sex, topography and histology. The study showed an increase in malignant gastrointestinal tumours over the years, from 9% in 1961 to 17% in 1992 with respect to all malignant tumours reported. The tumours affected a much younger age in our population, 74% occurring between 35-64 years of age. Carcinoma oesophagus accounted for 10% of all malignancies (48.7% male and 62.4% female gastrointestinal tumours), while gastric carcinoma remained unchanged (14% male and 9% female GI tumours). The colorectal carcinoma (25.4% of male and 20.1% of female GI tumours) and carcinoma pancreas (1.2% male and 1.5% female GI tumours) were less frequently seen. It was observed that malignant gastrointestinal tumours have increased significantly over the years in our local population as part of international trend and are occurring at a much younger age as compared to western population. Carcinoma oesophagus was seen more frequently than gastric carcinoma and colorectal carcinoma. A substantially higher number tend to be more anaplastic being seen at an advanced stage of disease at the time of diagnosis.

South Asian Journal of Cancer, Jul 1, 2012

PubMed, Nov 1, 2010

Objective: To evaluate occurrence of synchronous and metachronous malignant tumours, to find tumo... more Objective: To evaluate occurrence of synchronous and metachronous malignant tumours, to find tumour types, age group, and relationship to treatment received. Methods: Previously diagnosed 1st primary tumour cases experiencing a synchronous or metachronous tumour, seen at AOI from February 2003 to August 2009 (78 months) were included. The cases were analyzed for morphology/histology of 1st primary tumour, age and gender of patient, treatment received for first tumour, time interval between the 1st and 2nd primary tumour, morphology/histology of second tumour, and the treatment conferred for 2nd tumour. Results: The 2nd synchronous and metachronous tumours were 46/4025 (1.14%), in 18 males and 28 females (M:F 1:1.6). The age range was 16-75 years (median 43 years). The follow up time was 24-150 months. The time to 2nd primary tumour was 2-132 months. The 1st primary tumours were breast, ovary, GIT and urinary bladder. The patients received surgery, radiotherapy, chemotherapy, and hormonal therapy alone or as multi-modality treatment for the 1st tumours. The frequent 2nd tumours were breast, ovary and Gastro Intestinal tumours. Conclusion: It is imperative that patients with a primary malignant tumour should be thoroughly, closely, and regularly followed. Genetic counseling, risk estimation, cancer screening and chemoprevention must be emphasized. Every subsequent occurring tumour should be biopsied. The effect of 1st tumour on the 2nd or vice versa are still not fully understood and need exploration. The 2nd primary tumour is usually more aggressive, treatment resistant, and metastasizes early requiring a more aggressive treatment strategy.

Journal of Cancer Epidemiology and Prevention, 2021

Postgraduate Medical Journal, Aug 1, 2004

PubMed, Nov 1, 2011

Cutaneous T cell lymphoma (CTCL) is an uncommon diverse group of lympho-proliferative disorders i... more Cutaneous T cell lymphoma (CTCL) is an uncommon diverse group of lympho-proliferative disorders involving the skin. They vary considerably in clinical presentation, microscopic features and immunophenotyping. The diagnosis is challenging, zealous, and often not easy. CD30+ve anaplastic large cell lymphoma is extremely rare. Its clinical spectrum varies from a solitary unifocal skin lesion of excellent prognosis to a multi focal systemic disease having a poor out come. The diagnosis is quite cumbersome, and often difficult. The differential diagnosis include from benign skin lesions to secondary cutaneous involvement by lymphoma. A correct diagnosis is integral with a complete metastatic/staging work up to avoid over treatment. The treatment options depend on extent of disease involvement and include surgical excision, surveillance, local radiotherapy, and systemic chemotherapy. The prognosis is good with unifocal local disease. We present here a very rare case of CD30+ ALCL of scrotal skin, in a middle aged male patient.