Wasim Jafri - Academia.edu (original) (raw)

Papers by Wasim Jafri

Euroasian Journal of Hepato-Gastroenterology, Jun 1, 2019

Amongst the primary tumors of the liver, hepatocellular carcinoma (HCC) is the most common. It is... more Amongst the primary tumors of the liver, hepatocellular carcinoma (HCC) is the most common. It is also one of the most prevalent types of cancers in Asia. Mostly, HCC occurs on a background of chronic liver disease and liver cirrhosis; however, de novo HCCs can also arise in apparently normal looking livers on imaging. There are multiple risk factors for HCC, including hepatitis B and C infections, diabetes mellitus, alcohol, and nonalcoholic steatohepatitis. Other common risk factors which are known to be involved in the pathogenesis of HCC are obesity, food contaminated with aflatoxin and hemochromatosis. Many of these factors are commonly found in this part of the world, hence the high burden of disease. Besides these, smoking and familial predisposition to HCC also seem to have an important role to play in its development. Majority of HCC are missed at an early stage despite the emphasis on adequate screening and surveillance strategies. Therefore, most of the time these tumors are diagnosed at a fairly advanced stage, when palliative treatment is the only therapeutic option left. Hence, prevention of HCC by controlling and minimizing the possible risk factors is the need of the hour.

The collagenous colitis was first described by Lindstrom in 1976, in a 48 year old lady, who pres... more The collagenous colitis was first described by Lindstrom in 1976, in a 48 year old lady, who presented with cramps, abdominal pain and watery diarrhoea for 2-1/2 year. Her rectal biopsy showed a thickened layer of sub-epithelial collagen. Now this entity is being increasingly recognized as a cause of persistent watery diarrhoea Routine colonic biopsy despite endoscopically normal mucosa and increasing awareness of this condilion would help in the detection of this disease entity. CASE REPORT 65 year old lady presented with intermittent watery diarrhoea for the last 4 years. The bowels were open 5-6 times a day and were associated with urgency and episodes of incontinence. Antacids would aggravate the symptoms. There was no complaint of passing any mucous or blood in stools. She was operated for thyrotoxicosis in 1968 and now she was on thyroxine replacement. Her physical examination was unremarkable. Serum biochemistry and haematology were normal, so was the thyroid stimulating hormone level. Stool examinations were negative for any mucous, blood, pus or parasites. Bacterial cultures were also negative. Sigmoidoscopy showed normal looking mucosa. Biopsies were taken. There were focal degenerative changes in the surface epithelium with inflammatory cell infiltration. The sub-epithelial region showed a distinct collagen band. (Figure).

HSCs. The analysis revealed that 13 pathways were upregulated and 22 pathways were downregulated ... more HSCs. The analysis revealed that 13 pathways were upregulated and 22 pathways were downregulated by microRNA. Furthermore, mitochondrial integrity based on highly upregulated Bcl-2 and downregulated caspase 3, 9 was confirmed in HSCs and fibrotic livers by immnofluorescence assay, semiquantitative RT-PCR, qRT-PCR, and Western blot. These findings provide in vitro and in vivo evidence that the mitochondrial pathway of apoptosis plays a significant role in the progression of liver fibrogenesis via HSCs activation.

Helicobacter, 2007

histopathology, culture, and real-time polymerase chain reaction (PCR), whereas the serum samples... more histopathology, culture, and real-time polymerase chain reaction (PCR), whereas the serum samples were used in enzyme-linked immunosorbent assay (ELISA). Results. Real-time PCR had the highest sensitivity (100%), followed by culture (86.9%), histopathology (83.7%), rapid urease test (82.6%), and ELISA (76.0%). Of the biopsy specimens tested independent of pathology, 93.5% were cagA positive. The vacA s1-m2 genotype was the predominant subtype, found in 63.3% of the patients with CG and 68.7% of those with DU. Most H. pylori strains in CG (66.6%) were iceA2 positive, whereas iceA1 was predominant in DU (68.7%). In terms of the association between iceA alleles with other genes in this study, both alleles were significantly associated with the cagA-positive and vacA s1-m2 genotype. Conclusion. All genotypes can be directly detected in H. pylori strains isolated from single gastric biopsy specimen by real-time PCR. The prevalent circulating genotypes in CG and DU were cagA vacA s1m2 iceA2, and cagA vacA s1m2 iceA1 genotype, respectively. It was found that cagA vacA s1m2 genotype seems to be common virulence factors in both CG and DU, whereas iceA alleles show specificity for gastroduodenal pathologies in this study.

Euroasian Journal of Hepato-Gastroenterology, 2019

World Journal of Gastroenterology, 2006

additionally 35 (17%) patients also underwent surgery. In a 425 ± 120 d follow-up period 12 patie... more additionally 35 (17%) patients also underwent surgery. In a 425 ± 120 d follow-up period 12 patients died (eight post operative) and no case of relapse was noted. CONCLUSION: Abdominal TB has diverse and nonspecific symptomatology. No single test is adequate for diagnosis of abdominal tuberculosis in all patients. Abdominal TB in non-HIV patients remains an ongoing diagnostic dilemma requiring a high index of clinical suspicion.

World Journal of Gastroenterology, 2003

It is known that deficiencies of micronutrients due to infections increase morbidity and mortalit... more 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 and glucose metabolism. In this paper H pylori infection in associaed with various micronutrients deficiencies is briefly reviewed.

Journal of evidence-based complementary & alternative medicine, Jan 16, 2015

Natural plant product Psyllium has anti-inflammatory activity that can modulate the function of c... more Natural plant product Psyllium has anti-inflammatory activity that can modulate the function of cytokines. We determined the effect of Psyllium husk extract on interleukin (IL)-8 and NF-κB secretion by gastric epithelial cells in response to Helicobacter pylori. Human gastric adenocarcinoma cell line (AGS) cells were pretreated with Psyllium extract in different concentrations before H pylori infection. Cell culture supernatant was analyzed for IL-8 and NF-κB by ELISA. RNA from cells was used for real-time polymerase chain reaction for messenger RNA expression of IL-8. Psyllium extract 5 and 10 μg/mL markedly (P < .001) lowered basal IL-8 by 64.71% and 74.51%, respectively, and H pylori-stimulated IL-8 was also (P < .001) lowered by 41.67% and 66.67%, respectively. Psyllium 5 and 10 μg/mL also reduced (P < .0001) cagA-positive H pylori-induced IL-8 mRNA expression by 42.3% and 67.6%, respectively. Psyllium also reduced (P = .0001) NF-κB in response to H pylori strains confi...

World Journal of Gastroenterology, 2007

AIM: To study the prevalence, predictors and control of bleeding following N-butyl 2 cyanoacrylat... more AIM: To study the prevalence, predictors and control of bleeding following N-butyl 2 cyanoacrylate (NBC) sclerotherapy of gastric varix (GV). METHODS: We analyzed case records of 1436 patients with portal hypertension, who underwent endoscopy during the past five years for variceal screening or upper gastrointestinal (GI) bleeding. Fifty patients with bleeding GV underwent sclerotherapy with a mean of 2 mL NBC for control of bleeding. Outcome parameters were primary hemostasis (bleeding control within the fi rst 48 h), recurrent bleeding (after 48 h of esophagogastro-duodenoscopy) and in-hospital mortality were analyzed. RESULTS: The prevalence of GV in patients with portal hypertension was 15% (220/1436) and the incidence of bleeding was 22.7% (50/220). Out of the 50 bleeding GV patients, isolated gastric varices (IGV-I) were seen in 22 (44%), gastro-oesophageal varices (GOV) on lesser curvature (GOV-) in 16 (32%), and GOV on greater curvature (GOV-) in 15 (30%). IGV-was seen in 44% (22/50) patients who had bleeding as compared to 23% (39/170) who did not have bleeding (P < 0.003). Primary hemostasis was achieved with NBC in all patients. Re-bleeding occurred in 7 (14%) patients after 48 h of initial sclerotherapy. Secondary hemostasis was achieved with repeat NBC sclerotherapy in 4/7 (57%). Three patients died after repeat sclerotherapy, one during transjugular intrahepatic portosystemic stem shunt (TIPSS), one during surgery and one due to uncontrolled bleeding. Treatment failure-related mortality rate was 6% (3/50). CONCLUSION: GV can be seen in 15% of patients with portal hypertension and the incidence of bleeding is 22.7%. NBC is highly effective in controlling GV bleeding. In hospital mortality of patients with bleeding GV is 6%.

JPMA. The Journal of the Pakistan Medical Association, 1993

Microscopic colitis is a syndrome of chronic watery diarrhoea for which no cause can be identifie... more Microscopic colitis is a syndrome of chronic watery diarrhoea for which no cause can be identified other than the presence of diffuse, chronic inflammation in the lamina propria on colonic biopsy. Endoscopically and radiologically the colon appears normal. We studied case records of 215 patients presenting to our institution over a three year period with chronic diarrhoea. Nineteen patients were included in the study where two pathologists agreed on the presence of chronic inflammation on colonic biopsies. All patients had watery diarrhoea with urgency. Stool examination, laboratory indices, radiology of the large and small bowel and colonoscopy were normal in all patients. Patients did not respond to a variety of drugs. A significant improvement was noted in one patient given salazopyrin. In developing countries chronic diarrhoea is most often attributed to infection and treated with antibiotics. Microscopic colitis should be considered in the diagnosis of such patients.

JPMA. The Journal of the Pakistan Medical Association, 1990

Amyloidosis is a disorder of protein metabolism which is characterized by deposition of eosinophi... more Amyloidosis is a disorder of protein metabolism which is characterized by deposition of eosinophilic material intercellularly which has characteristic ultra-structural morphology and biochemical features. Amyloidosis may be primary but more often it is secondary to various inflammatory, neoplastic and suppurative conditions. Inflammatory bowel disease is an unusual cause for secondary amyloidosis. The incidence of amyloidosis in Crohn's disease varies from 1-8% 1,2 ; however it is extremely rare in ulcerative colitis. We describe a case which was admitted to determine the cause for fever of unknown origin (F.U.O.) which turned out to be a case of secondary amyloidosis due to ulcerative colitis.

JPMA. The Journal of the Pakistan Medical Association, 1992

JPMA. The Journal of the Pakistan Medical Association, 2006

To determine the efficacy and tolerability of phloroglucinol, an antispasmodic agent in the treat... more To determine the efficacy and tolerability of phloroglucinol, an antispasmodic agent in the treatment of Irritable Bowel Syndrome (IBS). 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. One hundred patients were enrolled in the study. Of them 61% (61/100) were males and 39% (39/100) were females. Their mean age was 41 +/- 14 years. Sixty-eight patients completed the study and 28 dropped out. On Phloroglucinol treatment there was an overall statistically significant improvement in abdominal pain (p<0.001), frequency of stools per day (p<0.001), urgency (p<0.001), passage of ...

Saudi Journal of Gastroenterology, 2011

Background /Aim: The symptoms of irritable bowel syndrome resemble those of small intestinal bact... more Background /Aim: The symptoms of irritable bowel syndrome resemble those of small intestinal bacterial overgrowth (SIBO). The aim of this study was to determine the frequency of SIBO and lactose intolerance (LI) occurrence in patients with diarrhea-predominant irritable bowel syndrome (IBS-D) according to Rome III criteria. Patients and Methods: In this retrospective case-control study, patients over 18 years of age with altered bowel habit, bloating, and patients who had lactose Hydrogen breath test (H 2 BT) done were included. The "cases" were defined as patients who fulfill Rome III criteria for IBS-D, while "controls" were those having chronic nonspecific diarrhea (CNSD) who did not fulfill Rome III criteria for IBS-D. Demographic data, predominant bowel habit pattern, concurrent use of medications, etc., were noted. Results: Patients with IBS-D were 119 (51%) with a mean age of 35 ± 13 years, while those with CNSD were 115 (49%) with mean age 36 ± 15 years. Patients in both IBS-D and CNSD were comparable in gender, with male 87 (74%) and female 77 (64%). SIBO was documented by lactose H 2 BT in 32/234 (14%) cases. It was positive in 22/119 (19%) cases with IBS-D, while 10/115 (9%) cases had CNSD (P = 0.03). LI was positive in 43/234 (18%) cases. Of these, 25/119 (21%) cases had IBS-D and 18/115 (16%) cases had CNSD (P = 0.29). Conclusion: SIBO was seen in a significant number of our patients with IBS-D. There was no significant age or gender difference in patients with or without SIBO.

Parasitology, 2014

SUMMARYWe determined cytokines (e.g. interleukin-8, 10, 12 and TNF-α) expression by peripheral bl... more SUMMARYWe determined cytokines (e.g. interleukin-8, 10, 12 and TNF-α) expression by peripheral blood mononuclear cells (PBMCs) and in rectal mucosa in diarrhoea-predominant irritable bowel syndrome (D-IBS) withBlastocystisspp. Eighty patients with D-IBS andBlastocystisspp. infection were classified as ‘cases’ and 80 with D-IBS withoutBlastocystisspp. infection were classified as ‘control’. Cases were subdivided into D-IBS andBlastocystissp. defined type 1 (subtype-specific primer SB83) and type 3 (SB227). Stool microscopy and culture were performed. Rectal biopsies were obtained for histology and cytokines by real-time PCR for mRNA expression of cytokines. PBMCs IL-8 was similar in different groups but in type 1, IL-8mRNA was increased compared with type 3 (P = 0·001) and control (P = 0·001). In type 1, IL-10 by PBMCs had a low mean value (14·5±1·6) compared with (16·7±1·5) type 3 and (16±2·3) in controls (P<0·001 andP<0·001, respectively). InBlastocystissp. type 1, low IL-10 ...

BMC Gastroenterology, 2012

Background: Solitary rectal ulcer syndrome (SRUS) is an uncommon although benign defecation disor... more Background: Solitary rectal ulcer syndrome (SRUS) is an uncommon although benign defecation disorder. The aim of this study was to evaluate the variable endoscopic manifestations of SRUS and its association with other diseases. Methods: All the patients diagnosed with SRUS histologically from January 1990 to February 2011 at The Aga Khan University, Karachi were included in the study. The medical records were reviewed retrospectively to evaluate the clinical spectrum of the patients along with the endoscopic and histological findings. Results: A total of 116 patients were evaluated. The mean age was 37.4 ± 16.6 (range: 13-80) years, 61 (53%) of the patients were male. Bleeding per rectum was present in 82%, abdominal pain in 49%, constipation in 23% and diarrhea in 22%. Endoscopically, solitary and multiple lesions were present in 79 (68%) and 33 (28%) patients respectively; ulcerative lesions in 90 (78%), polypoidal in 29 (25%), erythematous patches in 3 (2.5%) and petechial spots in one patient. Associated underlying conditions were hemorrhoids in 7 (6%), hyperplastic polyps in 4 (3.5%), adenomatous polyps in 2(2%), history of ulcerative colitis in 3 (2.5%) while adenocarcinoma of colon was observed in two patients. One patient had previous surgery for colonic carcinoma. Conclusion: SRUS may manifest on endoscopy as multiple ulcers, polypoidal growth and erythematous patches and has shown to share clinicopathological features with rectal prolapse, proctitis cystica profunda (PCP) and inflammatory cloacogenic polyp; therefore collectively grouped as mucosal prolapse syndrome. This may be associated with underlying conditions such as polyps, ulcerative colitis, hemorrhoids and malignancy. High index of suspicion is required to diagnose potentially serious disease by repeated endoscopies with biopsies to look for potentially serious underlying conditions associated with SRUS.

BMC Gastroenterology, 2013

Background The aim was to investigate the reinfection rate of H. pylori during a follow-up period... more Background The aim was to investigate the reinfection rate of H. pylori during a follow-up period of 12 months in adults who had undergone eradication therapy. Methods One hundred-twenty patients; 116 with gastritis, 3 with duodenal ulcer and 1 gastric ulcer, were studied. Their mean age was 41 ± 13 years (range 18–77) and male: female ratio of 2:1. H. pylori were cultured and antibiotic sensitivity was determined by Epsilometer test (E-test) for clarithromycin (CLR) and amoxicillin (AMX). Primers of urease C gene of H. pylori and Sau-3 and Hha I restriction enzymes were used for polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP). 14C urea breath test (14C-UBT) was performed 4 weeks after the eradication therapy. The successfully treated patients were observed for 12 months with 14C-UBT to assess H. pylori status. If 14C-UBT was negative, it was repeated after every 12 weeks. If 14C-UBT was positive, endoscopy was repeated with biopsies. Result Th...

Helicobacter, 2005

no.: 01.03 Disulphide Reductases of Campylobacterales: Are They Involved in Drug Resistance and R... more no.: 01.03 Disulphide Reductases of Campylobacterales: Are They Involved in Drug Resistance and Response to Environmental Stresses? N. O. Kaakoush and G. L. Mendz University of New South Wales, Sydney, Australia Disulphide reductases of pathogenic bacteria are involved in the resistance to drugs and the elimination of compounds toxic to the pathogen, functions that are crucial to the success of infections. CXXCor CXXC-derived motifs characterize disulphide reductases and are involved in the catalysis of redox reactions. Genome searches of CXXCand CXXC-derived motifs were performed to identify putative disulphide reductases in the epsilonproteobacteria Campylobacterales Campylobacter jejuni, Helicobacter pylori, and Wolinella succinogenes. Genes encoding thioredoxin, ferredoxin, and methionine sulphoxide reduction were identified in the genomes of the three species, with the exception of genes encoding methionine sulphoxide reduction in W. succinogenes. Phylogenetic trees of the thre...