Shad Ahmed - Academia.edu (original) (raw)

Papers by Shad Ahmed

Research paper thumbnail of Prevalence and antibiotic susceptibility pattern of methicillin resistant Staphylococcus aureus at Armed Forces Hospital in Saudi Arabia

Bangladesh Medical Research Council Bulletin, 2009

The present study was carried out to investigate the prevalence of MRSA and MRCoNS and their rate... more The present study was carried out to investigate the prevalence of MRSA and MRCoNS and their rate of resistance to different antistaphylococcal antibiotics used broadly for treatment. Of the 235 isolates, 164 isolates (69.8%) were identified as Staphylococcus aureus and the remaining seventy one (30.2%) were coagulase negative staphylococcus (CoNS), the frequency of MRSA by oxacillin screen agar method, eighty nine (54.2%) strains were MRSA and twenty eight (39.4%) were MRCoNS. The rate of multidrug resistance observed was 69% for MRSA and 72.5% for MRCoNS strains. Antibiotic resistance pattern of these isolates was high against penicillin 100 and 93%, erythromycin 83 and 75%, co-trimoxazole 82 and 79% for MRSA and MRCoNS strains respectively. In order to test beta-lactamase production, 83 and 86% of MRSA and MRCoNS isolates were beta-lactamase positive, respectively. However all strains of Staphylococcus were sensitive to vancomycin. Findings presented in this study indicated a high level of resistance to widely used therapeutic agents. An appropriate knowledge on the current antibiotic susceptibility pattern of MRSA and MRCoNS is essential for appropriate therapeutic scenario.

Research paper thumbnail of Acute myocardial infarction: a rare complication of protein C deficiency

The American Journal of Medicine

Research paper thumbnail of Methemoglobinemia complicating topical lidocaine used during endoscopic procedures

The American Journal of Medicine

Research paper thumbnail of Thrombotic thrombocytopenic purpura: a rare cause of thrombocytopenia in HIV-infected hemophiliacs

Annals of Hematology

Thrombocytopenia is a common complication in human immunodeficiency virus (HIV)-infected hemophil... more Thrombocytopenia is a common complication in human immunodeficiency virus (HIV)-infected hemophiliacs. The etiology is multifactorial and a majority of the patients with hemophilia exhibit a decreased platelet count within 10 years of seroconversion. Thrombocytopenia in these patients is associated with a high risk of bleeding and death. Thrombotic microangiopathy causing thrombocytopenia in HIV-infected hemophiliacs is extremely rare. We describe an HIV-infected hemophilic patient who presented with bleeding, renal insufficiency, and thrombocytopenia. Platelet transfusion resulted in deterioration of clinical condition. Examination of blood smears demonstrated a microangiopathic process. The patient responded well to plasmapheresis with normalization of platelet and renal function. Thrombotic thrombocytopenic purpura should be suspected in HIV-infected hemophiliacs who present with a new onset of thrombocytopenia and anemia as delay in treatment may result in fatal sequelae.

Research paper thumbnail of Pulmonary manifestations of sickle cell disease

Postgraduate Medical Journal

Pulmonary complications account for significant morbidity and mortality in patients with sickle c... more Pulmonary complications account for significant morbidity and mortality in patients with sickle cell disease. Clinical lung involvement manifests in two major forms: the acute chest syndrome and sickle cell chronic lung disease. Acute chest syndrome is characterised by fever, chest pain, and appearance of a new infiltrate on chest radiograph. Sickle cell chronic lung disease, on the other hand, manifests as radiographic interstitial abnormalities, impaired pulmonary function, and, in its most severe form, by the evidence of pulmonary hypertension. Progress has been made in understanding the pathophysiology and management of these complications. In this review the current knowledge of the mechanism, diagnosis, and treatment of pulmonary complications of sickle cell disease are discussed.

Research paper thumbnail of Interstitial pneumonitis in a patient treated with alpha-interferon and ribavirin for hepatitis C infection

The American Journal of the Medical Sciences

Hepatitis C is a common infection with worldwide prevalence. It has a variable course and can lea... more Hepatitis C is a common infection with worldwide prevalence. It has a variable course and can lead to chronic hepatitis, cirrhosis and hepatocellular carcinoma. Until recently alpha-interferon (IFN-alpha) was the only effective treatment available. Combination therapy with IFN-alpha and ribavirin has been found to be more efficacious than IFN-alpha alone. Various side effects have been ascribed to interferon, such as arthralgias, myalgias, fatigue, and gastrointestinal and neuropsychiatric symptoms. Interstitial pneumonitis is a rare but known complication of IFN-alpha when given at a high dosage of 6 to 10 million units per day. Ribavirin is associated with dose-dependent hemolytic anemia, cough, dyspnea, rash, depression, and dyspepsia, although a potential role in interferon-induced interstitial pneumonitis has not been described. We describe a patient with an excellent clinical response of chronic hepatitis C to combination therapy with IFN-alpha at a dosage of 3 million units per day and ribavirin. The patient developed interstitial pneumonitis that resolved after discontinuation of IFN-alpha and ribavirin. Given that interstitial pneumonitis has previously been reported with high-dose IFN-alpha, this case suggests that this complication may occur with lower dosages of IFN-alpha, although a potential role for ribavirin in this disorder at present remains speculative.

Research paper thumbnail of Prevalence and antibiotic susceptibility pattern of methicillin resistant Staphylococcus aureus at Armed Forces Hospital in Saudi Arabia

Bangladesh Medical Research Council Bulletin, 2009

The present study was carried out to investigate the prevalence of MRSA and MRCoNS and their rate... more The present study was carried out to investigate the prevalence of MRSA and MRCoNS and their rate of resistance to different antistaphylococcal antibiotics used broadly for treatment. Of the 235 isolates, 164 isolates (69.8%) were identified as Staphylococcus aureus and the remaining seventy one (30.2%) were coagulase negative staphylococcus (CoNS), the frequency of MRSA by oxacillin screen agar method, eighty nine (54.2%) strains were MRSA and twenty eight (39.4%) were MRCoNS. The rate of multidrug resistance observed was 69% for MRSA and 72.5% for MRCoNS strains. Antibiotic resistance pattern of these isolates was high against penicillin 100 and 93%, erythromycin 83 and 75%, co-trimoxazole 82 and 79% for MRSA and MRCoNS strains respectively. In order to test beta-lactamase production, 83 and 86% of MRSA and MRCoNS isolates were beta-lactamase positive, respectively. However all strains of Staphylococcus were sensitive to vancomycin. Findings presented in this study indicated a high level of resistance to widely used therapeutic agents. An appropriate knowledge on the current antibiotic susceptibility pattern of MRSA and MRCoNS is essential for appropriate therapeutic scenario.

Research paper thumbnail of Acute myocardial infarction: a rare complication of protein C deficiency

The American Journal of Medicine

Research paper thumbnail of Methemoglobinemia complicating topical lidocaine used during endoscopic procedures

The American Journal of Medicine

Research paper thumbnail of Thrombotic thrombocytopenic purpura: a rare cause of thrombocytopenia in HIV-infected hemophiliacs

Annals of Hematology

Thrombocytopenia is a common complication in human immunodeficiency virus (HIV)-infected hemophil... more Thrombocytopenia is a common complication in human immunodeficiency virus (HIV)-infected hemophiliacs. The etiology is multifactorial and a majority of the patients with hemophilia exhibit a decreased platelet count within 10 years of seroconversion. Thrombocytopenia in these patients is associated with a high risk of bleeding and death. Thrombotic microangiopathy causing thrombocytopenia in HIV-infected hemophiliacs is extremely rare. We describe an HIV-infected hemophilic patient who presented with bleeding, renal insufficiency, and thrombocytopenia. Platelet transfusion resulted in deterioration of clinical condition. Examination of blood smears demonstrated a microangiopathic process. The patient responded well to plasmapheresis with normalization of platelet and renal function. Thrombotic thrombocytopenic purpura should be suspected in HIV-infected hemophiliacs who present with a new onset of thrombocytopenia and anemia as delay in treatment may result in fatal sequelae.

Research paper thumbnail of Pulmonary manifestations of sickle cell disease

Postgraduate Medical Journal

Pulmonary complications account for significant morbidity and mortality in patients with sickle c... more Pulmonary complications account for significant morbidity and mortality in patients with sickle cell disease. Clinical lung involvement manifests in two major forms: the acute chest syndrome and sickle cell chronic lung disease. Acute chest syndrome is characterised by fever, chest pain, and appearance of a new infiltrate on chest radiograph. Sickle cell chronic lung disease, on the other hand, manifests as radiographic interstitial abnormalities, impaired pulmonary function, and, in its most severe form, by the evidence of pulmonary hypertension. Progress has been made in understanding the pathophysiology and management of these complications. In this review the current knowledge of the mechanism, diagnosis, and treatment of pulmonary complications of sickle cell disease are discussed.

Research paper thumbnail of Interstitial pneumonitis in a patient treated with alpha-interferon and ribavirin for hepatitis C infection

The American Journal of the Medical Sciences

Hepatitis C is a common infection with worldwide prevalence. It has a variable course and can lea... more Hepatitis C is a common infection with worldwide prevalence. It has a variable course and can lead to chronic hepatitis, cirrhosis and hepatocellular carcinoma. Until recently alpha-interferon (IFN-alpha) was the only effective treatment available. Combination therapy with IFN-alpha and ribavirin has been found to be more efficacious than IFN-alpha alone. Various side effects have been ascribed to interferon, such as arthralgias, myalgias, fatigue, and gastrointestinal and neuropsychiatric symptoms. Interstitial pneumonitis is a rare but known complication of IFN-alpha when given at a high dosage of 6 to 10 million units per day. Ribavirin is associated with dose-dependent hemolytic anemia, cough, dyspnea, rash, depression, and dyspepsia, although a potential role in interferon-induced interstitial pneumonitis has not been described. We describe a patient with an excellent clinical response of chronic hepatitis C to combination therapy with IFN-alpha at a dosage of 3 million units per day and ribavirin. The patient developed interstitial pneumonitis that resolved after discontinuation of IFN-alpha and ribavirin. Given that interstitial pneumonitis has previously been reported with high-dose IFN-alpha, this case suggests that this complication may occur with lower dosages of IFN-alpha, although a potential role for ribavirin in this disorder at present remains speculative.