M Zafar

Publications of M Zafar

• Idiopathic chronic active hepatitis: a diagnostic and therapeutic dilemma.

  Authors: M Al-Fadda, M Zafar, A Ayub, K al-Kahtani

  Journal of clinical gastroenterology. 12/1994; 19(4):313-7.

  A 56-year-old Saudi male was admitted with abnormal liver chemistry values and a > 5-month history of lethargy, malaise, anorexia, and jaundice. Extensive investigations did not establish anA 56-year-old Saudi male was admitted with abnormal liver chemistry values and a > 5-month history of lethargy, malaise, anorexia, and jaundice. Extensive investigations did not establish an etiological diagnosis. Liver histology confirmed the clinically apparent aggressive hepatitis with fibrosis but gave no clue to its etiology. The patient was empirically treated with alpha-interferon for presumed non-A, non-B hepatitis, with clinical and biochemical worsening. Interferon was discontinued and the patient was started on immunosuppression. Dramatic clinical and biochemical improvement occurred, with normalization of the liver chemistry within 4 weeks. The patient has been followed-up for 12 months and has not suffered a relapse. This case highlights the etiological heterogeneity of chronic active hepatitis. The entity of autoimmune chronic active hepatitis is unclear, and perhaps it is better defined as steroid-responsive hepatitis. Steroid-responsive hepatitis should always be considered in cases of cryptogenic chronic active hepatitis.

• Intraabdominal abscess after esophageal variceal sclerotherapy.

  Authors: A Ayub, T Linjawi, S M Qadri, S Ingemannson, M Zafar, A Al-Harbi

  Journal of clinical gastroenterology. 05/1994; 18(3):238-9.

• Histologically advanced chronic hepatitis C treated with recombinant alpha-interferon: a randomized placebo-controlled double-blind cross-over study.

  Authors: J O Sieck, M E Ellis, O Alfurayh, M A Ali, H A Ali, A Ayub, M Al-Fadda, M Zafar, M Halim, S S Bernvil

  Journal of hepatology. 11/1993; 19(3):418-23.

  Chronic hepatitis C is common in Saudi Arabia and most often presents in an advanced stage. To assess the response of patients to interferon, a randomized placebo-controlled double-blind study wasChronic hepatitis C is common in Saudi Arabia and most often presents in an advanced stage. To assess the response of patients to interferon, a randomized placebo-controlled double-blind study was undertaken. All but 1 patient had cirrhosis or fibrosis before interferon. After a 24-week observation period patients received alpha 2a interferon, 3 mega units sc tiw or placebo for 24 weeks, then the opposite treatment for another 24 weeks followed by 24 weeks of observation. Liver biopsies were performed before and after each of the treatment phases. Twenty-two out of 24 patients completed the study. The mean alanine aminotransferase (ALT) levels fell from 150.7 +/- 118.7 units/l to 91.0 +/- 42.6 units/l after 6 months interferon treatment (P = 0.03) but only 3 patients (14%) had complete normalization of mean ALT levels and 4 (18%) had > 50% reduction. The mean hepatitis activity index fell from 12.2 +/- 2.6 immediately before to 11.6 +/- 2.5 just after interferon (P = 0.4). After interferon there was an insignificant raise in 6-month mean ALT. Hepatitis C virus-RNA was positive in all 17 patients tested and remained so after treatment. Side-effects were mild and well tolerated. Alpha interferon 3 mega units tiw for 24 weeks is not an effective treatment of histologically advanced chronic hepatitis C.

• Primary hepatic vipoma.

  Authors: A Ayub, M Zafar, A Abdulkareem, M A Ali, T Lingawi, A Harbi

  The American journal of gastroenterology. 07/1993; 88(6):958-61.

  A 35-yr-old male presented with a 3-yr history of voluminous watery diarrhea. He had episodes of severe generalized weakness which responded to fluid and electrolyte replacement therapy.A 35-yr-old male presented with a 3-yr history of voluminous watery diarrhea. He had episodes of severe generalized weakness which responded to fluid and electrolyte replacement therapy. Investigations revealed a solitary liver mass and an elevated vasoactive intestinal polypeptide level. An extensive work-up did not show any other extrahepatic primary lesion. Surgical resection ameliorated all of his symptoms, accompanied by a decrease in the vasoactive intestinal polypeptide level. We believe that this patient represents a case of primary hepatic vipoma syndrome. To our present knowledge, this has not been reported previously. We discuss the clinical manifestations, investigations, and management of the case.

• Can isolation of Aeromonas hydrophila from human feces have any clinical significance?

  Authors: S M Qadri, M Zafar, G C Lee

  Journal of clinical gastroenterology. 11/1991; 13(5):537-40.

  A total of 27,480 stool specimens from 15,548 patients with gastroenteritis were analyzed for bacterial enteropathogens during a 4-year period between 1986-89 at a major referral center in SaudiA total of 27,480 stool specimens from 15,548 patients with gastroenteritis were analyzed for bacterial enteropathogens during a 4-year period between 1986-89 at a major referral center in Saudi Arabia. Bacterial pathogens were isolated from 1,152 patients, Salmonella being the most frequent, followed by Campylobacter, Shigella, and Aeromonas hydrophila. The latter bacterium was found in 58 patients; seven of them were associated with other enteric pathogens, but A. hydrophila was the only organism in 51 patients. All had gastrointestinal symptoms, the most common being diarrhea (92%), followed by abdominal pain (68%), fever (37%), and vomiting (27%). Stool specimens from 1,368 control patients were negative for A. hydrophila.