Papers by Mohammed Qaseem Khan
S3139 Prevalence, Clinical Presentation, Diagnosis, and Management Strategy for Esophago-Gastric Junction Outflow Obstruction
American Journal of Gastroenterology, 2020
S3142 Adherence to Seattle Biopsy Protocol in Patients With Long Segment Barrett’s Esophagus at Cairns Hospital, Australia
American Journal of Gastroenterology, 2020
Scientific Reports, 2019
Interleukin-37 (IL-37) has recently been recognized as a strong anti-inflammatory cytokine having... more Interleukin-37 (IL-37) has recently been recognized as a strong anti-inflammatory cytokine having anti-tumor activity against hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-infected patients. HCC is a typical inflammation-related cancer, and genetic variations within the IL-37 gene may be associated with the risk of HBV infection. Identification of the allelic patterns that genetically have a high disease risk is essential for the development of preventive diagnostics for HBV-mediated liver disease pathogenesis. In this study, we aimed to investigate the association between single nucleotide polymorphisms (SNPs) within the IL-37 gene and disease sequelae associated with HBV infection. We genotyped ten IL-37 SNPs in 1274 patients infected with HBV and 599 healthy controls from a Saudi Arabian population. Among the selected SNPs, two SNPs (rs2723175 and rs2708973) were strongly associated with HBV infection, and six SNPs (rs2723176, rs2723175, rs2723186, rs364030, rs2894720...
Bone mineral density loss in patients with cirrhosis
Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association, Jan 20, 2018
Evidence of increased risk of osteoporosis and osteopenia in chronic liver disease and cirrhosis ... more Evidence of increased risk of osteoporosis and osteopenia in chronic liver disease and cirrhosis is inconsistent. This study aims to investigate this relationship and to identify the predictors of increased loss of bone mineral density in Saudi patients. One hundred and sixty-four patients and controls who are age and gender matched, were included in this study with 1:1 ratio. Patients' included in this study were adults with confirmed liver cirrhosis. Bone mineral densitometry (BMD) at both lumbar spine (LS) and femoral neck (FN) were collected for both groups. Univariate and multivariate regression analyses were performed to identify predictors of BMD loss. Results showed that cirrhotic patients are at higher risk of developing osteoporosis or osteopenia at LS (OR 2.23, 95% CI [1.19-4.19], P = 0.01) but not at FN, when compared to control sample. Patients with cirrhosis were found to have lower vitamin D and PTH levels (P = 0.0005) and (P = 0.006), respectively. Of the possibl...
Gastrosplenic fistula in Hodgkin's lymphoma treated successfully by laparoscopic surgery and chemotherapy
Saudi Medical Journal, 2007
A gastrosplenic fistula is a rare complication of a gastric or splenic lesion. We report a case o... more A gastrosplenic fistula is a rare complication of a gastric or splenic lesion. We report a case of Hodgkin's lymphoma nodular sclerosis involving the spleen that was complicated by spontaneous gastrosplenic fistula. The fistula was closed laparoscopically, and the patient underwent partial gastrectomy and gastric wall repair, followed by successful chemotherapy. This is also the first reported case in published literature where closure of gastrosplenic fistula and partial gastrectomy was carried out laparoscopically. We recommend that extensive open surgical procedures including total gastrectomy, splenectomy, and pancreatectomy may be avoided in the management of gastrosplenic fistula, and the patient could be managed by less radical, simple laparoscopic fistulectomy, with partial gastric resection. If the fistula is caused by a malignant process, the surgical repair should be followed by definitive treatment with chemotherapy and radiotherapy.
Saudi Journal of Gastroenterology, 2016
Saudi Journal of Gastroenterology, 2015
Helicobacter pylori is a slow-growing, spiral-shaped, highly motile, gram-negative bacteria. Appr... more Helicobacter pylori is a slow-growing, spiral-shaped, highly motile, gram-negative bacteria. Approximately half of the world's population has H. pylori infection with an estimated prevalence of 51%-78% in Saudi Arabia. [2] Consequences of infection include chronic gastritis, duodenal ulcer, gastric ulcer, gastric cancer, or primary gastric MALT lymphoma. Curing H. pylori infection might cure dyspepsia, peptic ulcer, and MALT lymphoma and may prevent the development of gastric cancer as well. Recommended first-line treatment for H. pylori infection consists of a triple-therapy regimen containing a proton pump inhibitor (PPI), clarithromycin (CLR), and either amoxicillin (AML) or metronidazole (MTZ) given for 7-14 days. Recent data suggest that the success rate of classic triple therapy has decreased worldwide with increased rates of resistance to CLR and/or MTZ suspected as the underlying cause. A previous study from Saudi Arabia reported H. pylori resistance to MTZ in 80%, CLR in 4%, AML in 1.3%, and tetracycline (TE) in 0.4% of infected people. Assessment of H. pylori clinical isolates from 368 Saudi patients found a similar pattern of antibiotic resistance. The highest resistance was reported for MTZ (48.2%) followed by CLR (27.7%), AML (14.6%), and TE (9.5%). There are no new drugs in development for treating this infection. Therefore, researchers have looked at combinations of antibiotics and determined sequential therapy as a
Saudi Journal of Gastroenterology, 2013
More than 170 million people throughout the world are infected with Hepatitis C virus (HCV). HCV ... more More than 170 million people throughout the world are infected with Hepatitis C virus (HCV). HCV genotype 4 (HCV-4) is the most common genotype in the Middle East and Africa. It is responsible for > 80% of HCV infections, which has recently also spread to several European countries. Previous studies in Saudi Arabia have indicated that the anti-HCV prevalence was 0.4-1.7% for adults and 0.1% for children. The frequency of different genotypes in Saudi Arabia were as followed: HCV-4 genotype (69.2%), genotype 1a (12.8%), genotype 1b (11.4%), genotypes 2b (1.4%), genotype 5 (1.4%), and mixed infections with genotypes 4 and 5 (3.6%). HCV-4 is a very heterogeneous genotype, showing significant genetic divergence compared with other HCV genotypes. Phylogenetic analysis of the NS5B region is commonly used for sub-typing. Until date, the number of sub-types has increased up to 20. Of the 20 different subtypes identified, the most common ones are 4a and 4d, while others 4b, 4c, 4e, 4f, 4g, 4h, 4i, 4j, 4k, 4l, 4m, 4n, 4o, 4p, 4q, 4r, 4s, and 4t have been identified in different geographic regions of the world. The full clinical significance of HCV-4 subtypes is not known, because very few studies have correlated HCV-4 subtypes to the epidemiology, natural history, pathogenesis, disease severity, and outcomes of therapy. A recent study from Egypt reported a significant association between subtype 4o and hepatocellular carcinoma. Sub-genotype 4d has been linked particularly in epidemiological studies to intravenous drug abusers in Poland and southern Europe. Prevalence of HCV-4 subtype and their response to treatment are not
Saudi Journal of Gastroenterology, 2008
Background/Aim: This retrospective study assessed the efÞ cacy, safety, and the predictors of sus... more Background/Aim: This retrospective study assessed the efÞ cacy, safety, and the predictors of sustained viral response (SVR) to a 48-week-course of peginterferon α-2a (Pegasys) and ribavirin combination therapy in 335 consecutive Saudi patients with chronic hepatitis C virus (HCV) infection. Materials and Methods: Clinical, biochemical, and virological parameters were collected at time 0 (pretreatment) and at 12, 24, 48, and 72 weeks posttreatment. The mean ± SD age was 49.1 ± 13.0 years; 229 (68.4%) were males, mean ± SD body mass index was 27.8 ± 7.4, 85 (25.4%) were diabetic, 25 (7.5%) had renal impairment, 136 (40.6%) had previously received interferon ± ribavirin therapy, and 247 (73.7%) underwent pretreatment liver biopsy. Patients with genotypes 1, 2 or 3, 4 and mixed genotype were 60 (22.15%), 30 (11.0%), 148 (54.4%), and 34 (12.5%), respectively. Results: Early viral response (≥2-log10 HCV-RNA decline 12 weeks posttreatment) was achieved in 253 (75.3%). Patients who completed 48 weeks of treatment were 292 (87.1%); of these, 121 (75.6%) achieved ETVR, 161 (55.1%) continued to have SVR and 60 (20.5%) had a viral relapse following end-of-treatment response, that is 48.1 and 17.9% of all patients (n = 335), respectively. Nonresponders (NR) were 71 (24.3%) patients and 43 (12.8%) were unable to complete treatment (due to side effects or loss to follow up). Compared to the relapsers, patients with SVR were signiÞ cantly younger (P = 0.000), nondiabetics (P = 0.015), had higher serum albumin (P = 0.007), had less pretreatment inß ammatory grade (P = 0.011), infected with genotypes 2 or 3 (P = 0.014), and treatment-naïve patients (P = 0.001). However, in stepwise multivariate logistic regression analysis, only treatment naiveté and low pretreatment inß ammatory score were the independent predictors of SVR (P = 0.005 and P = 0.018, respectively). Conclusion: Combination therapy, if tolerated and completed, is effective in treating chronic HCV patients, especially those with no previous interferon therapy and lower pretreatment inß ammatory grade.
Peginterferon alpha-2b plus ribavirin compared with interferon alpha-2b plus ribavirin for initial treatment of chronic hepatitis C in Saudi patients commonly infected with genotype 4
Liver International, 2004
Comparing the efficacy of peginterferon alpha-2b plus ribavirin with interferon alpha -2b plus ri... more Comparing the efficacy of peginterferon alpha-2b plus ribavirin with interferon alpha -2b plus ribavirin in Saudi patients with chronic hepatitis C virus (HCV) commonly infected with genotype 4. A total of 96 patients with chronic HCV infection were randomly assigned to two treatment groups. Forty-eight patients received once weekly 100 microg of peginterferon alpha-2b plus ribavirin given orally 800 mg/day (peginterferon group). Another 48 patients received thrice weekly 3 million units of interferon alpha-2b plus ribavirin 800 mg/day (interferon group). At the end of treatment (48 weeks) and sustained (72 weeks) biochemical and virologic responses were determined. In the peginterferon group, 70.8% (34/48) patients attained both biochemical and virologic responses at the end of the treatment as against 52.1% (25/48) patients in the interferon group. (P=0.09 for both). Similarly, sustained biochemical and virologic responses in the peginterferon group were attained in 52.1% (25/48) and 43.8% (21/48) patients as against 43.8% (21/48) and 29.2% (14/48) patients in the interferon group, respectively (P=0.54 and 0.20, respectively). The sustained virologic response rates in patients with genotype 4 were 42.9% (12/28) in the peginterferon group and 32.3% (10/31) in the interferon group (P=0.43). Patients in peginterferon group had higher, although statistically not significant adverse reactions. Saudi patients with chronic HCV attained a higher, although statistically not significant sustained virologic response with pegylated interferon plus ribavirin compared with interferon plus ribavirin.
Journal of Viral Hepatitis, 2011
Summary. Current guidelines recommend antiviral therapy in chronic hepatitis B (HBV) patients wi... more Summary. Current guidelines recommend antiviral therapy in chronic hepatitis B (HBV) patients with significant histological disease. We aimed to compare histological fibrosis (METAVIR, ≥F2) in patients with HBV DNA ≥20 000 IU/mL vs≥2000 IU/mL and identify predictors of fibrosis. We performed prospective liver biopsies on 203 HBeAg‐negative patients in four groups: Group I (n = 55): HBV DNA ≥20 000 IU/mL and persistently elevated alanine aminotransferase (ALT) levels (PEALT; >40 U/L); Group II (n = 34): HBV DNA ≥20 000 IU/mL and persistently normal ALT (PNALT); Group III (n = 40): HBV DNA <20 000 IU/mL and PEALT; and Group IV (n = 74): HBV DNA <20 000 IU/mL, and PNALT. We reanalysed all groups in relation to updated cut‐off for treatable viremia (2000 IU/mL). Genotype D was detected in 86% of patients. Hepatic fibrosis ≥F2 was detected in 72.7%, 52.9%, 57.5% and 18.9% in Groups I–IV, respectively (P < 0.0001). Except in Group II with a trend for lower ≥F2 fibrosis (P = 0...
M1857 Relevance of Esophageal Dysmotility in Gastro-Esophageal Reflux Disease (GERD) Diagnosed By BRAVO Capsule
Gastroenterology, 2009
European Journal of Gastroenterology & Hepatology, 2013
Introduction The role of serum interferon-c-inducible protein-10 kDa (IP-10) level in the treatme... more Introduction The role of serum interferon-c-inducible protein-10 kDa (IP-10) level in the treatment of chronic hepatitis C genotype-4 (HCV-4) and its various subtypes remains unknown. We aimed to study the impact of pretreatment IP-10 levels on the sustained viral response (SVR) in HCV-4 patients (n = 64) undergoing peginterferon a-2a/ribavirin therapy. Patients and methods Pretreatment IP-10 levels and HCV-4 subtypes (4a = 48.4%, 4d = 39%, others = 12.5%) were measured and correlated with treatment responses. Variables significantly associated with SVR on univariate analysis were included in a multivariate logistic regression model. Patients with SVR had lower pretreatment IP-10 levels (462.4±282.7 vs. 840.1±490.6 pg/ml; P = 0.002), but the levels were not significantly different in those with a rapid (P = 0.245) or an early viral response (P = 0.221). IP-10 levels were similar across all subtypes. The pretreatment level was significantly lower in subtype 4d patients with SVR (465.9±349.1) compared with non-SVR patients (904.9±532.1; P < 0.001), but not when compared with genotype 4a patients (564.7±288.9 vs. 658.6±374.9, respectively; P = 0.330). IP-10 levels [odds ratio (OR), 0.998; 95% confidence interval (CI): 0.996-0.999; P = 0.006], low viremia (OR, 8.852; 95% CI: 1.244-63.03; P = 0.029), and early viral response (OR, 4.162; 95% CI: 1.023-16.94; P = 0.046) were independent predictors of SVR. Receiver operating characteristic curve analysis identified a threshold IP-10 level of 359 pg/ml (area under receiver operating characteristic curve, 0.737; sensitivity, 81.8%; specificity, 45.2; positive predictive value, 43.9%; negative predictive value, 82.6%) for SVR. Conclusion Pretreatment serum IP-10 level is a predictor for SVR in HCV-4-infected patients. The baseline IP-10 level is significantly lower in responders among HCV genotype-4d patients as compared with 4a patients. Eur J Gastroenterol Hepatol 25:404-410
Annals of Saudi Medicine, 2009
Hepatology International, 2011
Background Peginterferon (PEG-IFN) a-2a has been shown to induce a sustained virologic response (... more Background Peginterferon (PEG-IFN) a-2a has been shown to induce a sustained virologic response (SVR) in 20-30% of ''hepatitis B e antigen (HBeAg)''-negative patients. Aim To determine the safety and efficacy of PEG-IFN a-2a in HBeAg-negative, genotype D-naive patients and to analyze the predictors of response. Methods This prospective, multicenter, open-label, nonrandomized trial was conducted at four hospitals. A total of 35 consecutive HBeAg-negative naive genotype D patients received PEG-IFN a-2a for 48 weeks. Results Based on a cutoff of hepatitis B virus (HBV) DNA \400 copies ml-1 , an early virologic response (EVR) at week 12, end of treatment virologic response (ETVR) at week 48, and SVR at week 72 were achieved by 3 (9%), 9 (26%), and 8 patients (23%), respectively. The EVR rate improved to 43%, ETVR to 49%, and SVR to 57%, when a HBV DNA cutoff level of \20,000 copies ml-1 was used. Pretreatment HBsAg level was not a predictor for SVR on univariate analysis, but correlated with decline in HBV DNA levels at weeks 48 and 72. On multivariate logistic regression analysis, low body weight, high alanine aminotransferase (ALT), low HBV DNA, and low triglyceride levels were identified as baseline predictors of SVR. Conclusion HBeAg-negative genotype D-naive patients treated with PEG-IFN a-2a achieved SVR in 23 (HBV \400 copies ml-1) and 57% (HBV \20,000 copies ml-1) of patients, a better response than previously reported that might be related to the absence of drug resistance in these naive patients. Pretreatment predictors of SVR were low body weight, high ALT, low HBV DNA, and low triglycerides.
Association of toll-like receptor 4 polymorphisms with type 2 diabetes mellitus
APMIS, 2012
Toll-like receptor 4 (TLR4) plays important roles in modulating innate immunity. Type 2 diabetes ... more Toll-like receptor 4 (TLR4) plays important roles in modulating innate immunity. Type 2 diabetes mellitus (T2DM) is a chronic and complex disease that is characterized by impaired insulin resistance and dysregulated immune response. In the current study, we investigated whether TLR4 polymorphisms were correlated with susceptibility to T2DM in the Chinese population. Four TLR4 polymorphisms (-2431T/C, Asp299Gly, Thr399Il3, and +3725G/C) were genotyped in 936 T2DM patients and 978 healthy controls. Results showed that the prevalence of TLR4 +3725GC and CC genotypes was significantly decreased in T2DM cases than those in controls [odds ratio (OR) = 0.68, 95% confidence interval (CI) = 0.55-0.84, p = 0.0003, and OR=0.46, 95% CI = 0.32-0.67, p = 3.71 × 10(-5) , respectively). Also, the frequency of TLR4 +3725C allele was significantly lower in T2DM patients (p = 2.50 × 10(-8) ). The -2431T/C did not reveal any significant differences between cases and controls. We did not detect Asp299Gly and Thr399Il3 polymorphisms in our study group. Stratification analysis of the clinical features in the patients demonstrated that frequency of +3725CC genotype was lower in patients older than 50 years old (p = 0.047). In conclusion, these results indicate that TLR4 +3725G/C polymorphism may be a novel protective factor against T2DM in the Chinese population.
BMC infectious diseases, Jan 31, 2014
BackgroundVariations at DEPDC5 gene have been recently reported as genetic markers associated wit... more BackgroundVariations at DEPDC5 gene have been recently reported as genetic markers associated with hepatocellular carcinoma (HCC) progression in chronic HCV-infected patients. This study was conducted to assess the association of DEPDC5 variants with advanced liver cirrhosis and HCC development among chronic HCV-infected patients in Saudi Arabian population.MethodsSix-hundred and one HCV-infected patients were genotyped for DEPDC5 polymorphisms (rs1012068 and rs5998152), in comparison with 592 non-infected healthy control subjects. The allelic frequency and genotype distribution of both DEPDC5 polymorphisms were determined followed by haplotype frequency estimation and multiple logistic regression analysis.ResultsThe frequency of the risk alleles of both rs1012068 and rs5998152 was shown to be more in healthy control subjects than in patients (p =0.0001, OR =0.704, CI =0.591-0.839; p =0.002, OR =0.761, CI =0. 0.639-0.907, respectively). Also, our results revealed that GT for SNP rs1...
Gadjah Mada International Journal of Business, 2010
Designing a Performance Management System (PMS) is anintegral part of management control systems.... more Designing a Performance Management System (PMS) is anintegral part of management control systems. This paper presents ahybrid framework for the design of a PMS for the Indonesiancontext, and the tailor-made design is expected to overcome theshortcomings of earlier models. The present hybrid PMS modelseeks to improve the earlier research models using the followingnovel approaches: (1) implementation of a Knowledge-Based (KB)expert system, (2) Gauging Absences of Prerequisite (GAP) analysis, and (3) Analytical Hierarchy Process (AHP) methodology in anintegrated KBPMS. The paper shows that the present hybrid (KB-AHP-GAP) approach to developing a PMS model is a realisticmethodology. The combination of the KB-AHP-GAP approachallows detailed benchmarking of the PMS existing in an Indonesiancompany. Furthermore, this approach can assist in identifying andprioritising the key decisions that need to be executed to overcomethe existing PMS shortcomings.symbiotic strategic alliances. Con-verse...
Frontiers in cellular and infection microbiology, 2018
Viral mutations acquired during the course of chronic hepatitis B virus (HBV) infection are known... more Viral mutations acquired during the course of chronic hepatitis B virus (HBV) infection are known to be associated with the progression and severity of HBV-related liver disease. This study of HBV-infected Saudi Arabian patients aimed to identify amino acid substitutions within the precore/core (preC/C) region of HBV, and investigate their impact on disease progression toward hepatocellular carcinoma (HCC). Patients were categorized according to the severity of their disease, and were divided into the following groups: inactive HBV carriers, active HBV carriers, liver cirrhosis patients, and HCC patients. Two precore mutations, W28 and G29D, and six core mutations, F24Y, E64D, E77Q, A80I/T/V, L116I, and E180A were significantly associated with the development of cirrhosis and HCC. Six of the seven significant core mutations that were identified in this study were located within immuno-active epitopes; E77Q, A80I/T/V, and L116I were located within B-cell epitopes, and F24Y, E64D, and...
Oncotarget, 2017
Hepatitis B virus (HBV) is one of the most widespread human pathogens causing chronic hepatitis, ... more Hepatitis B virus (HBV) is one of the most widespread human pathogens causing chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma (HCC). This study investigated the clinical impact of single and combinational mutations in HBx gene on the pathogenesis of HCC during progressive stages of liver disease. The patients were categorized into inactive HBV carriers, active carriers, cirrhosis and HCC groups based on disease severity. Male sex, age > 50 years, and high serum alanine aminotransferase level were associated with risk of progressive liver disease. I127T, V131I, and F132Y/I/R mutations showed a significant increasing trend associated with the disease progression to HCC. H94Y and K130M mutations were also significantly associated with severe liver disease. One double mutation (K130M+V131I) and two triple mutations (I127T+K130M+V131L and K130M+V131I+F132Y) were observed, with significant rising prevalence through progressive clinical phases of liver disease to HCC. S...
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Papers by Mohammed Qaseem Khan