Digital Commons Network^™

Survival Of Patients Treated With Intra-Aortic Balloon Counterpulsation At A Tertiary Care Center In Pakistan - Patient Characteristics And Predictors Of In-Hospital Mortality., Fahim H. Jafary, Sohail A. Khan, Haresh Kumar, Numaan F. Malik, K. Kazmi, Sajid Dhakam, Azam Shafquat, Aamir Hameed, Javed Tai, Najaf Nadeem

Department of Medicine

BACKGROUND: Intra-aortic balloon counterpulsation (IABC) has an established role in the treatment of patients presenting with critical cardiac illnesses, including cardiogenic shock, refractory ischemia and for prophylaxis and treatment of complications of percutaneous coronary interventions (PCI). Patients requiring IABC represent a high-risk subset with an expected high mortality. There are virtually no data on usage patterns as well as outcomes of patients in the Indo-Pakistan subcontinent who require IABC. This is the first report on a sizeable experience with IABC from Pakistan.

METHODS: Hospital charts of 95 patients (mean age 58.8 (+/- 10.4) years; 78.9% male) undergoing IABC between 2000-2002 …

Anaesthesia For Surgical Correction Of Scoliosis With Spinal Cord Monitoring--A Case Series, M Q. Hoda, S U. Zafar

Department of Anaesthesia

Objective: To share our experience of anaesthetic management of scoliosis with intra-operative somatosensory evoked potential monitoring and wake up test.Methods: All the cases of scoliosis surgery scheduled during a period of two years in which SSEP and intra-operative wake-up test was planned were included in the study. The patient in which intra-operative wake-up test was not planned were excluded from this case series.Results: We managed a series of sixteen cases of scoliosis in our hospital. Eleven patients were female and five were male with the age ranging from six to twenty two years. SSEPs were monitored throughout the procedure and …

Maternal Anaemia And Its Impact On Perinatal Outcome In A Tertiary Care Hospital In Pakistan, F W. Lone, R N. Qureshi, F Emmanuel

Department of Obstetrics & Gynaecology

Maternal anaemia is a common problem in pregnancy, particularly in developing countries. We investigated the relationship between maternal anaemia and perinatal outcome in a cohort of 629 pregnant women from October 2001 to 2002. Of these, 313 were anaemic (haemoglobin < 11 g/L). Perinatal outcomes included preterm delivery, low birth weight, intrauterine growth retardation, perinatal death, low Apgar scores and intrauterine fetal death. Univariate and multivariate analyses were performed. The risk of preterm delivery and low birth weight among the anaemic women was 4 and 1.9 times more respectively than the non-anaemic women. The neonates of anaemic women also had 1.8 times increased risk having low Apgar scores at 1 minute and there was a 3.7 greater risk of intrauterine fetal death among the anaemic women than the non-anaemic women.

Orbital Embryonal Rhabdomyosarcomain Karachi (1998-2002), Yasmin Bhurgri, A. Mazhar, H. Bhurgri, A. Usman, J. Malik, A. Bhurgri, R. Ahmed, S. Muzaffar, N. Kayani, Shahid Pervez, S. H. Hasan

Department of Pathology and Laboratory Medicine

Objective: To study the epidemiology of ocular Rhabdomyosarcoma (ORMS) in Karachi.

Methods: Incident ORMS cases resident of Karachi, registered at Karachi Cancer Registry (KCR) during 1st January 1998 to 31st December 2002 were included in the study. The data were classified using ICD-O2; computerized with Canreg-3, and analyzed using SPSS 10.0.

Results: Ten cases of ORMS were reported to KCR during 1998-2002. RMS originated in the orbit in eight cases, conjunctiva in one and eyelid in one. Nine cases presented with proptosis, associated with conjunctivitis in four cases. One case presented with eyelid swelling. The crude annual incidence rate was …

Frequency Of Hereditary Thrombophilia: An Akuh Experience., Safoorah Khalid, Raihan Sajid, Salman Adil, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Abstract

Objective: To determine the frequency of various causes of hereditary thrombophilia at a referral laboratory and the age and gender distribution.

Methods: This is a descriptive study incorporating a retrospective analysis of requests for thrombophilia screening sent to Clinical laboratory, Aga Khan University Hospital from November 1995 to May 2002.
Patients were screened for hereditary causes of thrombophilia including Protein C, Protein S, antithrombin III, Factor V Leiden and homocysteine. Frequency of each disorder; and age and sex distribution was determined.

Results: All the patients suspected clinically for thrombophilia were screened. Of the 2825 patients, 70 were diagnosed to …

Cancer Esophagus Karachi 1995-2002:Epidemiology, Risk Factors And Trends, Y. Bhurgri, N. Faridi, L. A.G. Kazi, S. K. Ali, H. Bhurgri, A. Usman, J. Malik, A. Bhurgri, R. Ahmed, S. Muzaffar, N. Kayani, Shahid Pervez, S. H. Hasan

Department of Pathology and Laboratory Medicine

Objective: To study the trends of cancer esophagus in Karachi South during 1995-2002 and identify risk factors.

Methods: Incident esophageal cancer cases recorded at the Karachi Cancer Registry for Karachi South, during 1st January 1995 to 31st December 2003 were reviewed. For maximum completion of data, incident cases registered from 1st January 1995 to 31st December 2002 were included for final analyses.

Results: The Age Standardized Incidence Rates (ASIRs) of cancer esophagus in Karachi South for males were 6.5/100,000 (1995-1997) and 6.4/100,000 (1998-2002). In females the observed rates were 7.0/100,000 (1995-1997) and 8.6/100,000 (1998-2002).

Conclusion: In the moderately high incidence, …

Clinical Features And Outcome Of Surgery In 30 Patients With Acromegaly, A Chandna, N Islam, A Jabbar, L Zuberi, N Haque

Section of Diabetes, Endocrinology and Metabolism

Objective: To assess the surgical outcome of hypophysectomy in acromegalic patients, differences in response to surgery in micro and macroadenoma and the development of associated hormonal deficiency after surgery.

Methods: Retrospective analysis of charts of acromegalic patients who were operated upon at Aga Khan University Hospital, Karachi, was done. Information regarding presentation, laboratory data, radiological assessment, details of surgery and postoperative outcome was recorded. Surgical outcome was classified depending on the degree of disease control after surgery as biochemical cure, remission and treatment failure.

Results: Out of 30 patients, eighteen (60%) were males and 12 (40%) females with …

Risk Factors And Behaviours For Coronary Artery Disease (Cad) Among Ambulatory Pakistanis, S P. Iqbal, S Dodani, Riaz Qureshi

Department of Family Medicine

Objective: To determine the frequency and distribution of various risk factors and behaviours for coronary artery disease (CAD) among ambulatory Pakistanis.
Methods: It is a cross-sectional descriptive study carried out at the Aga Khan University Hospital, a teaching hospital in Karachi. All the subjects were adults (18-60 years) presenting at the general checkup clinic with no history or evidence of CAD by convenient sampling method. Demographic variables included risk factors and behaviors including diabetes, hypertension, dyslipidemia, family history of heart disease, obesity, smoking and sedentary lifestyle.
Results: Among 370 ambulatory Pakistanis, the proportions of major risk factors for CAD were: …

Association Study Of The Angiotensin-Converting Enzyme (Ace) Gene G2350a Dimorphism With Myocardial Infarction, M Perwaiz Iqbal, Saeed Mahmood, Naseema Mehboobali, Mohammad Ishaq, Tasnim Fatima, Saddiqa Parveen, Philippe Frossard

Department of Biological & Biomedical Sciences

The angiotensin converting enzyme (ACE) is a strong candidate gene for myocardial infarction (MI). Insertion-deletion dimorphism in intron 16 of this gene has been inconclusively found to be associated with it. Several new polymorphisms in the ACE gene have been identified and among these, a dimorphism in exon 17, ACE G2350A, has a significant effect on plasma ACE concentrations. To assess the value of genotyping the ACE G2350A dimorphism in a genetically homogeneous population, we carried out a case-control study of dimorphism G2350A for a putative association with MI among Pakistani nationals. We investigated a sample population of 370 Pakistanis, …

A National Survey Of New Zealand Registered Nurses Caring Attributes, Professional Self Concept And Technological Influences, A O'Brien, David Arthur, M Woods, P Watson

School of Nursing & Midwifery

No abstract provided.

Is An Excretory Urogram Mandatory In Patients With Small To Medium-Sized Renal And Ureteric Stones Treated By Extra Corporeal Shock Wave Lithotripsy?, Hammad Ather, Nuzhat Faruqui, Sobia Akhtar, M Nasir Sulaiman

Section of Urology

Background: An intravenous urogram (IVU) has traditionally been considered mandatory before treating renal and ureteric stones by extracorporeal shock wave lithotripsy (ESWL). This study was designed to see whether there is a difference in complications and the need for ancillary procedures in patients managed by ESWL for renal and ureteric calculi, according to preoperative imaging technique.
Methods: This retrospective study compared 133 patients undergoing ESWL from January 2001 to July 2002. Patients were divided into three groups according to the preoperative imaging technique used: i) IVU; ii) non-contrast enhanced helical computed tomography (UHCT); and iii) ultrasound (US) + X-ray …

The Hippocratic Oath: Has It Ceased To Be Relevant?, Waris Qidwai

Department of Family Medicine

The Greek physician Hippocrates (460-377 B.C) is traditionally regarded as the founder of medicine, scientific discipline and medical ethics.The Hippocratic Oath, taken by ancient and medieval doctors, requires high ethical standards from medical doctors. Its principles are considered important in professional and ethical education of medical doctors even today. The Hippocratic Oath has survived, with over-riding power, the test of time since it addresses the intrinsic nature of medicine. Even those who know little of it or reject parts of it acknowledge it to be a symbol of the values of medicine. It has been argued that it is its …

Morning Report Is An Effective Teaching Activity: Residents And Faculty Perspectives, M. Tariq, Shahab Abid, Wasim Jafri

Section of Internal Medicine

No abstract provided.

Awareness Of The Process Of Informed Consent Among Family Practice Patients In Karachi, H. Bhurgri, Waris Qidwai

Department of Family Medicine

Objective: To study the awareness of 'Informed Consent', among patients presenting to Family Physicians.
Methods: A cross-sectional study was carried out at the Community Health Centre, Aga Khan University Hospital, Karachi in July 2002. Written Consent was taken and confidentially was assured
Results: Out of the 100 patients interviewed, 80 agreed to participate in the study, forty-four men and thirty-six women. Approximately half the participants (45%) were graduates and 40% had less than five years of school education. The awareness of the process of 'informed consent' was observed in only 20% of the respondents, all in the educational …

Hematologic And Cytogenetic Findings In Eleven Chronic Myelogenous Leukemia Patients Treated With Imatinib Mesylate At A Tertiary Care Hospital, M. Usman, G. N. Kakepoto, Salman Adil, R. Sajid, S. Arain, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To evaluate the response of Imatinib mesylate in patients with myeloid leukemia in chronic ,accelerated and blast phase.
Methods:Eleven patients with established diagnosis of chronic myeloid leukemia were treatedwith Imatinib mesylate. Adverse events were documented with regular follow ups. Hematological and cytogeneticresponses were assessed according to established criteria. Patients with zero percent Philadelphia positivemetaphases were labeled as complete cytogenetic response while patients with 1% to 35% Philadelphia positive metaphases were termed as partial responders.
Results: Of 11 cases there were 7 males and 4 females with a mean age of 39.5 years and median age 51 years(range 21-69). …