Digital Commons Network^™

Maternal Characteristics And Outcomes Affected By Hypothyroidism During Pregnancy (Maternal Hypothyroidism On Pregnancy Outcomes, Mhpo-1), Zareen Kiran, Aisha Sheikh, Sarwar Malik, Areeba Meraj, Maha Masood, Safana Ismail, Owais Rashid, Quratulain Shaikh, Numan Majeed, Lumaan Sheikh, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background: Hypothyroidism in pregnancy is an arena of ongoing research, with international conflicts regarding screening, management, and outcomes. Various studies have described the outcomes depending on geographical and international diagnostic criteria. No study has been conducted in this regard from the region of Pakistan. Therefore, we aim to report the clinical features and maternal outcomes of hypothyroid pregnancies and compare the maternal outcomes between uncontrolled and controlled TSH levels in the preconception as well as the gestational period.
Methods: We conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital after ethical approval. We collected information …

Intravenous Dexamethasone Along With Caudal Block Improves Analgesic Efficacy Following Day-Case Inguinal Hernia Repair In Children: A Randomized Controlled Trial, Amjad Nadeem, Aliya Ahmed

Department of Anaesthesia

Objective: To assess the effectiveness of intravenous dexamethasone along with caudal block in improving analgesia following inguinal hernia repair in children.
Methods: The double-blind randomised controlled trial was conducted over a 6-month period from June 01, 2016 to November 30, 2016 at the Aga Khan University Hospital, Karachi, and comprised patients aged 1-5 years, scheduled for elective inguinal hernia repair. The subjects were randomised into two groups using the sealed envelope technique. Group D patients received 0.5mg/kg dexamethasone intravenous in 5ml, and group P was given placebo (5ml 0.9% saline). Assessment of postoperative pain was made through the faces, legs, …

Caesarean Section Rates In South Asian Cities: Can Midwifery Help Stem The Rise?, Sulochana Dhakal Rai, Amudha Poobalan, Rafat Jan, Malin Bogren, Juliet Wood, Ganesh Dangal, Pramod Regmi, Edwin Van Teijlingen, Keshar Bahadur Dhakal, Sahib Jan Badar, Farhana Shahid

Journal of Asian Midwives (JAM)

Introduction: Caesarean section (CS) is a life-saving surgical intervention for delivering a baby when complications arisein childbirth. World Health Organization recommends a rate of CS from 10% to 15%. However, CS rates increased steadily in recent decades and have almost doubled from 12.1% in 2000 to 21.1% in 2015. Therefore, this has become a global public health problem. The main purpose of the scoping review article is to give an overview and analysis of the rising CS use in four South Asian countries: Bangladesh, India, Nepal and Pakistan.
Methods: A scoping review was carried-out using several bibliographic electronic databases (MEDLINE, …

Healthcare Malpractice And Continuing Hiv Outbreaks In Pakistan, Salima Davlidova, Syed Hani Abidi, Syed Ali

Department of Biological & Biomedical Sciences

No abstract provided.

Interprofessional Education: The Way Forward In Health Profession Education, Kanza Muzaffar, Rehana Rehman, Salman Siddiqi

Department of Biological & Biomedical Sciences

Abstract are not provided by the author/publisher

Current State Of Knowledge Of Basic Life Support In Health Professionals Of The Largest City In Pakistan: A Cross-Sectional Study, Babar Irfan, Ibrahim Zahid, Muhammad Sharjeel Khan, Omar Abdul Aziz Khan, Shayan Zaidi, Safia Awan, Sobia Bilal, Omar Irfan

Section of Neurology

Background: Basic Life Support (BLS) is the recognition of sudden cardiac arrest and activation of the emergency response system, followed by resuscitation, and rapid defibrillation. According to WHO, Pakistan has one of the highest mortality rates from accidental deaths therefore assessment and comparison of BLS knowledge in health professionals is crucial. We thereby aim to assess and compare the knowledge of BLS in doctors, dentists and nurses.

Methods: A multi-centric cross-sectional survey was conducted in Karachi at different institutions belonging to the private as well as government sector from January to March 2018. We used a structured questionnaire which was …

Cime Newsletter : November 2019, Cime

CIME Newsletter

-Pakistan Air Force Lands Again @ CIME
-SeeMe in Singapore!
-SeeMe in Finland!
-Healthcare Assistants refresh their skills
-SimMan takes drugs!
-Body Mechanics in Patient Moving and Handling
-Training in techniques of Continuous Renal Replacement Therapy (CRRT) Needs Simulation

Value Of Elastography In Differentiating Benign From Malignant Breast Lesions Keeping Histopathology As Gold Standard, Faryal Farooq, Syed Mubarak, Shaista Shaukat, Noman Khan, Kahkashan Jafar, Tariq Mahmood, Muhammad Arif Saeed

Department of Radiology

Background: Breast cancer is the most common cancer in females, both in developed and developing countries. Pakistan has the highest breast cancer incidence rate in Asia. Guidelines recommend screening for detecting breast cancer with mammography and ultrasonography (US). Shear-wave elastography (SWE) is a newer technique that can aid additional characterization of breast lesions.
Objective: The aim of this study was to determine the diagnostic accuracy of breast ultrasound elastography in differentiating benign from malignant breast lesions using histology diagnosis as the gold standard.
Materials and methods: The study was conducted at the Abbasi Shaheed Hospital and Jinnah Post Graduate Medical …

Illegal Motorcycle Street Racing- A Growing Threat To Public Safety, Madiha Mumshad, Aisha Ashraf

Department of Emergency Medicine

No abstract provided.

The Natural Predominant Sleeping Positions In Cerebral Palsy; Does It Correlate With The Type Of Cerebral Palsy?, Sarah Razaq, Muhammad Aleem Arshad, Tahira Amjad

Pakistan Journal of Neurological Sciences (PJNS)

To see the natural positions of cerebral palsy subjects during sleep and their correlation with the particular type of cerebral palsy.

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C. Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Rabia Hussain, Najeeha Talat Iqbal

Department of Pathology and Laboratory Medicine

Background: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.
Methods and Findings: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …

Association Between Maxillary Transverse Discrepancy And Occurrence Of Potentially Impacted Maxillary Canines In Mixed Dentition Patients, Farhana Ghaffar, Rashna Hoshang Sukhia, Mubassar Fida

Section of Dental-Oral Maxillofacial Surgery

Objective: The aim of this study was to determine the association between transverse maxillary discrepancy and occurrence of potentially impacted maxillary canines in mixed dentition patients.
Material and methods: This cross-sectional analytical study was conducted on 85 Pakistani subjects (32 males and 53 females) aged between 8 to 13 years, having good quality orthopantomographs and dental casts. Maxillary transverse discrepancy was assessed by subtracting the mandibular intermolar width from the maxillary intermolar width on dental cast. Maxillary lateral incisors and canines were traced from orthopantomographs, and canines were placed into sector classification. Chi-square test was used to determine the difference …

Isolation And Culture Of Dental Pulp Stem Cells From Permanent And Deciduous Teeth, Shagufta Naz, Farhan Raza Khan, Raheela Rahat, Sahreena Ladhani, Mehwish Saghir Khan, Nuruddin Badruddin Mohammed, Tashfeen Ahmad

Section of Dental-Oral Maxillofacial Surgery

OBJECTIVE:
To isolate dental pulp mesenchymal stem cells (MSCs) from non-infected human permanent and deciduous teeth.
METHODS:
It was an in-vitro experimental study. Human teeth were collected from 13 apparently healthy subjects including nine adults and four children. After decoronation dental pulps were extirpated from teeth and cultured via explant method in a stem cell defined media. Data was analyzed by descriptive statistics. RESULTS:
As above MSCs emerged exhibiting fibroblast-like morphology. In vitro culture was positive for 100% (9/9) and 75% (3/4) of the permanent and deciduous teeth respectively. First cell appeared from deciduous teeth pulp in 10±6.2 days while …

Study Of Environmental Enteropathy And Malnutrition (Seem) In Pakistan: Protocols For Biopsy Based Biomarker Discovery And Validation, Najeeha Talat Iqbal, Sana Saeed, Kamran Sadiq, Marium N. Khan, Junaid Iqbal, Jennie Z. Ma, Fayaz Umrani, Sheraz Ahmed, Elizabeth A. Maier, Lee A. Denson, Shahida Qureshi, Syed Asad Ali

Department of Paediatrics and Child Health

Background:
Environmental Enteropathy (EE), characterized by alterations in intestinal structure, function, and immune activation, is believed to be an important contributor to childhood undernutrition and its associated morbidities, including stunting. Half of all global deaths in children < 5 years are attributable to under-nutrition, making the study of EE an area of critical priority.
Methods:
Community based intervention study, divided into two sub-studies, 1) Longitudinal analyses and 2) Biopsy studies for identification of EE features via omics analyses. Birth cohorts in Matiari, Pakistan established: moderately or severely malnourished (weight for height Z score (WHZ) < − 2) children, and well-nourished (WHZ > 0) children. Blood, urine, and fecal samples, for evaluation of potential biomarkers, will be collected at various time points from all participants (longitudinal …

Application Of New Biomedical Materials In Orthodontic Appliances, Hafiz Taha Mahmood, Adeel Tahir Kamal, Bushra Khan, Mubassar Fida

Department of Surgery

This review article describes the application and characteristics of certain biomedical materials in orthodontic appliances. The elastic recoil of shape memory polymers, determination of the forces and moments experienced by the brackets and eventually by the tooth, reduction in treatment time by employing self-healing smart brackets and decreased enamel lost during debonding due to usage of biomimetic adhesives such as dihydroxyphenylalanine (DOPA) is discussed. Increased plaque retention and microbial attachment around brackets and teeth is of profound concern and by utilisation of hydrophobic properties of self-cleaning materials, this can be reduced significantly. Implantation of bioresorbable temporary anchorage devices, which resorb …

Performance Of The Timi Risk Score In Predicting Mortality After Primary Percutaneous Coronary Intervention In Elderly Women: Results From A Developing Country, Shumaila Furnaz, Musa Karim, Tariq Ashraf, Sajjad Ali, Izza Shahid, Sara Ali, Uzzam Ahmed Khawaja, Muhammad Tanzeel Ul Haque, Muhammad Shariq Usman, Tariq Jamal Siddiqi

Section of Internal Medicine

Background: Despite women undergoing primary percutaneous coronary intervention (PPCI) having a higher rate of adverse outcomes than men, data evaluating prognostic risk scores, especially in elderly women, remains scarce. This study was conducted to validate the predictive value of Thrombolysis in Myocardial Infarction (TIMI) risk score in elderly female patients.

Materials and Methods: This was a retrospective analysis of elderly (>65 years) female patients who underwent PPCI for ST-elevated myocardial infarction (STEMI) from October 2016 to September 2018. Patients' demographic details and elements of TIMI risk score including age, co-morbidities, Killip classification; weight, anterior MI and total ischemic time …

Stethoscope As A Vector For Nosocomial Bacterial Infections, Rehana Rehman, Khalid Ahmed, Saifullah Shaikh

Department of Biological & Biomedical Sciences

No abstract provided.

Blood Film Says It All! Rare Case Of Congenital Ttp Misdiagnosed As Itp, Ayesha Majeed Memon, Natasha Ali

Department of Pathology and Laboratory Medicine

We report a case of a 16-year-old female who presented with bleeding diathesis. Peripheral blood film examination was consistent with microangiopathic hemolytic anemia with 7% fragmented red blood cells. The ADAMTS13 level was 40 ng/ml (reference range: 630-850 ng/ml). She responded to plasma exchange therapy and methylprednisolone and was discharged in a stable condition.

Implications Of Genetic Variation Of Common Drug Metabolizing Enzymes And Abc Transporters Among The Pakistani Population, Nasir Ali Afsar, Henrike Bruckmueller, Anneke Nina Werk, Muhammad Kashif Nisa, H R. Ahmad, Ingolf Cascorbi

Department of Biological & Biomedical Sciences

Genetic polymorphism of drug metabolizing enzymes and transporters may influence drug response. The frequency varies substantially between ethnicities thus having implications on appropriate selection and dosage of various drugs in different populations. The distribution of genetic polymorphisms in healthy Pakistanis has so far not been described. In this study, 155 healthy adults (98 females) were included from all districts of Karachi. DNA was extracted from saliva and genotyped for relevant SNVs in CYP1A1, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4 and CYP3A5 as well as ALDH3A1, GSTA1, ABCB1 and ABCC2. About 64% of the participants were born to parents who were unrelated …

Khat Use And Psychotic Symptoms In A Rural Khat Growing Population In Kenya: A Household Survey, Linnet Ongeri, Fredrick Kirui, Erastus Muniu, Veronica Manduku, Leah Kirumbi, Lukoye Atwoli, Safari Agure, Peter Wanzala, Lydia Kaduka, Mercy Karimi, Richard Mutisya, Elizabeth Echoka, Joseph Mutai, David Mathu, Charles Mbakaya

Internal Medicine, East Africa

Background:Khat is an amphetamine like psychostimulant chewed by over 10 million people globally. Khat use is thought to increase the risk of psychosis among its chewers. The evidence around this however remains inconclusive stemming from the scanty number of studies in this area and small study sample sizes. We undertook a large household survey to determine the association between psychotic symptoms and khat chewing in a rural khat growing and chewing population in Kenya.

Methods:For this cross-sectional household survey, we randomly selected 831 participants aged 10 years and above residing in the Eastern region of Kenya. We used …

Evaluation Of Cervical Spine Posture After Functional Therapy With Twin-Block Appliances: A Retrospective Cohort Study, Adeel Tahir Kamal, Mubassar Fida

Section of Dental-Oral Maxillofacial Surgery

INTRODUCTION:
It has been postulated that a change in cervical posture occurs as a consequence of forward repositioning of the mandible. Therefore, the objective of this study was to compare the cervical spine posture between subjects with and without functional appliance therapy.
METHODS:
A retrospective cohort study was conducted with the use of pre- and post-functional therapy cephalograms of orthodontic patients. A total of 60 subjects was composed of 2 groups of 30 subjects each: those who underwent treatment with a twin-block (TB) functional appliance and a control group selected from the Bolton-Brush Growth Study. Three sagittal and 7 cervical …

Most Effective Method For The Management Of Physiologic Gingival Hyperpigmentation: A Systematic Review And Meta-Analysis, Meisha Gul, Muhammad Hasan Hameed, Muhammad Rizwan Nazeer, Rabia Ghafoor, Farhan Raza Khan

Section of Dental-Oral Maxillofacial Surgery

MATERIALS AND METHODS:
A systematic review and meta-analysis were done (1919 to October 2018) using PubMed, CINHAL, Dental and Oral Science, and manual searches. Twenty-five articles were finally reviewed. Only human clinical trials were considered with physiological gingival pigmentation treated with different depigmentation methods and compared with surgical stripping. The outcome was the achievement of gingival depigmentation and its recurrence. RevMan software was used for data analysis.
RESULTS:
Of 26,132 articles, 25 met the inclusion criteria. Seventeen were randomized control trials and 8 were nonrandomized control trials. Most of the studies were on laser. The control group was scalpel surgery. …

Childhood Oral Infections And Subclinical Atherosclerosis In Adulthood: Should We Wait For Causality Or Just Treat?, Anwar T. Merchant, Salim S. Virani

Office of the Provost

No abstract provided.

Orthokeratinized Odontogenic Cyst (Ooc): Clinicopathological And Radiological Features Of A Series Of 10 Cases, Nasir Ud Din, Maha Zubair, Jamshid Abdul-Ghafar, Zia Ullah Khan, Zubair Ahmad

Department of Pathology and Laboratory Medicine

Background: Orthokeratinized Odontogenic Cyst (OOC) is a rare, developmental odontogenic cyst which was considered in the past to be a variant of Odontogenic keratocyst (OKC) later renamed as keratocystic odontogenic tumor (KCOT). The treatment of OOC is by enucleation and the prognosis, following enucleation is excellent with a recurrence rate of less than 2%. On the other hand, OKC has a recurrence rate between 8 and 25% after enucleation. Thus it is important to differentiate between the two entities.
Methods: All cases reported in our section as OOC during the period 2013 to 2018 were retrieved from the surgical pathology …

Inspire : Vol 2, Issue 4, Department Of Medicine

INSPIRE

Content

• Message From The Chair
• The Story of a Stroke Champion; Professor Ayeesha Kamran Kamal
• Department of Medicine Appreciation Evening
• Conquering Hepatitis via Micro-elimination (CHIME) Grant
• Department of Medicine
• Pilot Project;
• Electronic Attendance for Grand Rounds & Meetings
• Potential to sync with One45
• Say Good-Bye to Manual Attendance Sheets
• Department of Medicine at National and International Forums Featured Faculty Profile Dr. Syed Ahsan; “ Humility and patience are the hallmarks of a good leader.”
• What Are Academics Around the World Reading This Month?

Designing Ethakul: A Mobile Just-In-Time Learning Environment For Bioethics In Pakistan, Azra Naseem, Kulsoom Ghias, Sohail Bawani, Mohammad Ali Shahab, Sameer Nizamuddin, Waqar Kashif, Kausar S. Khan, Tashfeen Ahmad, Murad Khan

Institute for Educational Development, Karachi

In developing countries such as Pakistan, bioethics has not been included in mainstream thinking in medical education. The authors’ experiences suggest that current methods of teaching bioethics are problematic as students are unable to translate theory to practice. Alternative pedagogies, such as just-in-time learning (JiTL) using mobile devices, may be able to foster the development and implementation of ethical reasoning among nurses, doctors, and medical and nursing students. This research was conceived to determine the effectiveness of mobile JiTL – anytime, anyplace learning through mobile devices – for teaching bioethics. After obtaining ethical clearance, a participatory design (PD) approach was …

Cancer And How The Patients See It; Prevalence And Perception Of Risk Factors: A Cross-Sectional Survey From A Tertiary Care Centre Of Karachi, Pakistan, Saira Saeed, Javaid Khan, Nousheen Iqbal, Sana Irfan, Alviya Shafique, Safia Awan

Section of Pulmonary & Critical Care

Background: The incidence of cancer is rising but data available regarding prevalence of cancer and patient perception of the disease in Pakistan is limited. It is difficult to deal with Cancer if the main causes are negligence towards risk factors and bizarre myths. This study was aimed to investigate common cancer presentations at a government sector hospital and to gain insight into patient knowledge of the disease.

Methods: This was a cross-sectional study conducted on cancer patients from Jinnah Postgraduate Medical Centre. A self-made questionnaire was used to assess the norms related to cancer prevalence in our society, associated myths, …

Cime Newsletter : March - April 2019, Cime

CIME Newsletter

-Tools in Critical Care Nursing
-SIMWARS
-Marching in step: Boot Camp for the New Private Wing
-Protecting our most vulnerable Pneumonia
-Clinical Simulation Educators Programme: Championing the Cause
-Artificial Intelligence?
-Be Prepared: Mass Casualty Incidents can happen at any time.

Antimicrobial Susceptibility Patterns Of Salmonella Species In Southern Pakistan, Ghulam Shabbir Laghari, Zahid Hussain, Syed Zohaib Maroof Hussain, Haresh Kumar, Syed Mohammad Mazhar Uddin,, Aatera Haq

Section of Internal Medicine

Introduction Typhoid fever is a major infectious disease among the pediatric population of Pakistan. With inappropriate use of antibiotics and rising trends of multidrug-resistant (MDR) and extended drug-resistant (XDR) typhoid, it is becoming a public health emergency. This study evaluated the current trends in antibiotic susceptibilities to Salmonella (S) typhi and paratyphi A, B, and C in southern Pakistan. Materials and methods This cross-sectional study, conducted in the Pediatrics Department, Civil Hospital, Jamshoro from July to December 2018, included children with S. typhi and S. paratyphi A and B strains isolated from the laboratory-based culture of blood samples. Results There …

Comparison Of The Depth Of Cure Of Flowable Composites Polymerized At Variable Increment Thicknesses And Voltages: An In Vitro Study, Sadia Tabassum, Muhammad Hasan Hameed, Farhan Raza Khan

Section of Dental-Oral Maxillofacial Surgery

Objectives: The aim of this study is to compare the depth of cure of two composite materials (SDR and Filtek bulk-fill) cured at variable increment depths (2, 4, and 6 mm) and voltages (180 and 220 volts).
Materials and Methods: Each sample of the composite material was packed in a mold of 2 mm, 4 mm, and 6 mm and curing light (quartz tungsten halogen) of optimal intensity was exposed for 20 s at 2 different voltages on each specimen. After curing, the specimens were removed and the composite on the nonexposed end was scraped with a plastic instrument. The …