Medicine and Health Sciences Commons^™

Functional Evaluation Of The Urinary Tract By Duplex Doppler Ultrasonography In Patients With Acute Renal Colic., Raza Sayani, Muhammad Ali, Kashif Shazlee, Rana Shoaib Hamid, Kamran Hamid

Department of Radiology

Purpose: To determine the role of duplex Doppler ultrasonography (DDU) in Patients with acute unilateral renal obstruction. Subjects And Methods:A total of 161 Patients with suspected renal colic due to urolithiasis were evaluated by DDU followed by intravenous urography (IVU). The mean intra-arterial resistive index (RI) and the difference of mean resistive index between both kidneys (delta RI) were determined for each person. An RI value of ≥0.70 and a delta RI value of ≥0.06 were taken as the discriminatory threshold for obstruction. IVU results were considered the " reference standard" against which renal DDU findings were compared.

Results: …

Earlier Surgical Intervention In Congenital Heart Disease Results In Better Outcome And Resource Utilization, Roheena Z. Panni, Awais Ashfaq, Muhammad M. Amanullah

Section of Cardiothoracic Surgery

Background:Congenital heart disease (CHD) accounts for a major proportion of disease in the pediatric age group. The objective of the study was to estimate the cost of illness associated with CHD pre, intra and postoperatively, among Patients referred to a tertiary care hospital in Karachi, Pakistan. This is the first study conducted to estimate the cost of managing CHD in Pakistan.

Methods:

A prevalence based cost of illness Study Design was used to estimate the cost of cardiac surgery (corrective & palliative) for congenital heart defects in children Results:The mean age at the time of surgery in group …

A Critical Analysis Of The Current State Of Neurosurgery Training In Pakistan, Muhammad Shahzad Shamim, Muhammad Zubair Tahir, Saniya Siraj Godil, Rajesh Kumar, Arshad Ali Siddiqui

Section of Neurosurgery

Objective: To observe interdepartmental variation in the availability of resources and academic activities within the various neurosurgery programs of Pakistan.
Methods: This was a proforma-based survey of neurosurgery trainees and young neurosurgeons of Pakistan, looking at the academic infrastructure and output of their programs. The proforma was filled by 36 respondents from 11 neurosurgery centers of the country. All these centers were accredited for neurosurgery training in Pakistan.
Results: Out of the 36 respondents, 30 were completing a Fellowship training (FCPS) and six were enrolled for a Master in Surgery (MS) program. About 80% of the participants used the Youman's …

Outbreak Of Beriberi Among African Union Troops In Mogadishu, Somalia, John T. Watson, Hassan El Bushra, Emmaculate J. Lebo, Godfrey Bwire, James Kiyengo, Gideon Emukule, Victor Omballa, John Tole, Muvunyi Zuberi, Robert F. Breiman, Mark A. Katz

Internal Medicine, East Africa

Context and Objectives: In July 2009, WHO and partners were notified of a large outbreak of unknown illness, including deaths, among African Union (AU) soldiers in Mogadishu. Illnesses were characterized by peripheral edema, dyspnea, palpitations, and fever. Our objectives were to determine the cause of the outbreak, and to design and recommend control strategies.

Design, Setting, and Participants: The illness was defined as acute onset of lower limb edema, with dyspnea, chest pain, palpitations, nausea, vomiting, abdominal pain, or headache. Investigations in Nairobi and Mogadishu included clinical, epidemiologic, environmental, and laboratory studies. A case-control study was performed to identify risk …

Factors Influencing The Opinion Of Individuals In Determining Tumour Spread After Biopsy, Tayyaba Z. Ansari, Adnan A. Zaidi, Asra Parekh, Owais Iqbal, Nehal Masood, Ahmed Mateen, Tehseen Fatima

Section of General Surgery

Background: People often have concerns regarding tumour spread after biopsy which leads to a delay in seeking expert medical advice. The data regarding this perception is scanty. Therefore, we conducted this cross sectional study to explore the beliefs and perceptions of individuals regarding tumour spread after biopsy and the basis of those beliefs.
Methods: The survey was conducted in outPatient areas of two different tertiary care hospitals of Karachi namely Aga Khan University Hospital Karachi (AKUH) and Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN). We interviewed 600 individuals and documented their responses on a questionnaire. There were 400 responders …

Cerebrospinal Fluid Rhinorrhea: An Institutional Perspective From Pakistan, Muhammad Zubair Tahir, Muhammad Babar Khan, Muhammad Umair Bashir, Shabbir Akhtar, Muhammad Ehsan Bari

Section of Neurosurgery

Background:The management of cerebrospinal fluid (CSF) rhinorrhea has evolved over the last two decades. We present here a review of our 11-year data on CSF rhinorrhea and its management at a tertiary care hospital in a developing country, with particular reference to the diagnosis, surgical management and outcome of the disease.
Methods: The medical charts of all Patients with a diagnosis of CSF rhinorrhea over an 11-year period were reviewed. The etiology of CSF rhinorrhea was classified into three categories: spontaneous, iatrogenic and traumatic. All the Patients were divided into three categories based on the type of management as …

Risk Factors Of Gallbladder Cancer In Karachi-A Case-Control Study, A. Rehman Alvi, Nadeem Ahmed Siddiqui, Hasnain Zafar

Department of Surgery

Background:Gallbladder carcinoma (GC) is a relatively rare malignancy worldwide but is the second commonest gastrointestinal cancer in Pakistani women. Gallstones have a positive association with GC but other factors also influence in causation.

Methods:

This is a retrospective case control study over a period of 19 years. The cases (Group A) were Patients with histopathological proven carcinoma gallbladder (N = 60) and controls were Patients with cholelithiasis but no carcinoma gallbladder on histopathology (N = 120). Multivariate regression analysis was done to calculate the odds ratio, 95% confidence interval and P-Value. A positive relationship was found between size of …

Interferon Alpha For Chronic Hepatitis D, Zaigham Abbas, Muhammad Arsalan Khan, Mohammad Salih, Wasim Jafri

Department of Medicine

Background:

Hepatitis D virus is a small defective RNA virus that requires the presence of hepatitis B virus infection to infect a person. Hepatitis D is a difficult-to-treat infection. Several clinical trials have been published on the efficacy of interferon alpha for hepatitis D virus (HDV) infection. However, there are few randomised trials evaluating the effects of interferon alpha, and it is difficult to judge any benefit of this intervention from the individual trials.

Objectives:

To evaluate the beneficial and harmful effects of interferon alpha for Patients with chronic hepatitis D.

Search methods:

We identified relevant for the review randomised …

Can Computer Assisted Diagnosis (Cad) Be Used As A Screening Tool In The Detection Of Pulmonary Nodules When Using 64-Slice Multidetector Computed Tomography?, Zishan Haider, Muhammad Idris, W. Memon, Nazia Kashif, Sidra Idris, Zafar Sajjad, Saeed Akram

Department of Radiology

Objectives:To evaluate (1) whether or not the addition of computer-assisted diagnosis (CAD) to 64-slice multidetector computed tomography (CT) can be used as a screening tool for detection of pulmonary nodules in routine CT chest examinations and (2) whether or not to advocate the incorporation of CAD as a screening tool into our daily practice. Materials And

Methods:

A retrospective cross-sectional analysis of 109 consecutive Patients who had all undergone routine contrast-enhanced CT chest examinations for indications other than lung cancer at the Radiology Department of Aga Khan University Hospital, Karachi, between November 2010 and January 2011. All examinations were …

Teachers’ And Parents’ Perspective As How The Social Environment Of Immediate Vicinity Can Affect The Academic Learning Of A Child 4-6 Years Age Group, Salma Amin Rattani, Deedar Shah

School of Nursing & Midwifery

In the process of human development environment plays a pivotal role. At the age of 4 -6 years, children's immediate vicinity expands from home to school and in his social environment parents and teachers play a vital role. Therefore, in this study which was conducted in Phander district Ghizer, Northern areas; of Pakistan, employing descriptive research design five parents and five school teachers were enrolled. Participants shared their definition and understanding about social environment and immediate vicinity and its effects on academic learning. This research is part of Advanced Diploma in Human Development: Early Child Development Programme, Aga Khan University. …

Role Of Pre-Hospital Care And Ambulance Services In Karachi, Syed Muhammad Baqir, Kiran Ejaz

Department of Emergency Medicine

No abstract provided.

Variations In Practice Patterns Among Neurosurgeons And Orthopaedic Surgeons In The Management Of Spinal Disorders, Manzar Hussain, Sadaf Nasir, Amber Moed, Ghulam Murtaza

Section of Neurosurgery

Study design: This is a case series.
Purpose: We wanted to identify variations in the practice patterns among neurosurgeons and orthopedic surgeons for the management of spinal disorders.
Overview of literature: Spinal disorders are common in the clinical practice of both neurosurgeons and orthopedic surgeons. It has been observed that despite the availability of various guidelines, there is lack of consensus among surgeons about the management of various disorders.
Methods: A questionnaire was distributed, either directly or via e-mail, to the both the neurosurgeons and orthopedic surgeons who worked at 5 tertiary care centers within a single region of Korea. …

Outcomes In St Elevation Myocardial Infarction; A Comparison Of A Tertiary Care Center In Pakistan With European Centers, Sadia Arshad, Sajid Dhakam, Safia Awan

Section of Cardiology

OBJECTIVES: To evaluate the clinical characteristics and in hospital outcome data of patients presenting to the Aga Khan University Hospital with ST elevation Myocardial Infarction (STEMI) and its comparison with data from patients enrolled in the European Heart registry for the same duration.METHODS: Data on 296 patients with STEMI was prospectively collected from 1st January 2010, till 31st December 2010 from the cardiology section at the Aga Khan University Hospital. European data was collected on 7485 patients retrieved from the Eurobservational Research programme Acute Coronary Syndrome Registry 2010 for the same duration.RESULTS: A total of 296 patients were enrolled from …

Biotinidase Deficiency- A Treatable Inherited Metabolic Disorder, Bushra Afroze

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Sonographic Fetal Biometry Charts For A Pakistani Cohort., W. Akhtar, A. Ali, M. A. Arain, F. Saeed, S. Siddiqui, A Memon

Department of Radiology

This study aimed to develop growth centiles at different gestational weeks for fetal biparietal diameter, abdominal circumference, femur length and head circumference in a Pakistani cohort. Data were collected at a tertiary referral hospital from pregnant women at gestational ages 13-40 weeks referred for obstetric ultrasound as a part of routine antenatal care. A total of 1599 fetal sonographic biometric measurements were collected after screening for the inclusion criteria. For each measurement, separate regression models were derived to estimate the mean, standard deviation and reference percentiles at each week of gestational age for this cohort. The best fitting model for …

Anaesthetic Management Of Abdominal Hysterectomy In Patient With Congenital Sinus Node Dysfunction, Dileep Kumar, Faisal Shamim

Department of Anaesthesia

A 45 years old woman having dysfunctional uterine bleeding was scheduled for total abdominal hysterectomy with bilateral salpingo-oophorectomy under general anaesthesia. On pre-operative anaesthesia assessment, she was found to have junctional rhythm at rate of 44 beats/minute with bigeminies and pre-mature ventricular contractions on ECG. On further evaluation, she was diagnosed as having congenital sinus node dysfunction on the basis of 24 hours Holter monitoring. She was asymptomatic, no prior comorbidity and belonged to functional class one. General anaesthesia was successfully managed by vigilance, invasive monitoring, standby transcutaneous and transvenous pacemakers; use of cardiostable and vagolytic anaesthetic agents like Etomidate, …

Magnesium, A Drug Of Diverse Use, Mohammad Irfan Akhtar, Hameed Ullah, Mohammad Hamid

Department of Anaesthesia

Magnesium has evolved as a drug with diverse clinical applications. Mg++ is an important caution and its homeostasis is very important for normal body functioning. The physiological role of Mg is due to its calcium channel blocking properties at smooth muscle, skeletal muscle and conduction system levels. The analgesic properties are due to NMDA receptor blocking action. Mg++ is beneficial in acute Myocardial Infarction, protection during open heart surgery and treatment and prevention of heart rhythm disturbances. Mg has an established role in the management of preeclampsia and eclampsia. Magnesium prevents or controls convulsions by blocking neuromuscular transmission and decreasing …

Ambulatory Blood Pressure Monitoring In Stroke Survivors: What Do We Add To The Care Of Our Patients?, Shaista Anwar Siddiqi, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Proliferating Tricholemmal Tumour: Clinicopathological Aspects Of A Case., Adeel Khoja, Yan B, Lee Sj, Cheong E. C, Tan K B

Department of Medicine

We report the case of a 49-year-old man who presented with an enlarging mass over his occipital scalp. The clinical impression was either a squamous cell carcinoma or an unusual adnexal tumour. A wide excision was performed with skin grafting. Gross examination revealed a large exophytic tumour mass measuring 10 cm. Histopathological examination showed a circumscribed, well-differentiated squamoproliferative lesion with a lobulated architecture. Clear cell features, pilar-type keratinisation, microcalcifications and the presence of mucinous degeneration were noted. A diagnosis of proliferating tricholemmal tumour was made. This entity incorporates a spectrum of lesions, ranging from the mostly benign proliferating tricholemmal cyst …

Determining The Factors Associated With Unmet Need For Family Planning: A Cross-Sectional Survey In 49 Districts Of Pakistan, Waqas Hameed, Syed Khurram Azmat, Mohsina Bilgrami, Muhammad Ishaqe

Community Health Sciences

Introduction & Background: Around 137 million women in the developing world who would like to avoid childbearing are unable to do so, despite a huge increase in contraceptive access and use globally. Ironically, the prevalence of unmet need in Pakistan is among the highest in the world despite being one of the first countries in South Asia to launch national family planning program. The aim of this paper is to estimate the prevalence of unmet need for contraception and to indentify the factors associated with it.
Methods: A cross-sectional survey was conducted in forty nine districts of Pakistan across all …

Ambulatory Blood Pressure Monitoring In Stroke Survivors: What Do We Add To The Care Of Our Patients, Shaista Anwar Siddiqi, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Pediatric Neurology In The 21st Century: Its Outlook In Pakistan, Shahnaz Ibrahim

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Baseline Profile Of Childhood Focal Epilepsies In Jordan, Wael Hayel Khreisat

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Dural Sinus Thrombosis A Local Experience At Shifa International Hospital, Islamabad, Pakistan, Maimoona Siddiqui, Nadia Mehboob, Ismail A. Khatri

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

The Effect Electroacupuncture On Postoperative Pain Management Following Inguinal Surgery, Kamiar Tavakkoli Tabassi, Rahim T.R, Shabnam M, A.A Kabiri, Amir G

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Familial Hypocupremia With Neurological Manifestations, Bilal Mustafa, Arsalan Ahmad, Ismail A. Khatri

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Cryptococcal Meningitis In A Patient With Diabetes Mellitus And Chronic Liver Disease Case Report With Neuroimaging, Abdul Salam, Arsalan Ahmad, Ayesha Junaid, Ismail A Khatri, Maimoona Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Snap, Crackle & Pop A Normal Variant Of Increased Insertional Activity: May Be Misleading For Electromyographer, Ghulam Shabbir, M Al Hakami, Manzoor A.L, Asad Ullah, Mustafa Khan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurology, Farzin Majeed Dr.

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neuroradiology, Zafar Sajjad Dr.

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.