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2017

Articles 61 - 90 of 393

Full-Text Articles in Medicine and Health Sciences

Congenital Diaphragmatic Hernia Presenting In The Sixth Decade Mimicking Pneumonia, Saulat H. Fatimi, Nida Sajjad, Marium Muzaffar, Hashim Muhammad Hanif Sep 2017

Congenital Diaphragmatic Hernia Presenting In The Sixth Decade Mimicking Pneumonia, Saulat H. Fatimi, Nida Sajjad, Marium Muzaffar, Hashim Muhammad Hanif

Saulat Fatimi

Congenital diaphragmatic hernia presentation in adults is extremely rare. Patients who present with late diaphragmatic hernias complain of a wide variety of symptoms and diagnosis can be difficult. We report a case of a 64 year old male who presented with a six month history of cough, shortness of breath and weight loss. The most common strategy to treat a Bochdalek hernia is via a thoracotomy or laparotomy or both. In our patient the repair was performed with a thoracotomy.

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Aspergilloma In A Patient With No Previous History Of Chronic Lung Disease, Sadaf Sheikh, Saulat H. Fatimi Sep 2017

Aspergilloma In A Patient With No Previous History Of Chronic Lung Disease, Sadaf Sheikh, Saulat H. Fatimi

Saulat Fatimi

Patients with aspergilloma should undergo surgical treatment, because there is a risk of sudden life threatening hemoptysis and because there is no effective alternate medical therapy. We report a case of aspergilloma in a 47 year old man with no past history of tuberculosis presented with the complaint of hemoptysis for two weeks. It was diagnosed radiologically and treated with left upper lobectomy. Post operative course was complicated by cardiorhythmic disorder.

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Aortic Dissection Or Myocardial Infarction?, Saulat H. Fatimi, Maria Mahboob, Awais Ashfaq Sep 2017

Aortic Dissection Or Myocardial Infarction?, Saulat H. Fatimi, Maria Mahboob, Awais Ashfaq

Saulat Fatimi

Aortic dissection is a rare and a life threatening event. Classically, aortic dissection presents as sudden, severe chest, back or abdominal pain that is characterized as ripping or tearing in nature. However, a timely diagnosis can be elusive in the event of an atypical presentation. So, a high index of clinical suspicion is mandatory for the accurate and rapid diagnosis of aortic dissection .We report a case of a 56 years old male who presented with signs and symptoms of myocardial infarction and was later found to have aortic dissection. This patient was successfully managed with surgery.

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Atresia Of The Descending Aorta In A Young Woman Requiring Bypass Graft, Ammarah Mashhood, Taimur Asif Ali, Saulat H. Fatimi Sep 2017

Atresia Of The Descending Aorta In A Young Woman Requiring Bypass Graft, Ammarah Mashhood, Taimur Asif Ali, Saulat H. Fatimi

Saulat Fatimi

Congenital aortic atresia is a malformation accounting for 4 - 6% of all congenital heart diseases in children. Left ventricular outflow obstruction due to atresia is common at the aortic valve but rarely has atresia been identified in the descending aorta. We report the case of a 25-year woman who was evaluated for headache and uncontrolled hypertension. CTscan chest showed a short atretic segment in the descending aorta at the isthmus, distal to the takeoff of the subclavian artery. She underwent surgery; a 22 mm Dacron graft was taken and jump graft was placed between the arch of the aorta …

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Use Of Intravenous Anti-D In Patients With Refractory And Relapsed Immune Thrombocytopenic Purpura, R. Sajid, Salman Adil, Z. Fadoo, S. Sabir, Mohammad Khurshid Sep 2017

Use Of Intravenous Anti-D In Patients With Refractory And Relapsed Immune Thrombocytopenic Purpura, R. Sajid, Salman Adil, Z. Fadoo, S. Sabir, Mohammad Khurshid

Mohammad Khurshid

Objective: To determine the response to IV anti-D and its comparison with splenectomy as second line therapy in refractory and relapsed cases of ITP, in the Aga Khan University Hospital, Karachi. Methods: A total of 23 patients with chronic ITP were treated with either anti-D or splenectomy as second line treatment. The patients were assessed for time to achieve a response to second line treatment, duration ofresponse and adverse events. Results: There were 12 patients in the anti-D group and 11 in the splenectomy group. The mean platelet count at presentation was 9,000/cumm. The mean age was 8.9 years and …

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Waldenstrom's Macroglobulinemia Terminating In Acute Myeloid Leukemia, Safoorah Khalid, Salman Adil, Mohammad Khurshid Sep 2017

Waldenstrom's Macroglobulinemia Terminating In Acute Myeloid Leukemia, Safoorah Khalid, Salman Adil, Mohammad Khurshid

Mohammad Khurshid

Waldenstrom's macroglobulinemia (WM) is a rare condition, accounting for approximately 2% of haematologic malignancies. The most common causes of death in these patients are progression of the malignant lymphoproliferative process, infection and cardiac failure. Acute leukemia is a rare event in the clinical course of WM. A number of case reports have documented the development of terminal acute leukemia in patients with WM following prolonged chemotherapy.

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Serum Cholesterol In Neonates And Their Mothers. A Pilot Study, S.H. Badruddin, R. Lalani, Mohammad Khurshid, A. Molla, R. Qureshi, M.A. Khan Sep 2017

Serum Cholesterol In Neonates And Their Mothers. A Pilot Study, S.H. Badruddin, R. Lalani, Mohammad Khurshid, A. Molla, R. Qureshi, M.A. Khan

Mohammad Khurshid

Reports from the Aga Khan University indicate that 58% of 400 school children studied had undesirably high serum cholesterol levels. The present study was undertaken to determine whether the high cholesterol levels are present at birth and to determine the relationship between cord blood, maternal blood cholesterol and maternal diet. Cord blood from 58 neonates and fasting venous blood form 45 mothers were analyzed for total serum cholesterol. Mothers were interviewed regarding their usual diet during pregnancy. Mean cord blood cholesterol was 56.90 mg/dl (range 26 to 123 mg/dI). Mean maternal blood cholesterol was 232.4mg/dl (range 141-382 mg/dl). Mean maternal …

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Role Of Serum Angiotensin Converting Enzyme In Sarcoidosis, Aysha Habib, Farooq Ghani, Mohammad Khurshid, Amanullah Khan, M. Atta Khan Sep 2017

Role Of Serum Angiotensin Converting Enzyme In Sarcoidosis, Aysha Habib, Farooq Ghani, Mohammad Khurshid, Amanullah Khan, M. Atta Khan

Mohammad Khurshid

This study was conducted to determine the role of Serum Angiotensin Converting Enzyme (SACE) as a marker in the differential diagnosis of pulmonary diseases and prognosis of sarcoidosis, A retrospective analysis of 113 medical records of patients at The Aga Khan University Hospital, with laboratory investigation for SACE was performed. Among 113 patients, 51 cases were found to have sarcoidosis, 44 of them had SACE levels greater than 52 lU/L (mean ACE 104.44). SACE levels were also found elevated in other clinical conditions like tuberculosis (mean 58.64 lUlL), but the enzyme level were less (p0.04) than those found in sarcoidosis …

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Significance Of Cytogenetic Abnormalities In Acute Myeloid Leukaemia, Mahadev S. Harani, Salman Adil, Ghulam Nabi Kakepoto, Zahida Khilji, Usman Shaikh, Mohammad Khurshid Sep 2017

Significance Of Cytogenetic Abnormalities In Acute Myeloid Leukaemia, Mahadev S. Harani, Salman Adil, Ghulam Nabi Kakepoto, Zahida Khilji, Usman Shaikh, Mohammad Khurshid

Mohammad Khurshid

Objective: To evaluate the role of karyotype in acute myeloid leukaemia (AML) as a predictor of response to induction chemotherapy. Methods: A cross-sectional study was carried out at the department of Pathology and Oncology, Aga Khan University Karachi from January 2003 to January 2005. Newly diagnosed patients with denovo AML admitted to the hospital were included in the study. Diagnosis of AML was based on FAB criteria, immunophenotyping and cytogenetic studies. They were treated according to standard protocols (combination of anthracycline and cytarabine -3+7) and those who had acute promyelocytic leukaemia additionally received all- trans retinoic acid (ATRA). Results: A …

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Suggested Reference Ranges In Clinical Chemistry For Apparently Healthy Males And Females Of Pakistan., Ayesha Molla, Mohammad Khurshid, William T. Manser, Rukhsana Lalani, Anis Alam, Zubaida Mohammad Sep 2017

Suggested Reference Ranges In Clinical Chemistry For Apparently Healthy Males And Females Of Pakistan., Ayesha Molla, Mohammad Khurshid, William T. Manser, Rukhsana Lalani, Anis Alam, Zubaida Mohammad

Mohammad Khurshid

Abstract Seven hundred and eighty six apparently healthy males (418) and females (368) aged 0-69 years were randomly selected for estimation of reference ranges of 24 serum analytes at the clinical chemistry laboratory of The Ago Khon University Hospital (AKUH). Of the total study samples, 56% (439/786) were in the poediatric age group (0-14 years) and 44% (347/786) in the adult (1 5_60 years) group. Beckman Astra Ideal Autoanalyzer was used for all the estimations. Moon and standard deviations (SD) were calculated for each of the age groups. Reference ranges were calculated following standard methods of the International Federation of …

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Polycythemia Vera And Idiopathic Erythrocytosis: Comparison Of Clinical And Laboratory Parameters, M. Usman, F. Bilwani, G. N. Kakepoto, Salman Adil, R. Sajid, Mohammad Khurshid Sep 2017

Polycythemia Vera And Idiopathic Erythrocytosis: Comparison Of Clinical And Laboratory Parameters, M. Usman, F. Bilwani, G. N. Kakepoto, Salman Adil, R. Sajid, Mohammad Khurshid

Mohammad Khurshid

Objective: To evaluate the various clinical and laboratory parameters of Polycythemia vera and idiopathic erythrocytosis in order to differentiate between two entities at the Aga Khan University Hospital. Methods: Twenty six patients of polycythemia vera and 34 patients of idiopathic erythrocytosis were analyzed with respect to clinical features and laboratory findings. Results: Patients with idiopathic erythrocytosis were males with a mean age of 41 years and no splenomegaly. Patients with polycythemia were older males and females with splenomegaly, red cell count of mor than 6.5 million/cmm, haematocrit 55%, leucocytosis, thrombocytosis and low erythropoietin level. Conclusion: Based on the above-mentioned findings, …

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Prevalence Of Iron Deficiency Anaemia In Children Of The Urban Slums Of Karachi, Ayesha Molla, Mohammad Khurshid, A. Majid Molla Sep 2017

Prevalence Of Iron Deficiency Anaemia In Children Of The Urban Slums Of Karachi, Ayesha Molla, Mohammad Khurshid, A. Majid Molla

Mohammad Khurshid

A preliminary baseline survey was conducted to estimate the prevalence of anaemia in a group of 391 children aged 6-60 months, randomly selected from three urban slums of Karachi. Haemoglobin and the red cell indices including haematocrit, MCV, MCH, MCHC, ABC and red cell distribution width (RDW) were estimated for each of the selected children. Ferritin estimation was done on 354 (9 1%) children to assess the iron storage status. According to WHO criteria, the accepted cut-off point for anaemia screening in children is set at 11 gm/dl, 70 fI and 20 pg for haemoglobin, MCV and MCH respectively. Following …

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Rhesus And Kell Phenotyping Of Voluntary Blood Donors: Foundation Of A Donor Data Bank, Farheen Karim, Bushra Moiz, Fahmida Jan Muhammad, Fatima Ausat, Mohammad Khurshid Sep 2017

Rhesus And Kell Phenotyping Of Voluntary Blood Donors: Foundation Of A Donor Data Bank, Farheen Karim, Bushra Moiz, Fahmida Jan Muhammad, Fatima Ausat, Mohammad Khurshid

Mohammad Khurshid

OBJECTIVE: To assess the Rhesus (Rh) and Kell (K) phenotype of voluntary blood donors and lay foundation of a data bank of voluntary blood donors. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Blood Bank, The Aga Khan University Hospital, Karachi, in the year 2014. METHODOLOGY: Voluntary blood donors were inducted after taking written informed consent. Three -5cc of EDTA anticoagulated blood sample was taken to phenotype red cells for C, c, E, e, and Kell antigens using antisera. [DiaMedSwitzerland]. RESULTS: Hundred blood donors were included in the study. ABO blood groups of the donors were: O [37%], B …

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Radiation Induced Tumor Lysis Syndrome In Patients With Leukemia, Imtiaz A. Malik, Paul Vellozo, Mohammad Khurshid, M. Ata Khan Sep 2017

Radiation Induced Tumor Lysis Syndrome In Patients With Leukemia, Imtiaz A. Malik, Paul Vellozo, Mohammad Khurshid, M. Ata Khan

Mohammad Khurshid

Tumour lysis syndrome is a catastrophic complica­lion of treatment of certain neoplasms. It is usually seen with the tumours that have high growth fractions, increased bulk and extreme sensitivity to cytotoxic therapy. Most commonly it occurs in association with hematologic malignancies such as lymphomas and leukaemias. Rarely it has been observed with solid tumours like small cell lung cancer, seminoma and carcinoma of the breast. The syndrome develops due to massive cell lysis occurring within a few hours to a few days of starting the cytotoxic therapy. It is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcaemia. Acute renal failure, cardiac …

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Presentation Of A Patient With Palpable Purpuric Rash, Safoorah Khalid, Mohammad Khurshid Sep 2017

Presentation Of A Patient With Palpable Purpuric Rash, Safoorah Khalid, Mohammad Khurshid

Mohammad Khurshid

Henoch Shonlein purpura (HSP) is a form of systemic vasculitis characterized by deposition of IgA dominant immune complexes in the small vessels. The triad of palpable purpuric rash on lower extremities, abdominal or renal involvement and arthritis is the typical presentation in this condition. The disease primarily affects children and is less common in adults. We report a case of a young female who presented with palpable purpura on legs, classical symptoms of HSP i.e. arthritis and off and on abdominal pain.

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Pattern Of Dyslipoproteinemia In Selected Population Of Karachi, Erum Khan, Ayesha Molla, Naila Kayani, Mohammad Khurshid Sep 2017

Pattern Of Dyslipoproteinemia In Selected Population Of Karachi, Erum Khan, Ayesha Molla, Naila Kayani, Mohammad Khurshid

Mohammad Khurshid

Pattern of dyslipoproteinemia was studied ,over a period of 3-1/2 years in 487(394 males, 93 females) cases aged 4 to above 70 years. Type IV hyperlipoproteinemia was most prevalent (36%) followed by type V (15%)

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Prevalence Of Hepatitis C Virus In Lymphoproliferative Disorders, F. Bilwani, Y. Zaidi, G. N. Kakepoto, Salman Adil, Mohammad Khurshid Sep 2017

Prevalence Of Hepatitis C Virus In Lymphoproliferative Disorders, F. Bilwani, Y. Zaidi, G. N. Kakepoto, Salman Adil, Mohammad Khurshid

Mohammad Khurshid

Objective: To study the prevalence of hepatitis C virus in lymphoproliferative disorders. Methods: A case control prospective study was performed on 143 patients with lymphoproliferative disorders and 29 patients with non-hematological malignancies were taken as controls. All the patients in both groups were analyzed for various risk factors for infection with hepatitis C virus and were tested for the presence of hepatitis C virus antibody (anti HCV), cryoglobulins and rheumatoid factor antibody. Hepatitis C viremia was documented by detection of HCV RNA by polymerase chain reaction. Results: There was no significant difference for risk factors for hepatitis C virus infection …

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Nutritional Parameters Predicting Postoperative Infections, Jamsheer Talati, M. Shameem, Mohammad Khurshid Sep 2017

Nutritional Parameters Predicting Postoperative Infections, Jamsheer Talati, M. Shameem, Mohammad Khurshid

Mohammad Khurshid

Thirteen nutritional parameters viz body mass index (BMI), mid arm circumference (MAC), mid calf circumference (MCC), triceps skin fold thickness (TST), abdominal skin fold thickness (ASFT), abdominal girth at umbilicus (AG U), haemoglobin (Hb), total leucocytes count (WBC), absolute lymphocyte count (ALC), serum proteins (Prot.), serum albumin (AIb), serum total iron binding capacity (TIBC) and serum iron (Fe) were estimated in 52 (36 male and 16 female) consecutive patients admitted to a surgical service at the Abbasi Shaheed Hospital, Karachi. Nine males and one female developed surgical infections whilst the wounds of 27 males and 15 females healed by primary …

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Increased Expression Of Hla Dr2 In Acquired Aplastic Anemia And Its Impact On Response To Immunosuppressive Therapy, M. Usman, Salman Adil, Tariq Moatter, F. Bilwani, S. Arian, Mohammad Khurshid Sep 2017

Increased Expression Of Hla Dr2 In Acquired Aplastic Anemia And Its Impact On Response To Immunosuppressive Therapy, M. Usman, Salman Adil, Tariq Moatter, F. Bilwani, S. Arian, Mohammad Khurshid

Mohammad Khurshid

Objective: To study the frequency of HLA DR2 status of patients with aplastic anemia and their response to immunosuppressive therapy at a tertiary care hospital. Methods: Thirty eight consecutive patients of acquired aplastic anemia were evaluated with respect to demographic features, severity of HLA DR2 status and response outcome to immunosuppressive therapy. Results: The mean age of the patients was 24.6 years + 16.4 with a male to female ratio of 2.8:1. Positivity of HLA DR2 was markedly high in acquired aplastic anemia patients. Twenty four (65%) out of 38 patients as compared to 45 (15%) of 300 healthy controls …

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Lack Of Benefit Of Granulocyte Macrophage Or Granulocyte Colony Stimulating Factor In Patients With Febrile Neutropenia, T. Siddiqui, I. A. Burney, A. Salam, G. N. Kakepoto, Mohammad Khurshid, R. A. Smego Sep 2017

Lack Of Benefit Of Granulocyte Macrophage Or Granulocyte Colony Stimulating Factor In Patients With Febrile Neutropenia, T. Siddiqui, I. A. Burney, A. Salam, G. N. Kakepoto, Mohammad Khurshid, R. A. Smego

Mohammad Khurshid

Objectives: To compare the clinical benefits of granulocyte-colony stimulating factor (G-CSF) or granulocyte macrophage-colony stimulating factor (GM-CSF) plus standard supportive care to supportive care alone among cancer patients with febrile neutropenia. Methods: Clinical data were collected retrospectively from 148 consecutive cancer patients with neutropenia and fever. Patients had hematologic (i.e., acute leukemias or lymphoproliferative disorders) or non-hematologic malignancies (i.e., solid tumors including carcinoma of breast, lung, or colon). Clinical variables analyzed included: age and sex; underlying malignancies; chemotherapy regimens; symptoms at time of presentation; duration of fever prior to study enrollment; days from chemotherapy until administration of GM-CSF or G-CSF; …

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Hairy Cell Leukemia: Clinical Presentation And Long Term Follow Up After Treatment With 2-Chlorodeoxyadenosine (2-Cda), Fareena Bilwani, Mohammad Usman, Salman Adil, Ghulam N. Kakepoto, Mohammad Khurshid Sep 2017

Hairy Cell Leukemia: Clinical Presentation And Long Term Follow Up After Treatment With 2-Chlorodeoxyadenosine (2-Cda), Fareena Bilwani, Mohammad Usman, Salman Adil, Ghulam N. Kakepoto, Mohammad Khurshid

Mohammad Khurshid

The aim of the study was to the clinical features and long term follow up after treatment with Cladarbine in a tertiary care hospital. Seven patients with hairy cell leukemia were diagnosed between January 1990 till December 2003. Diagnosis in all the patients was established by bone marrow aspirates and trephine biopsy along with TRAP. In two patients the diagnosis was supplemented by flowcytometry and in another two patients by splenectomy. Six patients were male while one was female. Mean age was 47.7 years (range 36-64). Most common presenting features were pallor and weakness (n=5). All patients had splenomegaly. Blood …

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Frequency Of Irregular Red Cell Alloantibodies In Patients With Thalassemia Major: A Bicenter Study, Fareena Bilwani, Ghulam Nabi, Salman Adil, Mohammad Usman, Farrukh Hassan, Mohammad Khurshid Sep 2017

Frequency Of Irregular Red Cell Alloantibodies In Patients With Thalassemia Major: A Bicenter Study, Fareena Bilwani, Ghulam Nabi, Salman Adil, Mohammad Usman, Farrukh Hassan, Mohammad Khurshid

Mohammad Khurshid

Objective: To provide frequency and distribution pattern of various types of irregular red cell alloantibodies in patients with thalassemia major. Methods: This is a descriptive study conducted at two centers from January to December 2001. Purposive sampling was done and all patients diagnosed to have thalassemia major were included in the study. Antibody identification was carried out on serum employing commercial two-cell panel using standardized blood bank methods. If patients were found to have an irregular red cell alloantibody then the antibody identification was performed using 16 panel cells. Results: A total of ninety-seven patients were included in the study. …

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Frequency Of Hereditary Thrombophilia: An Akuh Experience., Safoorah Khalid, Raihan Sajid, Salman Adil, Mohammad Khurshid Sep 2017

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

Mohammad Khurshid

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 have …

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Frequency And Clinical Spectrum Of Rare Inherited Coagulopathies--A Tricenter Study, Safoorah Khalid, Fareena Bilwani, Salman Naseem Adil, Mohammad Khurshid Sep 2017

Frequency And Clinical Spectrum Of Rare Inherited Coagulopathies--A Tricenter Study, Safoorah Khalid, Fareena Bilwani, Salman Naseem Adil, Mohammad Khurshid

Mohammad Khurshid

OBJECTIVE: To determine the frequency of rare inherited coagulopathies at three centers of haematology in Karachi and to study the clinical spectrum and laboratory data of these coagulopathies. METHODS: This was a descriptive study conducted from September 2003 to December 2004 on subjects from Aga Khan University Hospital, Husaini Blood Bank and Fatimid Blood Transfusion Centre. All the subjects with bleeding tendency without any acquired causes of bleeding were selected for further investigation, and were asked relevant questions as present in the questionnaire. Screening tests including platelet count, PT, APTT and bleeding time were performed on all patients and subsequently, …

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Flow Cytometric And Demographic Analysis Of T Cell Acute Lymphoblastic Leukemia In Pakistani Population., M R. Khawaja, S S. Allana, N N. Akbaral, S N. Adil, M. Khurshid, Shahid Pervez Sep 2017

Flow Cytometric And Demographic Analysis Of T Cell Acute Lymphoblastic Leukemia In Pakistani Population., M R. Khawaja, S S. Allana, N N. Akbaral, S N. Adil, M. Khurshid, Shahid Pervez

Mohammad Khurshid

Background: This study was carried out to analyze the proportion of T cell acute lymphoblastic leukemia (TALL) among all acute lymphoblastic leukemia (ALL) in Pakistani population and its correlation with the demographic features. Accuracy of cell surface markers used in flow cytometric analysis of the leukemic cells was also determined. Methods: Data of 209 consecutive cases of acute lymphoblastic leukemia (ALL) presenting between July 1995 and July 2003 was analyzed. Flow cytometry was performed on all ALL cases using the standard protocols. TALL markers included CD3, CD5 and CD7. Results: Proportion of TALL among known ALL Pakistani patients was 17.22%. …

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Effect Of L-Type Calcium Channel Blocker (Amlodipine) On Myocardial Iron Deposition In Patients With Thalassaemia With Moderate-To-Severe Myocardial Iron Deposition: Protocol For A Randomised, Controlled Trial, Amarah Shakoor, Maaman Zahoor, Alina Sadaf, Najveen Alvi, Zehra Fadoo, Arjumand Rizvi, Farheen Quadri, Fateh Ali Tipoo, Mohammad Khurshid, Zaffar Sajjad, Steven Colan, Babar S Hasan Sep 2017

Effect Of L-Type Calcium Channel Blocker (Amlodipine) On Myocardial Iron Deposition In Patients With Thalassaemia With Moderate-To-Severe Myocardial Iron Deposition: Protocol For A Randomised, Controlled Trial, Amarah Shakoor, Maaman Zahoor, Alina Sadaf, Najveen Alvi, Zehra Fadoo, Arjumand Rizvi, Farheen Quadri, Fateh Ali Tipoo, Mohammad Khurshid, Zaffar Sajjad, Steven Colan, Babar S Hasan

Mohammad Khurshid

Introduction: Sideroblastic cardiomyopathy secondary to repeated blood transfusions is a feared complication in thalassaemia. Control of myocardial iron is thus becoming the cornerstone of thalassaemia management. Recent evidence suggests a role for L-type Ca2+ channels in mediating iron uptake by the heart. Blocking the cellular iron uptake through these channels may add to the benefit of therapy to standard chelation in reducing myocardial iron. We aim to determine the efficacy of amlodipine (a calcium channel blocker) as an adjunct to standard aggressive chelation in retarding myocardial iron deposition in thalassaemics with or without cardiomyopathy.Outcomes: The primary outcome is to compare …

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Does Red Blood Cell Distribution Width (Rdw) Improve Evaluation Of Microcytic Anaemias?, Muhammad Sajjad Baqar, Mohammad Khurshid, A Molla Sep 2017

Does Red Blood Cell Distribution Width (Rdw) Improve Evaluation Of Microcytic Anaemias?, Muhammad Sajjad Baqar, Mohammad Khurshid, A Molla

Mohammad Khurshid

Abstract The red cell distribution width (RDW) is an index of the variation in red cells size (anisocytosis). A study was conducted to examine the validity of using RDW in improving classification of microcytic anaemias. A total of 300 blood samples collected from a patient population aged 3 months to 55 years who were referred for haemoglobin electrophoresis were examined at The Aga Khan University Hospital (AKUH). On complete blood count, initially 200 patients (66.6%) were found to have hypochromic microcytic anaemia. Following haemoglobin electrophoresis 41% (821200) patients were diagnosed to have thalassemia minor and 59% (1181200) had hypochromic microcytic …

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Epidemiological Features Of Aplastic Anaemia In Pakistan, Salman Adil, G. N. Kakepoto, Mohammad Khurshid, I. A. Burney Sep 2017

Epidemiological Features Of Aplastic Anaemia In Pakistan, Salman Adil, G. N. Kakepoto, Mohammad Khurshid, I. A. Burney

Mohammad Khurshid

Objective: To complete the data on the demographic features of patients diagnosed to have aplastic anemia at a single institution over a 7.5 years period. Methods: Demographic information was retrieved from the patients medical records retrospectively as well as prospectively of those patients who presented with features of aplastic anaemia. Their diagnosis was confirmed by performing a complete blood count and bone marrow trephine. Results: One hundred and forty four patients were diagnosed to have aplastic anemia; there were 106 males and 38 females. Their ages ranged from 2 to 75 years, with a median of 17 years, 112 (77.7%) …

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Fludarabine Induced Immune Thrombocytopenia In A Patient With Cd5 Positive B Cell Chronic Lymphocytic Leukemia, M. Usman, Salman Adil, R. Sajid, Mohammad Khurshid Sep 2017

Fludarabine Induced Immune Thrombocytopenia In A Patient With Cd5 Positive B Cell Chronic Lymphocytic Leukemia, M. Usman, Salman Adil, R. Sajid, Mohammad Khurshid

Mohammad Khurshid

Fludarabine is a purine nucleoside analogue, which inhibits DNA synthesis by inhibiting DNA polymerase and ribonucleoside reductase.1 It affects both dividing and non- dividing cells.2 Fludarabine possesses proven efficacy in the treatment of a variety of indolent B cell lymphoproliferative disorders including chronic lymphocytic leukemia3, low-grade non-Hodgkin's lymphoma4 and Waldenstrom macroglobulinemia.5 It is also a part of conditioning regimes in non-myeloablative bone marrow transplantation.6 The common side effects include myelosuppression, immunosuppression, and neurologic toxicity.7 The rare side effects are immune mediated hemolytic anemia8 and thrombocytopenia.9 Here we describe a case of a middle-aged lady who was diagnosed as B cell …

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Fludarabine Induced Autoimmune Haemolytic Anaemia In A Patient With Chronic Lymphocytic Leukaemia, Naveen Naz Syed, Mohammad Khurshid Sep 2017

Fludarabine Induced Autoimmune Haemolytic Anaemia In A Patient With Chronic Lymphocytic Leukaemia, Naveen Naz Syed, Mohammad Khurshid

Mohammad Khurshid

Autoimmune haemolytic anaemia following fludarabine is an uncommon complication and previously treated patients are at higher risk. We describe a case of 57- year old lady with chronic lymphocytic leukaemia; she received intermittent courses of alkylating agents and purine analogue, fludarabine. Reintroduction of fludarabine for her relapsing disease induced autoimmune haemolytic anaemia. Numbers of cases have been reported regarding autoimmune haemolytic anaemia following fludarabine administration, but none have been published from our part of the world. Normally T-cell suppresses autoreactive lymphocytes that can produce autoantibodies. Suppression of T-cells by fludarabine, in addition to the underlying disease process appears to be …

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