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Full-Text Articles in Medicine and Health Sciences

Cime Newsletter : November 2018, Cime Nov 2018

Cime Newsletter : November 2018, Cime

CIME Newsletter

-A Knowledge Enhancement and Skills Updating Workshop For 75 Infection Control Nurses and Staff
-Acquiring Skills, Knowledge and Confidence in Transurethral Resection of the Prostate and Transurethral Resection of Bladder – A Simulation Workshop
-A Pioneering Simulation Session for Nursing Year III Students
-A First Interdisciplinary Tracheostomy Workshop for AKU
-SimWars 2019
-The Department of Surgery holds a Mini Breast Surgery Symposium
-Staff in Action!


Expression Analysis Of Cyclooxygenase-2 In Patients Suffering From Esophageal Squamous Cell Carcinoma, Shahida Tasneem, , Muhammad Tahir Sarwa, Muhammad Rizwan Bashi, Hamid Hussain, Jawad Ahmed, Shahid Pervez Oct 2018

Expression Analysis Of Cyclooxygenase-2 In Patients Suffering From Esophageal Squamous Cell Carcinoma, Shahida Tasneem, , Muhammad Tahir Sarwa, Muhammad Rizwan Bashi, Hamid Hussain, Jawad Ahmed, Shahid Pervez

Department of Pathology and Laboratory Medicine

Esophageal squamous cell carcinoma (ESCC) is one of the aggressive malignancies and mechanisms underlying its pathogenesis remain unclear. Cyclooxygenase-2 (COX-2) enzyme system plays a crucial role in many gastrointestinal malignancies and is an important regulator of cell growth, proliferation, apoptosis, differentiation and transformation. More precise outcome of COX-2 in ESCC is less investigated. In this study we investigated the risk factors of ESCC and expression of COX-2 in Carcinoma in situ (CIS) and ESCC compared to normal esophageal mucosa. ESCC relationship to clinico-pathological parameters using immunohistochemistry was also part of this investigation. Current study was conducted in the Institute of ...


The Sleep Quality Using Pittsburgh Sleep Quality Index., Khushbakht Khan Awan, Muhammad Talha Farooq, Pashma Farooq, Muhammad Yasir Tarar Oct 2018

The Sleep Quality Using Pittsburgh Sleep Quality Index., Khushbakht Khan Awan, Muhammad Talha Farooq, Pashma Farooq, Muhammad Yasir Tarar

Pakistan Journal of Neurological Sciences (PJNS)

Good quality and enough sleep are necessary for the proper cognitive performance of medical students. There is a wide prevalence of sleep disturbances among Pakistani medical students and there is a need to spread awareness regarding the problems concerning sleep patterns. OBJECTIVE: To determine the quality of sleep among first and final year medical students. METHODOLOGY: It’s a cross sectional study conducted at Services Institute of Medical College Lahore from the 10th May to 15th June 2016.A total of 300 Male and female medical students of first and final year were administered PSQI and their socio-demographic profile along ...


Cime Newsletter : October 2018, Cime Oct 2018

Cime Newsletter : October 2018, Cime

CIME Newsletter

-Healthcare Simulation Week 2018
-1st Clinical Simulation Educator Programme
-Train the Trainers Workshop by CIME
-Knee Arthroscopy Workshop
-1st Paediatric Airway Surgery Conference


Use Of Quantitative Molecular Diagnostic Methods To Assess The Aetiology, Burden, And Clinical Characteristics Of Diarrhoea In Children In Low-Resource Settings: A Reanalysis Of The Mal-Ed Cohort Study, James A. Platts-Mills Md, Jie Liu, Elizabeth T. Rogawski, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta Oct 2018

Use Of Quantitative Molecular Diagnostic Methods To Assess The Aetiology, Burden, And Clinical Characteristics Of Diarrhoea In Children In Low-Resource Settings: A Reanalysis Of The Mal-Ed Cohort Study, James A. Platts-Mills Md, Jie Liu, Elizabeth T. Rogawski, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Optimum management of childhood diarrhoea in low-resource settings has been hampered by insufficient data on aetiology, burden, and associated clinical characteristics. We used quantitative diagnostic methods to reassess and refine estimates of diarrhoea aetiology from the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study.
Methods: We re-analysed stool specimens from the multisite MAL-ED cohort study of children aged 0–2 years done at eight locations (Dhaka, Bangladesh; Vellore, India; Bhaktapur, Nepal; Naushero Feroze, Pakistan; Venda, South Africa; Haydom, Tanzania; Fortaleza, Brazil; and Loreto, Peru), which included ...


Use Of Quantitative Molecular Diagnostic Methods To Investigate The Effect Of Enteropathogen Infections On Linear Growth In Children In Low-Resource Settings: Longitudinal Analysis Of Results From The Mal-Ed Cohort Study, Elizabeth T. Rogawsk, Jie Liu, James A. Platts-Mill, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta Oct 2018

Use Of Quantitative Molecular Diagnostic Methods To Investigate The Effect Of Enteropathogen Infections On Linear Growth In Children In Low-Resource Settings: Longitudinal Analysis Of Results From The Mal-Ed Cohort Study, Elizabeth T. Rogawsk, Jie Liu, James A. Platts-Mill, Furqan Kabir, Paphavee Lertsethtakarn, Adil Kalam, Fatima Aziz, Shahida Qureshi, Najeeha Talat Iqbal, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Enteropathogen infections in early childhood not only cause diarrhoea but contribute to poor growth. We used molecular diagnostics to assess whether particular enteropathogens were associated with linear growth across seven low-resource settings.
Methods: We used quantitative PCR to detect 29 enteropathogens in diarrhoeal and non-diarrhoeal stools collected from children in the first 2 years of life obtained during the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) multisite cohort study. Length was measured monthly. We estimated associations between aetiology-specific diarrhoea and subclinical enteropathogen infection and quantity and attained ...


Integration Of Therapies In Autistic Children; A Survey Based In Karachi, Pakistan, Masnoon Akhter, Mussarat Ashraf, Adnan Ali, Irum Rizwan, Rehana Rehman Oct 2018

Integration Of Therapies In Autistic Children; A Survey Based In Karachi, Pakistan, Masnoon Akhter, Mussarat Ashraf, Adnan Ali, Irum Rizwan, Rehana Rehman

Department of Biological & Biomedical Sciences

A cross-sectional study was conducted from January to June 2016 on autistic children at the Autism Unit of Dow University of Health Sciences to compare speech therapy, occupational therapy and combination of both for rehabilitation of autistic children in the selected population. A total of 55 children with autism age range from 1-12 years of both gender and all ethnic groups were recruited. All data was analysed in IBM-SPSS version 23.0. Pearson chi-square test was used to determine association of type of therapy with the diagnosed age of child, gender, mode of delivery, history of vaccination and parent's ...


Accuracy Of Echocardiography In Diagnosing Total Anomalous Pulmonary Venous Return, Fatima Ali, Sonia Qureshi, Muneer Amanullah, Mehnaz Atiq Oct 2018

Accuracy Of Echocardiography In Diagnosing Total Anomalous Pulmonary Venous Return, Fatima Ali, Sonia Qureshi, Muneer Amanullah, Mehnaz Atiq

Department of Paediatrics and Child Health

Objective: Total anomalous pulmonary venous return is an uncommon cyanotic congenital heart defect. Echocardiography is the initial diagnostic tool. Complimentary non-invasive modalities like cardiac computerized tomographic angiography and cardiac magnetic resonance imaging have replaced the need for cardiac catheterization in difficult cases. This study aimed to determine the accuracy of echocardiography in diagnosing total anomalous pulmonary venous return, and to determine the factors that may decrease its sensitivity.
Methods: This was a cross-sectional study conducted at the Aga Khan University Hospital Karachi, Pakistan from January 2010 to August 2016. All patients who were diagnosed with Total anomalous pulmonary venous return ...


Cime Newsletter : September 2018, Cime Sep 2018

Cime Newsletter : September 2018, Cime

CIME Newsletter

-Live Orbital and Oculoplastic Surgery Telecast and Fundoscopy Simulator Training
-CIME at SimGHOSTS
-Endoscopy Workshop in Partnership
-A Masterclass on the Mini-Gastric Bypass Procedure
-Vascular Surgery Workshop
-Complicated Intra-Abdominal Infections Workshop
-Shoulder Dystocia - Team Training Workshop
-Simulation Saves Lives by Dolliewood Production


A Framework For Cyclical Nursing Curriculum Review Across Multi-Site And Multi-Country Campuses, Sharon Brownie, Rachel Rossiter Sep 2018

A Framework For Cyclical Nursing Curriculum Review Across Multi-Site And Multi-Country Campuses, Sharon Brownie, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Cyclical curriculum review and continuous course improvement is an unarguable measure of quality nursing education. Higher education and professional regulators across the Middle East and North Africa (MENA) and African (Afro) regions are increasingly mandating cyclical review within accreditation and programme approval standards. Many nursing education providers in the region operate multi-site and multi-country campuses. A key challenge is to ensure that programmes keep pace with international standards in nursing education, and, that inter-campus drift does not occur in programme content and quality. Cyclical review offers a process whereby programmes can be updated to current best practice and consistent cross-campus ...


Supporting The Nationally Mandated Transition To Competency-Based Nursing Curricula In Egypt, Sharon Brownie, Rachel Rossiter Sep 2018

Supporting The Nationally Mandated Transition To Competency-Based Nursing Curricula In Egypt, Sharon Brownie, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Egypt has a substantive and rich history in nursing education with continuous evolution over many years. A government commitment to further enhance the capacity of the nursing workforce recently required all nursing curricula to be upgraded and presented in a competency-based format. In response to this directive, lead agencies in Egypt, including the Educational Development Fund and the Nursing Sector Group of the Supreme Council of Universities, have garnered internal and external nursing expertise to provide guidance in the curriculum reform process. The authors of this presentation are currently working in close partnership with several Egyptian nursing education providers supporting ...


Pharmacy Newsletter : September 2018, Pharmacy Department Sep 2018

Pharmacy Newsletter : September 2018, Pharmacy Department

Pharmacy Newsletter

Content:

  • Stress Ulcer Prophylaxis
  • New Update: Direct Oral Anti-Coagulants (DOACs)
  • Case Study: Use of Cholestyramine for Management Of Digoxin Toxicity
  • Updates : Use of Doxycycline in Children
  • Serotonin Syndrome – Myths & Misconceptions


Microbiological And Clinical Profile Of Infective Endocarditis Patients: An Observational Study Experience From Tertiary Care Center Karachi Pakistan, Uzma Shahid, Hasanat Sharif, Joveria Farooqi, Bushra Jamil, E. Khan Sep 2018

Microbiological And Clinical Profile Of Infective Endocarditis Patients: An Observational Study Experience From Tertiary Care Center Karachi Pakistan, Uzma Shahid, Hasanat Sharif, Joveria Farooqi, Bushra Jamil, E. Khan

Department of Pathology and Laboratory Medicine

Background:
The study analyzed microbiological and antimicrobial susceptibility profile of organisms isolated from patients with infective endocarditis (2015–17) and compared disease outcomes in cohorts of endocarditis patient with history of prior invasive vascular intervention (high risk group) vs those without (native valve group). We hypothesized that high risk group would be more likely to have severe disease outcomes.
Methods:
This was a prospective cohort study (2015–17). All blood and cardiac tissue samples of enrolled patients suspected of endocarditis according to modified Duke’s criteria were followed for microbiological and antimicrobial susceptibility profile. The high risk group was compared ...


Men’S Health In Industries: Plastic Plant Pollution And Prevalence Of Pre-Diabetes And Type 2 Diabetes Mellitus, Sultan Ayoub Meo, Faris Jamal Almutairi, Majed Mohammed Alasbali, Turki Badr Alqahtani, Saad Saeed Almutairi, Rakan Abdulaziz Albuhayjan, Fawziah Al Rouq, Naseer Ahmed Sep 2018

Men’S Health In Industries: Plastic Plant Pollution And Prevalence Of Pre-Diabetes And Type 2 Diabetes Mellitus, Sultan Ayoub Meo, Faris Jamal Almutairi, Majed Mohammed Alasbali, Turki Badr Alqahtani, Saad Saeed Almutairi, Rakan Abdulaziz Albuhayjan, Fawziah Al Rouq, Naseer Ahmed

Department of Biological & Biomedical Sciences

Plastic production is prominently increasing and its pollution is an emerging environmental global health concern. This study aimed to investigate the occurrence of pre-diabetes and type 2 diabetes mellitus (T2DM) among nonsmoking plastic industry workers. Three hundred and forty volunteers male plastic industry workers were interviewed after medical history and examination; finally, 278 nonsmoking plastic industry workers were selected. The mean age for the participants was 38.03 ± 10.86 years and body mass index was 25.52 ± 3.15 (kg/m)2. The plastic industry workers had been exposed to plastic plant pollution for 8 hr daily, 6 days ...


Promoting Clinical Breast Evaluations In A Lower Middle–Income Country Setting: An Approach Toward Achieving A Sustainable Breast Health Program, Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, Guldarbogh Sadonshoeva, Saleem Sayani, Aliya Aminmuhammad, Farin Amersi, Sheemain Asaria, Mansoor Saleh, Zohray Talib Sep 2018

Promoting Clinical Breast Evaluations In A Lower Middle–Income Country Setting: An Approach Toward Achieving A Sustainable Breast Health Program, Roziya Buribekova, Irina Shukurbekova, Surayo Ilnazarova, Nekruz Jamshevov, Guldarbogh Sadonshoeva, Saleem Sayani, Aliya Aminmuhammad, Farin Amersi, Sheemain Asaria, Mansoor Saleh, Zohray Talib

Medical College Documents

PURPOSE:
To promote a systems-based approach for the early detection and downstaging of breast cancer at presentation in the remote mountainous region of Gorno Badakhshan Autonomous Oblast (GBAO), Tajikistan, by introducing breast cancer awareness into the community and training health care professionals in clinical breast evaluation (CBE).
METHODS:
Through a public-private partnership between the Ministry of Health, the Aga Khan Health Services, Tajikistan, and the Aga Khan Health Board, we organized breast cancer screening in the community and trained family medicine doctors (FMDs) and family medicine nurses (FMNs) in CBE. We identified and trained CBE master trainers, who, in turn ...


Maternal Predictors Of Intrauterine Growth Retardation, Nadia Mohammad, Arjumand Sohaila, Unaib Rabbani, Sufian Ahmed, Shakeel Ahmed, Syed Rehan Ali Sep 2018

Maternal Predictors Of Intrauterine Growth Retardation, Nadia Mohammad, Arjumand Sohaila, Unaib Rabbani, Sufian Ahmed, Shakeel Ahmed, Syed Rehan Ali

Department of Paediatrics and Child Health

Objective: To identify maternal factors associated with intrauterine growth restriction (IUGR).
Study Design: A case-control study.
Place and Duration of Study: Neonatal Unit of The Aga Khan Hospital for Women (AKHW), Karimabad, from January 2014 to December 2015.
Methodology: Cases were IUGR live born babies (n=90), while control were appropriate-for-gestational age (AGA) babies (n=180). Information recorded in pre-designed proforma included gestational age and birth weight of baby, demographics of mothers, pregnancy related medical and obstetric complications. Data were analysed through SPSS-19. Multivariable logistic regression was used to determine the maternal factors associated with the intrauterine growth restriction.
Results ...


Compound Heterozygosity For A Whole Gene Deletion And P.R124c Mutation In Cyp21a2 Causing Nonclassic Congenital Adrenal Hyperplasia, Hamza Nasir, Syed Ibaad Ali, N Haque, Stefan K. Grebe,, Salman Kirmani Sep 2018

Compound Heterozygosity For A Whole Gene Deletion And P.R124c Mutation In Cyp21a2 Causing Nonclassic Congenital Adrenal Hyperplasia, Hamza Nasir, Syed Ibaad Ali, N Haque, Stefan K. Grebe,, Salman Kirmani

Section of Diabetes, Endocrinology and Metabolism

We present a family with 2 members who received long-term steroid treatment for presumed classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, until molecular testing revealed nonclassic CAH, not necessarily requiring treatment. A 17-year-old male presented to our clinic on glucocorticoid and mineralocorticoid treatment for classic CAH. He was diagnosed at 4 years of age based on mild-moderate elevations of 17-hydroxyprogesterone (17-OHP) and adrenocorticotropic hormone (ACTH), but without evidence of precocious adrenarche/puberty. Due to his diagnosis, his clinically asymptomatic 3-year-old sister was tested and also found to have elevated ACTH and 17-OHP levels and was started on glucocorticoids ...


Role Of Adc Values And Ratios Of Mri Scan In Differentiating Typical From Atypical/Anaplastic Meningiomas, Muhammad Azeemuddin, Waseem Mehmood Nizamani, Muhammad Usman Tariq, Mohammad Wasay Sep 2018

Role Of Adc Values And Ratios Of Mri Scan In Differentiating Typical From Atypical/Anaplastic Meningiomas, Muhammad Azeemuddin, Waseem Mehmood Nizamani, Muhammad Usman Tariq, Mohammad Wasay

Department of Radiology

Atypical/anaplastic meningiomas are prone to aggressive behaviour which affects treatment planning and prognostication. Our aim was to assess the role of Apparent Diffusion Coefficient (ADC) values of MRI brain in differentiating typical from atypical/anaplastic meningioma. We reviewed 84 typical and 37 atypical/anaplastic meningiomas and compared mean ADC values and ADC ratios of their preoperative MRI brain. At 3 Tesla, mean ADC value for typical meningioma was1.03±0.10x10-3 and 0.63±0.05x10-3 for atypical/anaplastic meningioma. At 1.5 Tesla, mean ADC value for typical meningioma was 1.05±0.11x10-3 and atypical/ anaplastic meningioma ...


Needs Assessment For Curricular Reform Of A Post Graduate Paediatric Training Programme At A Private University Hospital In Karachi, Pakistan, Sana Saeed, Khadija N. Humayun, Farah Qamar, Arshalooz Rahman, Kashif Karim Sep 2018

Needs Assessment For Curricular Reform Of A Post Graduate Paediatric Training Programme At A Private University Hospital In Karachi, Pakistan, Sana Saeed, Khadija N. Humayun, Farah Qamar, Arshalooz Rahman, Kashif Karim

Department of Paediatrics and Child Health

In order to make and sustain changes in the curriculum, needs assessment is the key. We conducted a need assessment survey using a questionnaire based on a 7 point Likert Scale by residents and alumni. Over all response rate in the study was 77.5%. Fifty eight percent participants were females. Highest level of agreement (mean score 5.7) was found between the alumni and residents regarding the need to revise the content, teaching and assessment strategies in the programme. Twenty seven alumni (n= 38, 71%) had cleared their FCPS exams. The alumni thought that the existing teaching and assessment ...


Fungal Osteomyelitis In A Patient With Chronic Granulomatous Disease: Case Report And Review Of The Literature, Muhammad Khalid, Syed Asad Ali Sep 2018

Fungal Osteomyelitis In A Patient With Chronic Granulomatous Disease: Case Report And Review Of The Literature, Muhammad Khalid, Syed Asad Ali

Department of Paediatrics and Child Health

Chronic granulomatous disease (CGD) is the most common of the primary immunodeficiency in children. It is caused by single gene defect resulting in dysfunctional nicotinamide adenine dineucleotide phosphate (NADPH) oxidase complex causing recurrent bacterial and fungal infections. Here we present the case of a 9 year old boy who was a known case of CGD since three years of age. He presented with recent history of fever, left sided pain in the scapular region and difficulty in breathing. Chest imaging revealed developing left upper lobe consolidation and erosion of the 3rd posterior rib. The child underwent video assisted thoracoscopic surgery ...


Setting The Stage: Reviewing Current Knowledge On The Health Of New Zealand Immigrants—An Integrative Review, Blessing Kanengoni, Sari Andajani-Sutjahjo, Eleanor Holroyd Aug 2018

Setting The Stage: Reviewing Current Knowledge On The Health Of New Zealand Immigrants—An Integrative Review, Blessing Kanengoni, Sari Andajani-Sutjahjo, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

The growth of migrant communities continues to rise globally, creating unique and complex health challenges. Literature on immigrant health in New Zealand (NZ) remains scant. This integrative literature review was conducted drawing on peer-reviewed research articles on immigrant health in NZ published between 2012 and 2018. The objectives were to: (i) provide a critical overview of immigrant health in NZ; (ii) identify general trends in health research conducted in NZ on immigrants; (iii) compare, contrast, and evaluate the quality of the information; (iv) develop a summary of research results and; (v) identify priorities and recommendations for future research. A search ...


“You Travel Faster Alone, But Further Together”: Learning From A Cross Country Research Collaboration From A British Council Newton Fund Grant, Priscilla Reddy, Rachana Desai, Sibusiso Sifunda, Kalipso Chalkidou, Charles Hongoro, William Macharia, Helen Roberts Aug 2018

“You Travel Faster Alone, But Further Together”: Learning From A Cross Country Research Collaboration From A British Council Newton Fund Grant, Priscilla Reddy, Rachana Desai, Sibusiso Sifunda, Kalipso Chalkidou, Charles Hongoro, William Macharia, Helen Roberts

Faculty of Health Sciences, East Africa

Abstract: Providing universal health coverage (UHC) through better maternal, neonatal, child and adolescent health (MNCAH) can benefit both parties through North–South research collaborations. This paper describes lessons learned from bringing together early career researchers, tutors, consultants and mentors from the United Kingdom, Kenya, and South Africa to work in multi-disciplinary teams in a capacity-building workshop in Johannesburg, co-ordinated by senior researchers from the three partner countries. We recruited early career researchers and research users from a range of sectors and institutions in the participating countries and offered networking sessions, plenary lectures, group activities and discussions. To encourage bonding and ...


A Pilot Study Exploring Nursing Knowledge Of Depression And Suicidal Ideation In Kenya, Timothy Muga, Gladys Mbuthia, Samwel Gatimu, Rachel Rossiter Aug 2018

A Pilot Study Exploring Nursing Knowledge Of Depression And Suicidal Ideation In Kenya, Timothy Muga, Gladys Mbuthia, Samwel Gatimu, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Nurses play key roles in recognizing, diagnosing, managing, and referring persons with mental disorders. This cross-sectional study assessed mental health literacy (depression and suicidal ideation) among nurses in a private urban referral hospital in Kenya. Nurses read a vignette and answered questions regarding diagnosis, treatment/interventions, and related attitudes and beliefs. Thirty-seven nurses (12 males) completed the questionnaire. Three correctly identified the diagnosis and 23 identified depression only. Although 75% noted the symptoms were extremely distressing, fear, and stigma were common reactions. This highlights challenges in mental health promotion/prevention in Kenya, and suggests continuous nursing education and curriculum enhancement ...


The Socio-Political Debate Of Dying Today In The United Kingdom And New Zealand: ‘Letting Go’ Of The Biomedical Model Of Care In Order To Develop A Contemporary Ars Moriendi, Rhona Winnington, Eleanor Holroyd, Shelaine Zambas Aug 2018

The Socio-Political Debate Of Dying Today In The United Kingdom And New Zealand: ‘Letting Go’ Of The Biomedical Model Of Care In Order To Develop A Contemporary Ars Moriendi, Rhona Winnington, Eleanor Holroyd, Shelaine Zambas

School of Nursing & Midwifery, East Africa

Death is a reality of life. Despite this inevitability, death today remains unwelcome and has been sequestered into the enclaves of medical practice as a means of quelling the rising tide of fear it provokes. Medical practice currently maintains power over the dying individual, actualised through the selective collaboration between medicine and law as a means of subverting the individual who attempts to disrupt the contemporary accepted norms of dying. There is, however, a shift on the horizon as to whether we can make the notion of a true choice become a reality in New Zealand. This serves to offer ...


Epidemiology Of Patients Presenting To A Pediatric Emergency Department In Karachi, Pakistan, Nadir Ijaz, Matthew Strehlow, N. Ewen Wang, Elizabeth Pirrotta, Areeba Tariq, Naseeruddin Mahmood, Swaminatha Mahadevan Aug 2018

Epidemiology Of Patients Presenting To A Pediatric Emergency Department In Karachi, Pakistan, Nadir Ijaz, Matthew Strehlow, N. Ewen Wang, Elizabeth Pirrotta, Areeba Tariq, Naseeruddin Mahmood, Swaminatha Mahadevan

Department of Paediatrics and Child Health

Background: There is little data describing pediatric emergencies in resource-poor countries, such as Pakistan. We studied the demographics, management, and outcomes of patients presenting to the highest-volume, public, pediatric emergency department (ED) in Karachi, Pakistan.
Methods: In this prospective, observational study, we approached all patients presenting to the 50-bed ED during 28 12-h study periods over four consecutive weeks (July 2013). Participants’ chief complaints and medical care were documented. Patients were followed-up at 48-h and 14-days via telephone. Results: Of 3115 participants, 1846 were triaged to the outpatient department and 1269 to the ED. Patients triaged to the ED had ...


An Approach To Identify A Minimum And Rational Proportion Of Caesarean Sections In Resource-Poor Settings: A Global Network Study, José M. Belizán, Nicole Minckas, Elizabeth M. Mcclure, Sarah Saleem, Janet L. Moore, Shivaprasad S. Goudar, Fabian Esamai, Archana Patel, Elwyn Chomba, Ana L. Garces Aug 2018

An Approach To Identify A Minimum And Rational Proportion Of Caesarean Sections In Resource-Poor Settings: A Global Network Study, José M. Belizán, Nicole Minckas, Elizabeth M. Mcclure, Sarah Saleem, Janet L. Moore, Shivaprasad S. Goudar, Fabian Esamai, Archana Patel, Elwyn Chomba, Ana L. Garces

Community Health Sciences

Background: Caesarean section prevalence is increasing in Asia and Latin America while remaining low in most African regions. Caesarean section delivery is effective for saving maternal and infant lives when they are provided for medically-indicated reasons. On the basis of ecological studies, caesarean delivery prevalence between 9% and 19% has been associated with better maternal and perinatal outcomes, such as reduced maternal land fetal mortality. However, the specific prevalence of obstetric and medical complications that require caesarean section have not been established, especially in low-income and middle-income countries (LMICs). We sought to provide information to inform the approach to ...


Case Report: Lady With Bone Pains For 5 Years-Parathyroid Carcinoma, Azra Rizwan, Abid Jamal, Maseeh Uz Zaman, Saira Fatima Aug 2018

Case Report: Lady With Bone Pains For 5 Years-Parathyroid Carcinoma, Azra Rizwan, Abid Jamal, Maseeh Uz Zaman, Saira Fatima

Section of Diabetes, Endocrinology and Metabolism

Background: Parathyroid cancer is a rare cause of primary hyperparathyroidism. It presents a diagnostic and therapeutic challenge that may not be recognized preoperatively, and is often not conclusively identified during the operation. We present the case of a lady with backache and hypercalcemia, but with inadequate work-up for her condition for several years.

Case Presentation: A middle aged lady of Asian descent presented with backache. Initial work up revealed mild hypercalcemia, negative work up for multiple myeloma, negative sestamibi scan for parathyroid pathology. A phenomenally elevated parathormone (PTH) level-2105 pg/mL (16-87 pg/mL), and rising serum calcium, 15.1 ...


Assessment Of Malnutrition In Patients With Liver Cirrhosis Using Protein Calorie Malnutrition (Pcm) Score Verses Bio-Electrical Impedance Analysis (Bia), Om Parkash, Wasim Jafri, S. M. Munir, Romaina Iqbal Aug 2018

Assessment Of Malnutrition In Patients With Liver Cirrhosis Using Protein Calorie Malnutrition (Pcm) Score Verses Bio-Electrical Impedance Analysis (Bia), Om Parkash, Wasim Jafri, S. M. Munir, Romaina Iqbal

Section of Gastroenterology

Objective: Malnutrition is a common problem in patients with liver cirrhosis and tools for nutritional assessment are under debate. We conducted this study to assess prevalence of malnutrition in cirrhotic patients using PCM score and BIA. Additionally we compared BIA to PCM score for detecting malnutrition in this patient population.

Results: This was a cross sectional study conducted in two tertiary care hospitals of Karachi Pakistan on adults with liver cirrhosis. Malnutrition was assessed by PCM score using anthropometric measurements and biological specimens and (ii) Body cell mass was assessed using BIA. Malnutrition as estimated by the PCM score was ...


Predictors Of Serious Findings On Bi-Directional Endoscopy In Young Patients With Anemia And Gi Symptoms, Faisal Aslam, A. B. Khalid, Faraz Siddiqui, Yamna Jadoon Aug 2018

Predictors Of Serious Findings On Bi-Directional Endoscopy In Young Patients With Anemia And Gi Symptoms, Faisal Aslam, A. B. Khalid, Faraz Siddiqui, Yamna Jadoon

Section of Gastroenterology

Background: Iron deficiency anemia (IDA) has been cited as the most common cause of anemia globally. Gastrointestinal (GI) lesions are amongst the common cause of IDA. Endoscopic evaluation is the most effective way to investigate the IDA. The aim of this study was to show the association of alarming GI symptoms with abnormal endoscopic findings and to cut off the burden and cost of unnecessary endoscopies.

Methods: This is cross sectional study of anemic patient who underwent upper and lower GI endoscopies in Aga Khan University Hospital, Karachi between July-December 2016.

Results: Total 243 patients were identified after excluding ineligible ...


Coping With Illness: Insight From The Bhagavad Gita, Bharti Kalra, Ameya Joshi, Sanjay Kalra, Vivekanand G. Shanbhag, Jyoti Kunwar, Yatan Pal Singh Balhara, Sandeep Chaudhary, Deepak Khandelwal, Sameer Aggarwal, Nanik Ram Aug 2018

Coping With Illness: Insight From The Bhagavad Gita, Bharti Kalra, Ameya Joshi, Sanjay Kalra, Vivekanand G. Shanbhag, Jyoti Kunwar, Yatan Pal Singh Balhara, Sandeep Chaudhary, Deepak Khandelwal, Sameer Aggarwal, Nanik Ram

Section of Diabetes, Endocrinology and Metabolism

The Shrimad Bhagavad Gita enlightens everyone on how to cope up with various situations in life. It uses the conversation between Lord Krishna and Arjuna to highlight initial negative coping mechanisms exhibited by the latter. It goes on to showcase positive coping skills suggested by Lord Krishna and implemented by Arjuna. The Bhagavad Gita, through this "case-based methodology," teaches us how to cope with a demanding situation. Diabetes is a lifestyle disease, which warrants a thorough change in one's lifestyle, including changes in basic activities such as diet and exercise. This brief communication utilizes the teachings of Bhagavad Gita ...