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Aga Khan University

1991

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Articles 1 - 24 of 24

Full-Text Articles in Medicine and Health Sciences

Supervised Training Of Practical Procedures In The Internal Medicine Residency, Z Abbas, S Abid, J A. Khan, A Jabbar Dec 1991

Supervised Training Of Practical Procedures In The Internal Medicine Residency, Z Abbas, S Abid, J A. Khan, A Jabbar

Section of Gastroenterology

In order to get feedback whether the medical residents are getting adequate supervised training to perform practical procedures, a questionnaire was distributed among the residents asking their involvement in sixteen frequently performed procedures in the medical unit of the Aga Khan University Medical Centre. Though the residents were satisfied about their training in doing lumbar punctures, pleural and peritoneal aspirations, bone marrow aspiration and trephine and chest tubes placement, they showed their concern about training in putting central lines, venous cut downs, cardiac pacing and biopsies. A better schedule training programme, organized subspecialty rotation, continuous evaluation of resident's skill, credentialing …


Eosinophilic Gastroenteritis, S H. Shah, Z Abbas, S Abid, H Shaikh, T Qaseem, H Khan Dec 1991

Eosinophilic Gastroenteritis, S H. Shah, Z Abbas, S Abid, H Shaikh, T Qaseem, H Khan

Section of Gastroenterology

No abstract provided.


Enterolithiasis Secondary To Intestinal Tuberculosis, M Y. Sheikh, I H. Rizvi, S A. Naeem, I Ahmad Nov 1991

Enterolithiasis Secondary To Intestinal Tuberculosis, M Y. Sheikh, I H. Rizvi, S A. Naeem, I Ahmad

Department of Radiology

No abstract provided.


Yet Another Cause Of Chronic Viral Hepatitis?, H A. Shah, S Abid, S Hamid, S W. Jafri, Z Abbas, T Qaseem, H Shaikh, A H. Khan Nov 1991

Yet Another Cause Of Chronic Viral Hepatitis?, H A. Shah, S Abid, S Hamid, S W. Jafri, Z Abbas, T Qaseem, H Shaikh, A H. Khan

Section of Gastroenterology

The clinical features, course and histology of liver in 20 patients; mostly middle aged to elderly females, closely resembling chronic Non A Non B hepatitis is presented. They presented quite late in their disease and therefore, complications such as variceal bleeds, ascites and encephalopathy were frequent. Our patients were negative for hepatitis B and C virus serology. Metabolic and immune causes of chronic liver disease were also ruled out. To the best of our knowledge, this is the first study of its kind elaborating the clinical features, course and histology of liver in chronic Non B Non C hepatitis and …


Congenital Pyloric Atresia And Epidermolysis Bullosa, Zafar Nazir, Zeba Batool Attar, Farhat Moazam Oct 1991

Congenital Pyloric Atresia And Epidermolysis Bullosa, Zafar Nazir, Zeba Batool Attar, Farhat Moazam

Section of Paediatric Surgery

Congenital pyloric atresia with epidermolysis bul­losa is recognized as a rare but distinct entity which is uniformly fatal1,2. Until 1990 only 20 cases have been reported in the English literature3,4. We present an additional case managed at the Aga Khan University Hospital to demonstrate the difficulties encountered in the management of such infants.


Sertoli Cell Only Syndrome (Secos): Lessons From Case Studies, Jamsheer J Talati, Hizbullah Sheikh Sep 1991

Sertoli Cell Only Syndrome (Secos): Lessons From Case Studies, Jamsheer J Talati, Hizbullah Sheikh

Section of Urology

Between June 85 and December 87, 69 testicular biopsies were submitted for histopathological examination during investigation of infertility; ten (14%) patients had a Sertoli cell only syndrome. The history, clinical features, and hormonal profiles were analyzed in an attempt to categorize these patients on aetiological basis. Two followed treatment of malignancy--one by radiation for testicular cancer and one by cyclophosphamide for a lymphoma. One had unilateral cryptorchidism. Mumps was etiological factor in one patient. FSH levels determined in 6 patients were elevated in all suggesting a possible dependence of (sick) Sertoli cells on spermatogenic cells for production of inhibin. Alternative …


Collagenous Colitis, Z Abbas, S Abid, S Hamid, W Jafri, H Khan Sep 1991

Collagenous Colitis, Z Abbas, S Abid, S Hamid, W Jafri, H Khan

Section of Gastroenterology

No abstract provided.


Recent Concepts In Clinical Psychiatry: Drug Treatment In Schizophrenia, Shahin H. Hussain Sep 1991

Recent Concepts In Clinical Psychiatry: Drug Treatment In Schizophrenia, Shahin H. Hussain

Department of Psychiatry

No abstract provided.


Hepatic Dysfunction In Falciparum Malaria, J Khan, J Akhter, H Sheikh, W Jafri Aug 1991

Hepatic Dysfunction In Falciparum Malaria, J Khan, J Akhter, H Sheikh, W Jafri

Department of Pathology and Laboratory Medicine

No abstract provided.


Current Concepts In The Diagnosis And Management Of Childhood Asthma, Z A. Bhutta Aug 1991

Current Concepts In The Diagnosis And Management Of Childhood Asthma, Z A. Bhutta

Department of Paediatrics and Child Health

No abstract provided.


A Clinicopathological Analysis Of Ovarian Tumours, M Saeed, K Khawaja, I Rizwana, Iffat Rizwana, J Rizvi, Imtiaz Malik, A Khan Jul 1991

A Clinicopathological Analysis Of Ovarian Tumours, M Saeed, K Khawaja, I Rizwana, Iffat Rizwana, J Rizvi, Imtiaz Malik, A Khan

Department of Obstetrics & Gynaecology

We performed a retrospective analysis of patients with ovarian tumors who were admitted to the Aga Khan University Hospital from January 1985 to December 1989. Sixty one cases were reviewed. Mean age of the whole group was 44 years. Majority of the patients presented with abdominal pain and distention. Most frequent physical finding was a palpable mass on pelvic or abdominal examination. Overall these patients had a higher incidence of breast cancer than expected in the general population. Two-thirds of the tumors were malignant. Comparison of the patients with malignancy against those with benign tumors failed to show any correlation …


Transcutaneous Bilirubinometry In Pakistani Newborns: A Preliminary Report, Z A. Bhutta, K Yusuf Jul 1991

Transcutaneous Bilirubinometry In Pakistani Newborns: A Preliminary Report, Z A. Bhutta, K Yusuf

Department of Paediatrics and Child Health

Neonatal hyperbilirubinemia is a frequently encountered problem in the neonatal period and carries a potential risk of encephalopathy. Early detection and quantification is important, and transcutaneous bilirubinometry (TcB) has been recommended as a non-invasive method for rapid screening. We prospectively compared the efficacy of TcB in 65 normal Pakistani jaundiced newborns undergoing simultaneous serum bilirubin measurements. Although the correlation between the two methods was significant (r = 0.66, P less than 0.01), the scatter was wide and the specificity only 53%. Although the technique offers the potential for non-invasive early screening of neonatal hyperbilirubinemia, it requires further validation in a …


Heterogeneity Of Methotrexate Binding In Human Colon Tumor Cells, M P. Iqbal, N Mehboobali, M A. Waqar, M Ahmed Jun 1991

Heterogeneity Of Methotrexate Binding In Human Colon Tumor Cells, M P. Iqbal, N Mehboobali, M A. Waqar, M Ahmed

Department of Biological & Biomedical Sciences

[3H]-methotrexate binding at pH 5.0 and pH 7.2 by the cytosol of tumor tissues and the surrounding normal areas of the gastrointestinal tract of patients suffering from colon or gastric cancer has been used to identify in these cells the presence of a binder of methotrexate having low-affinity for this drug in addition to the enzyme dihydrofolate reductase. Scatchard analysis of the [3H]-methotrexate binding data by a colon tumor sample also reveals that there are two binders of this drug present in the cytosol of these cells. The association constant (Kass) for one binder of methotrexate is = 5.6 x …


Fulminant Hepatic Failure With Typhoid Fever In Childhood, Z A. Bhutta Jun 1991

Fulminant Hepatic Failure With Typhoid Fever In Childhood, Z A. Bhutta

Department of Paediatrics and Child Health

Although hepatic dysfunction has been described among adults with typhoid, there are few reports of significant hepatic functional impairment in children with typhoid. Of 355 children with culture proven typhoid seen at the Aga Khan University Hospital, hepatomegaly was noted in 118 (33%) and isolated right hypochondrial tenderness in 30 (8.5%). The liver function tests were normal in 78% and 47% of these children respectively and significant hepatic dysfunction was seen only in 26 (7.3%). However, children with typhoid and significant hepatic dysfunction had higher mortality (P less than 0.001) and two patients presented with a picture of fulminant hepatic …


Successful Eradication Of Flavobacterium Meningosepticum Neonatal Meningitis With Ceftizoxime, Z A. Bhutta, S H. Naqvi Jun 1991

Successful Eradication Of Flavobacterium Meningosepticum Neonatal Meningitis With Ceftizoxime, Z A. Bhutta, S H. Naqvi

Department of Paediatrics and Child Health

No abstract provided.


Efficient Immortalization Of Luminal Epithelial Cells From Human Mammary Gland By Introduction Of Simian Virus 40 Large Tumor Antigen With A Recombinant Retrovirus, Bartek J, Bartkova J, Kyprianou N, El-Nasir Lalani, Staskova Z, Shearer M, Chang S, Taylor Papadimitriou J May 1991

Efficient Immortalization Of Luminal Epithelial Cells From Human Mammary Gland By Introduction Of Simian Virus 40 Large Tumor Antigen With A Recombinant Retrovirus, Bartek J, Bartkova J, Kyprianou N, El-Nasir Lalani, Staskova Z, Shearer M, Chang S, Taylor Papadimitriou J

Department of Pathology and Laboratory Medicine

When defined in terms of markers for normal cell lineages, most invasive breast cancer cells correspond to the phenotype of the common luminal epithelial cell found in the terminal ductal lobular units. Luminal epithelial cells cultured from milk, which have limited proliferative potential, have now been immortalized by introducing the gene encoding simian virus 40 large tumor (T) antigen. Infection with a recombinant retrovirus proved to be 50-100 times more efficient than calcium phosphate transfection, and of the 17 cell lines isolated, only 5 passed through a crisis period as characterized by cessation of growth. When characterized by immunohistochemical staining …


Epidural Spinal Cord Compression From Metastatic Cancer: Clinical Features And Management, H Shaheen, S Abubakar, I Malik, I Altafullah, F Alam, A Khan Mar 1991

Epidural Spinal Cord Compression From Metastatic Cancer: Clinical Features And Management, H Shaheen, S Abubakar, I Malik, I Altafullah, F Alam, A Khan

Section of Nephrology

We retrospectively analyzed thirty-three patients (21 males, 12 females) with malignancy induced spinal cord compression (SCC). The mean age of the patients was 42.8 years and almost half (51%) of them presented with SCC. Mean duration of symptoms was 4.5 months and the mean interval between the original diagnosis of cancer and the development of SCC was 14.6 months. Back pain was the most frequent (97%) symptom with an equal number of patients having subjective or objective evidence of lower limb weakness. Majority (73%) of the patients were non-ambulatory at the time of diagnosis. Spinal level involvement was mostly thoracic …


The Effects Of Suxamethonium And Pancuronium On The Haemodynamic Response To Endotracheal Intubation, F A. Khan, R S. Kamal Mar 1991

The Effects Of Suxamethonium And Pancuronium On The Haemodynamic Response To Endotracheal Intubation, F A. Khan, R S. Kamal

Department of Anaesthesia

The pharmacological effects of suxamethonium and pancuronium on the cardiovascular system may vary and therefore alter the haemodynamic response to intubation. The arterial blood pressure, the heart rate and the rate pressure product were measured as parameters of haemodynamic change in forty adult ASA. I and II patients undergoing laryngoscopy and endotracheal intubation in a randomised controlled study. The patients were induced with either thiopentone/suxamethonium (Group A) or thiopentone/pancuronium (Group B). There was no significant difference between the groups on comparison of systolic and diastolic blood pressure changes. Pancuronium, however, caused a significantly higher rise in the heart rate after …


Clinical Features And Management Of Malignant Ascites, I Malik, S Abubakar, I Rizwana, F Alam, J Rizvi, A Khan Feb 1991

Clinical Features And Management Of Malignant Ascites, I Malik, S Abubakar, I Rizwana, F Alam, J Rizvi, A Khan

Section of Cardiology

Retrospective analysis of 45 patients (33 females, 12 males) with cytologically-proven malignant ascites is presented. Abdominal pain was the most frequent symptom (69%). Fiftythree percent cases had low serum albumin. Ascitic fluid was haemorrhagic or serosanguinous in 48% cases, in the rest it was clear or straw-coloured. Peritoneal effusion was exudative in 84% cases. Mean glucose content of ascitic fluid was 95 mg/dl and the mean white cell count of 919 cells/cmm. Vast majority (82%) of the cases had metastatic adenocarcinomas. Primary malignancy was mostly ovarian (47%) followed by non-Hodgkin's lymphoma (11%) and gall bladder carcinoma (9%). Primary site could …


Bacterial Isolates In Neutropenic Febrile Patients, M Karim, W Khan, B Farooqi, I Malik Feb 1991

Bacterial Isolates In Neutropenic Febrile Patients, M Karim, W Khan, B Farooqi, I Malik

Section of Internal Medicine

One hundred consecutive patients with documented bacteremia and neutrophil count of 0.5 x 10(9)/L or below were retrospectively studied to determine the pattern of infection at the Aga Khan University Hospital in Karachi. These included patients with primary haematologic malignancies presenting with low counts, and those patients with cancer who developed neutropenia as a result of chemotherapy. The gram negative organism pseudomonas aeruginosa was the most common bacterial organism isolated constituting 31% of all positive blood cultures. Gram positive organisms were frequently isolated comprising 24% of all isolates of which 15% were Staph.aureus. Staph. epidermidis was not isolated in this …


Gestational Diabetes In A Developing Country, Experience Of Screening At The Aga Khan University Medical Centre, Karachi, Khalid S. Khan, Javaid H. Rizvi,, Rahat Qureshi, Rauf Mazhar Feb 1991

Gestational Diabetes In A Developing Country, Experience Of Screening At The Aga Khan University Medical Centre, Karachi, Khalid S. Khan, Javaid H. Rizvi,, Rahat Qureshi, Rauf Mazhar

Department of Obstetrics & Gynaecology

In order to determine the prevalence of glucose intolerance in pregnancy, 1267 consecutive women attending the antenatal clinic of the Aga khan University Medical Centre were subjected to a 75g glucose challenge followed 2hr later by plasma glucose determination irrespective of gestation on the first antenatal visit. The test was repeated at 28-32 weeks of gestation if the patients had an abnormal initial screen at < 28 weeks gestation and a normal glucose tolerance test on diagnostic follow-up and for those who had a risk factor for gestational diabetes and a normal initial screen at < 28 weeks gestation. The glucose challenge test was abnormal (2hr plasma glucose> 1 40mg%) in 8.6% of the screened population. Follow-up oral glucose tolerance test on these patients revealed a prevalence of 3.2% of gestationat diabetes and 1.9% of impaired glucose tolerance test based on the modified …


Gestational Diabetes In A Developing Country, Experience Of Screening At The Aga Khan University Medical Centre, Karachi, Khalid S. Khan, J H. Rizvi, R N. Qureshi, R Mazhar Feb 1991

Gestational Diabetes In A Developing Country, Experience Of Screening At The Aga Khan University Medical Centre, Karachi, Khalid S. Khan, J H. Rizvi, R N. Qureshi, R Mazhar

Department of Obstetrics & Gynaecology

In order to determine the prevalence of glucose intolerance in pregnancy, 1267 consecutive women attending the antenatal clinic of the Aga Khan University Medical Centre were subjected to a 75 g glucose challenge followed 2 hr later by plasma glucose determination irrespective of gestation on the first antenatal visit. The test was repeated at 28-32 weeks of gestation if the patients had an abnormal initial screen at less than 28 weeks gestation and a normal glucose tolerance test on diagnostic follow-up and for those who had a risk factor for gestational diabetes and a normal initial screen at less than …


Chloramphenicol Therapy Of Typhoid Fever, Z A. Bhutta, S H. Naqvi, S Durrani, A Suria Feb 1991

Chloramphenicol Therapy Of Typhoid Fever, Z A. Bhutta, S H. Naqvi, S Durrani, A Suria

Department of Paediatrics and Child Health

In a prospective study we compared two different dosage regimens of IV chloramphenicol succinate (100 mg/kg/day and 75 mg/kg/day) in children with culture proven typhoid. Trough and peak blood samples, obtained at 48 hrs, were analysed for free chloramphenicol by high pressure liquid chromatography (HPLC). Although the mean trough (8.8 +/- 7.7 versus 5.4 +/- 2.6 mcg/ml) and peak (19.9 +/- 12.2 versus 15.4 +/- 6.1 mcg/ml) chloramphenicol concentrations were comparable in both groups, a significantly wider range was found in the group receiving 100 mg/kg/day. Potentially toxic levels (greater than 30 mcg/ml) developed in two patients with liver dysfunction. …


The Undrained Brain: The Other Side Of The Foreign Medical Graduate Resident Issue, C M. Smythe Jan 1991

The Undrained Brain: The Other Side Of The Foreign Medical Graduate Resident Issue, C M. Smythe

Section of Neurology

No abstract provided.