Medicine and Health Sciences Commons^™

Self-Medication Amongst University Students Of Karachi: Prevalence, Knowledge And Attitudes, Syed Nabeel Zafar, Reema Syed, Sana Waqar, Akbar Jaleel Zubairi, Talha Vaqar, Mehrine Shaikh, Wajeeha Yousaf, Saman Shahid, Sarah Saleem

Community Health Sciences

OBJECTIVE: To determine the prevalence, attitude and knowledge of self-medication amongst university students of Karachi, Pakistan.

METHODS: This cross-sectional, study was conducted from Jan-Feb 2007. A convenience sample was taken from 2 medical and 2 non-medical universities of the city of Karachi, Pakistan. Data was analyzed using SPSS v 14 and associations were tested using the Chi square test.

RESULTS: Of the 572 participants (mean age=21 +/- 1.8 years, Male: Female ratio=1:1.5), 295 were medical and 277 were non-medical students. The prevalence of self-medication was 76%. Forty three percent students stated that they alter the regimen of prescribed medicines while …

Gastric Juice For The Diagnosis Of H Pylori Infection In Patients On Proton Pump Inhibitors, Javed Yakoob, Shahid Rasool, Z Abbas, Wasim Jafri, Shahab Abid, Muhammad Islam, Zubair Ahmad

Section of Gastroenterology

Aim:To determine the efficacy of gastric juice polymerase chain reaction (PCR) for the detection of H pylori infection in comparison with histology and gastric antral biopsy PCR in Patients on a proton pump inhibitor (PPI).

Methods:

Eighty-five consecutive Patients with dyspeptic symptoms were enrolled. Gastric biopsies for histology, PCR and gastric juice were collected at endoscopy for PCR of the H pylori urease C gene (ure C). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, positive and negative likelihood ratio for PCR of gastric juice for the H pylori ure C gene was compared to histology …

Juvenile Myelomonocytic Leukaemia, Emaduddin Siddiqui, Shaheena Hanif

Department of Emergency Medicine

No abstract provided.

Admission Criteria And Subsequent Academic Performance Of General Nursing Diploma Students, Parveen Azam Ali

School of Nursing & Midwifery

OBJECTIVE: To determine the relationship between admission criteria used to select students and their subsequent academic performance in general nursing diploma Programme in the province of Sindh.

METHODS: Using a descriptive co-relational study design, data was collected retrospectively from records of the entire nursing student population of the batch of 2004. Using multiple linear regression analysis method, three regression models were developed to identify the group of variables that could predict academic performance of the students in the three-year general nursing diploma programme.

RESULTS: Results identified a significant relationship between admission criteria and subsequent academic performance of the students in …

Knowledge And Practice Of Radiation Safety Among Invasive Cardiologists, Nasir Rahman, Sajid H. Dhakam, Azam Shafqut, Sadia Qadir, Fateh Ali Tipoo

Section of Cardiology

OBJECTIVE: To assess the availability, practices and knowledge of radiation safety measures among invasive cardiologists in a tertiary care hospital.

METHOD: A cross sectional survey of invasive cardiologists working in academic institutions was conducted using a questionnaire.

RESULTS: A total of 28 cardiologists completed the questionnaire with a mean working experience of 10.5 + 7.6 years. All were of the opinion that radiation safety is extremely important and 93% always used lead aprons. Less than half of them used other radiation protective measures including thyroid collar, lead eyeglasses and lead shields. Only 7% regularly utilized a radiation dose badge to …

Film Retakes In Digital And Conventional Radiography, Waseem Akhtar, Mubashir Aslam, Arif Ali, Kashif Mirza, Nadeem Ahmad

Department of Radiology

Objective: To determine the film-retake rates and causes in digital radiography comparison to conventional X-rays method.

Study Design: Comparative study.

Place and Duration of Study: Radiology Department, Aga Khan University Hospital, Karachi, from January 2004 to December 2006. Patients and Methods: X-rays of different body parts, conducted during the year 2004, with conventional radiography (n=170300), and in 2006 with digital radiography (n=174550), were included in this study. Measurements were done for number of X-rays re-take due to different quality control reasons for both the conventional and digital radiography. Quality control reasons included underexposure, overexposure, positioning errors, patient movements, portable X-rays, …

Primary Drug Resistance Against Mycobacterium Tuberculosis In Karachi, Nisar Ahmed Rao, Muhammad Irfan, Shahid Javed Hussain

Section of Pulmonary & Critical Care

OBJECTIVE: To evaluate the primary drug resistance of new culture positive cases of pulmonary tuberculosis in Karachi.

METHODS: All new suspected pulmonary tuberculosis patients were recruited initially. They were instructed to produce three-sputum samples for smear examination and on one of the specimen's culture was applied. Bronchoscopy and bronchial wash was done in patients who were not expectorating. Bronchial wash was then applied for both smear and culture for Mycobacterium tuberculosis.

RESULTS: Out of 79 cases recruited initially, 52 were able to produce sputum while bronchoscopy was performed in the remaining. AFB direct smear was positive in 32/52 sputum and …

Schizophrenia: A Concept, Haider A Naqvi

Department of Psychiatry

Much of the current research-work into biological basis of mental disorders is predicted on implicit concept of disease that is less critical and sophisticated as it should be. It is remarkable, how the fundamental conceptual frame work of schizophrenia, as proposed by Professor Emil Kraepelin has stayed the same, since its inception almost 100-years ago. This review explores these issues besides highlighting alternative disease classification that suits behavioural neuroscience research.

Dubin-Johnson Syndrome, Aziz-Un Nisa, Zubair Ahmad

Department of Pathology and Laboratory Medicine

A young man presented with recurrent episodes of mild jaundice. Apart from conjugated hyperbilirubinemia, other liver function tests were always normal. Clinical suspicion of Dubin-Johnson syndrome was raised. Liver biopsy showed diffuse deposition of coarse granular dark brown pigment in hepatocytes. Dubin-Johnson syndrome is a benign condition, which results from a hereditary defect in biliary secretion of bilirubin pigments, and manifests as recurrent jaundice with conjugated hyperbilirubinemia. The defect is due to the absence of the canalicular protein MRP2 located on chromosomes 10q 24, which is responsible for the transport of biliary glucuronides and related organic anions into bile. No …

Gastric Corpus Polyps Associated With Proton Pump Inhibitors Therapy, Javed Yakoob, Zaigham Abbas, Wasim Jafri, Zubair Ahmad

Section of Gastroenterology

The prevalence of Gastroesophageal Reflux Disease (GERD) is rapidly rising in Asia. We describe here a case of 51 years old man who had surgery for esophageal leiomyoma and received long-term therapy with Proton Pump Inhibitors (PPIs) for persisting reflux symptoms. On Esophago-Gastroduodenoscopy (EGD) several sessile polyps were seen in the gastric corpus. Earlier EGD done 15 years back had not demonstrated those polyps. Sections revealed polypoid fragments of glandular epithelium with dilated glands and negative histology for H. pylori. Polymerase chain reaction for 16S ribosomal RNA gene (16S rRNA PCR) of H. pylori was also negative. This is the …

Cervical Cancer Vaccine In Pakistan: Let's Start Thinking, Ali Jawaid

Medical College Documents

No abstract provided.

What Do Patients Want From Their Psychiatrist? A Cross-Sectional Questionnaire Based Exploratory Study From Karachi, Roomasa Channa, M. N. Siddiqi

Department of Psychiatry

Background: The aspects of consultation that are important for psychiatric Patients have always remained a less acknowledged area. The aim of this study was to identify these aspects. Methods: A Cross- sectional, questionnaire based study was carried out in a psychiatry outPatient clinic of two tertiary care hospitals in a developing country. The Patients were asked to fill out the questionnaire containing a total of 11 close-ended questions plus 1 open- ended question. They graded them as not important, important, very important or do not know. Non-psychotic Patients aged 18 and above, visiting the clinic were recruited into the study …

Images In Cardiovascular Medicine. Cardiac Tuberculoma., Jeilan Mohamed, Matthias Schmitt, Gerry Mccann, Joan Davies, Joseph Leverment, Derek Chin

Internal Medicine, East Africa

A 43-year–old man with a 6-month history of cough, dyspnea, nocturnal sweats, and weight loss was reviewed in the clinic. Clinical examination revealed cervical lymphadenopathy and indicated constrictive physiology. Initial tests, including chest radiography, sputum examination, QuantiFERON-TB Gold test, and lymph node biopsy, were unyielding. HIV serology was nonreactive.

N-Acetyl-B-D-Glucosaminidase And Inflammatory Response After Cardiopulmonary Bypass, Perwaiz Iqbal, Hasanat M Sharif, Naseema Mehboobali, Farzana A Yousuf, Abrar H Khan, Frank W Sellke

Department of Biological & Biomedical Sciences

OBJECTIVE: To determine the changes in activity of plasma N-acetyl-beta-D-glucosaminidase, a marker for inflammation as well as renal, pulmonary and cardiac damage and proinflammatory cytokines in patients undergoing coronary artery bypass grafting and find out the relationship between their plasma levels with clinical outcome of patients.

STUDY DESIGN: Cross-sectional study.

PLACE AND DURATION OF STUDY: The Aga Khan University, Karachi, from January to June 2003.

PATIENTS AND METHODS: N-acetyl-beta-D-glucosaminidase (NAG) activity and concentrations of tumor necrosis factor-alpha of (TNFalpha), interleukin 6 (IL-6), interleukin 8 (IL8) and granulocyte-macrophage colony stimulating factor (GM-CSF) were monitored in plasma samples of 12 angina patients …

The Need For Formal Paediatric Resuscitation Training In Pakistan., Adina R., Sheikh Sajjad, Junaid Razzak

Department of Emergency Medicine

No abstract provided.

Precipitating Factors Of Hepatic Encephalopathy In Patients With Chronic Liver Disease At Civil Hospital Karachi, Dileep K Rohra, Jaipal, Ameer A Khowaja, Khalid Mahmood, Kanya Lal Ahuja

Department of Biological & Biomedical Sciences

No abstract provided.

Isolated Tuberculous Thyroiditis As Solitary Thyroid Nodule, Maseeh Uz-Zaman, Riffat Hussain, Muhammad Kashif Mirza, Khalil Ahmed Khan, Ghufran Mohammad Khan, M. Nadeem Ahmad

Department of Radiology

Isolated involvement of the thyroid by tuberculosis is very rare as reported in literature. We are presenting a case of isolated tuberculous thyroiditis presented as a solitary thyroid nodule. The patient was treated with anti-tuberculous regimen and he responded well with disappearance of the nodule and normalization of the thyroid scan.

A Review Of Electroencephalograms Done At The Kenyatta National Hospital, Nairobi, J. O. Jowi, Z. P Kidiga, M. G. Gitau

Internal Medicine, East Africa

Background: Electroencephalogram based studies done elsewhere suggest that epileptiform activity originates predominantly from the left cortical hemisphere. There is evidence that partial epilepsies (focal spike and wave epileptiform discharges on tracings) connotes focal;secondary structural cortical dysfunction.Studies seeking similar findings have not been done locally.

Objective: To review electroencephalograms (BEGs) done at Kenyatta National Hospital (KNH); looking for various types of epileptiform discharges and their cerebral cortex of origin.

Design: Retrospective observational study.

Setting: Kenyatta National Hospital, Nairobi, Kenya- from January 1986 to June 2004

Results: A total10431EEG records were reviewed. Ninety Eight percent of referrals for EEG evaluation was for …

Informed Consent And Some Of Its Problems In Pakistan, Robyna Irshad Khan

Department of Anaesthesia

Informed consent has become an essential element of human subject research. Certain components are essential for a well-understood informed consent. There are problems in procurement of a comprehensive and meaningful consent in the Pakistani research settings. The inefficient healthcare systems, low literacy rate with masses having no concept of individual rights, higher social status enjoyed by physicians inhibiting the patients from questioning them, and unwillingness to hear bad news are some of these factors. Establishing Bioethics education at all levels, encouraging the involvement of families in decision making, using improvisation in procurement of consent are suggested solutions. There needs to …

Sedation-Analgesia In Non Operative Locations: Practice Trends Of Anaesthetists, Fauzia Khan, Khalid Maudood Siddiqui, Rehan Qureshi

Department of Anaesthesia

Sedation/analgesia is a mode of anaesthesia which facilitates an uncomfortable or painful procedure, such as gastrointestinal endoscopy, in a rousable and cooperative patient. The objective of the study was to assess the practice trends for administering sedation analgesia in non operative locations in Aga Khan Hospital, Karachi by anaesthetists. It was a descriptive study which retrospective reviewed anaesthesia records. A total of 41 ASA I-IV cases were reviewed. Non invasive cardiorespiratory monitoring and clinical sedation monitoring were applied. Intravenous Propofol infusion and midazolam boluses were used, singly or in combination with fentanyl boluses. All our patients recovered uneventfully within 5 …

Precipitating Factors And The Outcome Of Hepatic Encephalopathy In Liver Cirrhosis., Dileep K. Rohra, Jaipal, Ameer A. Khowaja, Khalid Mahmood, Kanya Lal Ahuja

Department of Medicine

No abstract provided.

Conjunctival Malignant Melanoma Mimicking As A Chalazion, Sana Shoukat Memon, Roomasa Channa, Tanveer Anjum Chaudhry, Khabir Ahmad

Department of Surgery

No abstract provided.

Magnetic Resonance Imaging (Mri) Findings In White Matter Disease Of Brain, Humera Ahsan, Muhammad Zafar Rafique, Fozia Ajmal, Mohsin Wahid, Muhammad Azeemuddin, Farah Iqbal

Department of Radiology

Demyelinating and dysmyelinating white matter diseases are important components of neurological problems. Recently, Magnetic Resonance Imaging (MRI) has played a key role in diagnoses of white matter diseases. Therefore, the purpose of the current study is to evaluate the usefulness of MRI in determining the type and frequency of white matter disease. We studied 35 patients who visited the Radiology Department of the Aga Khan University Hospital (AKUH) for MRI with suspected demyelinating/dysmyelinating disorder from January 2003 to December 2005. Multiple Sclerosis (MS) (17; 48%) and leukodystrophies (10; 29%) were the most common diseases. The MRI helped identify the sites …

Metachronous Primary Cancers Of Colon And Stomac, Zubair Ahmad, Ayesha Memon, Khurram Minhas

Department of Pathology and Laboratory Medicine

Synchronous or metachronous occurrence of esophageal, gastric and colonic cancers is a very rare occurrence, although there are several case reports in literature. A case of a 41 years old man with metachronous cancers of colon and stomach is reported.

Knowledge, Attitudes And Practices Of Health Care Workers Regarding Needle Stick Injuries At A Tertiary Care Hospital In Pakistan, Afia Zafar, Naveen Aslam, Nosheen Nasir, Riffat Meraj, Vikram Mehraj

Department of Pathology and Laboratory Medicine

OBJECTIVE: To assess the knowledge, attitude and practices of HCWs regarding needle stick injuries at the Aga Khan University Hospital.

METHODS: A cross-sectional study was conducted on medical personnel. A structured pre-tested questionnaire was administered during June-July 2003. The data was analysed by SPSS 13.0. Percentages of the categorical variables were computed and compared by Chi square test at a 5% level of significance. Odds ratios and their 95% CIs were also computed.

RESULTS: Of 80 participants, 29 were doctors and 51 were registered nurses. About 45% reported having a needle stick injury in the past. Frequency of injury was …

An Open Study To Assess The Safety And Efficacy Of Heprovac-B Vaccine 10 Mcg-Dose For Adults, Hasnain Ali Shah, Wasim Jafri

Section of Gastroenterology

Heprovac B is a novel recombinant vaccine. There are many vaccines available in Pakistani market but Heprovac B claims to be immunogenic even at 10 meg dose. Aim of the study is to determine whether using 10 meg of Heprovac B vaccine is safe and effective in producing sufficient immunity in Pakistani population. One hundred and twenty five subjects, who fulfilled the Inclusion criteria, were enrolled for the study. Heprovac B was administered in a three-dose regimen given at 0, 1 and 6 months and adverse events were recorded. Immunogenicity was tested by measuring hepatitis B surface antibody one month …

A Fatal Case Of Gram Negative Bacterial Sepsis Associated With Disseminated Strongyloidiasis In An Immunocompromised Patient, Naima Fasih, Seema Irfan, Usman Sheikh, M. Sim Beg

Department of Pathology and Laboratory Medicine

We report a fatal case of disseminated strongyloidiasis in a patient with multiple myeloma receiving chemrotherapy. A fifty-seven years old man presented with severe diarrhoea and vomiting, fever, weight loss and dysphagia,due to mouth ulcers. Despite broad-spectrum intravenous antibiotics, albendazole (anti protozoal) and supportive treatment, the patient died of Gram-negative sepsis.

Socio-Demographic Correlates Of Exhaled Breath Carbon Monoxide In Karachi's Adult Population, Majid Shafiq, Sumera Khan, M. Rizwanulhaq Khawaja, Suleman Haque, Javaid Khan

Section of Pulmonary & Critical Care

OBJECTIVE: To examine the relationship between CO levels and putative factors including smoking status among residents of Karachi, an urban center with very high levels of air pollution.

METHODS: Two hundred and eighteen volunteering subjects were asked to maximally exhale into a Smokerlyzer breath CO analyzer. Each of the volunteers was also asked to reply to a questionnaire-based interview seeking demographic information as well as details of exposure to tobacco, traffic fumes and other air pollutants.

RESULTS: Out of the 218 participating subjects, 75% were males and 27% were current or ex-smokers. The mean CO level was 2.92 parts per …

Diagnostic Tool For Glanzmann's Thrombasthenia Clinicopathologic Spectrum, Natasha Bahadur Ali, Bushra Moiz, Mohammad Usman Shaikh, Salman Adil, Bushra Rizvi, Yasmeen Rahman

Department of Pathology and Laboratory Medicine

Objective: To platelet aggregometry and describe the clinical spectrum of Glanzmann's thrombasthenia diagnosed by platelet aggregometry.
Study design: A case-series.
Place and duration of study: This study was carried out at the clinical laboratories at the Aga Khan University Hospital, Karachi from January 2003 to January 2006.
Patients and methods: All patients irrespective of age and gender presenting with bleeding symptoms and having normal platelet count were evaluated. Demographic details, relevant clinical history along with results of complete blood count, bleeding time and platelet aggregation studies were retrieved through computerized data base and evaluated for the diagnosis of Glanzmann's thrombasthenia. …

Why Pakistani Medical Graduates Must Remain Free To Emigrate, Zarmeneh Aly, Fawad Taj

Medical College Documents

No abstract provided.