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Full-Text Articles in Medicine and Health Sciences

Effect Of Hospital Volume On Outcomes Of Total Hip Arthroplasty: A Systematic Review And Meta-Analysis, Syed Hamza Mufarrih, Muhammad Owais Abdul Ghani, Russell S. Martins, Nada Qaisar Qureshi, Sayyeda Aleena Mufarrih, Azeem Tariq Malik, Shahryar Noordin Dec 2019

Effect Of Hospital Volume On Outcomes Of Total Hip Arthroplasty: A Systematic Review And Meta-Analysis, Syed Hamza Mufarrih, Muhammad Owais Abdul Ghani, Russell S. Martins, Nada Qaisar Qureshi, Sayyeda Aleena Mufarrih, Azeem Tariq Malik, Shahryar Noordin

Department of Biological & Biomedical Sciences

Background: A shift in the healthcare system towards the centralization of common yet costly surgeries, such as total hip arthroplasty (THA), to high-volume centers of excellence, is an attempt to control the economic burden while simultaneously enhancing patient outcomes. The "volume-outcome" relationship suggests that hospitals performing more treatment of a given type exhibit better outcomes than hospitals performing fewer. This theory has surfaced as an important factor in determining patient outcomes following THA. We performed a systematic review with meta-analyses to review the available evidence on the impact of hospital volume on outcomes of THA.
Materials and methods: We conducted …


Fingolimod Plays Role In Attenuation Of Myocardial Injury Related To Experimental Model Of Cardiac Arrest And Extracorporeal Life Support Resuscitation, Naseer Ahmed, Abid Laghari, Bashar Albkhoor, Sobia Tabassum, Sultan Ayoub Meo, Nazeer Muhammad, Daniele Linardi, Abeer A. Al-Masri, Guido Fumagalli, Giovanni Battista Luciani, Giuseppe Faggian, Alessio Rungatscher Dec 2019

Fingolimod Plays Role In Attenuation Of Myocardial Injury Related To Experimental Model Of Cardiac Arrest And Extracorporeal Life Support Resuscitation, Naseer Ahmed, Abid Laghari, Bashar Albkhoor, Sobia Tabassum, Sultan Ayoub Meo, Nazeer Muhammad, Daniele Linardi, Abeer A. Al-Masri, Guido Fumagalli, Giovanni Battista Luciani, Giuseppe Faggian, Alessio Rungatscher

Department of Biological & Biomedical Sciences

Background: Sudden cardiac arrest is a major global health concern, and survival of patients with ischemia-reperfusion injury is a leading cause of myocardial dysfunction. The mechanism of this phenomenon is not well understood because of the complex pathophysiological nature of the disease. Aim of the study was to investigate the cardioprotective role of fingolimod in an in vivo model of cardiac arrest and resuscitation.
Methods: In this study, an in vivo rat model of cardiac arrest using extracorporeal membrane oxygenation resuscitation monitored by invasive hemodynamic measurement was developed. At the beginning of extracorporeal life support (ECLS), animals were randomly treated …


Burnout, Job Dissatisfaction, And Mental Health Outcomes Among Medical Students And Health Care Professionals At A Tertiary Care Hospital In Pakistan: Protocol For A Multi-Center Cross-Sectional Study, Syed Hamza Mufarrih, Aeman Naseer, Nada Qaisar Qureshi, Zohaib Anwar, Nida Zahid, Riaz Hussain Lakdawala, Shahryar Noordin Nov 2019

Burnout, Job Dissatisfaction, And Mental Health Outcomes Among Medical Students And Health Care Professionals At A Tertiary Care Hospital In Pakistan: Protocol For A Multi-Center Cross-Sectional Study, Syed Hamza Mufarrih, Aeman Naseer, Nada Qaisar Qureshi, Zohaib Anwar, Nida Zahid, Riaz Hussain Lakdawala, Shahryar Noordin

Department of Biological & Biomedical Sciences

Burnout, a state of vital exhaustion, has frequently been related to work-related stress and job dissatisfaction. Given the emotionally and physically challenging nature of their work, high rates of burnout have been reported among health care professionals. This may put them at a higher risk for of suffering from adverse mental health outcomes, including depression, anxiety and stress. In our study, we aim to assess the prevalence i of and associations among burnout and job dissatisfaction and adverse mental health outcomes in a developing country, where the challenges faced by the health care system are unique. Facilities are over-burdened and …


Teaching "Shock Pathophysiology" By Flipped Classroom, Syeda Sadia Fatima, Satwat Hashmi, Rehana Rehman, Rozmeen Akbar Nov 2019

Teaching "Shock Pathophysiology" By Flipped Classroom, Syeda Sadia Fatima, Satwat Hashmi, Rehana Rehman, Rozmeen Akbar

Department of Biological & Biomedical Sciences

Objective: To assess usefulness of flipped style of teaching conducted as small-group format in Cardiovascular and Respiration module for Year-I undergraduate medical students at Aga Khan University.
Methods: The study was planned and conducted over a period of eight months from March to October 2017 including the time taken for planning, mock run, execution followed by analysis and dissemination. It was carried out at the Aga Khan University Medical College, Karachi. Pre and post test scores of students after flipped class room sessions was compared. Moreover, perception of students was assessed on Likert scale (0-4) by a pretested validated questionnaire. …


Prevalence Of Malaria Reported During Summer And Winter At A Tertiary Care Hospital In Karachi, Pakistan, Fazal M. Arain, Aisha Memon, Roohi Jamal, Ahmed Raheem Buksh, Mohammad Asim Beg Nov 2019

Prevalence Of Malaria Reported During Summer And Winter At A Tertiary Care Hospital In Karachi, Pakistan, Fazal M. Arain, Aisha Memon, Roohi Jamal, Ahmed Raheem Buksh, Mohammad Asim Beg

Department of Biological & Biomedical Sciences

This study was designed to determine the prevalence and type of malaria cases that presented throughout the year 2014 in a tertiary care hospital in Karachi, Pakistan. A total of 1099 cases, (377 females, 722 males) were reported. Plasmodium vivax (P. vivax) was discovered in 93.7% cases compared to 6.3% Plasmodium falciparum (P. falciparum). Based on the highest and lowest weather temperatures, in summer (June, July and August) and in winter (December, January and February) were differentiated. The number of cases were greater during summer months compared to winter. Interestingly, the ratio of P. falciparum to P. vivax during winter …


Relationship Between Smoking Habit And Sperm Parameters Among Patients Attending An Infertility Clinic, Rehana Rehman, Nida Zahid, Sofia Amjad, Mukhtiar Baig, Zohair Jamil Gazzaz Oct 2019

Relationship Between Smoking Habit And Sperm Parameters Among Patients Attending An Infertility Clinic, Rehana Rehman, Nida Zahid, Sofia Amjad, Mukhtiar Baig, Zohair Jamil Gazzaz

Department of Biological & Biomedical Sciences

Background: This study aimed to estimate stress markers, oxidative stress (OS), reproductive hormones and sperm parameters in male smokers and non-smokers and observe the impact of oxidative stress markers and smoking on sperm count, motility and morphology in a selected population of Karachi, Pakistan.
Methods: This cross-sectional study was conducted from July 2017 to July 2018 at Aga Khan University (AKU), in Karachi, Pakistan. The subjects were recruited from the Sindh Institute of Reproductive Medicine (SIRM), Karachi based on defined inclusion criteria. The subjects were categorized into fertile and infertile based on cut off values of sperm parameters as recommended …


Colostrum And Mature Breast Milk Analysis Of Serum Irisin And Sterol Regulatory Element-Binding Proteins-1c In Gestational Diabetes Mellitus, Syeda Sadia Fatima, Erum Khalid, Asma Akbar Ladak, Syed Adnan Ali Sep 2019

Colostrum And Mature Breast Milk Analysis Of Serum Irisin And Sterol Regulatory Element-Binding Proteins-1c In Gestational Diabetes Mellitus, Syeda Sadia Fatima, Erum Khalid, Asma Akbar Ladak, Syed Adnan Ali

Department of Biological & Biomedical Sciences

Background: We aimed to evaluate irisin and SREBP-1c levels in serum, colostrum and mature breast milk in women with and without gestational diabetes (GDM); and to relate them with maternal glucose, lipid profile and weight status of babies.
Methods: GDM positive women (n = 33) and normal glucose tolerant women (NGT) (n = 33) were recruited. Maternal blood samples were collected at 28th week of gestation and later at 6-week post-partum while breast milk samples of the lactating mothers were collected within 72 hours of birth (colostrum) and at 6 weeks post-partum (mature milk). Irisin and SREBP-1c levels were analyzed …


Three-Dimensional Visualization Software Assists Learning In Students With Diverse Spatial Intelligence In Medical Education, Zehra Jamil, Amna A. Saeed, Sarosh Madhani, Safia Baig, Zahra Cheema, Syeda Sadia Fatima Sep 2019

Three-Dimensional Visualization Software Assists Learning In Students With Diverse Spatial Intelligence In Medical Education, Zehra Jamil, Amna A. Saeed, Sarosh Madhani, Safia Baig, Zahra Cheema, Syeda Sadia Fatima

Department of Biological & Biomedical Sciences

This study evaluated effect of mental rotation (MR) training on learning outcomes and explored effectiveness of teaching via three-dimensional (3D) software among medical students with diverse spatial intelligence. Data from n = 67 student volunteers were included. A preliminary test was conducted to obtain baseline level of MR competency and was utilized to assign participants to two experimental conditions, i.e., trained group (n = 25) and untrained group (n = 42). Data on the effectiveness of training were collected to measure participants' speed and accuracy in performing various MR activities. Six weeks later, a large class format (LCF) session was …


Cardioprotective Effects Of Sphingosine-1-Phosphate Receptor Immunomodulator Fty720 In A Clinically Relevant Model Of Cardioplegic Arrest And Cardiopulmonary Bypass, Naseer Ahmed, Adeela Mehmood, Daniele Linardi, Soban Sadiq Sadiq, Maddalena Tessari, Sultan Ayoub Meo, Rehana Rehman, Waseem M. Hajjar, Nazeer Muhammad, Mohammad Iqbal, Anwar Gilani, Giuseppe Faggian, Alessio Rungatscher Jul 2019

Cardioprotective Effects Of Sphingosine-1-Phosphate Receptor Immunomodulator Fty720 In A Clinically Relevant Model Of Cardioplegic Arrest And Cardiopulmonary Bypass, Naseer Ahmed, Adeela Mehmood, Daniele Linardi, Soban Sadiq Sadiq, Maddalena Tessari, Sultan Ayoub Meo, Rehana Rehman, Waseem M. Hajjar, Nazeer Muhammad, Mohammad Iqbal, Anwar Gilani, Giuseppe Faggian, Alessio Rungatscher

Department of Biological & Biomedical Sciences

Objective: FTY720, an immunomodulator derived from sphingosine-1-phosphate, has recently demonstrated its immunomodulatory, anti-inflammatory, anti-oxidant, anti-apoptotic and anti-inflammatory properties. Furthermore, FTY720 might be a key pharmacological target for preconditioning. In this preclinical model, we have investigated the effects of FTY720 on myocardium during reperfusion in an experimental model of cardioplegic arrest (CPA) and cardiopulmonary bypass.
Methods: 30 Sprague-Dawley rats (300-350 g) were randomized into two groups: Group-A, treated with FTY720 1 mg/kg via intravenous cannulation, and Group-B, as control. After 15 min of treatment, rats underwent CPA for 30 min followed by initiation of extracorporeal life support for 2 h. Support …


Evaluation Of Kidney Injury Molecule-1 As A Disease Progression Biomarker In Diabetic Nephropathy, Fatima Abid Khan, Syeda Sadia Fatima, Ghulam Mustafa Khan, Sana Shahid Jul 2019

Evaluation Of Kidney Injury Molecule-1 As A Disease Progression Biomarker In Diabetic Nephropathy, Fatima Abid Khan, Syeda Sadia Fatima, Ghulam Mustafa Khan, Sana Shahid

Department of Biological & Biomedical Sciences

Background & Objective: Kidney Injury Molecule-1 (KIM-1) is a peptide whose release into circulation is specific to tubular injury. This study aimed to estimate levels of kidney injury molecule-1 in diabetic patients with and without kidney disease. And evaluate the role of KIM-1 as an early screening marker of progressive kidney injury.
Methods: This follow-up study included n=85 subjects from the diabetic clinic of Jinnah Post Graduate Medical Center (JPMC) in collaboration with Aga Khan University from November 2016 till September 2017. They were divided as: i) Group A1 (n=30) participants with diabetes for <5 years without microalbuminuria ii) Group A2 (n= 30) subjects with diabetes for 6-10 years with microalbuminuria; iii) Group B (n=25) subjects as healthy control group. All study participants were followed for 6 months and their blood glucose, urea, creatinine, electrolytes, albuminuria and serum KIM-1 were assayed.
Results: High KIM-1 at baseline was …


Can Low Vitamin D Binding Protein Levels Be A Cause Of Infertility In Females?, Bisma Badr, Sadia Cassim, Rehana Rehman Jul 2019

Can Low Vitamin D Binding Protein Levels Be A Cause Of Infertility In Females?, Bisma Badr, Sadia Cassim, Rehana Rehman

Department of Biological & Biomedical Sciences

Abstract are not provided by the author/publisher


Role Of Ajwa Date (Phoenix Dactyl L) Derived Polyphenols In Male Infertility, Naseer Ahmed, Rehana Rehman, Anwar Gilani Jun 2019

Role Of Ajwa Date (Phoenix Dactyl L) Derived Polyphenols In Male Infertility, Naseer Ahmed, Rehana Rehman, Anwar Gilani

Department of Biological & Biomedical Sciences

Madam, prevalence of male infertility with its associated social and health problems calls for an insight for its elucidation.1 Over the past few decades, there have been many experimental and clinical studies on the pathophysiology of oxidative stress and its impact on fertility disorders, both in men and women. Oxidative stress impairs sperm function and count, damage to DNA and accelerates the cellular apoptotic functions leading to the inability to achieve conception or lack of development of the embryo. 234563


Mutational Landscape Of Head And Neck Squamous Cell Carcinomas In A South Asian Population, Kulsoom Ghias, Sadiq S. Rehmani, Safina Abdul Razzak, Sarosh Madani, M Kamran Azim, Rashida Ahmed, Mumtaz J Khan Jun 2019

Mutational Landscape Of Head And Neck Squamous Cell Carcinomas In A South Asian Population, Kulsoom Ghias, Sadiq S. Rehmani, Safina Abdul Razzak, Sarosh Madani, M Kamran Azim, Rashida Ahmed, Mumtaz J Khan

Department of Biological & Biomedical Sciences

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer type globally and contributes significantly to burden of disease in South Asia. In Pakistan, HNSCC is anmong the most commonly diagnosed cancer in males and females. The increasing regional burden of HNSCC along with a unique set of risk factors merited a deeper investigation of the disease at the genomic level. Whole exome sequencing of HNSCC samples and matched normal genomic DNA (n=7) was performed. Significant somatic single nucleotide variants (SNVs) were identified and pathway analysis performed to determine frequently affected signaling pathways. We identified significant, novel …


Implications Of Genetic Variation Of Common Drug Metabolizing Enzymes And Abc Transporters Among The Pakistani Population, Nasir Ali Afsar, Henrike Bruckmueller, Anneke Nina Werk, Muhammad Kashif Nisa, H R. Ahmad, Ingolf Cascorbi May 2019

Implications Of Genetic Variation Of Common Drug Metabolizing Enzymes And Abc Transporters Among The Pakistani Population, Nasir Ali Afsar, Henrike Bruckmueller, Anneke Nina Werk, Muhammad Kashif Nisa, H R. Ahmad, Ingolf Cascorbi

Department of Biological & Biomedical Sciences

Genetic polymorphism of drug metabolizing enzymes and transporters may influence drug response. The frequency varies substantially between ethnicities thus having implications on appropriate selection and dosage of various drugs in different populations. The distribution of genetic polymorphisms in healthy Pakistanis has so far not been described. In this study, 155 healthy adults (98 females) were included from all districts of Karachi. DNA was extracted from saliva and genotyped for relevant SNVs in CYP1A1, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4 and CYP3A5 as well as ALDH3A1, GSTA1, ABCB1 and ABCC2. About 64% of the participants were born to parents who were unrelated …


Gastric-Type Enteric Duplication Cyst In The Tail Of A Bifid Pancreas In Association With Complete Intestinal Malrotation, Muhammad Awais, Abdul Rehman, Noor Ul-Ain Baloch May 2019

Gastric-Type Enteric Duplication Cyst In The Tail Of A Bifid Pancreas In Association With Complete Intestinal Malrotation, Muhammad Awais, Abdul Rehman, Noor Ul-Ain Baloch

Department of Biological & Biomedical Sciences

Abstract are not provided by the author/publisher


Blended Learning: Call Of The Day For Medical Education In The Global South, Zehra Jamil, Azra Naseem, Eman Rashwan, Sumrah Khalid Apr 2019

Blended Learning: Call Of The Day For Medical Education In The Global South, Zehra Jamil, Azra Naseem, Eman Rashwan, Sumrah Khalid

Department of Biological & Biomedical Sciences

Blended learning (BL) is an e-learning approach that combines the strengths of both online and face-to-face learning, creating meaningful interactions between students, teachers, and resources. This paper explores students’ expectations and satisfaction with, and participation in, a basic science course offered through BL approaches in an undergraduate medical education programme in Pakistan. Developmental anatomy (embryology) was redesigned as a BL course and offered to a hundred first-year students. Both online activities and technology-assisted face-to-face interactive discussions were used in each topic. Students’ expectations were gathered at the start of the course and perceptions regarding their satisfaction with the course was …


Serum Anti Mullerian Hormone And Renalase Levels In Predicting The Risk Of Preeclampsia, Zehra Jamil, Sana Shahid, Erum Baig, Rida Ahmad, Faryal Subhani, Syeda Sadia Fatima Mar 2019

Serum Anti Mullerian Hormone And Renalase Levels In Predicting The Risk Of Preeclampsia, Zehra Jamil, Sana Shahid, Erum Baig, Rida Ahmad, Faryal Subhani, Syeda Sadia Fatima

Department of Biological & Biomedical Sciences

Objective: The aim of the study was to explore the association of serum AMH and Renalase with the risk of preeclampsia thereby assessing them as screening tools, reducing the risk of gravid consequences of preeclampsia.
Materials and Methods: This cross-sectional study recruited n = 95 pregnant women between 14 and 32 gestational weeks. They were categorized as a) women with gestational hypertension (n = 45); b) women with pre-eclampsia (n = 20) and c) normotensive pregnant women (n = 30) according to the ACOG criteria. Anthropometrics data and blood and urine samples were collected. AMH and Renalase levels were measured …


Longer Trinucleotide Repeats Of Androgen Receptor Gene: Infertility In Males, Mussarat Ashraf, Hemaila Tariq, Rehana Rehman Mar 2019

Longer Trinucleotide Repeats Of Androgen Receptor Gene: Infertility In Males, Mussarat Ashraf, Hemaila Tariq, Rehana Rehman

Department of Biological & Biomedical Sciences

No abstract provided.


Comparison Of Serum Levels Of Vitamin D And Vitamin D-Binding Protein In Normal, Osteopenic And Osteoporotic Postmenopausal Women, Rafat Murad, Tabassum Mahboob, Rehana Rehman, Rozeena Baig Mar 2019

Comparison Of Serum Levels Of Vitamin D And Vitamin D-Binding Protein In Normal, Osteopenic And Osteoporotic Postmenopausal Women, Rafat Murad, Tabassum Mahboob, Rehana Rehman, Rozeena Baig

Department of Biological & Biomedical Sciences

Objective: To compare the serum levels of vitamin D, vitamin D binding protein (VDBP) calcium and phosphate in normal, osteopenic and osteoporotic postmenopausal women categorized on the basis of bone mineral density (BMD) scores.
Methods: A cross sectional study carried out from May 2017 to August 2018. BMD measured by Dual energy X-ray Absorptiometry categorized women (aged 20- 70 years) into normal (n=37) (T score ≥ -1.0) osteopenic (n=25) (-2.5< T score, < -1) and osteoporotic (n= 26) (T score < -2.5) according to WHO classification. Serum concentrations of vitamin D, VDBP, calcium, phosphate analyzed by enzyme linked immunosorbent assay were compared by Analysis of Variance.
Results: In normal females higher levels of vitamin D and VDBP were observed [15.82 (8 - 69.18), 469.9 (269.57 - 875.55)] vs. osteopenic [(7.45 (4.66 - 15.1), 296.05 (232.58 - …


Enhancing Cognitive Engagement Of Pre-Clinical Undergraduate Medical Students Via Video Cases And Interactive Quizzes In Problem-Based Learning, Syeda Sadia Fatima, Kulsoom Ghias, Kauser Jabeen, Saniya Sabzwari Jan 2019

Enhancing Cognitive Engagement Of Pre-Clinical Undergraduate Medical Students Via Video Cases And Interactive Quizzes In Problem-Based Learning, Syeda Sadia Fatima, Kulsoom Ghias, Kauser Jabeen, Saniya Sabzwari

Department of Biological & Biomedical Sciences

Background: Problem-based learning (PBL) is one of the main pedagogical approaches utilized in the undergraduate medical education (UGME) program at a private medical college in Karachi, Pakistan. Video-enhanced cases and formative assessments were introduced at the end of PBL sessions to evaluate their effectiveness in enhancing student engagement.
Methods: A mixed methods study was conducted with Year 2 medical students (n=102; divided into 11 groups) and faculty (n=11) facilitating the PBL process. Of the 10 PBL cases, five were converted to video-enhanced cases and five were kept as paper-based, “traditional” cases. “Micro” videos were used to introduce clinical scenarios, augmented …


Relationship Of Sociodemographic Factors With Serum Levels Of Vitamin D In A Healthy Population Of Pakistan, Khalida Iqbal, Najmul Islam, Naseema Mehboobali, Ali Asghar, Saleem Perwaiz Iqbal, Mohammad Perwaiz Iqbal Jan 2019

Relationship Of Sociodemographic Factors With Serum Levels Of Vitamin D In A Healthy Population Of Pakistan, Khalida Iqbal, Najmul Islam, Naseema Mehboobali, Ali Asghar, Saleem Perwaiz Iqbal, Mohammad Perwaiz Iqbal

Department of Biological & Biomedical Sciences

High prevalence of vitamin D deficiency has been reported from Pakistan. Association of sociodemographic factors with vitamin D status has received little attention in this region. Therefore, we embarked on investigating the relationship of sociodemographic factors with vitamin D levels in a healthy Pakistani population. Venous blood from 226 healthy participants (age range 19-69 years) was collected and analyzed for serum concentrations of 25(OH) vitamin D [25(OH)D] and other related biomarkers. Demographic characteristics of the study participants were collected. Vitamin D deficiency (25(OH)D levels less than 20 ng/ml) was found to be 75% in this cohort. Gender, sunlight exposure and …