Digital Commons Network^™

Perceptions On Bioethics Among General Practitioners In Karachi, Pakistan, Waris Qidwai, Hafeez Qureshi, Iqbal Azam, Syed Sohail Ali, Semi Ayub

Department of Family Medicine

Objective: To study the perceptions on bioethics among general practitioners in Karachi, Pakistan.
Design: A questionnaire based cross sectional survey. Settings: 85 general practitioners in Karachi were surveyed at their clinic premises. Main outcome measures: Perceptions on the broad principles of bioethics.
Results: The majority of general practitioners were males, with mean age of 36.3 years, had minimal postgraduate qualifications and continuing medical education. They reported the top five moral duties of a physician and their reaction in the event of the death of a close relative due to a doctor's negligence. A significant number of respondents agreed …

Patterns Of Use And Non-Use Of The Services Of Hakim Practitioners Among Patients In Karachi, Waris Qidwai

Department of Family Medicine

Objective: To study the pattern of use and non-use of the services of hakim practitioners, among patients visiting the Family Physicians, at a teaching hospital in Karachi.
Design: Cross-sectional survey
Place and Duration of Study: Family practice centre, The Aga Khan University, Karachi, from March to June, 2001.
Methods: A total of 387 patients were surveyed against an estimated sample size of 347. A questionnaire was developed and administered to collect information on the patterns of the use and non-use of the services of hakim practitioners among the respondents.
Results: The majority of the respondents were young, well-educated …

Knowledge About Sexually Transmitted Infections Among Young Pakistani Men, Waris Qidwai

Department of Family Medicine

Prevalence of Human Immuno-deficiency Virus (HIV) infection is still believed to be low in Pakistan. However, because of its location in South Asia and the presence of high risk group for the disease, it is likely that Pakistan would experience diffusion of HIV1. We therefore decided to cany out this study to access the understanding of young Pakistani men about sexually transmitted infections (STI s).

Early Surgical Results With Intent To Treat By Radical Retropubic Prostatectomy For Clinically Localized Prostate Cancer, Farhat Abbas, Kamran Siddiqui, Syed R. Biyabani, Jamsheer J. Talati, S. H. Hasan

Section of Urology

Aims: To evaluate the early cancer control rates, morbidity and mortality in men undergoing radical retropubic prostatectomy (RRP) for clinicallylocalized adenocarcinoma prostate.
Methods: Patient's characteristics, operative data, progressive-free survival rates, morbidity and mortality were analyzed for 23 men with clinical T1-2 prostate cancer who underwent surgery with an intent to treat by RRP between December 1997 to July 2001.
Results: Patient's mean age was 63 +/- 6.2 years (range 51 to 76 years) with American Society of Anesthesiology (ASA) status I in 4%, II in 65% and III in 31%. Two third of the patients had lower urinary tract obstructive …

Polymerase Chain Reaction: An Emerging Tool For Research In Pharmacology, Rishi Sharma, Manjeet Singh, Ajay Sharma

Pharmacy Faculty Articles and Research

Polymerase chain reaction (PCR) is a technique that can amplify a specific DNA segment in vitro using two site specific primers that hybridise to opposite DNA strands. The method produces large amounts of specific DNA from a complex DNA template in a single enzymatic reaction within a matter of hours. Reaction mixture contains a double helix DNA, two target specific primers, dNTPs, a DNA polymerase and a Mg2+ containing buffer. PCR is carried out in three distinct steps i.e. denaturation step, annealing step and extension step, which are repeated many times. The efficiency of PCR is measured in terms of …

Effect Of Zinc On The Treatment Of Plasmodium Falciparum Malaria In Children: A Randomized Controlled Trial, F. Sempertegui, B. Estrella, F.R. Toapanta, D.S. Torres, D.E. Calahorrano, K. Yeboah-Antwi, E. Addo-Yobo, P. Arthur, S. Newton, Zul Premji, M. Hubert, C.S. Makwaya, F. Ssengooba, J. Konde-Lule, E. Mukisa, D.H. Hamer, W. Macleod, C. Duggan, W. Fawzi, J. Simon, V. Mwanakasale, M. Mulenga, T. Sukwa, J. Tshiula

Pathology, East Africa

Background: Zinc supplementation in young children has been associated with reductions in the incidence and severity of diarrheal diseases, acute respiratory infections, and malaria.

Objective: The objective was to evaluate the potential role of zinc as an adjunct in the treatment of acute, uncomplicated falciparum malaria; a multicenter, double-blind, randomized placebo-controlled clinical trial was undertaken.

Design: Children (n = 1087) aged 6 mo to 5 y were enrolled at sites in Ecuador, Ghana, Tanzania, Uganda, and Zambia. Children with fever and ≥ 2000 asexual forms of Plasmodium falciparum/μL in a thick blood smear received chloroquine and were randomly assigned to …

Long-Term Outcomes Of Acute Myeloid Leukemia In Adults In Pakistan, G. N. Kakepoto, S. N. Adil, Mohammad Khurshid, I. A. Bumey, S. Zaki

Department of Pathology and Laboratory Medicine

Objective: To describe the long-term outcomes of Acute Myeloid Leukemia (AML) and to study clinico­pathological features at presentation, morphological subtypesand remission rates.
Methods: Demographic information, response to therapy and survival of patients (>14 years of age) admitted between January 1988 to August 1996 with acute myeloid leukaemia was retrieved and analysed.
Results: Seventy-four patients were admitted with a diagnosis of AML during the study period. There were 43 males and 31 females. Age ranged between 15 and 70 years with a mean age of 38 years. The most common presenting feature was fever (67.5%) and the …

Acridine Orange For Malaria Diagnosis: Its Diagnostic Performance, Its Promotion And Implementation In Tanzania, And The Implications For Malaria Control, J. Keiser, J. Utzinger, Zul Premji, Y. Yamagata, B.H. Singer

Pathology, East Africa

One hundred years ago, Giemsa's stain was employed for the first time for malaria diagnosis. Giemsa staining continues to be the method of choice in most malarious countries, although, in the recent past, several alternatives have been developed that exhibit some advantages. Considerable progress has been made with fluorescent dyes, particularly with Acridine Orange (AO). The literature on the discovery, development and validation of the AO method for malaria diagnosis is reviewed here. Compared with conventional Giemsa staining, AO shows a good diagnostic performance, with sensitivities of 81.3%-100% and specificities of 86.4%-100%. However, sensitivities decrease with lower parasite densities, and …

Prevalence And Risk Factors For Vaginal Candida Colonization In Women With Type 1 And Type 2 Diabetes, Ella M. De Leon, Scott J. Jacober, Jack D. Sobel, Betsy Foxman

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Diabetes mellitus increases the rate of vaginal colonization and infection with Candida species

Methods

We surveyed women with diabetes receiving care at either an urban or suburban diabetes clinic to examine the relationship between vaginal Candida colonization, diabetes type and duration, and HbA_1c level. 101 participants completed the self-administered questionnaire and self-collected a vaginal swab for Candida culture. Candida colonization was similar by age and race.

Results

Type 1 diabetics were three times as likely as type 2 diabetics to be colonized with any Candida species (OR = 3.4; 95% CI: 1.03, 11.41; p = 0.04); even …

Health Professions Division Catalog Academic Year 2002-2003, Nova Southeastern University

Health Professions Divisions Course Catalogs and Course Descriptions

No abstract provided.

Acute Myeloid Leukemia In Children In Pakistan: An Audit, S. Zaki, I. A. Burney, Mohammad Khurshid

Section of Haematology/Oncology

Objective: To see the clinical features and treatment of children with Acute Myeloid Leukemia (AML) in Pakistan. Setting: Tertiary referral at a specialist Hematology/Oncology center.
Methods: Retrospective, chart-based review of children (less than 14 years) admitted to the hospital with a diagnosis of AML between January 1987 and August 1997.
Results: A total of 23 patients were admitted. There were 18 males and 5 females. The mean age was 8 5 years. M3 was the commonest morphological subtype (43%). Twenty- two percent of the patients presented with hyperleucocytosis (TLC> 100 x i09 /L) and 95% with an elevated …

Abscesses In The Liver: Amoebic Or Pyogenic?, Bushra Jamil, Saeed Hamid

Department of Medicine

No abstract provided.

Acute Lung Injury/Acute Respiratory Distress Syndrome, Fazal Hameed Khan

Department of Anaesthesia

Reports of pulmonary physiopathological insults following severe trauma resulting in respiratory failure are not new in medical literature^1,2. In 1967 Ashbaugh and colleagues described a syndrome of acute respiratory distress following a variety of precipitating conditions³. Severe hypoxemia, diffuse pulmonary infiltrates, poor lung compliance and absence of left heart failure characterize this condition. Ashbaugh et al⁴ subsequently named it as adult respiratory distress syndrome to differentiate it from infant respiratory distress syndrome. It was proposed at that time that both conditions manifest similar physiopathological changes. It was also referred to as “traumatic wet lung”, “congestive …

Nipple Aspirate Cytology And Pathologic Parameters Predict Residual Cancer And Nodal Involvement After Excisional Breast Biopsy., E R Sauter, H Ehya, A Mammen, G Klein

Department of Surgery Faculty Papers

We previously demonstrated that abnormal nipple aspirate fluid (NAF) cytology predicted residual breast cancer (RC) and tumour size after excisional biopsy (EB), although normal NAF cytology did not exclude RC. Tumour size correlates with the risk of lymph node (LN) metastases. LN metastases provide prognostic information allowing medical and radiation oncologists to determine the need for adjuvant therapy. We hypothesized that pathologic factors known after EB, combined with NAF cytology, would predict with a high degree of accuracy the presence of RC and LN spread. NAF cytology and pathologic parameters: tumour distance from biopsy margins, multifocal and multicentric disease, sub-type …

Parental [Correction Of Perinatal] Consanguinity: A Risk Factor For Developmental Delay In Pakistani Children, S Ibrahim, Z Habib, S Hyder, I S. Azam, R Ahmed

Department of Paediatrics and Child Health

Objective: To investigate the association of parental consanguinity and delayed development in terms of gross motor, fine motor, speech and social aspects in their children.
Methods: One hundred and seventy seven children (age 15 days--72 months) were evaluated for their developmental status utilizing the Denver Developmental Screening Test (DDST). An unmatched case-control study design was used. Case group consisted of 94 children and control group 83 children. Odds ratios were calculated for parental consanguinity and delay in gross and fine motor, speech and social development in their children, for cases and controls, utilizing Binary Multiple Logistic Regression Analysis. Acquired delay …

Prevalence Of Smokers Among Air-Conditioned Coaches, Pakistan, R Mal, N Rizvi, S Rathi

Section of Otolaryngology, Head & Neck Surgery

Objective: To estimate the proportion of smokers among passengers of air-conditioned (A/C) coaches running between Karachi and Hyderabad. Pakistan.METHOD: A cross-sectional survey was done on passengers and staff members of 20 air-conditioned coaches.Results: Of 847 passengers interviewed, 17.3% were smokers and 11.7% passengers smoked during travel while rest of them remained passive smokers. Out of 147 smokers 91.2% were literate persons. Among staff members 59.3% were smokers. Approximately 56% of smokers among passengers were in the age range of 14-40 years. In 95% of A/C coaches there were no anti-smoking warning signs or written words present.CONCLUSION: In this study majority …

Role Of Protein Kinase C-Delta In The Regulation Of Collagen Gene Expression In Scleroderma Fibroblasts, Sergio A. Jimenez, Svetlana Gaidarova, Biagio Saitta, Nora Sandorfi, David J. Herrich, Joan C. Rosenbloom, Umberto Kucich, William R. Abrams, Joel Rosenbloom

Selected Works of Sergio Jiménez, MD, MACR

Working with cultured dermal fibroblasts derived from control individuals and patients with systemic sclerosis (SSc), we have examined the effects of protein kinase C-delta (PKC-delta) on type I collagen biosynthesis and steady-state levels of COL1A1 and COL3A1 mRNAs. Rottlerin, a specific inhibitor of PKC-delta, exerted a powerful, dose-dependent inhibition of type I and type III collagen gene expression in normal and SSc cells. Optimal rottlerin concentrations caused a 70-90% inhibition of type I collagen production, a >80% reduction in COL1A1 mRNA, and a >70% reduction in COL3A1 mRNA in both cell types. In vitro nuclear transcription assays and transient transfections …

Sex And Race Differences In Electrocardiogram Use (The National Hospital Ambulatory Medical Care Survey), Amy L. Arnold, Kerry A. Milner, Viola Vaccarino

Nursing Faculty Publications

There are sex and race differences in many aspects of health care delivery. For example, blacks and women are less likely to receive aspirin and thrombolytic drugs. Blacks and women presenting with chest pain are less likely to be referred for cardiac catheterization. Blacks and women diagnosed with acute myocardial infarction (AMI) are also less likely to undergo cardiac catheterization. The gender differences in diagnostic evaluation after AMI appear more pronounced among younger women. The American College of Cardiology and the American Heart Association joint electrocardiography guidelines state that all patients presenting to the emergency department (ED) with chest pain …

Mysterious Rectal Bleeding In A Female Adolescent, Hatim A. Omar

Pediatrics Faculty Publications

A 15-year-old female referred to our adolescent clinic for further evaluation of rectal bleeding was seen a week earlier in the acute care clinic with a two-day history of bright red rectal bleeding. The physical examination at that time was reportedly normal, including the rectal exam. The blood count with differential, liver function tests, ESR, and barium enema were all within normal limits. The patient, however, continued to complain of rectal bleeding and this led to the referral. She was known in the adolescent clinic as having a history of learning disability and mild mental retardation. She was started on …

Labial Adhesion As A Complication Of Primary Genital Herpes In Young Women, Hatim A. Omar

Pediatrics Faculty Publications

Genital herpes is a common sexually transmitted disease in adolescents. It may be associated with significant morbidity if not diagnosed on time or not properly treated. The objective of this study was to determine the incidence of labial adhesion secondary to primary herpes in young women and the possible predisposing factors for this complication. The method was analysis of clinical data regarding primary genital herpes in young women seen in an adolescent outpatient clinic at a university hospital. Cases of primary genital herpes seen between December 1^st 1998 and November 30^th 1999 were included. A total of 34 …

Morphological Pattern Of Salivary Gland Tumours, M. S. Gill, S. Muzaffar, I. N. Soomro, Naila Kayani, A. S. Hussainy, Shahid Pervez, S. H. Hasan

Department of Pathology and Laboratory Medicine

Objective: To delineate the spectrum of salivary gland tumors in our setup.

Setting: The Aga Khan University Medical Centre, Karachi.

Method: Tumors were analysed considering histological type, age and sex of the patients and anatomic location. The diagnosis of individual tumours was based on the 1991 World Health Organisation Classification.

Results: During the span of eight years (1991-1998), 379 cases of salivary gland tumours were diagnosed. Of these, 205 (65.7%) were male and 174 (34.3%) were female. The median age at the time of diagnosis was 35 years. The median age for patients with malignant lesions (44 years) was 12 …

Presentation And Symptom Predictors Of Coronary Heart Disease In Patients With And Without Diabetes, Marjorie Funk, Janice B. Naum, Kerry A. Milner, Deborah Chyun

Nursing Faculty Publications

The aims of this prospective, observational study were to compare: (1) symptom presentation of coronary heart disease (CHD) between patients with and without diabetes and (2) symptom predictors of CHD in patients with and without diabetes. We directly observed 528 patients with symptoms suggestive of CHD as they presented to the ED of a 900-bed cardiac referral center in the northeastern United States. There were no significant differences in symptom presentation of CHD between patients with and without diabetes, although patients with diabetes were slightly more likely to present with shortness of breath (P =.056). Patients with diabetes reported …

Bilateral Cervical Radiculopathy As A Presentation Of Spinal Tuberculosis: Report Of Two Cases, G R. Sharma, Rashid Jooma

Section of Neurosurgery

No abstract provided.

Continuous Quality Assessment; Development Of A Simple Computer Based Model For Audit, N K. Waheed, F S. Awan, A Ahad, A Rahman, K M. Pal

Department of Surgery Docs

Objective: Accurate assessment of quality of care is a fundamental first step in the process of quality improvement. The vast amount of data generated in a hospital mandates some form of computerization for management of information. We describe a locally developed simple computer based program to access relevant information from a hospital patient management network. The objective was to reduce the amount of manual work involved for busy clinicians attempting to audit quality of care.Methods: A single surgical procedure, Laparoscopic Cholecystectomy was chosen. Quality indicators were identified by literature review as conversion rate from laparoscopic to open cholecystectomy and length …

Percutaneous Transhepatic Biliary Stenting, T U. Haq, M Sanaullah, H Mohsin, M Y. Sheikh, B Ahmed

Department of Radiology

Objective: Bilary stenting with endoprosthesis is a palliative procedure to relieve malignant biliary obstruction. Percutaneous transhepatic technique has been employed whenever endoscopic technique was not possible or had failed.SETTING: Angiography/intervention suite, department of radiology, Aga Khan University hospital, Karachi.Methods: We present retrospective analysis of 17 patients with malignant jaundice who were treated with percutaneous techniques after the endoscopic route had failed.Results: The success rate was 94% with placement of single plastic stent in 14 patients, double stents in 3 patients and self-expandable stent in one patient. The overall complication rate was 41% including sepsis, liver abscess, biloma formation, biliary leakage …

Communication About End Of Life For Patients Living With Amyotrophic Lateral Sclerosis: A Scoping Review Of The Empirical Evidence, Shelagh K. Genuis, Westerly Luth, Sandra Campbell, Tania M. Bubela, Wendy S. Johnston

Office of the Provost

Background: Communication about end of life, including advance care planning, life-sustaining therapies, palliative care, and end-of-life options, is critical for the clinical management of amyotrophic lateral sclerosis patients. The empirical evidence base for this communication has not been systematically examined.
Objective: To support evidence-based communication guidance by (1) analyzing the scope and nature of research on health communication about end of life for amyotrophic lateral sclerosis; and (2) summarizing resultant recommendations.
Methods: A scoping review of empirical literature was conducted following recommended practices. Fifteen health-related and three legal databases were searched; 296 articles were screened for inclusion/exclusion criteria; and quantitative …

Giant Hypothalamic Hamartoma And Associated Seizure Types, M K. Chishti, Ashfaq A. Razzaq

Section of Neurosurgery

No abstract provided.

Problem Based Learning, Jamsheer J Talati

Section of Urology

No abstract provided.

Digest Of The Philadelphia College Of Osteopathic Medicine (Fall 2001), Philadelphia College Of Osteopathic Medicine

Digest

The Fall 2001 issue of the Digest of the Philadelphia College of Osteopathic Medicine includes the following articles:

• PCOM Updates
• Digest Takes the Gold
• Comfort Zone
• Cover Story: OMM Fellows: Keeping the Osteopathic Tradition Alive
• Faculty Profile
• At The Heart of Clinical Research
• Donor Profile
• Class Notes
• In Memoriam
• My Turn
• Annual Fund
• PCOM Events

A Critical Step In The Operative Management Of Non-Functioning Asymptomatic Incidentaloma, M H. Ather, S Altaf, A Memon

Section of Urology

No abstract provided.