Digital Commons Network^™

Resistance Of Blastocystis Hominis Cysts To Chlorine, M Zaki, V Zaman, N A. Sheikh

Department of Pathology and Laboratory Medicine

No abstract provided.

Critical Appraisal By Reading For Medical Students--A Case Study From Pakistan, F F. Fikree, D R. Marsh

Community Health Sciences

Doctors read literature to keep abreast of medical advances. A recommendation from the 1993 World Summit for Medical Education is that medical schools should teach medical students to critically appraise scientific reports. The Department of Community Health Sciences of Aga Khan University Medical College teaches basic research methods to medical students. This is now supplemented with "Critical Reading". Critical reading was first taught to 67 third year students between October, 1993 and May, 1994. A "validity check-list for critical readers" was introduced in a two week orientation consisting of three one-hour classroom sessions and four one-hour small group sessions. Thereafter, …

Physicians To The World, Johns Hopkins International Services

Selected secondary sources and publications with substantial content about AKU

A 1996 brochure introducing Johns Hopkins International Services, offering international patients access to top-ranked medical care in the U.S. It highlights the hospital’s global reputation, patient-centered services, and broad range of specialties, supported by cutting-edge research and education through Johns Hopkins University.

Selective Increases In Antibody Isotypes And Immunoglobulin G Subclass Responses To Secreted Antigens In Tuberculosis Patients And Healthy Household Contacts Of The Patients, R Hussain, G Dawood, N Abrar, Z Toossi, A Minai, M Dojki, J J. Ellner

Department of Pathology and Laboratory Medicine

Mycobacterium tuberculosis-specific antibodies (immunoglobulin M [IgM], IgE, IgG, and IgG subclasses) were determined in 164 tuberculosis patients (pulmonary involvement, n = 135; lymph node involvement, n = 29), 59 healthy household contacts (HC), and 51 healthy endemic donors (EC) by a quantitative enzyme-linked immunosorbent assay for reactivity with culture filtrate. Among the isotypes, significant differences between tuberculosis patient groups with either pulmonary or lymph node involvement and healthy control groups (HC and EC) were detected only for IgG (P < 0.001) and IgG1 (P < 0.001) antibodies. Pulmonary patients also showed a significant difference with IgM (P < 0.01) and IgE (P < 0.05) antibodies. HC showed elevation of only IgM antibodies compared with EC, indicating that IgM antibodies may be an indicator of recent infection with M. tuberculosis. These results suggest that the switching of IgM antibody response to IgG1 is a critical event in disease progression. Polyclonal IgG1, IgG3, and IgE antibodies also showed significant elevation (P < 0.05) in patients compared with EC. A strong correlation (rho = 0.254; P < 0.003) was observed between M. tuberculosis-specific IgG1 and polyclonal IgG1 in patients, suggesting that activations of antigen-specific and polyclonal antibodies are related events. No correlation was found between IgG1 antibodies and purified protein derivative skin test results. Since IgG1 antibody responses to culture filtrate are present only after disease establishment, IgG1 responses could provide a useful diagnostic marker of disease.

The Aga Khan Health Services - International Newsletter No. 60, Aga Khan University

The Aga Khan Health Services Archives

• AKU’s 2nd National Symposium Brings Experts And Young Scientists Together

• Story Cards for Health Education

• Life Saving Hotline

• DWHP Program Begins Training LHVs

• Dr. John H. Dirks

• Beating the Odds of Preterm Birth

• Story Cards

• The Theory of Islamic Medicine -Part ll

• International Molecular Biology Workshop At AKU

• The Horrors of Hospital Waste Mis-Management

• Hira makes remarkable recovery

Appendices To Assessment Of Quality Activities At Akuh May 1995, Nadeem Mustafa Khan

Nadeem Mustafa Khan Archives

• Terms of Reference of the Quality Assurance Co-ordinating Committee
• Committee Mandate
• Reporting Relationship
• Quality Assessment and Improvement
• Quality Assessment and Improvement Questionnaire and Results
• Quality Processes and Activities: Detailed Results
• Leadership and Quality Improvement
• Monitoring and Evaluation of Patient Care
• Quality Indicators and Measurement
• Infection Control and Patient Safety
• Clinical Quality Assessment
• Continuous Quality Improvement (CQI) Activities

A Change Of Il-2 And Il-4 Production In Patients With Helicobactor Pylori Infection, X. G. Fan, Javed Yakoob, X. J. Fan, P. W. N. Keeling

Section of Gastroenterology

Helicobactor pylori is the most common cause of gastroduodenal inflammation. However, the exact immune pathogenesis is not fully understood. To look for evidence of the immunological mechanism in H. pylori associated disease, we measured cytokine interleukin-2 (IL-2) and IL-4 levels produced by peripheral blood lymphocytes (PBL) and gastric biopsies in 20 subjects with or without H. pylori infection. H. pylori can stimulate IL-2 and IL-4 production from PBL in H. pylori negative as well as H. pylori positive individuals. The spontaneous IL-2 production by PBL and gastric biopsies was greater (p < 0.0025, <0.001)in H. pylori negative individuals than that in H. pylori infected patients. Increased IL-4 levels from PBL in H. pylori infected patients were found in the presence of H. pylori (p < 0.0025). An increased spontaneous production of IL-4 from gastric biopsies was also observed in H. pylori infected patients (p < 0.025). In conclusion, an enhanced type 2 cytokine production was observed in H. pylori infected patients, which may be responsible for H. pylori chronic infection.

Thrombolytic Therapy In Acute Myocardial Infarction In Pakistan., M. Asad Karim, Ata Ata-Ur- Rehman Qureshi, Syed Faisal Mahmood, J. Akhter

Department of Medicine

To characterize features of acute myocardial infarction (AMI) in a Pakistani population, and assess the role of thrombolysis in our country, we studied 194 consecutive admitted patients with enzyme positive AMI. Males were affected three times more frequently; women, although affected less, had a higher incidence of complications than men. Premature coronary artery disease (CAD) was present in 50% patients presenting with AMI. An unusually high incidence of anterior wall myocardial infarction (39%) was seen. Complications were frequent with a predominance of LV failure symptoms. Cardiogenic shock was associated with a very high mortality, in excess of 93%. Streptokinase (SK) …

Phase Ii Trial Of Murine Monoclonal Antibody D612 Combined With Recombinant Human Monocyte Colony-Stimulating Factor (Rhm-Csf) In Patients With Metastatic Gastrointestinal Cancer, Mansoor Saleh, Michael Khazaeli, Richard Wheeler, Pat Bucy, Tiepe Liu, Michael Everson, David Mun, Jeff Schlom

Haematology and Oncology, East Africa

In a Phase II study, 14 patients with metastatic gastrointestinal cancer received the mAb D612 (40 mg/m2, days 4, 7, and 11) in combination with recombinant human monocyte colony-stimulating factor [(rhM-CSF) 80 ug/kg/days 1-14]. The combined treatment was well tolerated and resulted in characteristic biological activity associated with each of the agents. Thus, 10 of 14 patients experienced D612-associated secretory diarrhea, which responded to the prostaglandin inhibitor Indomethacin in 5 of 7 patients. rhM-CSF therapy was associated with peripheral mono- cytosis (peak absolute monocyte count, 1444 ±394/mm3) and thrombocytopenia (nadir count, 78 ±10/nim '). Monocyte surface marker analysis revealed a …

The Aga Khan Health Services - International Newsletter No. 58, Aga Khan University

The Aga Khan Health Services Archives

Prime Minister Commends AKU’s Role in National Development

• AKU Tenth Anniversary Special Issue

• A Mela with a Difference

• AKUH Declared “Baby Friendly Hospital”

• NICU Graduates Reunion at AKUH Newborn Health - A Neglected Sector in Pakistan

• Dr. Camer W. Vellani

• MRI to Enhance Diagnostic Capabilites at AKUH

• Foundation Stone of Rufaida Building Laid

• Cardiac Services Inaugurated at AKUH

• Cardiac Services at AKUH

• Donors and Volunteers’ Reception

• Memorable Moments from AKU’,

• Convocation 1994

• Convocation '94

• A Mela with a Difference

• Grand Seminar 1994

• AKU Alumni …

The Impact Of Nutritional Counselling On Serum Lipids, Dietary And Physical Activity Patterns Of School Children, S H. Badruddin, A Molla, M Khursheed, S Vaz

Section of Internal Medicine

Eighty-eight school children and their parents who had been counselled regarding appropriate dietary and activity patterns aimed at reducing serum cholesterol were followed-up 21 months later to determine changes in dietary and activity patterns and in serum lipid levels. The decline in serum total cholesterol ranged from 8 to 14% in the different age and sex groups (P < 0.05 to P < 0.001). Serum triglycerides did not change significantly. Cholesterol intake decreased 36% and 54% in 10-14 year old boys and girls respectively (P > 0.001). The activity level increased significantly in both the 5-9 year and 10-14 year olds (P < 0.05 to P < 0.005). These results show that nutrition education can bring about a change in dietary and activity patterns, resulting in a decline in serum cholesterol levels.

Practical Epidemiology And Biostatistics In Research Epidemiologic Glossary, A F. Quresh, M A. Lobo, S N. Inam

Community Health Sciences

No abstract provided.

Crowding--A Risk Factor For Perinatal Mortality?, F F. Fikree

Community Health Sciences

Crowding is known to be associated with an increased risk of infant and child morbidity and mortality particularly due to infections. We examined the association of crowding with perinatal mortality. Our results indicated a paradoxical relationship with the least crowded households showing the highest perinatal mortality (7.7% as compared to 4.7%). However, further analysis indicated that the observed paradoxical relationship is a spurious one, largely explained by the confounding effect of gravidity.

The Aga Khan Health Services - International Newsletter No. 54, Aga Khan University

The Aga Khan Health Services Archives

• Kenya Workshop on Drug Addiction
• A Commitment to Long Term Community Development
• New Chairman of the Department of Community Health Sciences at AKU
• Highest Quality Rating for Prince Aly Khan Hospital Laboratory
• Rani's Fight for Life
• Dr. Shameela Karmali-Rawji— Prospects for East-West Collaboration
• Dr. Shameela Rawji
• "Modern" Islamic Hospitals
• Honours for AKU Faculty
• Harambee for Mtaa Dispensary
• Public Health Policy Forum
• The Aga Khan University Medical Centre, Karachi.

Causes Of Reproductive Age Mortality In Low Socioeconomic Settlements Of Karachi, F F. Fikree, M S. Karim, F Midhet, H W. Berendes

Community Health Sciences

The Maternal and Infant Mortality Survey (MIMS) was conducted in eight squatter settlements of Karachi. The female mortality rate was 151.0 per 100,000 women aged 10-49 years and the maternal mortality ratio was 281 per 100,000 livebirths. The leading causes of deaths among women were complications of pregnancy (28.1%), infectious diseases (24.8%), cardiovascular diseases (20.7%), neoplasia (10.7%) and trauma (10.7%). Hemorrhage (47.1% of all maternal deaths), tuberculosis (40.0% of all infectious disease deaths), oropharyngeal cancer (23.1% of all neoplastic deaths), and burns (61.5% of all trauma deaths) were among the major causes identified. Maternal deaths were associated with young age …

The Aga Khan Health Services - International Newsletter No. 53, Aga Khan University

The Aga Khan Health Services Archives

• Theme of International Nurses Day at AKUMC
• Training in the Management of HIV/AIDS Patients
• Community Health: From the People for the People
• Nuri Sinuff Wins Award for Work with Eskimos
• Recent Visitors To The AKUMC
• Dr. John H. Bryant — The Role of a Third World University
• Dr. John H. Bryant
• Al-Zahrawi’s Tenth Century Surgical Treatise
• Aslam's New Lease on Life
• Nairobi Health Exhibition Promotes Disease Prevention
• Nursing Seminar — a renewed commitment

Cerebral Amoebiasis, T A. Rana, T Hameed, N Rao

Department of Radiology

No abstract provided.

Childhood Acute Respiratory Infection In Pakistan, D R. Marsh, Inam-Ul-Haq, A F. Qureshi, Q Noorani, R Noorali

Community Health Sciences

No abstract provided.

The Aga Khan University Prospectus 1993, The Aga Khan University

The Aga Khan University Prospectuses and Brochures

• The University
• Board of Trustees
• Medical College
• School of Nursing
• University Hospital
• Health Sciences Library
• English Language Unit
• Student & Alumni Affairs
• Admissions
• Students’ Advisors
• Financial Assistance
• Accommodation
• Student Health Service
• Discipline
• Contested Decisions
• THE MEDICAL COLLEGE
• The Curriculum
• Evaluation
• M.B.B.S. examination
• Degrees
• Post-Graduate Training
• Admissions
• Tuition and Fees
• THE SCHOOL OF NURSING
• Administration
• The Curriculum
• Evaluation
• Admissions
• Tuition and Fees
• LIST OF FACULTIES

The Aga Khan Health Services - International Newsletter No. 48, Aga Khan University

The Aga Khan Health Services Archives

• Aga Khan Foundation Reelected to the NGO World Bank Committee
• Medical Librarians from Iran train at Aga Khan University
• Aga Khan University’s Commitment to Research
• Interview with Dr. Meher Elavia Administrator of PAKH
• Self Help Project in Mombasa Ensures Availability of Medicine
• 53 Volunteers Recognised at AKUMC's Volunteers Appreciation Day
• Physiotherapy Brings Relief to Mountain Folk
• Chemical Therapy in Tenth Century Islamic Medicine
• Got Nyabondo Self Help Fund Raiser
• The Private Sector In Higher Education

Family Medicine Postgraduate Training In Pakistan, Cynthia Lawrence Haq, Asma Fozia Qureshi, Rukhsana Wamiq Zuberi, S. N. Bazmi Inam, John H. Bryant

Department for Educational Development

There is no organized system of postgraduate training for family medicine or general practice in Pakistan. This paper describes the status of primary health care delivery in Pakistan and the growth of family medicine throughout the world. It stresses the need for organized postgraduate training relevant to the needs of primary health care in Pakistan and describes efforts currently under-way in this regard at the Aga Khan University Medical Center (AKUMC) in collaboration with the College of Physicians and Surgeons of Pakistan

Necrotizing Enterocolitis In Infants Weighing Less Than 2000 G, P Mufti, Z A. Bhutta

Department of Paediatrics and Child Health

Over a 4 year period, nine of 180 (5%) infants weighing less than 2000 G, admitted to the Aga Khan University Hospital (AKUH) developed necrotizing enterocolitis (NEC). An outbreak of NEC occurred in 1989, during which six infants developed the clinical illness. Overall incidence was 1.1%. Thirty-one birth weight and gestation matched controls were selected for comparison. Risk factors usually considered as predisposing factors, i.e., low 5 min Apgar score, rate of maternal complications, respiratory distress syndrome, mechanical ventilation, umbilical catheterisation, patient ductus arteriosus, use of antibiotics and feeding practices were found with equal frequency in both cases and controls. …

Evidence For The Elevation Of Serum Carcinoembryonic Antigen And Tumor-Associated Glycoprotein-72 Levels In Patients Administered Interferons, John Greiner, Fiorella Guadagni, David Goldstein, Ernest Borden, Roy Ritts, Patricia Witt, Albert Lobuglio, Mansoor Saleh, Jeffrey Schlom

Haematology and Oncology, East Africa

Sera were collected from 111 patients diagnosed with adenocarcinoma or nonadenocarcinoma malignancies who received different schedules of interferon (IFN)-γ or IFN-βser alone or in combination. Serum carcinoembryonic antigen (CEA) and tumor-associated glycoprotein-72 (TAG-72) antigen levels were measured to determine whether interferon could enhance the tumor shedding and, thereby, the serum level of either tumor antigen. Less than 10% of the sera samples from patients diagnosed with nonadenocarcinoma malignancies (e.g., hairy cell leukemia, melanoma) had positive titers of TAG-72 or CEA, and interferon neither increased nor resulted in the appearance of either tumor antigen in those sera. In contrast, 59.2% and …

Pharmacokinetics, Immune Response, And Biodistribution Of Iodine-131-Labeled Chimeric Mouse/Human Igg1, K 17-1a Monoclonal Antibody, Ruby Meredith, Albert Lobuglio, Walter Plott, Roger Orr, Ivan Brezovich, Charles Russell, Elizabeth Harvey, Michael Yester, Mansoor Saleh

Haematology and Oncology, East Africa

Pharmacokinetics,immunogenicity,and biodistributionof a 131I-Iabeledmouse/human chimenc monoclonal antibody (C17-1A) was studiedin six metastaticcoloncancerpatients. Pharmacokinetics obtalned from serum radioactivity or chi mera concentration were identical after 5 mCi of 131I(>17-1A withmeanalphahalf-livesof 17.6±2.3 and19.7±2.9 and meanbeta half-livesof 100.9±16.1 and 106.4±14.1 hr, respectively. HPLC analysis documented the monomeric chi rneiic17-lA withoutevidenceof immunecomplexesorfree 1311 None of the patients developed antibody after ‘31I-chi merle17-1A exposure.Radiolocalizationoccurredin known areas of disease >4 cm in all patients. The half-life of total body radioactivity was 58 ±7 hr by whole-body counts and 64 ±13 hr by urine measurements. Whole-body and bone marrow dose estimates ranged from 0.75-1 .03 and …

The Aga Khan Health Services - International Newsletter No. 43, Aga Khan University

The Aga Khan Health Services Archives

• Health Network's Five Year Plan Announced
• Afghan Refugees Benefit from AKU-IRC Collaboration
• Hospital and Nursing Administrators Develop Network Nursing Strategy in Mombasa
• Paediatric Conference in Quetta
• Kabir Mitha—A Multisectorial Approach to Improving Quality of Life in Rural India
• Junagadh Primary Health Care Project
• AKU Faculty and Students Participate in International Health Project in Indonesia
• Cardiologist from America Volunteers Service at AKUMC
• AKU Faculty News
• Alumnus Award
• Islamic Miniature Paintings in Medical Manuscripts
• Plugged-in Healthcare— Computers to Safeguard Your Health

Therapeutic Implications Of Ofloxacin In The Treatment Of Typhoid Fever Caused By Multiply Resistant Salmonella Typhi, M Ishaq, B J. Farooqui, M K. Ashfaq, M A. Khan

Section of Cardiology

The antibiotic of choice for the treatment of typhoid fever in most parts of the world is still chloramphenicol. Ampicillin and cotrimoxazole have been used in recent years. Selection of antimicrobials for therapy has been complicated by the emergence of Salmonella typhi strains resistant to the above mentioned antibiotics. Blood and/or bone marrow cultures of 30 adult patients grew S. typhi that was resistant to chloramphenicol, ampicillin and cotrimoxazole. However, these strains were sensitive to cefotaxime, ceftrioxone, aztreonam and ofloxacin. Ofloxacin 400 mg twice a day was given orally to these patients for 14 days. All patients recovered with no …

The Aga Khan Health Services - International Newsletter No. 42, Aga Khan University

The Aga Khan Health Services Archives

• Pakistan's First Drug and Poison Information Service at Aga Khan University Hospital
• Canadian Minister Visits AgaKhan University Medical Centre
• Primary Health Care Orientation for Volunteers
• Local Community Responds Enthusiastically to Health Exhibition
• Dr. Tajuddin A. Manji Honoured
• Professor Nimrod O. Bwibo —Building Bridges Between Medical Colleges in Third World Countries
• School Children Participate in Kisumu Primary Health Care Project
• Appointments at Aga Khan Hospitals
• First Regional Physicians Conference in Kenya
• Jalal H. Jamal Appointed on the Board of Muhimbili Medical Centre in Dar-es-Salaam
• Medical Ethics in Islam
• Aga Khan University Faculty Attends World Health Assembly
• Pakistan Desperately Needs its Med …

A Phase Ii Trial Of Murine Monoclonal Antibody 17-1a And Interferon-Γ: Clinical And Immunological Data, Mansoor Saleh, Albert Lobuglio, Richard Wheeler, Kimberly Rogers, Amy Haynes, Jeannette Lee, M B. Khazaeli

Haematology and Oncology, East Africa

A group of 15 patients with metastatic colorectal adenocarcinoma received a combination of interferon γ (0.1 mg/m², days 1–15) and the murine monoclonal antibody 17-1A (400 mg, days 5, 7, 9 and 12). The treatment was tolerated with minimal toxicity. Of the 14 evaluable patients, 13 developed human antibody to murine 17-1A, with 11 patients demonstrating antibody to the variable region of 17-1A (anti-idiotype). Antibody to the variable region was inhibited by 17-1A but not by mouse immunoglobulin. Sera from patients with substantial anti-idiotype reactivity were capable of inhibiting the binding of murine 17-1A to antigen expressing LS174-T …

The Aga Khan University Prospectus 1990-91, The Aga Khan University

The Aga Khan University Prospectuses and Brochures

• The University
• Board of Trustees
• The Medical College
• The School of Nursing
• The Hospital
• The Buildings
• The Library
• THE MEDICAL COLLEGE
• The Curriculum
• Evaluation
• Post-Graduate Training
• Degrees
• Student Affairs
• Admission of Students
• Tuition and Fees
• Financial Assistance
• Accommodation
• Student Health Service
• Discipline
• Contested Decisions
• THE SCHOOL OF NURSING
• Administration and Faculty
• The Curriculum
• Evaluation
• Admission of Students
• Tuition and Fees

The Aga Khan Health Services - International Newsletter No. 38, Aga Khan University

The Aga Khan Health Services Archives

• Networking Benefits Begin
• Nursing Conference in Dar-es-Salaam Focus on Quality Assurance
• New Appointments in Kenya and Tanzania Health Services
• Prince Aly Khan Hospital
• Posters Promote Health Awareness in Kisumu
• Surgeon General's Award for Dr. John Bryant
• Management Workshops in Tanzania
• Joseph de Mora —Challenges of Health Care in the Developing World
• Bridging the Gap— Linking People, Place’s and Services
• Symposium on Health Care in the Developing World in Canada
• “Patron for the Day") at Prince Aly Khan Hospital
• The Role of Mohtasib in Public Health
• Video Campaign on Prevention of Heart Diseases in Asian Communities in London
• Struggling for Equity …