Medicine and Health Sciences Commons^™

Primary Iga And Igg Subclass Deficiency In A 17-Year-Old Pakistani Girl: A Case Report., Taimur Saleem, Madiha Rabbani, Bushra Jamil

Department of Medicine

Primary immunodeficiency disorders pose a diagnostic dilemma for physicians in the developing countries such as Pakistan because of lack of adequate diagnostic facilities. We present here the case of a 17-year-old girl who had a history of recurrent respiratory tract infections since childhood and had been treated with anti-tuberculous medications thrice, for a total of 24 months. She had also received multiple courses of antibiotics. Her initial presentation to our hospital was with acute bronchopneumonia. Her past medical history of recurrent infections also alerted the treating physician to the possibility of bronchiectasis secondary to a variety of underlying potential pathologies …

An Autoregressive Integrated Moving Average Model For Short-Term Prediction Of Hepatitis C Virus Seropositivity Among Male Volunteer Blood Donors In Karachi, Pakistan, Saeed Akhtar, Shafquat Rozi

Community Health Sciences

Aim: To identify the stochastic autoregressive integrated moving average (ARIMA) model for short term forecasting of hepatitis C virus (HCV) seropositivity among volunteer blood donors in Karachi, Pakistan.
Methods: Ninety-six months (1998-2005) data on HCV seropositive cases (1000(-1) x month(-1)) among male volunteer blood donors tested at four major blood banks in Karachi, Pakistan were subjected to ARIMA modeling. Subsequently, a fitted ARIMA model was used to forecast HCV seropositive donors for 91-96 mo to contrast with observed series of the same months. To assess the forecast accuracy, the mean absolute error rate (%) between the observed and predicted HCV …

Fight Against Chronic Diseases (High Blood Pressure, Stroke, Diabetes And Cancer) In Pakistan; Cost-Effective Interventions, Mohammad Wasay, Abdul Jabbar

Department of Medicine

No abstract provided.

Assessment Of Asthma Control Using The Asthma Control Test At A Tertiary Care Centre In Karachi, Pakistan, Sana Shoukat, Saqib Ali Gowani, Ameer Ali Khowaja, Javaid Khan

Section of Pulmonary & Critical Care

The aim of our study was to assess asthma control among asthmatics at a tertiary care setting in Karachi using ACT questionnaire. The ACT questionnaire was filled by known asthmatics in January 2007. A total of 150 questionnaires were filled of which, 61 (40%) were males and 89 (60%) females. Mean ACT score was 17.71 +/- 4.41. Association between sex and asthma control was not statistically significant. Significant association was seen with asthma control and Ipratropium bromide inhaler. Asthma control among patients at a tertiary care centre is moderate. ACT can be used to follow patients in the hospital.

Changing Patterns And Outcome Of Dengue Infection; Report From A Tertiary Care Hospital In Pakistan, Mohammad Wasay, Roomasa Channa, Maliha Jumani, Afia Zafar

Department of Medicine

Objective: To identify predictors of outcome in patients with Dengue Infections at a tertiary care hospital and to analyze that if pattern of Dengue infection is changing in the past two years.

Methods: We reviewed 225 cases of confirmed dengue virus infection. The diagnosis was confirmed by presence of IgM antibodies against Dengue by ELISA in addition to fever according to WHO criteria.

Results: From years 2000-2004, 30(73%) had Dengue Fever (DF), 10(24%) had Dengue Haemorrhagic Fever (DHF) and 1(2.4%) had Dengue shock syndrome (DSS) while after 2005, 107(58%) had DF, 71(39%) had DHF and 6(3%) had DSS. Six …

Tetanus And Rabies Eradication In Pakistan; A Mission Not Impossible, Mohammad Wasay, Ismail A. Khatri, Naseem Salahuddin

Department of Medicine

No abstract provided.

Irritable Bowel Syndrome And Health Seeking Behaviour In Different Communities Of Pakistan, Wasim Jafri, Javed Yakoob, Nadim Jafri, Muhammad Islam, Qazi Masroor Ali

Section of Gastroenterology

OBJECTIVE:

To investigate the frequency of irritable bowel syndrome (IBS) and health seeking behaviour in patients belonging to different ethnic groups and their squatter settlements in two cities of Pakistan.

METHODS:

Questionnaire based on Rome II criteria for the diagnosis of IBS was sent to 1167 persons living in, Karachi and Bahawalpur and their squatter settlements in Baloch Colony and Tibba Badar Sher respectively. About 90% (1048) completed the questionnaire.

RESULTS:

The overall frequency of IBS was 14% with a mean age of 30 +/- 12.5 years and range of 16-85 years. Of the IBS positive patients, 56% (82/146) were …

Knowledge And Beliefs Of Adolescents Regarding Sexually Transmitted Infections And Hiv/Aids In A Rural District In Pakistan, Hafsa Raheel, Franklin White, Muhammad Masood Kadir, Zafar Fatmi

Community Health Sciences

Objective:

To assess the knowledge and beliefs of adolescents (15-19 years girls and boys) regarding sexually transmitted infections (STIs) and HIV/AIDS.

Methods:

A community based cross-sectional survey was conducted in October 2002 in a rural district (Mirpurkhas) of Sindh province, Pakistan.

Results:

A total of 428 adolescent girls and boys were interviewed. Only 44% correctly named at least one STI, while 55% knew at least two modes of transmission for HIV/AIDS. Adolescents with education greater than or equal to secondary level, those who were able to read the newspaper, possessed electricity in their homes and were allowed to meet their …

Resource Allocation Within The National Aids Control Program Of Pakistan: A Qualitative Assessment Of Decision Maker's Opinions, Sara Husain, Masood Kadir, Zafar Fatmi

Community Health Sciences

Background:

Limited resources, whether public or private, demand prioritisation among competing needs to maximise productivity. With a substantial increase in the number of reported HIV cases, little work has been done to understand how resources have been distributed and what factors may have influenced allocation within the newly introduced Enhanced National AIDS Control Program of Pakistan. The objective of this study was to identify perceptions of decision makers about the process of resource allocation within Pakistan's Enhanced National AIDS Control Program.

Methods:

A qualitative study was undertaken and in-depth interviews of decision makers at provincial and federal levels responsible to …

Hepatitis B And C: Prevalence And Risk Factors Associated With Seropositivity Among Children In Karachi, Pakistan, Wasim Jafri, Nadim Jafri, Javed Yakoob, Muhammad Islam, Syed Farhan Ali Tirmizi, Tazeen Jafar, Saeed Akhtar, Saeed Hamid, Hasnain Ali Shah, Sheikh Qamaruddin Nizami

Section of Gastroenterology

Background

Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) can lead to chronic liver disease and hepato-cellular carcinoma (HCC). This cross-sectional study estimated the prevalence and identified risk factors associated with Hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV) sero-positivity among children 1 to 15 years of age.

Methods

The study targeted the low to middle socioeconomic population that comprises 80% to 85% of the population. Consent was obtained from parents of the eligible children before administering questionnaire and collected a blood sample for anti-HCV and HBsAg serology.

Results

3533 children were screened for HBsAg and …

Knowledge, Attitude And Misconceptions Regarding Tuberculosis In Pakistani Patients, Javaid Ahmed Khan, Muhammad Irfan, Amna Zaki, Madiha Beg, Syed Fayyaz Hussain, Nadeem Rizvi

Section of Pulmonary & Critical Care

Objective:

To assess knowledge of patients with tuberculosis; about their disease and misconceptions regarding TB.

Methods:

A cross sectional study was conducted at Out-patient clinics of two teaching hospitals (private and public) in Karachi, Pakistan. A questionnaire was filled for the purpose.

Results:

A total of 170 patients were interviewed, 112 from private and 58 from a public sector hospital. Cough, fever, bloody sputum and chest pain were recognized as the common symptoms of TB. Eleven (7%) patients thought TB was not an infectious disease and 18 (10.6%) did not consider it a preventable disease. Contaminated food was considered the …

Socio-Demographic Correlates Of Betel, Areca And Smokeless Tobacco Use As A High Risk Behavior For Head And Neck Cancers In A Squatter Settlement Of Karachi, Pakistan, Samia Mazahir, Rabia Malik, Maria Maqsood, Kanwal Aliraza Merchant, Farida Malik, Atif Majeed, Zafar Fatmi, Muhammad Rizwanulhaq Khawaja, Shehzad Ghaffar

Community Health Sciences

Background

Head and neck cancers are a major cancer burden in Pakistan. They share a common risk factor profile including regular consumption of products of betel, areca and tobacco. Use of paan, chaalia, gutka, niswar and tumbaku is acceptable in Pakistan and is considered a normal cultural practice. This cross-sectional study was carried out to understand the relation of socio-demographic factors for the consumption of paan, chaalia, gutka, niswar and tumbaku in Pakistani population. Through systematic sampling, 425 subjects from a squatter settlement in Karachi were interviewed using a structured questionnaire. High risk behavior was defined as Daily use of …

Neuroleptic Malignant Syndrome: Need For Early Diagnosis And Therapy, Humaira M. Khan, Nadir A. Syed, Mughis Sheerani, Bhojo Khealani, Ayeesha Kamal, Mohammad Wasay

Department of Medicine

Background: Neuroleptic Malignant Syndrome (NMS) is a medical entity that has received little attention in the clinical settings in Pakistan. The aim of our study was to review the predisposing factors, outcomes and characteristics of in-patients diagnosed with NMS.

Methods: We performed a retrospective chart review of all cases (age > 15 years) at a tertiary care center in Karachi between January 01, 1990 and November 30, 2001, diagnosed using ICD 10 coding. Data was collected using a standardized data entry form and statistical analysis was performed using Epi Info 6, Version 6.02.

Results: There were a total of 20 patients …

Role Of Rapid Urease Test And Histopathology In The Diagnosis Of Helicobacter Pylori Infection In A Developing Country, Javed Yakoob, Wasim Jafri, Shahab Abid, Zaigham Abbas, Saeed Hamid, Muhammad Islam, Kashif Anis, Hasnain Ali Shah, Hizbullah Shaikh

Section of Gastroenterology

Background

The aim of this study was to determine the effect of commonly self-prescribed proton pump inhibitors (PPI) on the results of rapid urease test and histology for the diagnosis of H. pylori infection.

Methods

One hundred-nine consecutive patients with dyspeptic symptoms attending the endoscopy suite were enrolled in this study. Antrum biopsy specimens were collected at endoscopy for the rapid urease test (Pronto Dry, Medical Instrument Corp, France) and histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and like-hood ratio of a positive and negative of Pronto Dry test were compared against histology. The gold standard …

Neurological Care In Pakistan: Actions Are Needed, M. Wasay

Department of Medicine

No abstract provided.

Should Carotid Endarterectomy Be Performed For Symptomatic Carotid Stenosis Pakistan?, N. A. Syed, A. Zakaria, B. A. Khealani, M. Wasay, S. M. Baig, Z. Sophie

Department of Medicine

Objective: The risk of stroke and death associated with carotid endarterctomy is operator dependant. Data regarding risks of this procedure are not available in Pakistan and therefore it is difficult to make accurate risk benefit analysis for individual patients. Our objective was to determine safety of carotid endarterectomy at an academic tertiary care center in Pakistan.

Methods: Patients who underwent carotid endarterectomy (CEA) at our hospital during a ten-year period were identified through ICD-9 coding system of the hospital medical records. Demographic features. associated medical problems and immediate postoperative complications were recorded and analyzed.

Results: Sixty-three carotid endarterectomies were performed …

Socio-Economic And Diagnostic Aspects Of Tuberculosis In Pakistan, Saba Sohail

Department of Radiology

No abstract provided.

Candida Esophagitis: Risk Factors In Non-Hiv Population In Pakistan, Javed Yakoob, Wasim Jafri, Shahab Abid, Nadim Jafri, Muhammad Islam, Saeed Hamid, Hasnain Ali Shah, Akbar S. Hussainy

Section of Gastroenterology

AIM:

Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching hospital.

METHODS:

Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications' (ICD-9-CM), with candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were studied.

RESULTS:

Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34% of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and …

Hemoglobin E B-Thalassemia In A Pakistani Family, Aftab Ahmed, Atiya Abbasi, Gerhard Braunitzer, Zafar H. Zaidi

Pharmacy Faculty Articles and Research

Hemoglobin E is a slow moving B chain variant of hemoglobin, first discovered by Itano¹. Characterized by Hunt et al² showed glutamic acid at B 26 to be replaced by lysine. It is a common variant of hemoglobin in the world and reported in high frequency from South-East Asia^3-6. Cases of Hb E, in combination with thalassemia have been reported on the basis of electrophoretic pattern only. In this communication a case of Hb E with B thalassemia is reported on the basis of amino acid sequencing of the abnormal peptide.