Medicine and Health Sciences Commons^™

Effect Of Raised Body Fat On Vitamin D, Leptin And Bone Mass, Syeda Sadia Fatima, Saad Farooq, Maaida Asif Tauni, Omar Irfan, Faiza Alam

Department of Biological & Biomedical Sciences

Objective: To estimate leptin, vitamin D and bone mineral density levels in individuals with high fat mass, and to assess any correlation.Methods: The cross-sectional study was conducted at the Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi, and Aga Khan University, Karachi, from August 2012 to July 2014, and comprised healthy male volunteers between the ages of 18-60 years. Body fat percentage was determined using bioelectrical impedance analysis and the participants were classified as: Group A (15-21.9); Group B (22-27.9); and Group C ( > 28). Bone mineral density was calculated by ultrasound bone densitometer (T-score between +1 and …

Spectrum Of Histopathological Findings In Postmenopausal Bleeding, Muhammad Usman Tariq, Romana Idress, Ahmed Raheem, Naila Kayani

Department of Pathology and Laboratory Medicine

Objective:To determine the frequencies of histopathological findings in endometrial and endocervical biopsy samples with clinical history of Postmenopausal Bleeding (PMB). Study Design:Descriptive cross-sectional study. Place and Duration of Study:Section of Histopathology, Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, from February 2012 to January 2013. Methodology:Atotal of 157 consecutive endometrial and endocervical biopsy specimens with history of postmenopausal bleeding were included. After microscopic examination, frequencies of histological findings in different age groups were generated. Chi-square and independent sample t-tests were applied to see whether the difference was significant which was set at p < 0.05. Results:One hundred and twenty-one (77.1%) specimens showed benign pathologies while 36 (22.9%) were malignant. Endometrial polyp was seen in 67 (42.7%) cases followed by endometrial carcinomas in 25 (15.9%), endometrial hyperplasia in 21 (13.4%), cervical carcinoma in 12 (7.6%) and cervical polyps in 9 (5.7%) cases. Ahighly significant increase in the percentage of malignant and pre-malignant lesions was seen with increasing age group (p < 0.001). Mean age of patients with type-2 endometrial carcinoma was higher than type-1 endometrial carcinoma but statistical significance was not observed (70.2 ±6.5 vs. 61.8 ±9.1 years respectively, p=0.069). Conclusion:Although benign pathologies were more common in postmenopausal bleeding but the collective proportion of endometrial and cervical malignancies and pre-malignant conditions was quite high. Therefore, PMB should be urgently evaluated for cause and early commencement of treatment

Establishing Quality Control Values For Hematology Parameters: An Insight, Muhammad Shariq Shaikh

Department of Pathology and Laboratory Medicine

No abstract provided.

Hereditary Sensory Autonomic Neuropathy Ii, A Rare Disease In A Large Pakistani Family, Fazal M. Arain, Prem Chand

Department of Paediatrics and Child Health

Hereditary Sensory Autonomic Neuropathy II (HSAN II) is a rare genetic disorder, characterized by severe loss of pain, temperature and touch sensation. Injuries in these patients can progress to necrosis and shedding of digits and limbs. Here we report two cases of HSAN II belonging to a Pakistani family. Individual 1, a forty five year old man, had complete loss of pain sensation since birth. Self-mutilation and complication of injuries resulted in the shedding of all the digits and right foot and surgical amputation of left leg. Individual 2, a five year old girl,had delay in healing of wounds and …

Lymphangioma Circumscriptum: Clinicopathological Spectrum Of 29 Cases, Saira Fatima, Nasir Uddin, Romana Idrees, Khurram Minhas, Zubair Ahmad, Rashida Ahmad, Naila Kayani, Muhammad Arif

Department of Pathology and Laboratory Medicine

Objective:
To describe the clinicopathological spectrum of Lymphangioma Circumscriptum (LC).
Study Design:
Observational case series.
Place and Duration of Study:
Department of Pathology and Microbiology, AKUH, Karachi, from 2002 to 2012.
Methodology:
All reported cases of LC were retrieved from medical record. Clinical and pathological features were noted. Frequency percentages were determined.
Results:
There were 29 cases of LC predominantly males (62%). The mean age was 27.17 ±15.5 years. The commonest sites was anal/perianal region (24%) followed by extremities (17%) and tongue, (14%). Vulval LC was seen in 3 patients. Two cases were described on scrotum. The lesions were most …

Pathogen-Specific Burdens Of Community Diarrhoea In Developing Countries: A Multisite Birth Cohort Study (Mal-Ed), Sadia Shakoor, Shahida Qureshi, Furqan Kabir, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta, Imran Ahmed, Didar Alam, Syed Asad Ali, Muneera Rasheed, Sajid Bashir Soofi, Ali Turab, Aisha Khizar Yousafzai

Department of Pathology and Laboratory Medicine

Background: Most studies of the causes of diarrhoea in low-income and middle-income countries have looked at severe disease in people presenting for care, and there are few estimates of pathogen-specific diarrhoea burdens in the community.
Methods: We undertook a birth cohort study with not only intensive community surveillance for diarrhoea but also routine collection of non-diarrhoeal stools from eight sites in South America, Africa, and Asia. We enrolled children within 17 days of birth, and diarrhoeal episodes (defined as maternal report of three or more loose stools in 24 h, or one loose stool with visible blood) were identified through …

Acute Myocardial Infarction And Myocardial Ischemia-Reperfusion Injury: A Comparison, Satwat Hashmi, Suhail Al-Salam

Department of Biological & Biomedical Sciences

Myocardial infarction (MI) denotes the death of cardiac myocytes due to extended ischemia. Myocardial reperfusion is the restoration of coronary blood flow after a period of coronary occlusion. Reperfusion has the potential to salvage ischemic myocardium but paradoxically can cause injury, a phenomenon called as 'reperfusion injury' (IR). Standard histologic, immunohistochemical and Elisa techniques were used to study the histopathologic, oxidative, apoptotic and inflammatory changes in MI and IR. The IL-6 levels in the LV of the MI group were significantly raised as compared to the IR group (P=0.0008). Plasma IL-6 was also significantly increased in the MI group as …

Autologous Hematopoietic Stem Cell Transplantation-10 Years Of Data From A Developing Country, Natasha Ali, Salman Naseem Adil, Mohammad Usman Shaikh

Department of Pathology and Laboratory Medicine

Intensive chemotherapy followed by autologous stem cell transplantation is the treatment of choice for patients with hematological malignancies. The objective of the present study was to evaluate the outcomes of patients with mainly lymphoma and multiple myeloma after autologous stem cell transplant. The pretransplant workup consisted of the complete blood count, an evaluation of the liver, kidney, lung, and infectious profile, chest radiographs, and a dental review. For lymphoma, all patients who achieved at least a 25% reduction in the disease after salvage therapy were included in the study. Mobilization was done with cyclophosphamide, followed by granulocyte colony-stimulating factor, 300 …

Symptomatic Surgically Treated Non-Neoplastic Cysts Of The Central Nervous System: A Clinicopathological Study From Pakistan, Nasir Ud Din, Huma Arshad, Zubair Ahmad, Sheema H Hasan, Mohammad Ehsan Bar

Department of Pathology and Laboratory Medicine

Objective: To report clinicopathologic features of symptomatic surgically removed non-neoplastic cysts of the central nervous system (CNS). Study Design: Case series. Place and Duration of Study: The Aga Khan University Hospital, Karachi, from 2003 to 2012. Methodology: All non-neoplastic CNS cysts reported during the study period were retrieved and reviewed. Age, gender, location, histologic type and clinical features were noted. Results: A total of 124 cysts were diagnosed in the study period. These included 44 epidermoid cysts (mean age 30.5 ± 13.8 years), 35 colloid cysts (mean age 31 ± 13.2 years), 32 arachnoid cysts (mean age 24.8 ± 20.2 …

Aspergillus Fumigatus Spinal Abscess In An Immunocompetent Child, Mohammad Faizan Zahid, Joveria Farooqi

Department of Pathology and Laboratory Medicine

No abstract provided.

Iron Chelation In Patients With Transfusion Dependent Thalassemia: An Insight On Response To Deferasirox, Muhammad Shariq Shaikh, Salman Naseem Adil

Department of Pathology and Laboratory Medicine

No abstract provided.

Thyroxine Replacement In Patients On Parenteral Nutrition: A Clinical Conundrum, Abdul Rehman, Noor Ul-Ain Baloch, Muhammad Awais

Department of Biological & Biomedical Sciences

No abstract provided.

Galectin-1: A Biomarker Of Surgical Stress In Murine Model Of Cardiac Surgery, Satwat Hashmi, Suhail Al-Salam

Department of Biological & Biomedical Sciences

Galectin-1 (GAL-1) belongs to the family of β-galactoside-binding lectins. It regulates cell-cell and cell-matrix interactions, the immune response, apoptosis, cell cycle, RNA splicing and neoplastic transformation. We investigate the effect of heart manipulation secondary to cardiac surgery on the level of GAL-1 in murine heart and plasma. Male C57B6/J mice were used for adopted model of cardiac surgery. Heart samples were processed for immunohistochemical and immunofluorescent labeling, Enzyme linked immunosorbent assay and quantitative RT-PCR to identify GAL-1 levels in the heart and plasma during the first 24 hours following cardiac surgery. There is significant increase of GAL-1 in the LV …

Environmental And Food Allergens Reactivity And Its Association With Total Ige, Age And Gender In Karachi, Pakistan, Noreen Abbas, Ahmed Raheem, Farooq Ghani

Department of Pathology and Laboratory Medicine

Aim: The aim of this study is to assess the frequency of food and environmental allergens reactivity and its association in with age, gender and total IgE levels
Material and Methods: The study population consisted of 88 individuals including children and adults (male: 47 and female: 41). The study was conducted in the clinical laboratory, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital from May 2009 till May 2010. Sera of patients positive for total IgE were tested for allergen specific IgE levels by Immulite 2000, 3gAllergyTM. We divided allergens into two panels, namely food and environmental.
Results: …

Characterization Of Genomic Variations In Snps Of Pe_Pgrs Genes Reveals Deletions And Insertions In Extensively Drug Resistant (Xdr) M. Tuberculosis Strains From Pakistan., Akber Kanji, Zahra Hasan, Ruth Mcnerney, Mridul Nair, Asho Ali, Kim Mallard, Taane G. Clark, Ambreen Zaver, Sana Jafri,, Rumina Hasan

Department of Pathology and Laboratory Medicine

BACKGROUND:

Mycobacterium tuberculosis (MTB) PE_PGRS genes belong to the PE multigene family. Although the function of PE_PGRS genes is unknown, it is hypothesized that the PE_PGRS genes may be associated with antigenic variability in MTB.

MATERIAL AND METHODS:

Whole genome sequencing analysis was performed on (n=37) extensively drug-resistant (XDR) MTB strains from Pakistan, which included Lineage 1 (East African Indian, n=2); Other lineage 1 (n=3); Lineage 3 (Central Asian, n=24); Other lineage 3 (n=4); Lineage 4 (X3, n=1) and T group (n=3) MTB strains.

RESULTS:

There were 107 SNPs identified from the analysis of 42 PE_PGRS genes; of these, 13 …

Factors Affecting Ventriculoperitoneal Shunt Survival In Adult Patients, Farid Khan, Abdul Rehman, Muhammad Shahzad Shamim, Muhammad Ehsan Bari

Section of Neurosurgery

Background: Ventriculoperitoneal (VP) shunt insertion remains the mainstay of treatment for hydrocephalus despite a high rate of complications. The predictors of shunt malfunction have been studied mostly in pediatric patients. In this study, we report our 11-year experience with VP shunts in adult patients with hydrocephalus. We also assess the various factors affecting shunt survival in a developing country setting.
Methods: A retrospective chart analysis was conducted for all adult patients who had undergone shunt placement between the years 2001 and 2011. Kaplan-Meier curves were used to determine the duration from shunt placement to first malfunction and log-rank (Cox-Mantel) tests …

The Artificial Divide Between Biomedical Sciences And Clinical Medicine In Undergraduate Medical Education, Abdul Rehman, Noor Ul-Ain Baloch, Muhammad Awais

Department of Biological & Biomedical Sciences

No abstract provided.

Whole Genome Sequencing Based Characterization Of Extensively Drug-Resistant Mycobacterium Tuberculosis Isolates From Pakistan, Asho Ali, Zahra Hasan, Ruth Mcnerney, Kim Mallard, Grant Hill Cawthorne, Francesc Coll, Mridul Nair, Arnab Pain, Taane G. Clark, Rumina Hasan

Department of Pathology and Laboratory Medicine

Improved molecular diagnostic methods for detection drug resistance in Mycobacterium tuberculosis (MTB) strains are required. Resistance to first- and second- line anti-tuberculous drugs has been associated with single nucleotide polymorphisms (SNPs) in particular genes. However, these SNPs can vary between MTB lineages therefore local data is required to describe different strain populations. We used whole genome sequencing (WGS) to characterize 37 extensively drug-resistant (XDR) MTB isolates from Pakistan and investigated 40 genes associated with drug resistance. Rifampicin resistance was attributable to SNPs in the rpoB hot-spot region. Isoniazid resistance was most commonly associated with the katG codon 315 (92%) mutation …

Prevalence Of Obesity And Overweight, Its Clinical Markers And Associated Factors In A High Risk South-Asian Population, Faridah Amin, Syeda Sadia Fatima, Najmul Islam, Anwar H. Gilani

Department of Biological & Biomedical Sciences

Background: Obesity is a global epidemic, which is a risk factor for cardiovascular diseases and metabolic abnormalities. It is measured by body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), body fat (BF) distribution and abdominal fat mass, each having its own merits and limitations. Variability in body composition between ethnic groups in South-Asians is significant and may not be truly reflected by BMI alone, which may result in misclassification. This study therefore, aims to determine the frequency of obesity, body fat composition and distribution, in a high risk population of an urban slum of Karachi, Pakistan. This survey …

Mammary-Type Myofibroblastoma Of The Right Thigh: A Case Report And Review Of The Literature, Jamshid Abdul-Ghafar, Nasir Ud Din, Zubair Ahmad, Steven D. Billings

Department of Pathology and Laboratory Medicine

Introduction:
Mammary-type myofibroblastoma of the soft tissue is a very rare, benign, mesenchymal neoplasm with myofibroblastic differentiation. To date, 20 cases of extra-mammary myofibroblastoma have been described in literature. To the best of our knowledge, this is the largest extra-mammary myofibroblastoma described in the literature, and the first case reported in this location.
Case Presentation:
A 50-year-old Pakistani man presented with a long history of a painless, huge lump on his right thigh. His clinical examination showed normal-looking skin and there was no inguinal lymphadenopathy. The mass was excised with a clinical impression of soft tissue sarcoma. Gross examination showed …

Clinical Isolates Of Salmonella Enterica Serovar Agona Producing Ndm-1 Metallo-Beta-Lactamase: First Report From Pakistan, Seema Irfan, Erum Khan, Kauser Jabeen, Pushpa Bhawan, Katie L. Hopkins, Martin Day, Amna Nasir, Daniele Meunier, Neil Woodford

Department of Pathology and Laboratory Medicine

We report two cases of infantile diarrhea due to multidrug-resistant, NDM-1 metallo-beta-lactamase-producing Salmonella enterica serovar Agona from Pakistan. This study alerts toward possible risk of NDM-1 transmission to enteric fever pathogens and encourages microbiologists to consider active screening of carbapenem resistance in nontyphoidal Salmonella isolates.

Gastrointestinal Stromal Tumors: A Clinicopathologic And Risk Stratification Study Of 255 Cases From Pakistan And Review Of Literature, Nasir Ud Din, Zubair Ahmad, Huma Arshad, Romana Idrees, Naila Kayani

Department of Pathology and Laboratory Medicine

Purpose:
To describe the clinicopathological features of gastrointestinal stromal tumors (GIST) diagnosed in our section and to perform risk stratification of our cases by assigning them to specific risk categories and groups for disease progression based on proposals by Fletcher et al and Miettinen and Lasota.
Material and Results:
We retrieved 255 cases of GIST diagnosed between 2003 and 2014. Over 59% were male. The age range was 16 to 83 years with a mean of 51 years. Over 70% occurred between 40 and 70 years of age. Average diameter of tumors was 10 cms. The stomach was the most …

Hiv Prevalence In Blood Donors And Recipients In Pakistan: A Meta-Analysis And Analysis Of Blood-Bank Data, Bushra Moiz, Barkat Ali, Muhammad Hasnain Chatha, Ahmed Raheem, Hasan Abbas Zaheer

Department of Pathology and Laboratory Medicine

Background:
The first instances of HIV-antibody detection in donated blood in Pakistan were reported in 1988. Since then, documentation of HIV in blood donors and of rates of transmission via transfusion has been limited. Previously assumed to have a low prevalence, HIV is an increasing health concern in Pakistan. Since there is no national, centralized blood-banking system, there are no reliable data on which to base estimated risks of transfusion-associated HIV infection. This study was therefore conducted to estimate the prevalence of HIV in blood donors and recipients in Pakistan between 1988 and 2012.
Methods:
Meta-analyses were undertaken of reported …