Medicine and Health Sciences Commons^™

Foreign Body Granuloma After Craniotomy For Tumor: A Diagnostic Dilemma, Ashfaq A. Razzaq, M. K. N. Chishti

Section of Neurosurgery

No abstract provided.

Job's Syndrome, M A. Yousafzai, K Nasim, S Q. Nizami

Department of Paediatrics and Child Health

No abstract provided.

Retinoblastoma Tells The Story Of Our Health Care System, Irshad Soomro, Muhammad Nadeem Khan, Suhail Muzaffar, Naila Kayani, Shahid Pervez, Akbar Shah Hussainy, Rashida Ahmed, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:

To review cases of retinoblastoma.

Setting:

Department of Pathology Aga Khan University Hospital Karachi.

Method:

Twenty three specimens from cases of retinoblastoma received over a period of eight years were routinely processes and stained with haematoxylin and Eosin stain Other stains were used for tuberculosis and melanin. Immunochemistry was resorted to in undifferentiated tumors.

Results:

Over 60% cases of retinoblastoma were diagnosed after 5 years and nine cases showed involvement of opti-nerve.

Conclusion:

Late diagnosis of retinoblastoma effects the stage of the tumors and the prognisis.

Histological Pattern Of Ovarian Neoplasma., Zubair Ahmad, Naila Kayani, Sheema H. Hasan, Suhail Muzaffar, Muhammad Shafiq Gill

Department of Pathology and Laboratory Medicine

Abstract

Objective: To see the morphological pattern of benign and malignant ovarian neoplasms. Method: Retrospective study of all consecutive cases of ovarian neoplasms diagnosed at Aga Khan University Hospital between 1st January 1993 and 30th September 1998. Setting: The Section of Histopathology, AKUH, Karachi. Observation: Of 855 ovarian tumours 506 (59.18%) were benign and 349(40.81%) malignant. Surface epithelial - stromal tumours comprised 63.50% of all tumours. Benign cystic teratoma was the commonest benign tumour (35.17% of all benign tumours) and serous cystadenocarcinoma was the commonest malignant tumour (33.33% of all malignant tumours). Mucinous cystadenocarcinomas are more common in our population …

Granular Cell Tumor Of The Breast: An Uncommon Lesion That Mimics Carcinoma, S Muzafar, M S. Siddiqui, Naila Kayani, I K. Lodhi, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Human Subject Research, Ethics And The Developing World, F Moazam

Department of Surgery

No abstract provided.

Gram Negative Meningitis Resulting From Rupture Of A Spinal Epidural Abscess Into The Subarachnoid Space, S Lodhi, T Mozaffar, A R. Sarwari

Section of Neurology

No abstract provided.

Endocrine Cell Dysplasia (Nesidioblastosis): A Relatively Unrecognized Entity In Pakistan?, Nasim Sabir, Irshad Nabi Soomro, Zafar Nazir, Abdul Jabbar, Sheema Hasan

Section of Paediatric Surgery

Nesidioblastosis is quantitative as well as qualitative abnormality of pancreatic endocrine cells. There is scattering of small endocrine cell clusters arranged haphazardly rather than the peripheral location within the lobule^1,2. Islet contours are irregular, tailing off into parenchyma³. These islets are present in intimate association with ducts forming ductuloinsular complexes¹ We recently encountered a new born baby with signs and symptoms of endocrine cell dysplasia.

Non-Small Cell Lung Cancer: Disease Spectrum And Management In A Tertiary Care Hospital, M R. Khan, S B. Hasan, S A. Sami

Department of Surgery

Objectives: To review the spectrum of presentation and the surgical management of Non Small Cell Lung Cancer (NSCLC) and the role of various diagnostic modalities in predicting the post-operative stage and the correlation of the post-operative stage with the chances of recurrence.SETTINGS: The Aga Khan University Hospital, Karachi--a tertiary care referral center in Paksitan.Methods: This is a retrospective study of medical records of all the patients who were managed at the Aga Khan University Hospital (AKUH) between 1988 and 1998. The patients with a diagnosis of lung cancer were identified using the ICD-9-CM coding system and the data was analyzed …

Dna Ploidy Analysis Of Borderline Epithelial Ovarian Tumours, Saba Lodhi, Sabeen Najam, Shahid Pervez

Department of Pathology and Laboratory Medicine

Objective: Borderline epithelial ovarian tumors not uncommonly pose a great difficulty to surgical pathologists as morphologically they may show very similar features as those of malignant epithelial tumors except invasion. However it is important to separate these from their invasive counterparts because of their superior prognosis. Recently, attention has been focussed on the prognostic value of flow cytometric analysis of DNA ploidy in borderline epithelial ovarian tumors. The purpose of this study is to investigate whether flow cytometric analysis of cellular DNA content acts as a useful adjunct to the histopathological diagnosis of borderline malignancy.

Materials and Methods: Fifteen histologically …

A Comparative Study Of Positive Pressure Ventilation Via Laryngeal Mask Airway And Endotracheal Tube, A Idrees, F A. Khan

Department of Anaesthesia

Objective: To investigate the use of Laryngeal Mask Airway (LMA) and its comparison with the endotracheal tube for positive pressure ventilation.SETTING: A tertiary care teaching hospital.Methods: Fifty adult ASA I and II patients undergoing peripheral limb surgery were randomly allocated to 2 groups for LMA or endotracheal tube insertion. A standardized anaesthetic technique was used. The groups were then compared regarding haemodynamic changes on insertion as well as removal of LMA and ETT and any complications that occurred were noted.Results: The haemodynamic response to insertion was significantly attenuated (p < 0.05) in LMA group as compared to ETT group. The cardiovascular response to extubation was not significantly different between the groups. A higher incidence of coughing and mild hypoxaemia at extubation was noted in ETT group as compared to LMA group (p < 0.05) and blood was detected in 4 cases after LMA removal.CONCLUSION: It is concluded that the use of LMA during positive pressure ventilation is safe in selected cases. There is an attenuated haemodynamic response to insertion of LMA as compared to endotracheal tube which will be beneficial in certain patients e.g., those with ischaemic heart disease, vascular disease and hypertensives.

Clinical Spectrum Of Systemic Lupus Erythematosus At The Aga Khan University Hospital., K. Sulaiman, N. Sohail, A. A. Sheikh, F. Raza, F. Shahzad, A. Siddique, T. Shakir, Fauziah Rabbani

Community Health Sciences

BACKGROUND:

Systemic lupus erythematosus is a disease of unknown etiology, which at onest may involve only one organ system or be multisystemic. The aim of our study is to determine the clinical presentation of SLE patients presenting to AKUH to establish whether guidelines laid down about this disease are in agreement with our experience.

METHODS:

A retrospective log review was carried out at AKUH, based on data obtained from 165 files of individuals admitted to the hospital over a period of 12 years with a confirmed diagnosis of SLE.

RESULTS:

From the sample size of 165, 143 (86.7%) were females …

Why Has So Little Changed In Maternal And Child Health In South Asia?, Z A. Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Low Serum Alpha 1 Antitrypsin In Duodenal Ulcer--A Family Study, Anjum Shahid, Sarwar J, Zuberi Mohammad A, Waqar,Huma Qureshi Waqar,Huma Qureshi Waqar,Huma Qureshi, Anwar Ali Siddiqui, Taranum Sultana

Department of Biological & Biomedical Sciences

No abstract provided.

Surgical Management Of Penile Cancer: Report Of Two Cases, M Amjad Noor, Muhammad Hammad Ather, M Nasir Sulaiman, Farhat Abbas

Section of Urology

No abstract provided.

Genetic Diversity Of Beta-Thalassemia Mutations In Pakistani Population, B Khateeb, T Moatter, A M. Shaghil, S Haroon, G N. Kakepoto

Department of Pathology and Laboratory Medicine

Background:
beta-thalassemia is one of the most common inherited single gene disorder in Pakistan. It is characterized by reduced or absent beta-globin gene expression resulting in abnormal maturation and survival of red blood cells. Due to high prevalence of this disease in the local population, it has become important for the health care providers to encourage people to utilize laboratory facilities for carrier and prenatal genetic testing.
Objective:
To study the frequency of beta-thalassemia mutations in Pakistani population.
Setting:
A tertiary care teaching hospital.
Methods:
Blood samples of 72 couples and chorionic villus (CV) biopsy specimen collected at the Aga …

The Minds Of Mothers: Maternal Mental Health In An Urban Squatter Settlement Of Karachi., Fauziah Rabbani, Furqan Farooq Raja

Community Health Sciences

BACKGROUND:

Community-based information on maternal mental health in developing countries is meager and nearly non-existent in Pakistan.

OBJECTIVE:

To determine the proportion of probable cases of women with mental disorders and examine the associated conditions and risk factors which contribute to maternal mental ill-health.

METHODS:

With convenient sampling 260 mothers in an urban squatter settlement of Karachi were interviewed. The tools consisted of a household questionnaire collecting information on basic demographic and other characteristics and the Aga Khan University Anxiety and Depression Scale (AKUADS), an instrument to assess psychiatric morbidity.

RESULTS:

The proportion of probable cases of mental disorder was …

Genitourinary Tuberculosis: A Profile Of 55 In-Patients, N P. Buchholz, S Salahuddin, R Haque

Section of Urology

Objective: To outline the pattern and trends in major cases of genito-urinary tuberculosis (GUTB) which require hospital treatment.
Method: We retrospectively reviewed 55 patients with proven GUTB who were treated as in-patients in a major referral hospital in Pakistan.
Results: The male/female ratio was 3:1. Prevailing symptoms were lower urinary tract symptoms, flank pain, gross hematuria and fever. A urine culture was positive for tuberculosis (TB) in 57%, bladder biopsies in 54%. For renal TB, intravenous urogram (IVU) and ultrasound were suggestive in about 50% of cases. Ultrasound was very helpful in the diagnosis of testicular TB. Patients underwent surgery …

A Comparison Of Dissection-Method And Diathermy Tonsillectomies, Muneeb Ahmed, Adil Abbas Khan, Tanya Siddiqi, Mubasher Ikram, M Yousuf Mian

Section of Otolaryngology, Head & Neck Surgery

Objective: To compare the dissection and diathermy methds of tonsillectomy and evaluate their advantages and disadvantages during surgery and convalescence.
Methods and Setting: Patients who had tonsillectomy at Aga Khan University Hospital, between January 1994-December 1997.
Results: Four year retrospective analysis was done of 200 patients who underwent tonsillectomy by either electrocautery or dissection method. One hundred and eleven underwent tonsillectomy by electrocautery and the other 79 had their tonsils removed by dissection-method and 2 had a combination of both. The average intra­operative blood loss was 10 ml with cautery and 65 ml with dissection method. The average operative time …

Genetic Analysis Of Cystic Fibrosis In Pakistan: A Preliminary Report, Z A. Bhutta, T Moattar, U Shah

Department of Paediatrics and Child Health

Objective: Evaluation of the incidence of common delta F508 mutation in a cohort of Pakistani children with Cystic Fibrosis (CF).
Methodology: The presence of the CFTR gene mutation at position 508 (delta F508) was evaluated in 15 consecutively presenting children with CF, proven by clinical features and an unequivocally positive sweat chloride test. The DNA from mononuclear cells was extracted and the delta F508 mutation assessed by the amplification refractory mutation system using the polymerase chain reaction.
Results: The delta F508 mutation was found in 9 cases (60%), of which 5 were homozygous for the disorder.
Conclusion: In this preliminary …

Increased Levels Of Multiple Forms Of Dihydrofolate Reductase In Peripheral Blood Leucocytes Of Cancer Patients Receiving Haematopoietic Colony-Stimulating Factors: Interim Analysis, M P. Iqbal, I A. Burney, F Sultana, N Mehboobali, T Siddiqui

Department of Biological & Biomedical Sciences

The precise mechanism whereby granulocytes proliferate when haematopoietic colony stimulating factors (CSFs) are used in neutropenic cancer patients is poorly understood. The purpose of this study was to investigate whether these cytokines bring about leucocyte proliferation by increasing the levels of multiple forms of dihydrofolate reductase (DHFR). Blood samples were collected from 36 cancer patients (25 males and 11 females) with chemotherapy-induced neutropenia. One sample of blood from each patient was obtained before therapy either with CSF, such as granulocyte colony stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating factor (GM-CSF) or with placebo, and another one at the time of …

Tibial Plateau Fractures: A New Classification Scheme, Raja Muhammad Shahzad Khan, Shuja Hassan Khan, Agha Jamil Ahmad, Muhammad Umar

Section of Orthopaedic Surgery

Fractures of the tibial plateaus are common injuries. Various classification schemes have been used to describe these injuries. Although each system has its own purpose, the simpler systems do not allow comparison with more complex divisions. The problem is compounded by the variable use of adjectives that describe these fractures. A comprehensive classification of tibial plateau fractures should group fractures that are similar in topography, morphology, and pathogenesis, requiring similar treatment, and having a similar prognosis. Fracture dislocations and standard tibial plateau fractures should be incorporated into a single classification to avoid the use of two complementary classifications. Any such …

Cerebellopontine Angle Medulloblastoma, Naim-Ur-Rahman, A Jamjoom, M Al-Rayess, Z A. Jamjoom

Section of Neurosurgery

No abstract provided.

Pilomatrixoma And Pilomatrix Carcinoma Deceptively Similar But Distinct Entities, T S. Khan, A Khan

Department of Surgery

No abstract provided.

Incidence And Pattern Of Thrombocy To Penia In Cardiac Surgery Patients, S Bashir, S M. Shah, I Babar

Department of Anaesthesia

No abstract provided.

Audit Of Lymph Node Biopsies In Suspected Cases Of Lymphoproliferative Malignancies: Implications On Tissue Diagnosis And Patient Management, Mohammad Zeeshan Qamar, Mehrukh Mujib, Shahid Pervez

Department of Pathology and Laboratory Medicine

Aims: To carry out an audit ascertaining the importance of condition of lymph node specimen, submission of clinical history including site of biopsy and imrnunohistochemcial studies on conclusiveness of diagnosis made.

Methodology: Computer records of the Aga Khan University Hospital, Histopathology Laboratory were used to analyze all cases of lymphoproliferative malignancies presented at the hospital from 1992 to 1998.

Results: Out of a total of 466 cases studied, in 283 (61%) the lymph nodes were fragmented. The site of biopsy was mentioned in 361 (77.5%) cases with the cervical region forming the most common site (56.5%). A clinical history was …

Association Of Epstein Barr Virus (Ebv) With Nasopharyngeal Carcinoma (Npc), S H. Shah, I N. Soomro, S Haroon, T Moatter

Department of Pathology and Laboratory Medicine

Aim:
To observe the frequency of nasopharyngeal carcinoma (NPC) and its association with Epstein Barr Virus (EBV) infection.
Setting:
This study included consecutive cases of nasopharyngeal carcinoma, which were diagnosed in the Department of Pathology at the Aga Khan University Hospital, Karachi in the period of two years (1996-97).
Methods:
These tumors were initially evaluated on H&E stained sections. The tumors showing evidence of keratinization were excluded from the study. The Epstein Barr Virus was detected with the help of Polymerase chain reaction in formalin fixed, paraffin embedded tissue sections.
Results:
During the study period, seventeen cases of nasopharyngeal carcinoma …

Central Nervous System Lymphomas: A Histologic And Immunophenotypic Analysis, Suhail Muzaffar, M. Shahid Siddiqui, Irshad Nabi Soomro, Shahid Pervez, Naila Kayani Naila Kayani, Sheema H. Hasan Sheema H. Hasan Sheema H. Hasan, Lmran Siddiqui Lmran Siddiqui

Department of Pathology and Laboratory Medicine

Objective: To observe the spectrum of non-Hodkin’s lymphomas involving the central nervous system including morphological subtypes and immunophenotypic status.

Setting: Retrospective analysis of eleven years (1986 to 1996) data from surgical pathology files of Department of Pathology.

Results: orty-three cases of non-Hodgkin’s lymphomas were diagnosed during the period of eleven years (from 1986 to 1996), all of which were diffuse types. A total of 1177 Central Nervous CNS biopsies were examined, out of which 937 cases were diagnosed as CNS neoplasms, the remaining were non-neoplastic in nature. Among 937 CNS neoplasms, 43 cases (4.6%) were reported as non-Hodgkin’s lymphomas. As …

Center-Based Prevalence Of Anxiety And Depression In Women Of The Northern Areas Of Pakistan, Sunita Dodani, Rukhsana Wamiq Zuberi

Department for Educational Development

Objective: To estimate the prevalence of anxiety and depression in women of the Northern areas. Methods: A cross-sectional center-based study was conducted at Singal Medical Center (SNIC), Gilgit, in the Northern Areas of Pakistan, using the Hospital Anxiety and Depression Scale (HADS).

Results: One hundred and twenty women, between the ages of 16 and 60, attended the SMC over a two month period and were included in the study. Using HADS, it was found that 50% of the women had anxiety and/or depression; 25% suffered only from anxiety, 8% from depression and 17% had features of both.

Conclusion: This study …

Uterine Atony At A Tertiary Care Hospital In Pakistan: A Risk Factor Analysis, S H. Feerasta, A Motiei, S Motiwala, N F. Zuberi

Department of Obstetrics & Gynaecology

Objectives: To identify risk factors for uterine atony following assisted or unassisted vaginal delivery.
Design: This hospital based case control study was done at The Aga Khan University Karachi, Pakistan. Cases were defined as all women with uterine atony within 24 hours of an assisted or unassisted vaginal delivery. Controls were based on women with normal assisted or unassisted vaginal delivery without uterine atony. Data abstracted form the medical records; adjusted odds ratios were estimated by multiple logistic regression.
Results: Factors having a significant association with uterine atony were gestational diabetes mellitus (odds ratio 7.6, 95% CI 6.9-9.0, p = …