Medicine and Health Sciences Commons^™

Treatment Updates Regarding Anaplastic Oligodendroglioma And Anaplastic Oligoastrocytoma, Khurshid Ahmed Khan, Ahmed Nadeem Abbasi, Nasir Ali

Department of Radiation Oncology

Anaplastic Oligodendroglioma / Anaplastic Oligoastrocytoma (AO/AOA) is a WHO Grade-III primary brain tumor. These tumors comprise about 5 - 10% of all gliomas, which make them the third most common primary brain tumors after glioblastoma multiforme and astrocytomas. For many years standard of treatment remained Maximum Safe Resection (MSR) followed by Radiotherapy (RT). These tumors have also been known to be sensitive to alkylator-based chemotherapy particularly the subset having 1p/19q co-deletion signature. There is robust data showing that these tumors are responsive to chemotherapy in recurrent or progressive setting. Recently, up front chemotherapy has been added to standard post-surgery RT. …

Transfusion Practice In Orthopedic Patients: Do We Really Need It?, Kashif Abbas, Raza Askari, Masood Umer, Kamran Hafeez

Department of Surgery

Abstract

OBJECTIVE:

To determine the proportion of inappropriate transfusions in patients undergoing orthopaedic surgery at a tertiary care university hospital, and factors associated with inappropriate transfusions.

METHODS:

The prospective study was conducted at Aga Khan University Hospital, Karachi, from December 2008 to September 2009, and comprised patients admitted to the Orthopaedic Department and received transfusion of at least one packed cell. Patients were divided into four groups: A, those with haemoglobin < 7, B, haemoglobin 7.1-10 without ischemic heart disease, C, haemoglobin 7.1-10 with ischemic heart disease, and D, haemoglobin >10. Variables recorded were, pre-transfusion haemoglobin level, co-morbids, symptoms of hypovolemia, pre-transfusion volume replacement with fluids, transfusion reactions, and haemoglobin after 48 hours. Indications of transfusion were assessed in …

Operative Management Of Patients With Non-Spinal Metastatic Bone Disease. Does It Actually Improve Quality Of Life?, Masood Umer, Yasir Mohib, Hafiz Muhammad Umer

Department of Surgery

Abstract

OBJECTIVE:

To determine the survival rate and functional outcome of skeletal stabilisation in patients with metastatic bone disease.

METHODS:

The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients with non-spinalmetastatic bone disease managed surgically from January 2002 to December 2010. All patients had been managed by experienced orthopaedic, oncology and multidisciplinary teams. Patients managed by non-oncologic orthopaedic surgeons were excluded. The prognostic influence of clinical, pathological and treatment variables on Musculoskeletal Tumour Society score, range of motion, local complications and death rate were measured. SPSS 19 was used for statistical analysis.

RESULTS: …

Malrotation After Reamed Intramedullary Nailing With And Without A Fracture Table For Closed Fractures Of The Femoral Shaft, Rizwan Haroon Rashid, Akbar Jaleel Zubairi, Masood Umer

Department of Surgery

Abstract Introduction: To observe the effect of the choice of surgical table on the incidence of malrotation. Methods: The randomised trial was conducted from July 2012 to January 2013 at the Aga Khan University Hospital, Karachi, during which 74 patients were inducted. Randomisation was done via random allocation software version 1.0.0 and sealed envelopes were used to guide the choice of table. Malrotation was assessed by the operating surgeon using the lesser trochanteric shape signunder intra-operative fluoroscopy. SPSS 19 was used for statistical analysis. Results: The 74 patients in the study were divided into two groups of 37(50%) each using …

Asymptomatic Urinary Tract Infection: Cause Of Postoperative Wound Infection, Irfan A. Khan, Masood Umer

Department of Surgery

bstract

OBJECTIVE:

To determine the rate of urinary tract infection in patients given incomplete treatment before undergoing hip fracture surgery.

METHODS:

The descriptive case series was conducted at Aga Khan University Hospital, Karachi, From October 25, 2012 to April 24, 2013. 84 postmenopausal women having hip fracture along with asymptomatic urinary tract infection. The infection was treated incompletely and postoperatively wound infection rate was determined. The SPSS version 17 was used to analyze the data.

RESULTS:

The overall mean age of the 84 patients in the study was 63.57+10.34 years. Overall, 14(16.7%) patients had wound infection after orthopaedic implant surgery …

Comparison Between Greulich-Pyle And Girdany-Golden Methods For Estimating Skeletal Age Of Children In Pakistan, Muhammad Awais, Naila Nadeem, Yousuf Husen, Abdul Rehman, Madiha Beg, Yasir Jamil Khattak

Department of Radiology

Objective: To compare Greulich-Pyle (GP) and Girdany-Golden (GG) methods for estimation of Skeletal Age (SA) in children referred to a tertiary care hospital in Karachi, Pakistan.STUDY Design: Cross-sectional study.PLACE AND DURATION OF STUDY: Department of Radiology, The Aga Khan University Hospital, Karachi, Pakistan, from July 2010 to June 2012.METHODOLOGY: Children up to the age of 18 years, who had undergone X-ray for the evaluation of trauma were included. Each X-ray was interpreted using both methods by two consultant paediatric radiologists having at least 10 years experience, who were blinded to the actual Chronologic Age (CA) of children.Results: A total of …

Sexual Violence And Sub-Saharan Migrants In Morocco: A Community-Based Participatory Assessment Using Respondent Driven Sampling, Ines Keygnaert, Abdessamad Dialmy, Altay Manço, Jeroen Keygnaert, Nicole Vettenburg, Kristien Roelens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: The European Union contracted Morocco to regulate migration from so-called “transit migrants” from Morocco to Europe via the European Neighbourhood Policy. Yet, international organisations signal that human, asylum and refugee rights are not upheld in Morocco and that many sub-Saharan migrants suffer from ill-health and violence. Hence, our study aimed at 1) investigating the nature of violence that sub-Saharan migrants experience around and in Morocco, 2) assessing which determinants they perceive as decisive and 3) formulating prevention recommendations.

Methods: Applying Community-Based Participatory Research, we trained twelve sub-Saharan migrants as Community Researchers to conduct in-depth interviews with peers, using Respondent …

Maternal And Perinatal Health Research Priorities Beyond 2015: An International Survey And Prioritization Exercise, Joao Paulo Souza, Mariana Widmer, Ahmet Metin Gülmezoglu, Theresa Anne Lawrie, Ebunoluwa Aderonke Adejuyigbe, Guillermo Carroli, Caroline Crowther, Sheena M. Currie, Therese Dowswell, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Maternal mortality has declined by nearly half since 1990, but over a quarter million women still die every year of causes related to pregnancy and childbirth. Maternal-health related targets are falling short of the2015 Millennium Development Goals and a post-2015 Development Agenda is emerging. In connection with this, setting global research priorities for the next decade is now required.

Methods: We adapted the methods of the Child Health and Nutrition Research Initiative (CHNRI) to identify and set global research priorities for maternal and perinatal health for the period 2015 to 2025. Priority research questions were received from various international …

Implementation Of Evidence-Based Antenatal Care In Mozambique: A Cluster Randomized Controlled Trial: Study Protocol, Leonardo Chavane, Mario Merialdi, Ana Pilar Betrán, Jennifer Requejo-Harris, Eduardo Bergel, Alicia Aleman, Mercedes Colomar, Maria Luisa Cafferata, Alicia Carbonell, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Antenatal care (ANC) reduces maternal and perinatal morbidity and mortality directly through the detection and treatment of pregnancy-related illnesses, and indirectly through the detection of women at increased risk of delivery complications. The potential benefits of quality antenatal care services are most significant in low-resource countries where morbidity and mortality levels among women of reproductive age and neonates are higher. WHO developed an ANC model that recommended the delivery of services scientifically proven to improve maternal, perinatal and neonatal outcomes. The aim of this study is to determine the effect of an intervention designed to increase the use of …

Competing Interests Of Undergraduate Medical Education And Industry: Integration Into Longitudinal Curricular Themes., Shahryar Noordin, Sheilla Pinjani

Department of Surgery

Abstract

Recent changes in curricula around the globe with emphasis on teaching/learning and assessing professionalism in medical schools has been the priority. With the changing public expectations and professional demands, it has become imperative to develop clear guidelines and policies for students and faculty to better understand and meet the expectations of them as part of professionalism. In order to analyse this problem and highlight potential solutions, a literature search was conducted using Eric, Medline, Google Scholar and CINAHL Plus databases from 1985 to February 2013. We reviewed publications regarding the relationship between the pharmaceutical and device industry and medical …

Dynamic Hip Screw Fixation For Inter-Trochanteric Fractures: Determinants Of Outcomes, Adil Aijaz Shah, Santosh Kumar, Abdull Rehman

Department of Surgery

bstract

OBJECTIVE:

To evaluate factors associated with revision of dynamic hip screw implant in patients undergoing the procedure for the fixation of intertrochanteric fractures.

METHODS:

The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients who had undergone dynamic hip screw fixation surgery between 2008 and 2012. Medical records and data for all patients were obtained from the medical records office. For all patients, the record files were systematically reviewed using a structured, pre-defined data extraction sheet. SPSS 20 was used statistical analysis.

RESULTS:

Out of 317 patients who had undergone the procedure, …

Functional And Radiological Outcome Of Intramedullary Nailing Vs. Plate Fixation For Humeral Shaft Fractures. Does Treatment Method Bring Any Difference?, Pervaiz Hashmi, Yasir Mohib

Department of Surgery

Abstract

BACKGROUD:

Operative Management of Humeral shaft fractures may be accomplished with the help of Plate fixation or IM Nails. Controversy exists as to which modality is superior to the other in terms of fewer complications and better functional and radiologicaloutcome.

OBJECTIVE:

To compare the differences in radiological and functional outcome of humeral shaft fractures managed by platefixation and antegrade intramedullary nails.

METHODS:

The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of Patients managed surgically for uncomplicated humeral shaft fractures between 2007 and 2012. The patients were followed up for one year at clinic, …

Improving Community Case Management Of Diarrhoea And Pneumonia In District Badin, Pakistan Through A Cluster Randomised Study--The Nigraan Trial Protocol, Fauziah Rabbani, Aftab A. Ali Mukhi, Shagufta Perveen, Xaher Gul, Saleem Iqbal Perwaiz, Shamim Ahmed Qazi, Iqbal Azam Syed, Khalid Hussain Shaikh, Wafa Aftab

Community Health Sciences

BACKGROUND:

Diarrhoea and pneumonia contribute 30% of deaths in children under 5 in Pakistan. Pakistan's Lady Health Workers Programme (LHW-P) covers about 60% of the population but has had little impact in reducing morbidity and mortality related to these major childhood killers. An external evaluation of the LHW-P suggests that lack of supportive supervision of LHWs by lady health supervisors (LHSs) is a key determinant of this problem. Project NIGRAAN aims to improve knowledge and skills of LHWs and community caregivers through supervisory strategies employed by LHSs. Ultimately, community casemanagement (CCM) of childhood pneumonia and diarrhoea will improve.

METHODS/DESIGN:

NIGRAAN …

Risk Factors Associated With Birth Asphyxia In Rural District Matiari, Pakistan: A Case Control Study, Farhana Tabassum, Arjumand Rizvi, Shabina Ariff, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: During the past two decades there has been a sustained decline in child mortality; however, neonatal mortality has remained stagnant. Each year approximately 4 million babies are born asphyxiated resulting in 2 million neonatal deaths and intrapartum stillbirths. Almost all neonatal deaths occur in developing countries, where the majority is delivered at homes with negligible antenatal care and poor perinatal services.
Objectives: To identify socio-demographic and clinical risk factors associated with birth asphyxia in Matiari District of Sindh Province, Pakistan.
Method: A matched case control study was conducted in Matiari District with 246 cases and 492 controls. Newborn deaths …

Vaccine Effectiveness And Risk Factors Associated With Measles Among Children Presenting To The Hospitals Of Karachi, Pakistan., Aysha Zahidie, Saba Wasim, Zafar Fatmi

Community Health Sciences

OBJECTIVE:

To determine the risk factors regarding guardian's practices associated with development of Measles and also find out effectiveness of Measles vaccine among children less than 12 years of age presenting to the hospitals of Karachi.

STUDY DESIGN:

Matched case control study.

PLACE AND DURATION OF STUDY:

Multicenter surveillance was conducted in 11 public and private sector hospitals of Karachi from January 2011 to September 2012 in consultation with World Health Organization Measles Surveillance Cell.

METHODOLOGY:

Cases were children aged less than 12 years with Measles presenting to the hospitals. Controls for cases were enrolled from the same hospitals without …

Newborn Care In Indonesia, Lao People’S Democratic Republic And The Philippines: A Comprehensive Needs Assessment, Els Duysburgh, Birgit Kerstens, Melissa Diaz, Vini Fardhdiani, Katherine Ann Reyes, Khamphong Phommachanh, Marleen Temmerman, Basil Rodriques, Nabila Zaka

Obstetrics and Gynaecology, East Africa

Background: Between 1990 and 2011, global neonatal mortality decline was slower than that of under-five mortality. As a result, the proportion of under-five deaths due to neonatal mortality increased. This increase is primarily a consequence of decreasing post-neonatal and child under-five mortality as a result of the typical focus of child survival programmes of the past two decades on diseases affecting children over four weeks of age. Newborns are lagging behind in improved child health outcomes. The aim of this study was to conduct a comprehensive, equity-focussed newborn care assessment and to explore options to improve newborn survival in Indonesia, …

Multi-Drug Resistant Gram Negative Infections And Use Of Intravenous Polymyxin B In Critically Ill Children Of Developing Country: Retrospective Cohort Study, Naveed-Ur-Rehman Siddiqui, Farah Naz Qamar, Humaira Jurair, Anwarul Haque

Department of Paediatrics and Child Health

Background: Patients in pediatric intensive care Units (PICU) are susceptible to infections with antibiotic resistant organisms which increase the morbidity, mortality and cost of care. To describe the clinical characteristics and mortality in patients with Multi-Drug Resistant (MDR) gram negative organisms. We also report safety of Polymyxin B use in these patients.
Methods: Files of patients admitted in PICU of Aga Khan University Hospital, from January 2010 to December 2011, one month to 15 years of age were reviewed. Demographic and clinical features of patients with MDR gram negative infections, antibiotic susceptibility pattern of isolates, discharge disposition and adverse effects …

Emerging Antiretroviral Drug Resistance In Sub-Saharan Africa: Novel Affordable Technologies Are Needed To Provide Resistance Testing For Individual And Public Health Benefits, Gert U. Van Zyl, Lisa M. Frenkel, Michael Chung, Wolfgang Preiser, John W. Mellors, Jean B. Nachega

Internal Medicine, East Africa

In industrialized countries, viral load monitoring and genotypic antiretroviral drug resistance testing (GART) play an important role in the selection of initial and subsequent combination antiretroviral therapy (cART) regimens. In contrast, resource constraints in Africa limit access to assays that could detect virologic failure, transmitted drug resistance (TDR) and acquired drug resistance to cART. This has adverse consequences for both individual and public health. Although the further roll-out of antiretrovirals for prevention, including preexposure prophylaxis (PrEP) and universal test and treat (UTT) strategies, could reduce HIV-1 incidence, these strategies may increase TDR [1,2]. Here, we present arguments that the scale …

One-Year Evaluation Of The Impact Of An Emergency Obstetric And Neonatal Care Training Program In Western Kenya, Rachel F. Spitzer, Sarah Jane Steele, David Caloia, Julie Thorne, Alan D. Bocking, Astrid Christoffersen-Deb, Aaron Yarmoshuk, Loise Maina, Johanna Sitters, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Objective: To determine the impact of introducing an emergency obstetric and neonatal care training program on maternal and perinatal morbidity and mortality at Moi Teaching and Referral Hospital, Eldoret, Kenya.

Methods: A prospective chart review was conducted of all deliveries during the 3-month period (November 2009 to January 2010) before the introduction of the Advances in Labor and Risk Management International Program (AIP), and in the 3-month period (August–November 2011) 1 year after the introduction of the AIP. All women who were admitted and delivered after 28 weeks of pregnancy were included. The primary outcome was the direct obstetric case …

Body Mass Index Or Body Fat! Which Is A Better Obesity Scale For Pakistani Population?, Syeda Sadia Fatima, Rehana Rehman, Bushra Chaudhry

Department of Biological & Biomedical Sciences

Ojective: To compare two methods of classifying obesity based on body mass index and body fat percentage.
Methods: The cross-sectional study was conducted from November 2012 to August 2013 at Jinnah Postgraduate Medical Centre, Karachi. Male and female volunteers between the ages 15-65 years were selected using simple random sampling. They were classified into different groups for body mass index and body fat percentage measured through bioelectrical impedance scale. The subjects were sub-grouped into underweight, normal weight, overweight and obese. SPSS 11 was used for statistical analysis.
Results: The mean age of the 828 healthy volunteers was 25.67±10.10 years. A …

The Impact Of Polio Eradication On Routine Immunization And Primary Health Care: A Mixed-Methods Study, Svea Closser, Kelly Cox, Thomas M. Parris, R Matthew Landis, Judith Justice, Ranjani Gopinath, Kenneth Maes, Hailom Banteyerga Amaha, Ismaila Zango Mohammed, Rashid Jooma

Section of Neurosurgery

Background: After 2 decades of focused efforts to eradicate polio, the impact of eradication activities on health systems continues to be controversial. This study evaluated the impact of polio eradication activities on routine immunization (RI) and primary healthcare (PHC).
Methods: Quantitative analysis assessed the effects of polio eradication campaigns on RI and maternal healthcare coverage. A systematic qualitative analysis in 7 countries in South Asia and sub-Saharan Africa assessed impacts of polio eradication activities on key health system functions, using data from interviews, participant observation, and document review.
Results: Our quantitative analysis did not find compelling evidence of widespread and …

Choledochal Cyst--A Different Disease In Newborns And Infants, Zafar Nazir, Munira Abdul Aziz

Department of Surgery

Abstract

We report experience of managing Choledochal Cyst (CC) in different paediatric ages. Eleven neonates and infants (aged 0-8 months) and 24 paediatric cases (aged 2.5 - 18 years) were managed over 24 years (1988 to 2012). Neonates and infants presented with jaundice, acholic stools and abdominal mass whereas most of the paediatric cases presented with intermittent non-specific abdominal pain. Morphology of CC was mostly cystic in neonates whereas it was fusiform in majority (62%) of paediatric cases. Biliary amylase was high and correlated with the presence of abnormal pancreaticobiliary junction (PBJ) in 20 /24 paediatric patients. Obstruction at the …

Adult Neurogenesis In The Four-Striped Mice (Rhabdomys Pumilio), Olatunbosun O. Olaleye, Amadi O. Ihunwo

Brain and Mind Institute

In this study, we investigated non-captive four-striped mice (Rhabdomys pumilio) for evidence that adult neurogenesis occurs in the adult brain of animal models in natural environment. Ki-67 (a marker for cell proliferation) and doublecortin (a marker for immature neurons) immunostaining confirmed that adult neurogenesis occurs in the active sites of subventricular zone of the lateral ventricle with the migratory stream to the olfactory bulb, and the subgranular zone of the dentate gyrus of the hippocampus. No Ki-67 proliferating cells were observed in the striatum substantia nigra, amygdala, cerebral cortex or dorsal vagal complex. Doublecortin-immunoreactive cells were observed in …

The Mini-Mental State Examination As A Diagnostic And Screening Test For Delirium: Systematic Review And Meta-Analysis, Alex J. Mitchell, Deepak Shukla, Hafsa A. Ajumal, Brendon Stubbs, Tayyeb Tahir

Brain and Mind Institute

Objective

To analyse the evidence concerning the accuracy of the Mini-Mental State Examination (MMSE) as a diagnostic and screening test for the presence of delirium in adults.

Method

Two authors searched MEDLINE, PsychINFO and EMBASE from inception till March 2014. Articles were included that investigated the diagnostic validity of the MMSE to detect delirium against standardised criteria. A diagnostic validity meta-analysis was conducted.

Results

Thirteen studies were included representing 2017 patients in medical settings of whom 29.4% had delirium. The meta-analysis revealed the MMSE had an overall sensitivity and specificity estimate of 84.1% and 73.0%, but this was 81.1% and …

Labrad : Vol 40, Issue 2 - November 2014, Aga Khan University Hospital, Karachi

LABRAD

• Significance of HLA Typing in Transplant Medicine
• Role of Protocol Renal Biopsies in Transplant Patients
• Blood Product Utilization in Haematopoietic Stem Cell Transplant Recipients
• Use of Magic Marker “C4d” in the Diagnosis of Acute Antibody Mediated Rejection in Renal Transplant Patients
• Coagulopathy in Renal Transplantation
• Therapeutic Drug Monitoring of Cyclosporine
• Signifi cance of CMV antigenemia Assay In Renal Transplant Patients
• Pretransplant Serological Evaluation
• Importance of Monitoring Cytomegalovirus (CMV) and BKV (Polyomavirus) Infection in Renal Transplant Patients

Effects Of Polypharmacy On Adverse Drug Reactions Among Geriatric Outpatients At A Tertiary Care Hospital In Karachi: A Prospective Cohort Study., Bilal Ahmed, Kashmira Nanji, Rakshinda Mujeeb, Muhammad Junaid Patel

Department of Medicine

Background: Adverse drug reactions (ADRs) present a challenging and expensive public health problem. Polypharmacy is defined according to the WHO criteria as the, ‘‘concurrent use of five or more different prescription medication’’. Elderly are more prone to adverse reactions due to comorbid conditions, longer lists of medications and sensitivity to drug effects. The aim of the study is to estimate the incidence and strength of association of ADRs due to polypharmacy among the geriatric cohort attending outpatient clinics at a tertiary care center.

Methods: A hospital based prospective cohort study was conducted at ambulatory care clinics of Aga Khan University …

Oligonucleotide Ligation Assay Detects Hiv Drug Resistance Associated With Virologic Failure Among Antiretroviral-Naive Adults In Kenya, Michael Chung, Ingrid A. Beck, Sandra Dross, Kenneth Tapia, James N. Kiarie, Barbra A. Richardson, Julie Overbaugh, Samah R. Sakr, Grace C. John-Stewart, Lisa M. Frenkel

Internal Medicine, East Africa

Background: Transmitted drug resistance (TDR) is increasing in some areas of Africa. Detection of TDR may predict virologic failure of first-line non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART). We evaluated the utility of a relatively inexpensive oligonucleotide ligation assay (OLA) to detect clinically relevant TDR at time of ART initiation.

Methods: Pre-ART plasmas from ART-naive Kenyans initiating an NNRTI-based fixed-dose combination ART in a randomized adherence trial conducted in 2006 were retrospectively analyzed by OLA for mutations conferring resistance to NNRTI (K103N, Y181C, and G190A) and lamivudine (M184V). Post-ART plasmas were analyzed for virologic failure (≥1,000 copies/mL) at 6 month …

Outcomes Of Splenectomy For Idiopathic Thrombocytopenic Purpura In Adults: A Developing Country Perspective., Amyn Pardhan, Aamir Hameed, Hasnain Zafar, Samia Mazahir, Ghulam Murtaza

Department of Medicine

Objective: to determine the outcome of splenectomy done in adult patients of Idiopathic Thrombocytopenic Purpura over a period of 10 years and, secondarily, to determine the predictors of complete response to therapy.

Methods: The retrospective review comprised of adult patients over 14 years of age who underwent open or laparoscopic splenectomy for Idiopathic Thrombocytopenic Purpura at Aga Khan University Hospital, Karachi, from January 2000 to December 2010. Data was reviewed in January 2011 by a surgical resident. Outcome was the response to splenectomy as per new definition of response set by the American Society of Haematology 2011 evidence based practice …

Clinical Course And Outcome Of Acute Severe Asthma (Status Asthmaticus) In Adults., Ali Khawaja, Hira Shahzad, Murtaza Kazmi, Ali Bin Sarwar Zubairi

Department of Medicine

Objective: To evaluate the clinical course and outcomes in patients with acute severe asthma in a tertiary care setting.
Methods: The retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of patients of age 16 and above who were admitted with a diagnosis of acute severe asthma from January 2000 to December 2013.These patients had undergone clinical evaluation to assess the severity of illness as well as the complications and eventual outcomes. SPSS 16 was used for statistical analysis.
Results: Of the 50 patients in the study, 41 (82%) were females. The overall mean …

Motivation Of Clinical Faculty Towards Teaching And Learning., M. Tariq, Syed Ahsan Ali

Department of Medicine

No abstract provided.