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Articles 1831 - 1860 of 9507

Full-Text Articles in Medicine and Health Sciences

Significant Hyperbilirubinemia Among Well Neonates Due For Discharge At Kawempe-Mulago Hospital, Prevalence, Factors Associated, And Accuracy Of Transcutaneous Bilirubinometry For Screening, Carolyn Nassauna, Yaser Abdallah, Charles Karamagi, Jamir Mugalu Jan 2022

Significant Hyperbilirubinemia Among Well Neonates Due For Discharge At Kawempe-Mulago Hospital, Prevalence, Factors Associated, And Accuracy Of Transcutaneous Bilirubinometry For Screening, Carolyn Nassauna, Yaser Abdallah, Charles Karamagi, Jamir Mugalu

Paediatrics and Child Health, East Africa

Background: Neonates in low resource settings with a lack of pre-discharge screening and early intervention are at risk for complications associated with significant hyperbilirubinemia (SHB).

Objectives: To determine the prevalence, factors associated and performance of transcutaneous bilirubin (TCB) in identifying well neonates with SHB.

Methods: Over a one month period 235 well neonates 24 to 72 hours of age due for discharge at Kamempe-Mulago Hospital were enrolled in this study. Visual inspection using Kramer rule, transcutaneous bilirubin over the sternum using Draeger JM103 bilirubinometer, and serum bilirubin were determined. Neonates with SHB (total serum bilirubin warranting treatment) were …


Diagnostic Accuracy Of Computed Tomography In Adults With Suspected Acute Appendicitis At The Emergency Department In A Private Tertiary Hospital In Tanzania, Nyamuryekun'ge Miten, Miten Wr Patel, Ahmed Jusabani, Ali Akbar Zehri, Athar Ali Jan 2022

Diagnostic Accuracy Of Computed Tomography In Adults With Suspected Acute Appendicitis At The Emergency Department In A Private Tertiary Hospital In Tanzania, Nyamuryekun'ge Miten, Miten Wr Patel, Ahmed Jusabani, Ali Akbar Zehri, Athar Ali

General Surgery, East Africa

Introduction: The increasing incidence of acute appendicitis in sub-Saharan Africa emphasizes the need for accurate and reliable diagnostic tools. However, the variability in the diagnostic performance of computed tomography for suspected acute appendicitis coupled with comparatively higher negative appendectomy rates in this setting highlight a possible concern regarding the diagnostic accuracy. This study evaluated the diagnostic accuracy of a computed tomography scan for suspected acute appendicitis at the emergency department in Tanzania.

Methods: A retrospective diagnostic accuracy study was conducted from July to October 2020. All patients above 14 years of age who presented at the emergency department with …


Evaluation Of Venous Thromboembolism (Vte) Risk Assessment And Thrombo-Prophylaxis Practices In Hospitalized Medical And Surgical Patients At Aga Khan Hospital Dar Es Salaam: Single-Centre Retrospective Study, Allyzain Ismail, Nikhil Jadawji, Philip Adebayo, Ahmed Jusabani, Kamran Hamid, Ali Akbar Zehri, Willy Kiviri, Authar Ali Jan 2022

Evaluation Of Venous Thromboembolism (Vte) Risk Assessment And Thrombo-Prophylaxis Practices In Hospitalized Medical And Surgical Patients At Aga Khan Hospital Dar Es Salaam: Single-Centre Retrospective Study, Allyzain Ismail, Nikhil Jadawji, Philip Adebayo, Ahmed Jusabani, Kamran Hamid, Ali Akbar Zehri, Willy Kiviri, Authar Ali

General Surgery, East Africa

Introduction: venous thromboembolism is a complication among admitted medical and surgical patients. International guidelines recommend patients are assessed upon admission and appropriate thromboprophylaxis should be initiated. However, studies have shown that thromboprophylaxis for patients at risk of venous thromboembolism is underutilized.

Methods: this was a retrospective study conducted on hospitalized medical and surgical patients at Aga Khan Hospital Dar es salaam from January to June 2019. Patient’s medical records were reviewed and data was collected for analysis of venous thromboembolism assessment and compliance with Caprini risk assessment model. The data was entered into statistical package for the social …


Authorship Equity And Gender Representation In Global Oncology Publications, Paula Hornstein, Hubert Tuyishime, Miriam Mutebi, Nwamaka Lasebikan, Fidel Rubagumya, Temidayo Fadelu Jan 2022

Authorship Equity And Gender Representation In Global Oncology Publications, Paula Hornstein, Hubert Tuyishime, Miriam Mutebi, Nwamaka Lasebikan, Fidel Rubagumya, Temidayo Fadelu

General Surgery, East Africa

Purpose: Authorship gender disparities persist across academic disciplines, including oncology. However, little is known about global variation in authorship gender distribution.

Methods: This retrospective cross-sectional study describes the distribution of author gender as determined from the first name across variables such as authorship position (first, middle, and last), country region, and country income level. The 608 articles with 5,302 authors included in this analysis were published in the Journal of Clinical Oncology Global Oncology, from its inception in October 2015 through March 2020. Primary outcome measure was author gender on the basis of first name probabilities assessed by …


Severe Crohn’S Disease With Intra-Abdominal Fistula: First Reported Case From Tanzania, Nadeem Kassam, Omar Aziz, Eric Aghan, Melchisedeck Mandwa, Caroline Ngimba, Hanifa Mbithe, Salim Surani, Casmir Wambura Jan 2022

Severe Crohn’S Disease With Intra-Abdominal Fistula: First Reported Case From Tanzania, Nadeem Kassam, Omar Aziz, Eric Aghan, Melchisedeck Mandwa, Caroline Ngimba, Hanifa Mbithe, Salim Surani, Casmir Wambura

Internal Medicine, East Africa

We describe a case of Crohn's disease occurring in a young Tanzanian female. Crohn’s disease is rare in Africa and not encountered normally. The presentation of Crohn’s disease overlaps with many other abdominal disorders that are common in an African setting, such as tuberculosis and schistosomiasis. The disease is probably underdiagnosed in Africa due to limitations in diagnostic testing and rarity.


Demographic, Clinical, And Co-Morbidity Characteristics Of Covid-19 Patients: A Retrospective Cohort From A Tertiary Hospital In Kenya, Reena Shah, Jasmit Shah, Nancy Kunyiha, Sayed Karar, Shahin Sayed, Salim Surani, Mansoor Saleh Jan 2022

Demographic, Clinical, And Co-Morbidity Characteristics Of Covid-19 Patients: A Retrospective Cohort From A Tertiary Hospital In Kenya, Reena Shah, Jasmit Shah, Nancy Kunyiha, Sayed Karar, Shahin Sayed, Salim Surani, Mansoor Saleh

Internal Medicine, East Africa

Introduction: The first documented case of COVID-19 in Kenya was recorded March of 2020. Co-morbidities including hypertension and diabetes have been associated with increased morbidity, hospitalization, and mortality among COVID-19 patients. This retrospective study describes the clinical characteristics, disease severity, and outcomes among the patient population at a tertiary hospital in Kenya.

Methods: This was a retrospective descriptive study of COVID-19 patients who were admitted between March 2020 and December 2020 at the Aga Khan University Hospital in Nairobi, Kenya. Data collected include patient demographic and baseline characteristics. Differences between patients who were known to have diabetes and hypertension during …


Busting Contraception Myths And Misconceptions Among Youth In Kwale County, Kenya: Results Of A Digital Health Randomised Control Trial, Peter Gichangi, Lianne Gonsalves, Jefferson Mwaisaka, Mary Thiongo, Ndema Habib, Michael Waithaka, Tigest Tamrat, Alfred Agwanda, Hellen Sidha, Marleen Temmerman Jan 2022

Busting Contraception Myths And Misconceptions Among Youth In Kwale County, Kenya: Results Of A Digital Health Randomised Control Trial, Peter Gichangi, Lianne Gonsalves, Jefferson Mwaisaka, Mary Thiongo, Ndema Habib, Michael Waithaka, Tigest Tamrat, Alfred Agwanda, Hellen Sidha, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objectives: The objective of this randomised controlled trial in Kenya was to assess the effect of delivering sexual and reproductive health (SRH) information via text message to young people on their ability to reject contraception-related myths and misconceptions.

Design and setting: A three-arm, unblinded randomised controlled trial with a ratio of 1:1:1 in Kwale County, Kenya.

Participants and interventions: A total of 740 youth aged 18–24 years were randomised. Intervention arm participants could access informational SRH text messages on-demand. Contact arm participants received once weekly texts instructing them to study on an SRH topic on their own. Control arm participants …


Delivery Room St Segment Analysis To Predict Short Term Outcomes In Near-Term And Term Newborns, Jørgen Linde, Anne Lee Solevåg, Joar Eilevstjønn, Ladislaus Blacy, Hussein Kidanto, Hege Ersdal, Claus Klingenberg Jan 2022

Delivery Room St Segment Analysis To Predict Short Term Outcomes In Near-Term And Term Newborns, Jørgen Linde, Anne Lee Solevåg, Joar Eilevstjønn, Ladislaus Blacy, Hussein Kidanto, Hege Ersdal, Claus Klingenberg

Obstetrics and Gynaecology, East Africa

Background: ST-segment changes to the fetal electrocardiogram (ECG) may indicate fetal acidosis. No large-scale characterization of ECG morphology immediately after birth has been performed, but ECG is used for heart rate (HR) assessment. We aimed to investigate ECG morphology immediately after birth in asphyxiated infants, using one-lead dry-electrode ECG developed for HR measurement.

Methods: Observational study in Tanzania, between 2013-2018. Near-term and term infants that received bag-mask ventilation (BMV), and healthy controls, were monitored with one-lead dry-electrode ECG with a non-diagnostic bandwidth. ECGs were classified as normal, with ST-elevations or other ST-segment abnormalities including a biphasic ST-segment. We analyzed ECG …


Genetic Diversity In L1 Orf Of Human Papillomavirus In Women With Cervical Cancer With And Without Human Immunodeficiency Virus In Botswana And Kenya, Leabaneng Tawe, Wonderful T. Choga, Giacomo M. Paganotti, Ontlametse T. Bareng, Tlhalefo D. Ntereke, Pleasure Ramatlho, Doreen Ditshwanelo, Simani Gaseitsiwe, Ishmael Kasvosve, Elkanah Omenge Jan 2022

Genetic Diversity In L1 Orf Of Human Papillomavirus In Women With Cervical Cancer With And Without Human Immunodeficiency Virus In Botswana And Kenya, Leabaneng Tawe, Wonderful T. Choga, Giacomo M. Paganotti, Ontlametse T. Bareng, Tlhalefo D. Ntereke, Pleasure Ramatlho, Doreen Ditshwanelo, Simani Gaseitsiwe, Ishmael Kasvosve, Elkanah Omenge

Obstetrics and Gynaecology, East Africa

Background: The variation of human papillomavirus (HPV) genotypes shapes the risks of cervical cancer and these variations are not well defined in Africa. Nucleotide changes within the L1 gene, nucleotide variability, and phylogeny were explored in relation to HIV in samples from Botswana and Kenya. Methods: A total of 98 HPV-positive cervical samples were sequenced to identify diferent HPV variants. Phylogenetic inferences were used to determine HPV genotypes and investigate the clustering of sequences between women living with HIV (WLWHIV) and -women not living with HIV (WNLWHIV). Results: Out of 98 generated sequences, 83.7% (82/98) participants had high-risk (HR) HPV …


Barriers And Facilitators Of Availability Of Hydroxyurea For Sickle Cell Disease In Tanzania; A Qualitative Study Of Pharmaceutical Manufacturers, Importers, And Regulators, Hamu J. Mlyuka, Manase Kilonzi, Ritah F. Mutagonda, Lulu Chirande, Wigilya P. Mikomangwa, David T. Myemba, Godfrey Sambayi, Dorkasi L. Mwakawanga, Joyce Ndunguru, Paschal Ruggajo Jan 2022

Barriers And Facilitators Of Availability Of Hydroxyurea For Sickle Cell Disease In Tanzania; A Qualitative Study Of Pharmaceutical Manufacturers, Importers, And Regulators, Hamu J. Mlyuka, Manase Kilonzi, Ritah F. Mutagonda, Lulu Chirande, Wigilya P. Mikomangwa, David T. Myemba, Godfrey Sambayi, Dorkasi L. Mwakawanga, Joyce Ndunguru, Paschal Ruggajo

Internal Medicine, East Africa

Despite three decades of proven safety and effectiveness of hydroxyurea in modifying sickle cell disease (SCD), its accessibility is limited in Sub-Saharan Africa, which shares 75% of the world’s SCD burden. Therefore, it is time to explore the barriers and facilitators for manufacturing and importation of hydroxyurea for SCD in Tanzania. This was qualitative research that employed a case study approach. Purposive sampling followed by an in-depth interview (IDI) using a semi-structured questionnaire aspired by data saturation enabled us to gather data from 10 participants. The study participants were people with more than three years of experience in pharmaceuticals importation, …


Ccit Report 2022, Critical Creative Innovative Thinking Jan 2022

Ccit Report 2022, Critical Creative Innovative Thinking

Critical Creative Innovative Thinking (CCIT) Archives

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D-Dimer Testing In Covid-19: From Basics To Clinical Application, Bushra Moiz Jan 2022

D-Dimer Testing In Covid-19: From Basics To Clinical Application, Bushra Moiz

Department of Pathology and Laboratory Medicine

No abstract provided.


Knowledge, Experiences And Perceptions Of Abagusii Community Of Kisii County, Kenya On The Health Consequences Of Female Genital Mutilation (Fgm), Roselyter Riang’A, Moses Mutiso Jan 2022

Knowledge, Experiences And Perceptions Of Abagusii Community Of Kisii County, Kenya On The Health Consequences Of Female Genital Mutilation (Fgm), Roselyter Riang’A, Moses Mutiso

Population Health, East Africa

Background: Health education is among the prominent forms of interventions that are used to advocate for eradication of the practice of FGM. However, little is known on affected communities’ actual experiences, knowledge and perceptions on these health education messages hence need for this study.

Objective: To understand Abagusii people’s knowledge, experiences and perceptions on the health consequences of FGM.

Methods: Data was collected from Abagusii community of Kisii County in Kenya using interview schedules, focus group discussions, key informants and document analysis. The collected data were qualitatively and quantitatively analysed using SPSS and MAXQDA programs

Results: …


Factors Associated With Mammographic Breast Density Among Women In Karachi Pakistan, Uzma Shamsi, Shaista Afzal Saeed, Azra Shamsi, Syed Iqbal Azam, David Callen Dec 2021

Factors Associated With Mammographic Breast Density Among Women In Karachi Pakistan, Uzma Shamsi, Shaista Afzal Saeed, Azra Shamsi, Syed Iqbal Azam, David Callen

Community Health Sciences

Background: There are no studies done to evaluate the distribution of mammographic breast density and factors associated with it among Pakistani women.
Methods: Participants included 477 women, who had received either diagnostic or screening mammography at two hospitals in Karachi Pakistan. Mammographic breast density was assessed using the Breast Imaging Reporting and Data System. In person interviews were conducted using a detailed questionnaire, to assess risk factors of interest, and venous blood was collected to measure serum vitamin D level at the end of the interview. To determine the association of potential factors with mammographic breast density, multivariable polytomous logistic …


Biochemical Testing For The Diagnosis Of Wilson's Disease: A Systematic Review, Hafiz Muhammad Salman, Mahwish Amin, Javaria Syed, Zouina Sarfraz, Azza Sarfraz, Muzna Sarfraz, Maria Jose Farfán Bajaña, Miguel Felix, Ivan Cherrez-Ojeda Dec 2021

Biochemical Testing For The Diagnosis Of Wilson's Disease: A Systematic Review, Hafiz Muhammad Salman, Mahwish Amin, Javaria Syed, Zouina Sarfraz, Azza Sarfraz, Muzna Sarfraz, Maria Jose Farfán Bajaña, Miguel Felix, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Wilson's disease (WD) is a rare inherited disorder that leads to copper accumulation in the liver, brain, and other organs. WD is prevalent worldwide, with an occurrence of 1 per 30,000 live births. Currently, there is no gold standard diagnostic test for WD. The objective of this systematic review is to determine the diagnostic accuracy for WD of three biochemical tests, namely hepatic copper, 24-hour urinary copper, and ceruloplasmin using the Leipzig criteria.
Methods: Adhering to PRISMA guidelines, databases including PubMed/MEDLINE, CINAHL Plus, Web of Science, and Cochrane were searched. Studies that comprised of confirmed or suspected WD along …


Intensive Care Bundle With Blood Pressure Reduction In Acute Cerebral Hemorrhage Trial (Interact3): Study Protocol For A Pragmatic Stepped-Wedge Cluster-Randomized Controlled Trial, Lili Song, Xin Hu, Lu Ma, Xiaoying Chen, Menglu Ouyang, Laurent Billot, Qiang Li, Paula Muñoz-Venturelli, Carlos Abanto, Mohammad Wasay Dec 2021

Intensive Care Bundle With Blood Pressure Reduction In Acute Cerebral Hemorrhage Trial (Interact3): Study Protocol For A Pragmatic Stepped-Wedge Cluster-Randomized Controlled Trial, Lili Song, Xin Hu, Lu Ma, Xiaoying Chen, Menglu Ouyang, Laurent Billot, Qiang Li, Paula Muñoz-Venturelli, Carlos Abanto, Mohammad Wasay

Section of Neurology

Background: Early intensive blood pressure (BP) lowering remains the most promising treatment for acute intracerebral hemorrhage (ICH), despite discordant results between clinical trials and potential variation in the treatment effects by approach to control BP. As the third in a series of clinical trials on this topic, the INTEnsive care bundle with blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT3) aims to determine the effectiveness of a goal-directed care bundle protocol of early physiological control (intensive BP lowering, glycemic control, and pyrexia treatment) and reversal of anticoagulation, in acute ICH.
Methods: INTERACT3 is a pragmatic, international, multicenter, stepped-wedge (4 …


Does Digital Literacy Empower Adolescent Girls In Low- And Middle-Income Countries: A Systematic Review, Salima Meherali, Komal Abdul Rahim, Sandra Campbell, Zohra S. Lassi Dec 2021

Does Digital Literacy Empower Adolescent Girls In Low- And Middle-Income Countries: A Systematic Review, Salima Meherali, Komal Abdul Rahim, Sandra Campbell, Zohra S. Lassi

School of Nursing & Midwifery

Background: The vast majority (90%) of the world's adolescents aged 10-19 live in low- and middle-income countries (LMICs); and in those resource-limited settings, girls face distinct challenges across multiple health, social, and economic domains. Gender equality and girls' empowerment are key goals in their own right and are central to all other development goals. Digital literacy is a great enabler for the empowerment of young girls. This systematic review aims to assess the range and nature of digital literacy interventions implemented to empower adolescent girls in LMICs and identify evidence about adolescent girls' access and use of digital technologies in …


The Curious Case Of Hla-Dr-Positive Apl, Kanta Devi, Natasha Bahadur Ali Dec 2021

The Curious Case Of Hla-Dr-Positive Apl, Kanta Devi, Natasha Bahadur Ali

Section of Haematology/Oncology

The triad of weak/absent CD34, negative HLA-DR expression, and positivity to CD117 is pathognomonic for the diagnosis of acute promyelocytic leukemia. However, in rare cases, strong positivity to HLD-DR and CD34 may be noted.


Lipid A-Ara4n As An Alternate Pathway For (Colistin) Resistance In Klebsiella Pneumonia Isolates In Pakistan, Kiran I. Masood, Seema Umar, Zahra Hasan, Joveria Farooqi, Safina Abdul Razzak, Nazish Jabeen, Jason Rao Jason Rao, Sadia Shakoor, Rumina Hasan Dec 2021

Lipid A-Ara4n As An Alternate Pathway For (Colistin) Resistance In Klebsiella Pneumonia Isolates In Pakistan, Kiran I. Masood, Seema Umar, Zahra Hasan, Joveria Farooqi, Safina Abdul Razzak, Nazish Jabeen, Jason Rao Jason Rao, Sadia Shakoor, Rumina Hasan

Department of Pathology and Laboratory Medicine

Objectives: This study aimed to explore mechanism of colistin resistance amongst Klebsiella pneumoniae isolates through plasmid mediated mcr-1 gene in Pakistan. Carbapenem and Colistin resistant K. pneumoniae isolates (n = 34) stored at - 80 °C as part of the Aga Khan University Clinical Laboratory strain bank were randomly selected and subjected to mcr-1 gene PCR. To investigate mechanisms of resistance, other than plasmid mediated mcr-1 gene, whole genome sequencing was performed on 8 clinical isolates, including 6 with colistin resistance (MIC > 4 μg/ml) and 2 with intermediate resistance to colistin (MIC > 2 μg/ml).
Results: RT-PCR conducted revealed absence of …


Combined Clinical Audits And Low-Dose, High-Frequency, In-Service Training Of Health Care Providers And Community Health Workers To Improve Maternal And Newborn Health In Mali: Protocol For A Pragmatic Cluster Randomized Trial, David Zombre, Jean-Luc Kortenaar, Farhana Zareef, Moussa Doumbia, Sekou Doumbia, Fadima Haidara, Katie Mclaughlin, Samba Sow, Zulfiqar Ahmed Bhutta, Diego G. Bassani Dec 2021

Combined Clinical Audits And Low-Dose, High-Frequency, In-Service Training Of Health Care Providers And Community Health Workers To Improve Maternal And Newborn Health In Mali: Protocol For A Pragmatic Cluster Randomized Trial, David Zombre, Jean-Luc Kortenaar, Farhana Zareef, Moussa Doumbia, Sekou Doumbia, Fadima Haidara, Katie Mclaughlin, Samba Sow, Zulfiqar Ahmed Bhutta, Diego G. Bassani

Centre of Excellence in Women and Child Health

Background: Although most births in Mali occur in health facilities, a substantial number of newborns still die during delivery and within the first 7 days of life, mainly because of existing training deficiencies and the challenges of maintaining intrapartum and postpartum care skills.
Objective: This trial aims to assess the effectiveness and cost-effectiveness of an intervention combining clinical audits and low-dose, high-frequency (LDHF) in-service training of health care providers and community health workers to reduce perinatal mortality.
Methods: The study is a three-arm cluster randomized controlled trial in the Koulikoro region in Mali. The units of randomization are each of …


Generating Evidence From Contextual Clinical Research In Low- To Middle Income Countries: A Roadmap Based On Theory Of Change, Babar Hasan, Muneera Rasheed, Asra Wahid, Raman Krishna Kumar, Liesl Zuhlke Dec 2021

Generating Evidence From Contextual Clinical Research In Low- To Middle Income Countries: A Roadmap Based On Theory Of Change, Babar Hasan, Muneera Rasheed, Asra Wahid, Raman Krishna Kumar, Liesl Zuhlke

Department of Paediatrics and Child Health

Along with inadequate access to high-quality care, competing health priorities, fragile health systems, and conflicts, there is an associated delay in evidence generation and research from LMICs. Lack of basic epidemiologic understanding of the disease burden in these regions poses a significant knowledge gap as solutions can only be developed and sustained if the scope of the problem is accurately defined. Congenital heart disease (CHD), for example, is the most common birth defect in children. The prevalence of CHD from 1990 to 2017 has progressively increased by 18.7% and more than 90% of children with CHD are born in Low …


Bile Acid Profiling Reveals Distinct Signatures In Undernourished Children With Environmental Enteric Dysfunction, Xueheng Zhao, Kenneth D R. Setchell, Rong Huang, Indika Mallawaarachchi, Lubaina Ehsan, Edward Dobrzykowski Iii, Junfang Zhao, Sana Syed, Najeeha Talat Iqbal, Junaid Iqbal, Kamran Sadiq, Sheraz Ahmed, Syed Asad Ali Dec 2021

Bile Acid Profiling Reveals Distinct Signatures In Undernourished Children With Environmental Enteric Dysfunction, Xueheng Zhao, Kenneth D R. Setchell, Rong Huang, Indika Mallawaarachchi, Lubaina Ehsan, Edward Dobrzykowski Iii, Junfang Zhao, Sana Syed, Najeeha Talat Iqbal, Junaid Iqbal, Kamran Sadiq, Sheraz Ahmed, Syed Asad Ali

Department of Paediatrics and Child Health

Background: Intestinal inflammation and malabsorption in environmental enteric dysfunction (EED) are associated with early childhood growth faltering in impoverished settings worldwide.
Objectives: The goal of this study was to identify candidate biomarkers associated with inflammation, EED histology, and as predictors of later growth outcomes by focusing on the liver-gut axis by investigating the bile acid metabolome.
Methods: Undernourished rural Pakistani infants (n = 365) with weight-for-height Z score (WHZ) < -2 were followed up to the age of 24 mo and monitored for growth, infections, and EED. Well-nourished local children (n = 51) were controls, based on consistent WHZ > 0 and height-for-age Z score (HAZ) > -1 on 2 consecutive visits at 3 and 6 mo. Serum bile acid (sBA) profiles were measured by tandem MS at the ages of 3-6 …


Changing Perceptions Of Rural Frontline Workers And Caregivers About Management Of Childhood Diarrhea And Pneumonia Despite Several Inequities: The Nigraan Plus Trial In Pakistan, Fauziah Rabbani, Hyder Ali Khan, Suneel Piryani, Nousheen Pradhan, Natasha Shaukat, Anam Shahil Feroz, Shagufta Perveen Dec 2021

Changing Perceptions Of Rural Frontline Workers And Caregivers About Management Of Childhood Diarrhea And Pneumonia Despite Several Inequities: The Nigraan Plus Trial In Pakistan, Fauziah Rabbani, Hyder Ali Khan, Suneel Piryani, Nousheen Pradhan, Natasha Shaukat, Anam Shahil Feroz, Shagufta Perveen

Community Health Sciences

Purpose: Diarrhea and pneumonia greatly contribute to high childhood mortality in Pakistan. Frontline community health workers or the Lady Health Workers (LHWs) provide care at the doorstep of over 60% of Pakistan's rural residents. Difficult terrain, lack of supplies, and inadequate supervision put these LHWs at an added disadvantage in the timely diagnosis and delivery of known treatment options to community caregivers (CCGs). This study aims to assess whether a supportive supervision intervention through Lady Health Supervisors (LHSs) using enhanced mentorship and written feedback cards have the potential to improve case management of childhood diarrhea and pneumonia.
Study setting and …


Neonatal Outcomes And Congenital Anomalies In Pregnancies Affected By Hypothyroidism, Zareen Kiran,, Aisha Sheikh, Khadija N Humayun, Najmul Islam Dec 2021

Neonatal Outcomes And Congenital Anomalies In Pregnancies Affected By Hypothyroidism, Zareen Kiran,, Aisha Sheikh, Khadija N Humayun, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Background: Maternal hypothyroidism has been reported to have concerns over neonatal outcomes, not only in the context of neurocognitive development but also in the short term as birth weight and neonatal jaundice.
Patients and methods: We conducted a cross-sectional retrospective study on 638 cases who delivered live births in the Aga Khan University Hospital after ethical approval. Data were collected on hypothyroid pregnant females who were diagnosed before conception or during their antenatal visits during the year 2008-2016. Neonatal outcomes were noted for birth weight, maturity, and neonatal jaundice, neonatal hypothyroidism, neonatal respiratory distress syndrome, sepsis, hypocalcaemia, congenital anomalies, need …


The Truth About Brain Cells: Is Adult Neurogenesis Possible?, Ekene Nnagha, Queen-Helen Egbai, Ahtesham Khizar Dec 2021

The Truth About Brain Cells: Is Adult Neurogenesis Possible?, Ekene Nnagha, Queen-Helen Egbai, Ahtesham Khizar

Pakistan Journal of Neurological Sciences (PJNS)

Brain cells regeneration involves renewal and repair of neurons and other cells in the brain, with restoration of their functions. Although this phenomenon was thought to end in early childhood, research has proven that adult neurogenesis is highly possible with some limitations. Regeneration of axons in the central nervous system is very slow and more complicated than neuronal regeneration, especially regeneration of peripheral nerves. Brain cell regeneration in the adult brain can help in recovery of damaged brain cells and correct cellular and brain tissue dysfunction that are commonly seen in some neurological disorders such as Stroke, Traumatic Brain Injury …


Clinical Spectrum And Eeg Findings Of Non-Convulsive Status Epilepticus In Children, Shaila Ali, Natasha Ghani, Ather Khalily, Zia-Ur- Rehman, Tipu Sultan Dec 2021

Clinical Spectrum And Eeg Findings Of Non-Convulsive Status Epilepticus In Children, Shaila Ali, Natasha Ghani, Ather Khalily, Zia-Ur- Rehman, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT

OBJECTIVE:

To determine the clinical spectrum and EEG findings ofnon-convulsive status epilepticus in children. METHODS: A total of 38 children were included in this prospective cross sectional study, having EEG suggestive of NCSE after taking informed consent from guardians, keeping EEG as gold standard tracings were reviewed according to criteria of non-convulsive status epilepticus. Their clinical features were also noted leading to non- convulsive status epilepticus. Diagnostic workup will be done to find out the underlying cause, according to the suspected etiology of non-convulsive status epilepticus.

RESULTS: There were 26 male and 12 female patients, with ratio of 2:1. …


Frequency And Types Of Cerebral Infarctions On Brain Imaging In 2257 Hospitalized Patients With Covid-19, Raima Kaleemi, Zainab Rauf, Muhammad Azeemuddin, Muhammad Wasay Dec 2021

Frequency And Types Of Cerebral Infarctions On Brain Imaging In 2257 Hospitalized Patients With Covid-19, Raima Kaleemi, Zainab Rauf, Muhammad Azeemuddin, Muhammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT BACKGROUND AND OBJECTIVE:

SARS-COV (COVID-19) virus is not solely a pulmonary disease but affect multiorgan system including the brain. The objective of this study was to see the frequency of neuroimaging findings especially cerebral infarcts in our covid population. METHODS: This study is a retrospective observational study conducted in a large tertiary care hospital which was also a Covid center from March 1, 2020 to December 30, 2020.The frequency of neurological manifestations in COVID19 positive patients admitting in the hospital was observed through charts review. All scans were reviewed by two trained neuroradiologists. RESULTS: Total of 2257 patients enrolled …


Qualitative Exploration Of Feasibility And Acceptability Of The Modified Atkins Diet Therapy For Children With Drug Resistant Epilepsy In Kenya, Pauline Samia, Violet Naanyu, J. Helen Cross, Richard Idro, Paul Boon, Jo Wilmshurst, Stanley Luchters Dec 2021

Qualitative Exploration Of Feasibility And Acceptability Of The Modified Atkins Diet Therapy For Children With Drug Resistant Epilepsy In Kenya, Pauline Samia, Violet Naanyu, J. Helen Cross, Richard Idro, Paul Boon, Jo Wilmshurst, Stanley Luchters

Paediatrics and Child Health, East Africa

Purpose: Approximately one-third of children with epilepsy have clinical syndromes characterized by drug resistance. Modified Atkins dietary therapy (MADT) can reduce seizures and improve health out- comes for these children. This intervention is yet to be consistently offered as standard of care in sub- Saharan Africa.

Objectives: This study aimed to assess feasibility and acceptability of MADT for children with drug- resistant epilepsy and identify enabling strategies for implementation and adherence to the MADT. Methods: This qualitative inquiry utilized in-depth interviews with purposively selected caregivers and adolescent patients having used MADT for drug-resistant epilepsy. A qualified team consisting …


Thrombosis With Thrombocytopenia Syndrome After Administration Of Azd1222 Or Ad26.Cov2.S Vaccine For Covid-19: A Systematic Review, Usama Waqar, Shaheer Ahmed, Syed M H Ali Gardezi, Muhammad Sarmad Tahir, Zain Ul Abidin, Ali Hussain, Natasha Bahadur Ali, Syed Faisal Mahmood Dec 2021

Thrombosis With Thrombocytopenia Syndrome After Administration Of Azd1222 Or Ad26.Cov2.S Vaccine For Covid-19: A Systematic Review, Usama Waqar, Shaheer Ahmed, Syed M H Ali Gardezi, Muhammad Sarmad Tahir, Zain Ul Abidin, Ali Hussain, Natasha Bahadur Ali, Syed Faisal Mahmood

Medical College Documents

Background: Cases of thrombosis with thrombocytopenia syndrome (TTS) have been reported following vaccination with AZD1222 or Ad26.COV2.S. This review aimed to explore the pathophysiology, epidemiology, diagnosis, management, and prognosis of TTS.
Methods: A systematic review was conducted to identify evidence on TTS till 4th September 2021. Case reports and series reporting patient-level data were included. Descriptive statistics were reported and compared across patients with different sexes, age groups, vaccines, types of thrombosis, and outcomes.
Findings: Sixty-two studies reporting 160 cases were included from 16 countries. Patients were predominantly females with a median age of 42.50 (22) years. AZD1222 was administered …


Artificial Intelligence And Neurology - Opportunities And Challenges In Pakistan, Adeel A. Memon, Junaid S. Kalia Dec 2021

Artificial Intelligence And Neurology - Opportunities And Challenges In Pakistan, Adeel A. Memon, Junaid S. Kalia

Pakistan Journal of Neurological Sciences (PJNS)

The field of artificial intelligence (AI) has undergone rapid development in neurological disorders over the past few decades. AI relies on large volumes of high-quality data. As a result, their use in low-resource settings has been limited due to the lack of a digitized health care system. This article will address the challenges and opportunities involved in implementing AI for neurological care in Pakistan, as well as discuss the types of digital health care data and the benefits of applying AI in resource-limited countries