Medicine and Health Sciences Commons^™

The Role Of Mobile Phone-Based Interventions To Improve Routine Childhood Immunisation Coverage, Abdul Momin Kazi

Department of Paediatrics and Child Health

No abstract provided.

Perception Of Pathology As A Future Career Choice Among Medical Students From Karachi, Pakistan: Experience From A Private Medical School, Najia Bano Ghanchi, Raabia Nizamuddin Nizamuddin, Amna Qasim, Zahra Nur Khaled, Ahmed Buksh Raheem, Natasha Bahadur Ali, Naila Kayani, Mohammad Asim Beg

Medical College Documents

To determine the perception of pathology as a future career choice among medical students of a private medical school from Karachi, Pakistan. A descriptive cross-sectional study was conducted at the Aga Khan University, Karachi, Pakistan. A total of 201 students participated in this study. All Students were approached randomly to participate. A total of 201 students participant survey forms were evaluated in this study. The overall satisfaction level with pathology was observed in 61.8% ofthe students. Majority of the students understood subspecialties which were a part of clinical medicine. Over half of the students thought pathology as a specialty should …

Assessing Women Caregiving Role To People Living With Hiv/Aids In Nigeria, West Africa, Ekaete Asuquo, Josephine B. Etowa, Margaret I. Akpan

School of Nursing & Midwifery, East Africa

HIV/AIDS scourge remains high in most countries of sub-Saharan Africa such as Nigeria, which is home to about 3.3 million HIV positive individuals and represents the second largest burden of HIV/AIDS care, treatment and demand worldwide after South Africa. Anti-retroviral treatment options though a welcome development, has increased the number of people living with this chronic illness, and most of them depend on family members for physical and emotional support. Traditional gender norms in Nigeria ensure that legitimately, women and girls are the first options for caregiving roles. This mandatory role has in turn imposed psychosocial disruption in the lives …

Low Cost Quality Initiatives For Management Of Neurosurgical Patients In Developing Nations: Perspective From A Tertiary Care Centre In Pakistan, Hamid Hussain Rai, Muhammad Waqas, Muhammad Shahzad Shamim

Section of Neurosurgery

Background: Targeting resources on cost-effective care strategies is pertinent for developing nations, specifically for already burdened specialties such as neurosurgery, where without state support and insurance companies, expenses are borne by the patient themselves.
Methods: This was a descriptive review of literary work published by the section of neurosurgery at Aga Khan University Hospital, Pakistan. We searched PubMed and CiNAHL databases to identify articles, which were then critically analyzed and discussed from a perspective of low-cost quality care.
Results: We demonstrate the cost effectiveness of three initiatives, namely, blood ordering protocol for elective spine arthrodesis, nonoperative management being superior to …

Pharmacological Basis For The Medicinal Use Of Polyherbal Formulation And Its Ingredients In Cardiovascular Disorders Using Rodents, A Malik, Malik Hassan Mehmood, H Channa, Ms Akhtar, Ah Gilani

Department of Biological & Biomedical Sciences

A compound herbal formulation (POL4) has been used in the indigenous system of medicine to treat cardiometabolic disorders like diabetes and associated hypertension. POL4 and most of its constituents have not been studied widely for its therapeutic use in hypertension. This study is aimed to determine the efficacy and possible insight into mechanism(s) for the medicinal use of POL4 and its ingredients in hypertension.

Outpatient Percutaneous Release Of Trigger Finger: A Cost Effective And Safe Procedure, Marij Zahid, Aurangzeb Qureshi, Rizwan H. R, Haroon Rashid, Pervaiz M. Hashmi

Section of Orthopaedic Surgery

Introduction: Trigger finger is a common cause of pain and disability of the hand. Percutaneous release results in earlier functional recovery and patient satisfaction. This is a rapid and cost-effective method which saves a surgical procedure and results in better functional outcome.
Materials and Methods: This is a prospective observational study conducted on fifty-two fingers and thumbs in 52 patients treated from 1st July 2014 till 31st December 2014, in the Orthopaedic Section, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. All the baseline characteristics of the patients, like demographics, symptoms, Quinell's criteria and functional outcome were recorded. The …

Gullain Barré Syndrome: Complications, Commonly Acquired Nosocomial Infections And Antibiotic Susceptibilities At Pakistan Institute Of Medical Sciences, Islamabad, Ali Zohair Nomani, Uzma Jamil, Mansoor Iqbal, Sumaira Nabi, Haris Majid Rajput, Misbah Ahmed, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Introduction: The cause of demise in GBS may be related to the sequelae of complications associated with the disease or its treatment. The primary objective of this study was to enumerate the prevalence of complications associated with treatment of patients with GBS at a tertiary care setup in Islamabad. The secondary objective was to determine the antibiotic susceptibility patterns of commonly encountered infections in GBS during hospital stay in our setup. Materials and methods: The study was carried out between Jan 2014 and June 2015 on one hundred patients of GBS aged ≥ 12 years. Baseline characteristics, complications and antibiotic …

Frequency Of Non-Motor Symptoms In Parkinson Disease: Experience From Pakistan, Saira Saad, Ali Zohair Nomani, Mazhar Badshah, Aamir Afzal

Pakistan Journal of Neurological Sciences (PJNS)

The objective of this study was to determine the frequency of non-motor symptoms (NMS) in patients with Parkinson's disease (PD) and to compare frequency in mild and severe disease. Materials and methods: This descriptive observational study was done from January 2015 to June 2015 at Department of Neurology, Pakistan Institute of Medical Sciences, Islamabad. We used Non-Motor Symptom Questionnaire (NMS-Q); a validated scale using 30 questions related to 9 different domains of symptoms. Results: 62 patients were enrolled in the final data set of study (male 46, Female 16) with average age of 62.4 years (range=33-80). Non-motor symptoms were reported …

Assessing Decision Of Inpatient Or Outpatient Care In Community Acquired Pneumonia: Apt Care Study, Saleem Ullah, Javaid Khan, Amanullah Khan, Irfan Hashemy

Section of Pulmonary & Critical Care

Objective: To estimate the proportion of community-acquired pneumonia patients with disagreement between Confusion, Uraemia, Respiratory rate, Blood pressure, age > 65 years recommendation and physician\\\'s decision to hospitalise or not.
Methods: This cross-sectional nation-wide, non-interventional, cross-sectional study was carried out across 10 cities of Pakistan from December 2011 to May 2012, and recruited consenting adult patients with confirmatory diagnosis of community-acquired pneumonia on chest X-ray. Confusion, Uraemia, Respiratory rate, Blood pressure, age > 65 years recommendation for each patient was determined at the time of analysis. This recommendation was compared with treatment decision made by the physician. Disagreement was considered when the …

Establishment Of Site Specific Multi-Disciplinary Tumour Boards In Pakistan: Sharing Experience Of Neuro Oncology Team Based At A Tertiary Care University Hospital, Muhammad Waqas, Ahmed Nadeem Abbasi

Section of Neurosurgery

No abstract provided.

Preventing Peer Violence Against Children: Methods And Baseline Data Of A Cluster Randomized Controlled Trial In Pakistan, Judith Mc Farlane, Rozina Karmaliani Professor, Hussain Maqbool Ahmed Khuwaja, Saleema A. Gulzar, Rozina Somani, Tazeen Saeed Ali, Yasmeen Hassan Somani, Shireen Shehzad Bhamani, Ryan D. Krone, Rene M. Paulson, Atta Muhammad, Rachel Jewke

School of Nursing & Midwifery

Background: Violence against and among children is a global public health problem that annually affects 50% of youth worldwide with major impacts on child development, education, and health including increased probability of major causes of morbidity and mortality in adulthood. It is also associated with the experience of and perpetration of later violence against women. The aim of this article is to describe the intervention, study design, methods, and baseline findings of a cluster randomized controlled trial underway in Pakistan to evaluate a school-based play intervention aiming to reduce peer violence and enhance mental health.
Methods: A cluster randomized controlled …

Students' Perceptions Of Usefulness Of Anatomy Demonstrations In Traditional And Hybrid Undergraduate Medical Education Curricula, Ayesha Saba Naz, Rehana Rehman, Zehra Jamil, Khalid Ahmed, Ambreen Surti

Department of Biological & Biomedical Sciences

A cross-sectional study was carried out to study students' perceptions on the usefulness of Anatomy demonstrations (AD) in the undergraduate medical education by comparing the Conventional Medical College (CMC) and problem-based learning as hybrid curriculum (HMC). Purposive sampling technique was used and all students were included. The completed questionnaire responses were returned by 92 CMC and 87 HMC students. CMC cohort understood the structural relationship more than HMC (p=0.03). AD helped 50 students (54%) of CMC to get through the theory examination, however 73 (84%) students of HMC found them useful in preparation for theory examinations (p<0.001). The importance of AD as a major content delivery strategy cannot be overemphasized in the anatomy curriculum and useful teaching strategies from various undergraduate medical curricula, such as the use of the plastic and plastinated models and the session handouts.

Uchunguzi (Journal Watch/ Montre De Journal) March 2017, Benjamin Wachira

Emergency Medicine, East Africa

Without the need for expensive videoconferencing equipment or computer networks, doctors in the developing world have found practical use for WhatsApp Messenger in clinical and administrative settings because the service is ubiquitous, free and easy to use. This study reviewed the literature on WhatsApp in clinical practice, to determine how it was used, and users’ satisfaction. It revealed that the service was widely used in intradepartmental communication across a range of aspects, including second opinion, changes in treatment plans, sharing of X-rays and photographs, scheduling of academic meetings, and sharing of educational materials such as papers. There was a report …

Diastolic Dysfunction In Coronary Artery Disease, Sarwat Hashmi, H R. Ahmad, Hasanat Sharif, Syedah Saira Bokhari

Department of Biological & Biomedical Sciences

No abstract provided.

Recent Advances In Epilepsy, Mughis Sheerani

Pakistan Journal of Neurological Sciences (PJNS)

Listening to Dr Sarosh Irani in a recent Epilepsy conference about Fascio Brachial dystonic seizures associated with voltage gated potassium channel (VGKC complex/LG1 antibodies)(1) and then reading reports published in Neurology about continued recent use of trephination ‘expelling the demons’ in India(2), I was wondering how far we are in Southeast Asia in the understanding and treatment of this fascinating illness.

Labrad : Vol 43, Issue 1 - March 2017, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Chikungunya
• Rapid Molecular Diagnosis of Chlamydia Trachomatis (CT) and Neisseria Gonorrhoeae (NG) Urethritis
• Overview of Rubella Testing
• Most Common Bone and Soft Tissue Infections Seen in our Practice
• Diagnosis of Helicobacter Pylori Infection in Developing Countries- Pros & Cons
• Screening for Neonatal Infections with TORCH Profile
• Blood and Bone Marrow Changes in Viral Infections
• Malaria
• World Rare Disease Day
• Radiology Pathology Correlation

Endothelin Signaling In Bone, Jasmin Kristianto, Michael Johnson, Rafia Afzal, Robert D. Blank

Department of Anaesthesia

The endothelin (ET) system includes 3 small peptide hormones and a pair of G-protein-coupled receptors. This review first outlines the ET signaling pathway and ET metabolism. Next, it summarizes the role of ET1 signaling in craniofacial development. Then, it discusses observations relating ET signaling to osteoblastic and other osteosclerotic processes in cancer. Finally, it describes recent work in our laboratory that points to endothelin signaling as an upstream mediator of WNT signaling, promoting bone matrix synthesis and mineralization. It concludes with a statement of some remaining gaps in knowledge and proposals for future research.

The Effect Of A Preanaesthesia Clinic Consultation On Adult Patient Anxiety At A Tertiary Hospital In Kenya: A Cohort Study, Anthony Kamau, Vitalis Mung’Ayi, Gerald Yonga

Anaesthesiology, East Africa

Background: Preoperative anxiety is a common perioperative complication seen in approximately 11-80% of adults undergoing surgery. One of the goals of the preanaesthesia clinic is to allay anxiety. A preanaesthesia clinic evaluation has been shown to reduce anxiety however current studies on anxiety and the preanaesthesia clinic have not quantified this reduction.

Objective: To determine the reduction in anxiety in patients evaluated in the clinic versus those evaluated in the ward.

Methods: Fifty one adult patients with 28 patients in anaesthesia clinic (AC) group and 23 in the ward (W) group were sequentially recruited from both the surgical, gynaecology and …

X-Linked Agammaglobulinemia - First Case With Bruton Tyrosine Kinase Mutation From Pakistan, Samreen Kulsom Zaidi, Sonia Qureshi, Farah Naz Qamar

Department of Paediatrics and Child Health

X-linked agammaglobulinemia (XLA) is a primary immunodeficiency with more than 600 mutations in Bruton tyrosine kinase (Bkt) gene which are responsible for early-onset agammaglobulinemia and repeated infections. Herein we present a case of a 3-year-old boy with history of repeated diarrhoea and an episode of meningoencephalitis with hemiplegia. The workup showed extremely low levels of immunoglobulin with low CD+19 cells. Genetic analysis showed Btk mutation 18 c.1883delCp.T628fs. To the best of our knowledge this is the first report of a case of XLA confirmed by molecular technique from Pakistan.

Frequency Of Color Blindness In Pre-Employment Screening In A Tertiary Health Care Center In Pakistan, Shaukat Ali Chhipa, Farzeen K. Hash, Shehreen Ali, Mustafa Kama, Khabir Ahmed

Department of Surgery Docs

Abstract

OBJECTIVE:

To describe the frequency of color vision deficiency among Pakistani adults presenting for pre-employment health screening in a tertiary care hospital.

METHODS:

The cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, and the data was collected for color vision deficiency, age, gender, and job applied for from pre-employment examination during 2013-2014. IBM SPSS 20 was used for statistical analysis.

RESULTS:

Three thousand four hundred and thirty seven persons underwent pre-employment screening during 2013 and 2014; 1837 (53.44%) were males and 1600 (46.65%) females. The mean age was 29.01 (±6.53) years. A total of 0.9% …

Nurse Teachers’ Conceptions And Practices Of Written Feedback In Karachi., Sobia Idrees, Raisa B. Gul, Ambreen Tharani, Syeda Kauser Ali

School of Nursing & Midwifery

Background:

Written Feedback (WFB) plays a significant role in student’s learning in terms of improvement of their academic writing skills. However, the quality of WFB may be affected by various personal and contextual factors. This study aimed to identify nurse teachers’ conceptions and practices of WFB on written assignments in nursing degree offering institutions in Karachi, Pakistan.

Methods:

A cross-sectional descriptive study design was used to answer the study questions. The study was conducted at 11 nursing schools in Karachi by recruiting those teachers who were teaching in nursing degree programs. The sample size of the study consists of 80 …

Twin Chorionicity And Prospective Stillbirth Risk: Experience At A Tertiary Care Hospital, Shazia Masheer, Zaheena Islam, Dhanwanti Dileep, Shama Munim

Department of Obstetrics & Gynaecology

Objective: To determine the prospective risk of stillbirth, perinatal death and neonatal morbidities in twins.

Methods: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised cases of twin pregnancies from January 2001 to December 2012. . Cases of both monochorionic diamniotic and dichorionic diamniotic twin pregnancies were included. SPSS 19 was used for data analysis.

Results: Of the 394 cases, 84(21.3%) were monochorionic diamniotic twins and 310(78.7%) were dichorionic diamniotic twins. There were no cases of stillbirth beyond 30 and 34 weeks in monochorionic and dichorionic twins, respectively. Neonatal mortality stood reduced beyond 36 …

Motivating And Demotivating Factors For Community Health Workers Engaged In Maternal, Newborn And Child Health Programs In Low And Middle-Income Countries: A Systematic Review., Leah Shipton, Aysha Zahidie, F. Rabbani

Community Health Sciences

This systematic review aimed to synthesize primary research on motivating factors of community health workers (CHWs) for maternal, neonatal, and child health (MNCH) in low and middle-income countries (LMICs). Peer-reviewed literatures were systematically searched in five databases. Identified studies were then screened and selected for inclusion. The eligibility criteria were reported primary qualitative, quantitative, or mixed methods research, with participants being CHWs in LMICs who address MNCH, which investigated motivation or related concepts of retention, attrition, and performance. A thematic synthesis process was used to analyze findings of motivating factors, reported by included studies. Seventeen qualitative, quantitative, or mixed methods …

A Case Of Hashimoto’S Encephalopathy In A Patient With Lithium Toxicity, Saba Zaidi, Bashir A. Soomro, Dr Imran Chaudary, Fasiha Sohail

Pakistan Journal of Neurological Sciences (PJNS)

Hashimoto’s encephalopathy is a rare neurological disorder of unknown etiology. We presented, a case of middle aged male with bipolar disorder on Lithium carbonate for 30 years, admitted with altered behavior for 2 weeks and high Lithium levels. He was admitted with the suspicion of Lithium toxicity. EEG showed generalized epileptiform discharges. MRI brain revealed frontal cortical atrophy. CSF detailed report was normal. Further workup showed a high TSH level and positive anti-TPO (anti thyroid peroxidase) antibodies. Based on clinical picture, raised antibodies and no discernible cause, diagnosis of probable Hashimoto’s encephalopathy was made. He received pulse of methylprednisolone for …

Role Of Neuroradiology In Predicting Outome In Spontaneous Intracerebral Hemorrhage, Sumaira Nabi, Mazhar Badshah, Shahzad Ahmed, Ali Zohair Nomani

Pakistan Journal of Neurological Sciences (PJNS)

Spontaneous intracerebral hemorrhage (ICH) accounts for 8-13% of all strokes and is associated with a high mortality and morbidity. Western studies have identified various clinical and radiological factors which help in predicting outcome in patients with spontaneous ICH. Materials and methods: A consecutive series of 100 patients diagnosed with spontaneous ICH admitted to the neurology department were enrolled from 1stJanuary to 30th June, 2014.Radiological parameters on CT brain (plain) were recorded. In-hospital outcome was measured at the end of 7 days of hospital stay in terms of survival or mortality. Different radiological parameters and their effect on outcome were compared …

Frequency Of Miller Fisher Variant Of Guillain Barré Syndrome At A Tertiary Care Hospital, Karachi, Kiran Waqar, Sadaf Nasir, Khalid Sher, Meraj Fatima, Abdul Malik

Pakistan Journal of Neurological Sciences (PJNS)

Miller fisher syndrome is generally considered a rare but important variant of Guillain Barré Syndrome (GBS) having geographically variable incidence. Patients with this clinical syndrome are often misdiagnosed and mismanaged due to lack of awareness on the part of physician. Objective: To determine frequency of Miller fisher syndrome (MFS), variant of GBS in patients presenting to a tertiary care hospital in Karachi. Methods: This descriptive cross sectional study was conducted in the Department of Neurology, Jinnah Postgraduate Medical Centre (JPMC), Karachi. The duration was from April, 2014 to April, 2016 (two years). A total of 100 patients were included in …

Transcranial Direct Current Stimulation And Stroke Recovery: Opportunities And Challenges, Murtaza G, Hussain F, Iqbal M, Shahid Bashir

Pakistan Journal of Neurological Sciences (PJNS)

Transcranial direct current stimulation (tDCS) is one type of neuromodulation, which is an emerging technology that holds promise for the future studies on therapeutic and diagnosis applications in treatment of neurological and psychiatric diseases. However, there is a serious question among developing countries with limited financial and human resources, about the potential returns of an investment in this field and regarding the best time to transfer this technology from controlled experimental settings to health systems in the public and private sectors. This article reviews the tDCS as tools of neuromodulation for stroke and discusses the opportunities and challenges available for …

Spectrum Of Gullian Barre Syndrome In Children, Dr. Shaila Ali, Dr. M. Zia Ur Rehman, Dr. Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

GBS is a post-infectious poly-neuropathy involving mainly motor but sometimes also sensory and autonomic nerves. This is an epidemiological report on seasonal & monthly distribution of GBS & differences in GBS incidence between male & female in Punjab, Pakistan. Objective: To determine the seasonal variation, age and gender differentiation in children with GBS along with EMG/NCS findings. Study Design: Retrospective, observational,cross sectional study. Place and duration of study: Department of Neurology, Childrens Hospital & The Institute of Child Health, Lahore from January 2014 to December 2014. METHODS: We extracted data from multi centers retrospectively in a 1 year period (January …

A Giant Right Subclavian- Axillary Artery Aneurysm Presenting As Brachial Plexopathy, Mahnoor Hafeez,, Ateeque Ahmed Khan

Pakistan Journal of Neurological Sciences (PJNS)

We present a rare case of 60 years old lady with diabetes and uncontrolled systemic hypertension, who was referred to the Surgical Department of Civil Hospital Karachi in September 2016 with rapidly progressive mass at right shoulder region and acute onset of ipsilateral limb sensory and motor deficit for last 3 weeks. The nerve conduction studies (NCS) revealed right brachial plexopathy. Computed Tomography demonstrated an 8.2x8.7cm (width x length) fusiform giant aneurysm of right subclavian-axillary artery with reactive axillary lymphadenitis. Early Aneurysmectomy and arterial reconstruction with saphenous vein graft interposition was planned. Unfortunately, she succumbed to death due to spontaneous …

Intracranial Hypertension And Optic Nerve Sheath Fenestration, Irfan Jeeva

Pakistan Journal of Neurological Sciences (PJNS)

Intracranial Hypertension is a neurological condition secondary to raised intracranial pressure in the absence of identifiable intracranial pathology and with normal cerebrospinal fluid composition. It can be a challenging condition to manage. One of the treatment modalities, optic nerve sheath fenestration is an important, yet under utilized mode of treatment, particularly in patients with visual symptoms.