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South Asian Contributions To The International Rehabilitation Literature: An Online Literature Survey Of 10 Years, Sermad Ahmad Mangat, Farooq Azam Rathore, Shahbaz Ali Nasir, Mubasshar Shahid, Hassaan Altaf

Pakistan Journal of Neurological Sciences (PJNS)

Physical medicine and rehabilitation (PM & R) deals with management, rehabilitation and community reintegration persons with disabilities. It is an emerging medical specialty in the South-Asian region (Pakistan, India, Bangladesh, Nepal, Srilanka ,Afghanistan, Bhutan and Maldives,). The region comprises 24% of the world population with a huge burden of disability. The contributions of South Asian authors to the international rehabilitation medicine literature are unknown. The aim of this study was to document the contributions of south Asian authors in the international rehabilitation literature in the last decade.

Stroke As A First Presentation Of Malignancy, Farheen Niazi, Puneet Kakar, Ratneshwari Jha, Reena Dhami, Farook Edoo

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is a frequent complication in patients with cancer occurring in nearly 15% of the cases. However cerebrovascular disease as the first presentation of malignancy has rarely been reported. We report two such cases who were admitted with acute stroke but were later on found to be having malignancy. Routine workup was unrewarding in both patients. Both patients developed pulmonary embolism as well during hospital stay suggesting hypercoagulable state as likely etiology. Reaching to the final diagnosis was an arduous journey but can help guide other clinicians facing similar cases. Non Hodgkins B cell lymphoma and Carcinoma Gall bladder were …

Quality Of Life After Stroke In Pakistan, Wardah Khalid, Shafquat Rozi, Tazeen S. Ali, Iqbal Azam Syed, Michael Mullen, Saleem Illyas, Qamarunnisa, Nabila Soomro, Ayeesha Kamran Kamal

Department of Medicine

Background: There is very little information about the quality of life (QOL) of stroke survivors in LMIC countries with underdeveloped non communicable health infrastructures, who bear two thirds of the global stroke burden.

Methodology: We used a sequential mix methods approach. First, a quantitative analytical cross-sectional study was conducted on 700 participants, who constituted 350 stroke survivor and their caregiver dyads. QOL of stroke survivor was assessed via Stroke Specific Quality of Life Scale (SSQOLS) whereas QOL of caregivers was assessed through RAND-36. In addition; we assessed complications, psychosocial and functional disability of stroke survivors. Following this quantitative survey, …

Spectrum Of Acute Flaccid Paralysis In Children, Shaila Ali, M. Zia Ur Rehman, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

Acute flaccid paralysis (AFP) is a clinical syndrome characterized by rapid onset of weakness in a child aged less than 15 years due to any cause when polio is suspected(1). Exact cause of AFP with its incidence is needed for proper management.

Brief Report On 16th International Neurology Update And Joint Phs, Pss & Mdsp Conference, Abdul Malik

Pakistan Journal of Neurological Sciences (PJNS)

Keeping up to date with new developments in medicine is a real challenge. But it's a challenge all neurologists must take if they are to do justice to their patients and aim for superior clinical expertise. Although neurology specialty is in growing stage & by the Grace of Almighty in last decade neurology bodies showed remarkable development to strengthen and continuing the training & development for the undergraduates, graduates & postgraduates in Pakistan. This year it was also unique precedence that in Karachi, national neurology body jointly organized four days conference with three sub-specialties national organizations.

Antenatal Renal Pelvic Dilatation And Foetal Outcomes - Review Of Cases From A Tertiary Care Center In Karachi, Pakistan, Ruqiya Afroz, Shafia Shakoor, Muhammad Sohail Salat, Shama Munim

Woman and Child Health

Objective: To determine the incidence of antenatal renal pelvic dilatation to evaluate antenatal resolution/ progression and post-natal outcome.
Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of all women found with renal pelvic dilatation in antenatal scans between January 2011 and December 2013. A cut-off of 5mm was used to diagnose renal pelvic dilatation. Renal pelvic dilatation was categorised into three groups: mild (5-6mm in second trimester and 5-9mm in third trimester), moderate (7-10mm in second trimester and 10-15 in third) and severe (more than 10mm in second trimester and more than …

Labrad : Vol 42, Issue 3 - December 2016, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Provocative Testing for Growth Hormone Disorders
• Serum Procalcitonin for Early Sepsis Diagnosis
• Monoclonal Gammopathy of Undetermined Significance (MGUS)
• Understanding Six Sigma Methodology
• Blood Collection for Culture
• Molecular Analysis of Alpha Thalassaemia by Multiple Ligation Probe Assay
• Prognostification of Acute Myeloid Leukemia with FLT 3 Mutation
• Interferon Gamma Release Assay (IGRA) for Detection of Mycobacterium Tuberculosis Infection in the Host
• An Analysis of Needle Stick Injury in the Department of Radiology

Pharmacy Newsletter : December 2016, Pharmacy Department

Department of Pharmacy Archives

Content:

• Defined Daily Dose (DDD) – A step toward Antibiotic Stewardship Program
• Potential drug-drug interaction of Macrolide and Domperidone | QT prolongation
• 17th December, 1st National Medication Safety Symposium

Mapping The Geography Of Child Mortality: A Key Step In Addressing Disparities, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Global Research Priorities To Accelerate Early Child Development In The Sustainable Development Era, Tarun Dua, Mark Tomlinson, Elizabeth Tablante, Pia Britto, Aisha Khizar Yousafzai, Bernadette Daelmans, Gary L. Darmstadt

Department of Paediatrics and Child Health

No abstract provided.

Effect Of Time Duration Of Digestion/Decontamination Technique On Yield Of Mycobacteria And Contamination Rates From Sterile Body Fluids (Pleural And Ascitic Fluid) And Pus Specimens, Samreen Shafiq, Faryal Saleem, Kauser Jabeen, Joveria Farooqi, Warda Alam, Sadia Hanif, Shazia Ali, Sadia Shakoor, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background:
Duration of digestion/decontamination has a considerable impact on yield of mycobacteria especially from sterile body fluids and pus specimens. Additionally, duration of digestion/decontamination affects the contamination rates. This study evaluates the effect of digestion/decontamination protocol for 15 and 20min versus inoculation of media directly from the sample on contamination rates as well as the yield of mycobacteria from pus and sterile fluids other than cerebrospinal fluids.
Methods:
Pleural fluid (n=60), pus (n=48) and ascitic fluid (n=12) specimens were cultured for mycobacteria and evaluated for contamination and mycobacterial yield using three different processing methodologies: without digestion/decontamination with 5% NaOH-NALC (D/D), …

Predictors Of Diarrheal Mortality And Patterns Of Caregiver Health Seeking Behavior In In Karachi, Pakistan, Farah Naz Qamar, Umber Zaman, Farheen Quadri, Asia Khan, Babar Tasneem Shaikh, Iqbal Azam, Dilruba Nasrin, Karen Kotloff, Myron Levine, Nick Brown

Department of Paediatrics and Child Health

Background: Pakistan is unfortunately among the five countries that contributed to the most deaths due to diarrhea and pneumonia in 2010. To explore factors associated with diarrheal deaths we assessed care-seeking behavior and other predictors of diarrhea-related mortality in children in selected low-income peri-urban communities of Karachi, Pakistan.
Methods: A mixed methods study (qualitative and quantitative) using matched case-control design and focus group discussions with parents of children with moderate to severe diarrhea (MSD) was undertaken. Cases were children Demographic, clinical, and care-related behavioral predictors of mortality were assessed. Conditional logistic regression was performed, matched adjusted odds ratios (mOR) are …

Retrograde Bullet Migration From Inferior Vena Cava Into Right Common Iliac Vein Following Gunshot: A Case Report, Ibrahim Zahid, Hamza Abdur Rahim Khan, Omar Irfan, Benish Fatima,, Maha Tahir, Muhammad Tariq, Fazal Wahab Khan, Saulat H. Fatimi

Department of Surgery Docs

Abstract

Bullet embolization cases are rare and even rarer are its retrograde migration in the veins. We report the case of a 14 year old male with a gunshot wound to the left side of his chest. CT scan revealed bilateral haemothorax and foreign body in the right common iliac vein. The patient was immediately taken to the operating theatre and median sternotomy performed. Bullet entry tear was found in the inferior vena cava however, the bullet was found lodged in the right common iliac vein and slipped down against the flow of blood. The bullet was left in situ …

Mammographic Density Assessed On Paired Raw And Processed Digital Images And On Paired Screen-Film And Digital Images Across Three Mammography Systems, Anya Burton, Graham Byrnes, Jennifer Stone, Rulla M. Tamimi, John Heine, Celine Vachon, Vahit Ozmen, Ana Pereira, Maria Luisa Garmendia, Christopher Scott, John H. Hipwell, Caroline Dickens, Joachim Schüz, Mustafa Erkin Aribal, Kimberly Bertrand, Ava Kwong, Graham G. Giles, John Hopper, Beatriz Pérez Gómez, Marina Pollán, Soo-Hwang Teo, Shivaani Mariapun, Nur Aishah Mohd Taib, Martín Lajous, Ruy Lopez-Riduara, Megan Rice, Isabelle Romieu, Anath Arzee Flugelman, Giske Ursin, Samera Qureshi, Huiyan Ma, Eunjung Lee, Reza Sirous, Mehri Sirous, Jong Won Lee, Jisun Kim, Dorria Salem, Rasha Kamal, Mikael Hartman, Hui Miao, Kee-Seng Chia, Chisato Nagata, Sudhir Vinayak, Rose Ndumia, Carla H. Van Gils, Johanna O. P. Wanders, Beata Peplonska, Agnieszka Bukowska, Steve Allen, Sarah Vinnicombe, Sue Moss, Anna M. Chiarelli, Linda Linton, Gertraud Maskarinec, Martin J. Yaffe, Norman F. Boyd, Isabel Dos-Santos-Silva, Valerie A. Mccormack

Imaging & Diagnostic Radiology, East Africa

Background: Inter-women and intra-women comparisons of mammographic density (MD) are needed in research, clinical and screening applications; however, MD measurements are influenced by mammography modality (screen film/ digital) and digital image format (raw/processed). We aimed to examine differences in MD assessed on these image types.

Methods: We obtained 1294 pairs of images saved in both raw and processed formats from Hologic and General Electric (GE) direct digital systems and a Fuji computed radiography (CR) system, and 128 screen-film and processed CR-digital pairs from consecutive screening rounds. Four readers performed Cumulus-based MD measurements (n = 3441), with each image pair read …

News & Events

Journal of Asian Midwives (JAM)

No abstract provided.

Strengthening The Knowledge And Skills Of Community Midwives In Pakistan Through Clinical Practice Internships, Arusa Lakhani, Rafat Jan, Kiran Mubeen, Sadia Karimi, Shahnaz Shahid, Rozina Sewani, Marina Baig, Farzana Adnan

Journal of Asian Midwives (JAM)

Objective: On the-job training of Community Midwives (CMWs) is of critical importance in enabling midwives to provide services that meet standards of quality care. The objective of this study was to assess the intervention of an internship for CMWs that would increase their ability to provide quality maternal, newborn, and child health services.
Method: A pre and post-intervention design was used to evaluate the effectiveness of an internship of 32 working days. Validated questionnaire was used to assess the CMWs’ knowledge and skills before and after the intervention. Overall, 252 CMWs from 14 districts of the Sindh and …

‘Competent, But Not Allowed To Blossom’: Midwifery-Trained Registered Nurses’ Perceptions Of Their Service: A Qualitative Study In Sri Lanka, Sunethra Jayathilake, Vathsala Jayasuriya-Illesinghe, Rasika Perera, Himani Molligoda, Kerstin Samarasinghe

Journal of Asian Midwives (JAM)

Objective: To explore midwifery-trained registered nurses’ perceptions of their own profession as maternity care providers and how they identify their role, tasks, and responsibilities within a multi-professional team.
Design: An exploratory qualitative study using focus group discussions and qualitative content analysis.
Setting: Three selected tertiary care hospitals in the Capital Province in Sri Lanka.
Participants: Twenty-two midwifery-trained RNs working in intra-partum and postpartum units.
Findings: The overriding theme of the analysis was identified as ‘competent but not allowed to blossom fully in their practice’, based on two main categories: ‘provision of competent care’ and ‘working with disappointments’. Each main …

Effectiveness Of Video-Assisted Teaching On No-Scalpel Vasectomy On Knowledge And Attitude Of Married Men In Rural Nagaland, India, Arhoni Tungoe

Journal of Asian Midwives (JAM)

This study assessed whether video-assisted teaching increased the knowledge of,and resulted in a more favourable attitude among married men regarding No-Scalpel Vasectomy (NSV) in a selected village of 17,000 people,bordering Assam, in Nagaland, India. The study used a one group,before-and-after design. The participants were 30 married men who were selected through purposive sampling. Pre-tested and validated tools to assess knowledge and attitudes were used for data collection. The mean post-test scores, on both the knowledge and attitude scales,showed a significant increase from pretest scores (knowledge pre-test mean 11.53±3.41; post-test 21.23±2.18;attitude pre-test mean 20.87±2.64, post-test35.2±1.66).Thus we conclude that the video-assisted teaching …

Adolescent Pregnancies: The Case Of Pakistan, Kiran Mubeen, Marina Baig

Journal of Asian Midwives (JAM)

Early motherhood not only causes poor health outcomes, but often also deprives adolescent girls of educational, social, and economic development opportunities for the rest of their lives. Evidence suggests that although the burden of adolescent pregnancies is less in Pakistan than in Bangladesh, Afghanistan and Nepal, the pregnancy outcomes continue to be devastating in this country. This paper discusses the social barriers in addressing this issue in Pakistan and proposes recommendations for targeted interventions to reduce the high birth rate amongst adolescents in the country. The role of midwives asfrontlinegatekeepers can be pivotal for prevention ofteenagedpregnancies in Pakistan. Unfortunately, the …

Looking Forward To More And Better Midwifery In Asia In 2017, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Referral Pattern Of Emergencies In Obstetrics: Implications For Defining Scope Of Services And Policy, Rahat Najam Qureshi, Rozina Sikandar Sultanali, Zahra Hoodbhoy, Raffat Bano, Nigar Jabeen

Department of Obstetrics & Gynaecology

Objective: To analyse referral pattern of high-risk obstetric cases from secondary to tertiary care hospitals and to assess their maternal and neonatal outcomes.

Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised all referred obstetric cases from secondary-level hospitals to tertiary-level care within and outside the Hospital between January 2011 and December 2014. Day and time of referral, reason for referral as well as maternal and neonatal outcomes were collected. SPSS 19 was used for data analysis.

Results: Of the 634 obstetric referrals, 279(44%) patients were referred to the study site, while 355(56%) …

Reference Ranges Of Handgrip Strength From 125,462 Healthy Adults In 21 Countries: A Prospective Urban Rural Epidemiologic (Pure) Study., Darryl P. Leong, Koon K. Teo, Sumathy Rangarajan, V. Raman Kutty, Fernando Lanas, Chen Hui, Xiang Quanyong, Qian Zhenzhen, Tang Jinhua, Romaina Iqbal

Community Health Sciences

BACKGROUND:

The measurement of handgrip strength (HGS) has prognostic value with respect to all-cause mortality, cardiovascular mortality and cardiovascular disease, and is an important part of the evaluation of frailty. Published reference ranges for HGS are mostly derived from Caucasian populations in high-income countries. There is a paucity of information on normative HGS values in non-Caucasian populations from low- or middle-income countries. The objective of this study was to develop reference HGS ranges for healthy adults from a broad range of ethnicities and socioeconomically diverse geographic regions.

METHODS:

HGS was measured using a Jamar dynamometer in 125,462 healthy adults aged …

Sleep Medicine: A Deserted Field In Pakistan, Bhojo A. Khealani

Pakistan Journal of Neurological Sciences (PJNS)

Sleep is an important and essential aspect of life and we spend about one third of our lives sleeping. Sleep disorders often manifest with insomnia and excessive daytime sleepiness. Large population based studies have shown that people who sleep longer and lesser have shorter life span1,2. Other symptoms of the slep disorders include snoring, abnormal motor behaviors etc.

Clinical Profiles, Management And Outcome Of Myasthenic Crisis In A Tertiary Care Center In Karachi, Pakistan, Sara , Khan, Dureshahwar Kanwar, Sadia Nishat

Pakistan Journal of Neurological Sciences (PJNS)

To determine the clinical profiles, management and outcome of myasthenic crisis (MC) in patients presenting to a tertiary care hospital in Karachi, Pakistan. This was a retrospective study of forty patients with Myasthenic crisis(MC) admitted at the Aga Khan University Hospital, Karachi between 1999 and 2014.Demographics, clinical presentation, hospital course, management and outcomes were reviewed. Ventilatory support for respiratory muscle or bulbar weakness was taken as crisis identification at arrival. Out of the total 40 patients with MC; generalized onset was seen in 28 (70%) and isolated bulbar symptoms in 12 (30%) patients. Fifteen patients (37.5%) had MC as a …

Epidemiology And Prevalence Of Deep Venous Thrombosis In Patients With Spinal Cord Injury, Aatik Arsh, Haider Darain, Syed Muhammad Ilyas

Pakistan Journal of Neurological Sciences (PJNS)

Pressure ulcers in patients with spinal cord injury (SCI) are associated with incredible financial cost and human sufferings. The aim of this retrospective study was to determine prevalence of pressure ulcers amongst patients with different levels of SCI.

Attitude And Perception Of Physical Therapists Towards Multidisciplinary Team Aproach In Stroke Rehabilitation, Muhammad Naveed Babur, Shiasta Habibullah, Anam Aftab

Pakistan Journal of Neurological Sciences (PJNS)

Stroke is a long term disability in developing countries which is considered as major economic burden on part of Health care system. In developing countries multidisciplinary team approach for stroke rehabilitation is emerging in tertiary care hospitals and has considerably increased the chance of early independence, fast recovery and maximum outcome in daily activities of life. Objective: Objective of the study was to evaluate the attitude and perception of physical therapists towards multidisciplinary team approach working in stroke rehabilitation.

Concurrent Intracranial Chloromas And Leukemia Cutis In Chronic Myeloid Leukemia, Ateeque Ahmed Khan, Mahnoor Hafeez

Pakistan Journal of Neurological Sciences (PJNS)

Granulocytic sarcoma (chloroma) is an extramedullary solid tumor composed of immature white blood cells. Most common involvement sites are bone, periostium, soft tissue, lymph nodes and skin. Intracranial granulocytic sarcoma rarely occurs in meningeal or parenchymal form1. We report the of concurrent occurrence of intracranial chloromas and leukemia cutis in 26 years old male patient, known case of Chronic Myeloid Leukemia for 3 years [+ve Philadelphia (Ph) chromosome in bone marrow cells] who now presented to the Civil Hospital Karachi with continuous headache and multiple cutaneous nodules all over the body for last 2 months. The CT exam of the …

Nmda Encephalitis In An Elderly With Poor Prognosis, Farheen Niazi, Abdul Hameed, Tariq Hussain, Sarah Faiz, Hassan Atique

Pakistan Journal of Neurological Sciences (PJNS)

We present a case of a 65 years old man from Islamabad who presented with six months history of psychiatric and behavioural symptoms, significant weight loss. Later on he developed difficulty swallowing and altered sensorium. This was followed by an episode of shortness of breath leading to respiratory arrest, followed by ICU stay on ventilator support, then developed focal deficit in form of left sided weakness, dysautonomia, bradycardia leading to cardiac arrest and another cardiopulmonary resuscitation, myoclonic jerks, orofacial dyskinesias, status epilepticus, coma ultimately resulting in death of the patient. Patient was found to be NMDA receptor antibody positive. CT …

Rescue-Icp Trial, Muhammad Waqas, Muhammad Shahzad Shamim

Pakistan Journal of Neurological Sciences (PJNS)

Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension Peter J. Hutchinson, Angelos G. Kolias, Ivan S. Timofeev, Elizabeth A. Corteen, Marek Czosnyka, and other RESCUEicp Trial Collaborators N Engl J Med 2016; 375:1119-1130September 22, 2016DOI: 10.1056/NEJMoa1605215

Neurological Health Profile In Pakistan – A Health Systems Based Needs Assessment, Tauhid Awan, Arsalan Ahmad, Ather Javed, Mohammad Wasay, Muhammad Babar Khan, Haroon Awan

Pakistan Journal of Neurological Sciences (PJNS)

The aims of our study were to develop a neurological health profile in Pakistan from a health systems perspective, ascertain the readiness of neurology with regards to Sustainable Development Goals, and proffer recommendations for policy advocacy and planning in neurology.