Medicine and Health Sciences Commons^™

Eradication Of Advanced Pelvic Hydatid Bone Disease After Limb Salvage Surgery - 5-Year Follow-Up: A Case Report, Muhammad Shahid Khan, Pervaiz Hashmi, Dawar Khan

Department of Surgery Docs

Abstract

INTRODUCTION:

Echinococcosis is produced by the larval stage of Echinococcus granulosus; it is a parasitic disease which is seen rarely in humans and has adverse outcomes. We report a case of advanced pelvic hydatid bone disease with successful limb salvage surgery. Our patient had a 5-year follow-up without recurrence which is a rarity as per the literature. Early diagnosis and prompt medical therapy are necessary for effective management whereas delayed diagnosis is always fraught with the risk of recurrence and sepsis.

CASE PRESENTATION:

In 2009, a 30-year-old woman, native of Karachi (Sindhi ethnicity), presented at our clinic with history …

Successful Tricuspid Valvectomy In A Septic Patient With Tricuspid Valve Endocarditis, Taimur Asif Ali, Saulat Hasnain Fatimi, Syed Saad Naeem, Wasiq Faraz Rawasia

Department of Surgery Docs

Abstract

Endocarditis is characterized by vegetations, which is a mass of platelets, fibrin, micro-colonies of micro-organisms, and inflammatory cells, in the endocardium. Over the past three decades, the incidence of right-sided endocarditis has risen dramatically in Pakistan. We report a 36-year woman with a history of repeated intravenous analgesic injections for low back pain, presenting with high grade fever, sepsis and a white cell count of 44,000 with 90% neutrophils. Echocardiography showed large mobile vegetations on TricuspidValve (TV). Tricuspid Valve Endocarditis (TVE) is generally responsive to medical treatment; however, about 25% of TVE patients require surgical intervention. Long-term survival of …

Knowledge And Attitude Towards Rape And Child Sexual Abuse – A Community-Based Cross-Sectional Study In Rural Tanzania, Muzdalifat Abeid, Projestine Muganyizi, Siriel Massawe, Rose Mpembeni, Elisabeth Darj, Pia Axemo

Obstetrics and Gynaecology, East Africa

Background, Violence against women and children is globally recognized as a social and human rights concern. In Tanzania, sexual violence towards women and children is a public health problem. The aim of this study was to determine community knowledge of and attitudes towards rape and child sexual abuse, and assess associations between knowledge and attitudes and socio-demographic characteristics.

Methods, A cross-sectional study was undertaken between May and June 2012. The study was conducted in the Kilombero and Ulanga rural districts in the Morogoro Region of Tanzania. Men and women aged 18–49 years were eligible for the study. Through a three-stage …

Are We Empowered? A Qualitative Approach To Unfold The Experiences Of Female Nurses In Pakistan, Saleema A. Gulzar, Rozina Karmaliani, Nasreen Lalani, Qurratulain Nasiruddin

School of Nursing & Midwifery

The disparity of men and women in certain societies, such as Pakistan, is a growing concern. The disparity, unchanging mind-set, and definitions rooted in traditions do not free individuals from the socially bound gender identities. In such circumstances, educational institutions can become a way of transforming social structures. Considering female nurses in Pakistan as a case study, this paper explores the notion of “empowerment” and the factors responsible for empowerment or disempowerment of female nurses. The study also evaluates the role of a leading nursing institution in Pakistan namely the Aga Khan University- School of Nursing and Midwifery (AKUSONAM) in …

Quality Of Life Among Women With Symptoms Of Gynecological Morbidities: Results Of A Cross‐Sectional Study In Karachi, Pakistan, Neelofar Sami, Tazeen Saeed Ali, Muhammad Osama

Community Health Sciences

AIMS:

A population-based cross-sectional study design was used to study the effects of symptoms of various gynecological morbidities (GM) on health-related quality of life (HRQoL) of women, residents of squatter settlements of Karachi, Pakistan.

MATERIAL AND METHODS:

This cross-sectional study was conducted in squatter settlements of Karachi from September 2012 to August 2013, with 1002 married, non-pregnant women. After obtaining written informed consent from every participant, a structured questionnaire was used to collect information about symptoms of GM and their effect on four domains of HRQoL (physical, social, functional and financial domains).

RESULTS:

Of 1002 women who participated in the …

Frequency Of Electrolyte Derangement After Transurethral Resection Of Prostate: Need For Postoperative Electrolyte Monitoring, Wajahat Aziz, Hammad Ather

Department of Surgery Docs

Abstract

Objective. To determine the electrolyte derangement following transurethral resection of prostate (TURP). Methods. All patients undergoing TURP from June 2012 to April 2013 were included. Preoperative electrolytes were performed within a week of procedures. Monopolar TURP using 1.5% glycine was performed. Serum Na(+) and K(+) were assessed within 1 hour postoperatively and subsequently if clinically indicated. Results. The study included 280 patients. Sixty-six patients (23.6%) had electrolyte derangement after TURP. Patients with deranged electrolytes were older (mean age of 73.41 ± 4.08 yrs. versus 68.93 yrs. ± 10.34) and had a longer mean resection time (42.5 ± 20.04 min …

Salvage Of Infected Non-Union Of The Tibia With An Ilizarov Ring Fixator, Muhammad Shahid Khan, Haroon Rashid, Masood Umer, Irfan Qadir, Kamran Hafeez, Arshad Iqbal

Department of Surgery Docs

Purpose: To review outcomes of 24 patients who underwent Ilizarov ring fixation for infected nonunion of the tibia.
Methods: Medical records of 21 men and 3 women aged 13 to 74 (mean, 38) years who underwent Ilizarov ring fixation for infected non-union of the tibia were reviewed. The mean bone defect was 3.3 (range, 2-5) cm. The mean time from injury to presentation was 11.9 (range, 1-36) months. The mean number of previous surgeries was 2 (range, 0-14). A local flap was used in 2 patients and a free flap was used in one patient. Nine of the patients underwent …

Association Between Traumatic Events And Post-Traumatic Stress Disorder: Results From The Esemed-Spain Study, B Olaya, J Alonso, Lukoye Atwoli, R C. Kessler, G Vilagut, J M. Haro

Internal Medicine, East Africa

Background: The relative importance of traumatic events (TEs) in accounting for the social burden of post-traumatic stress disorder (PTSD) could vary according to cross-cultural factors. In that sense, no such studies have yet been conducted in the Spanish general population. The present study aims to determine the epidemiology of trauma and PTSD in a Spanish community sample using the randomly selected TEs method.

Methods: The European Study of the Epidemiology of Mental Disorders (ESEMeD)-Spain is a cross-sectional household survey of a representative sample of adult population. Lifetime prevalence of self-reported TEs and lifetime and 12-month prevalence of PTSD were evaluated …

Anaesthetic Consideration In A Cannabis Addict, Karima Karam, Shemila Abbasi, Fauzia Anis Khan

Department of Anaesthesia

This case report describes the anaesthetic management of a patient addicted to Bhang(cannabis) for 20 years. Cannabis use has implication in the anaesthetic management of a patient because of its effects on the cardiovascular system, respiratory system, and central nervous system and its interaction with anaesthetic drugs.

Comparing Lung Function Of Textile Workers With The Healthy Pakistani Population, Unaib Rabbani, Asaad Ahmed Nafees

Community Health Sciences

Background: The purpose of this study was to compare lung function of textile workers with healthy Pakistani population, compare predicted values based on the European Respiratory Society (ERS) equations with those based on the Pakistani equations, and to develop predictor equations for textile workers in Pakistan.
Methods: This was a secondary analysis of data from two previous surveys where lung function of textile workers was compared with healthy Pakistani men. Spirometry was performed according to the American Thoracic Society guidelines. Independent sample t-test was used to compare the lung function parameters and multivariate linear regression was used to develop predictor …

Isoniazid Induced Acute Pancreatitis In A Young Girl, Ali Faisal Saleem Dr, Saba Arbab, Farah Qamar Naz

Department of Paediatrics and Child Health

Isoniazid (INH) is the mainstay of management against Mycobacterium tuberculosis. INH-induced acute pancreatitis is an uncommon association and with dearth of literature on it. We are reporting a case of an 11 years old girl who developed acute pancreatitis after 2 weeks of antituberculous therapy. An INH free regimen was started. She was discharged and followed without complications.

Interferon Lambda-3 Polymorphism And Response To Pegylated Interferon In Patients With Hepatitis D, Zaigham Abbas, Javed Yakoob, Muhammad A. Umer,, Minaam Abbas, Saeed Hamid

Section of Gastroenterology

Background: Specific single nucleotide polymorphisms (SNPs) near the interferon lambda-3 (IFNλ3) gene (formerly interleukin 28B) influence the response to treatment with interferon in hepatitis C patients. We aimed to investigate such an influence in hepatitis D patients.
Methods: The study population consisted of hepatitis D patients who were previously treated with pegylated interferon for one year and who were spontaneous clearers of the virus post recent superinfection. The SNP of IFNλ3, rs12979860, was determined by polymerase chain reaction-restriction fragment length polymorphism protocol.
Results: The total number of patients was 64; median age was 30.5 years and 53 were male. The …

Implications Of Female Sex On Stroke Risk Factors, Care, Outcome And Rehabilitation: An Asian Perspective, Prachi Mehndiratta, Mohammad Wasay, Man Mohan Mehndiratta

Section of Neurology

Background:

Stroke affects 16.9 million people annually and the greatest burden of stroke is in low- and middle-income countries, where 69% of all strokes occur. Stroke risk factors, mortality and outcomes differ in developing countries as compared to the developed world. We performed a literature review of 28 articles pertaining to epidemiology of stroke in Asian women, stroke risk factors, gender-related differences, and stroke outcomes.

Summary:

Asian women differ from women worldwide due to differences in stroke awareness, risk factor profile, stroke subtypes, and social issues that impact stroke care. While Asian men have a higher incidence of stroke as …

Vivax Malaria And Chloroquine Resistance: A Neglected Disease As An Emerging Threat, Anam A. Waheed,, Najia Karim Ghanchi, Karim A. Rehman,, Afsheen Raza, Syed Faisal Mahmood, Syed Faisal Mahmood, Mohammad A. Beg

Department of Medicine

In Pakistan, Plasmodium vivax contributes to major malaria burden. In this case, a pregnant woman presented with P. vivax infection and which was not cleared by chloroquine, despite adequate treatment. This is probably the first confirmed case of chloroquine-resistant vivax from Pakistan, where severe malaria due to P. vivax is already an emerging problem.

Hair Dye Poisoning And Rhabdomyolysis., Munira Bokutz, Nosheen Nasir, Syed Faisal Mahmood, Sara Sajid

Department of Medicine

Hair dye ingestion is a rare cause of toxicity in Pakistan. We are presenting the case report of a 55 year old male who presented with accidental hair dye ingestion and developed laryngeal oedema requiring emergent tracheostomy. He had also developed aspiration pneumonitis and chemical oesophagitis. However, the most alarming manifestation was rhabdomyolysis. Hair dye toxicity can be fatal if not recognized early. There is no antidote available. Rhabdomyolysis is a complication and needs to be managed aggressively in order to prevent long term morbidity.

Long Term Follow-Up Of A Successful Lower Limb Replantation In A 3-Year-Old Child, Akbar Jaleel Zubairi, Pervaiz Mahmood Hashmi

Section of Orthopaedic Surgery

Replantation of the lower extremity has controversial indications but nevertheless it may be considered in carefully selected patients who present early and are expected to show good functional recoveries. Here we present a successful replantation in a 3-year-old boy who has made excellent recovery with no functional deficit evident at 12 years of follow-up. He sustained a traumatic amputation at the level of distal tibia when he fell of a "Qing Qi" (motorcycle rickshaw). Replantation was attempted at 8 hours cold ischemia time with the tibia shortened 4cm and all tendons, vessels, and nerves repaired. Patient required a second procedure …

Sarcoidosis Presented As Retroperitoneal And Lung Mass, Nousheen Iqbal, Aamer Mahmood, Muhammad Irfan, Khurram Minhas

Section of Pulmonary & Critical Care

Sarcoidosis is a multisystem granulomatous disorder of unknown aetiology characterised pathologically by the presence of non-caseating granulomas in involved organs. Sarcoidosis most frequently involves the lungs followed by eye and skin. Presentation as retroperitoneal and lung mass is rare in sarcoidosis. We describe an unusual case of sarcoidosis where the patient presented with large retroperitoneal and lung masses, and was treated as tuberculosis

Comparing Effectiveness Of Two Client Follow-Up Approaches In Sustaining The Use Of Long Acting Reversible Contraceptives (Larc) Among The Underserved In Rural Punjab, Pakistan: A Study Protocol And Participants' Profile, Syed Khurram Azmat, Waqas Hameed, Moazzam Ali, Muhammad Ishaque, Ghulam Mustafa, Omar Farooq Khan, Ghazunfer Abbas, Erik Munroe

Community Health Sciences

Background: Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of …

Relationship Between Antibody Susceptibility And Lipopolysaccharide O-Antigen Characteristics Of Invasive And Gastrointestinal Nontyphoidal Salmonellae Isolates From Kenya, Robert S. Onsare, Francesca Micoli, Luisa Lanzilao, Renzo Alfini, Chinyere K. Okoro, Anne W. Muigai, Gunturu Revathi, Allan Saul, Samuel Kariuki, Calman A. Maclennan, Simona Rondini

Pathology, East Africa

Background: Nontyphoidal Salmonellae (NTS) cause a large burden of invasive and gastrointestinal disease among young children in sub-Saharan Africa. No vaccine is currently available. Previous reports indicate the importance of the O-antigen of Salmonella lipopolysaccharide for virulence and resistance to antibody-mediated killing. We hypothesised that isolates with more O-antigen have increased resistance to antibody-mediated killing and are more likely to be invasive than gastrointestinal.

Methodology/Principal findings: We studied 192 NTS isolates (114 Typhimurium, 78 Enteritidis) from blood and stools, mostly from paediatric admissions in Kenya 2000-2011. Isolates were tested for susceptibility to antibody-mediated killing, using whole adult serum. O-antigen structural …

Nail As A Foreign Body In A Neonate, An Unusual Presentation At An Unusual Age, Sayyeda Ghazala Irfan Kazi, Muhammad Irfan Habib, Badar Afzal, Irum Qamar Khan, Emaduddin Siddiqui, Maryam Aftab

Department of Emergency Medicine

Children are prone to ingest substances due to their exploratory nature and tendency to put everything in the mouth. Commonly ingested foreign bodies are coins, batteries and buttons. Foreign body ingestion in neonates is a very rare presentation and always needs important consideration as it can be a part of child abuse and can lead to serious life threatening consequences

Determination Of The Factors Leading To Noncompliance With Antiepileptic Drug, Abdul Haz, Naila Naeem Shahbaz, Jai Perkash, Muslim Ali Lakhair

Pakistan Journal of Neurological Sciences (PJNS)

Background:
Epilepsy is a chronic disorder or group of chronic disorder in which the indispensable feature is recurrence of seizures that are typically unprovoked and usually unpredictable. It is well established that non-adherence to antiepileptic drugs may lead to a loss of seizure control. Negative outcomes that may be associated with a loss of seizure control include: injury, increase hospitalizations, and decrease in productivity. All of these contribute to increased direct and indirect healthcare costs related to epilepsy.

Objective:
To determine factors leading to noncompliance with antiepileptic drugs in patients attending a tertiary care hospital.

Methods & Results:
In the …

Psychiatric Diagnosis And Human Emotions, Riffat Moazam Zaman

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Restless Legs Syndrome In Patients With Type 2 Diabetes Mellitus, Shaista A. Siddiqi, Javeria Rauf, Anita Haroon, Bilal Ahmed, Saera Suhail Kidwai, Lubna Nazir

Pakistan Journal of Neurological Sciences (PJNS)

Objective:
To determine the frequency of restless legs syndrome (RLS) and its associated factors in patients with type 2 diabetes mellitus.

Design and Methods:
It was single centered, cross-sectional study done with convenient sampling. The study population comprised 174 subjects (120 diabetics and 54 non-diabetics). Participants were recruited from the Diabetes clinic of Jinnah Medical College Hospital, Karachi. The relevant clinical and laboratory parameters were obtained by clinical history and chart review. Multivariable logistic regression was done to identify the factors of RLS among diabetics.

Results:
Using the International RLS Study Group (IRLSSG) criteria, RLS was identified only in …

Re-Recurrent Dermatofibrosarcomaprotuberans Of The Chest Wall., Niaz Hussain, Mujtaba Zaki Naveed, Ghulam H

Section of Pulmonary & Critical Care

Dermatofibrosarcomaprotuberans is a rare, soft tissue tumour with high rate of recurrence. It is locally aggressive, with a low rate of metastasis. We describe the case of a 42 year old man who presented with a re-recurrent, large tumour situated on the anterior chest wall in the sternal region. We did a wide local excision and covered the resulting defect by using bilateral, pectoralis major myocutaneous flaps. Histopathology and immunohistochemical staining findings were consistent with the diagnosis of Dermatofibrosarcoma Protuberance. Post operatively the patient was treated with chemotherapy and radiotherapy.

Prevalence And Immediate Outcome Of Candida Colonized Preterm Neonates Admitted To Special Care Unit Of Mulago Hospital, Kampala Uganda, Yaser Abdallah, Deogratias Kaddu Mulindwa, Jolly Nankunda, Philippa M. Musoke

Faculty of Health Sciences, East Africa

Background:

Candida species is the third commonest cause of sepsis among neonates. Colonization by Candida is a predictor for candidemia among preterm neonates.

Objectives:

To determine prevalence of early Candida colonization and early outcome among colonized preterm neonates admitted to Mulago hospital Special Care Unit.

Methods:

A prospective observational cohort was conducted between December 2008 and April 2009. Preterm neonates aged >72 hours and less than one week were screened for Candida colonization of the groin, oral pharynx and rectum using CHROMagar. Colonized neonates were followed up for 14 days. Blood cultures were done for those with signs of septicaemia. …

Post Stroke Dementia And Its Putative Risk Factors: A Hospital - Based Study, Iranmanesh F, Sheykholeslami Nz, Rahimdel A, Gadari F, Vazirinajad R, Syedyazdi F

Pakistan Journal of Neurological Sciences (PJNS)

Introduction:
Dementia is common after stroke and has a considerable impact on mortality, rehabilitation and quality of life. There are some published articles regarding post stroke dementia but there are many controversies surrounding this topic. Our aim was to identify the prevalence of post stroke dementia 3 months after stroke and evaluation of some its putative risk factors in Iranian population.

Method:
In this cross-sectional study, 151 patients with acute stroke were evaluated. The diagnosis was confirmed by physical examination and neuroimaging. Three months after the stroke, all patients were visited again. The diagnosis of post stroke dementia was made …

The Land Of Opportunities For Research On Rare Genetic Neurological Disorders, Muhammad Ulusyar Khan, Fazal M. Arain

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Labrad : Vol 41, Issue 1 - March 2015, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• An Overview of Proficiency Testing
• Sources of Pre-analytical Variations
• Five Q-Framework for Implementing Total Quality Management in Laboratory
• Delta Check in Clinical Laboratory
• Indicators of Quality Improvement in Surgical Pathology
• Types of Analytical Errors
• Method Validation for Quantitative Tests: CAP Recommendations
• Levey Jenning Chart and a Guide to Use Westgard Rules
• Quality Control of Vitek-2 System
• Establishing Quality Control Values for Haematology Parameters

Mortality Patterns Among Critically Ill Children In A Pediatric Intensive Care Unit Of A Developing Country, Naveed-Ur-Rehman Siddiqui, Zohaib Ashraf, Humaira Jurair, Anwarul Haque

Department of Paediatrics and Child Health

Background and Aim: Advances in biomedical technology have made medical treatment to be continued beyond a point, at which it does not confer an advantage but may increase the suffering of patients. In such cases, continuation of care may not always be useful, and this has given rise to the concept of limitation of life-sustaining treatment. Our aim was to study mortality patterns over a 6-year period in a Pediatric Intensive Care Unit (PICU) in a developing country and to compare the results with published data from other countries.
Materials and Methods: Retrospective cohort study was conducted in a PICU …

Terrorist Attacks In The Largest Metropolitan City Of Pakistan: Profile Of Soft Tissue And Skeletal Injuries From A Single Trauma Center, Muhammad Shahid Khan, Shahan Waheed, Arif Ali, Narjis Rizvi, Asher B. Feroze, Shahryar Noordin

Department of Surgery Docs

BACKGROUND: Pakistan has been hugely struck with massive bomb explosions (car and suicide bombs) resulting in multiple casualties in the past few years. The aim of this study is to present the patterns of skeletal and soft tissue injuries and to review the outcome of the victims who presented to our hospital. METHODS: This is a retrospective chart review from January 2008 to December 2012. The medical record numbers of patients were obtained from the hospital Health Information and Management Sciences (HIMS) as per the ICD-9 coding. RESULTS: During the study period, more than 100 suicide and implanted bomb blast …