Medicine and Health Sciences Commons^™

Effect Of A Voice Recognition System On Paediatric Outpatient Medication Errors, Angela Nyangore Migowa

Master of Medicine in Paediatrics and Child Health

Background: Medication errors have potential to cause harm and death; especially children who are three times more vulnerable than adults. Risk of medication errors is higher in out- patient settings due to a stressful work environment with less familiarity of individual patients. This problem in sub-Saharan Africa is however largely undetermined. A Voice Recognition System that converts verbal messages into text and stores it in a database in a retrievable format could impact on reduction of medication errors. Objectives: The primary objective was to compare medication prescription and dispensing errors in written prescriptions with those from a Voice Recognition System. …

Coronary Calcium Scoring: Are The Results Comparable To Computed Tomography Coronary Angiography For Screening Coronary Artery Disease In A South Asian Population?, Nizar Bhulan, Ali Khawaja, Asif Jafferan, Maryam Baqir, Ramin Ebrahimi, Zafar Sajjad

Section of Nephrology

Background: The need of having feasible screening tools like Coronary Calcium Scoring (CCS) and CT Coronary Artery (CTCA) for Coronary Artery Disease (CAD) has become paramount. We aimed to evaluate the accuracy of CCS in determining the degree of stenosis of coronary vessels as compared to that determined by CTCA in a South Asian population.

Methods: A retrospective study was conducted at The Aga Khan University Hospital. A total of 539 patient records were reviewed who had undergone CCS and CTCA between 2008 and 2010. Patient records were reviewed by comparing their CCS and CTCA results.

Results: About 268 out …

Dowry Practices And Their Negative Consequences From A Female Perspective In Karachi, Pakistan —A Qualitative Study, Tazeen Saeed Ali, Gunnhildur Árnadóttir, Asli Kulane

School of Nursing & Midwifery

Aim:

To assess the pattern, demand and opinion of dowry among women in urban Karachi, Pakistan and their perceived negative consequences of dowry. Setting: Pakistan is a low income country, predominantly Muslim, with around 190 million inhabitants. Karachi is the biggest city with roughly 13 million inhabitants.

Method:

Qualitative study, using content analysis of five focus group discussions with women. Results: The theme “Dowry practices and their consequences” emerged, along with five categories and 14 subcategories, describing the “burden of dowry”, “dowry in society”, “dowry problems created by parents-in-law”, “negative consequences of dowry practice” and “good intentions”.

Conclusion:

Problems due …

Parents’ Role In Prevention Of Childhood Obesity, Shireen Shehzad

School of Nursing & Midwifery

No abstract provided.

Evaluation Of Chronic Liver Disease: Does Ultrasound Scoring Criteria Help?, Shaista Afzal Saeed, Imrana Masroor

Department of Radiology

Abstract

Noninvasive approaches for assessment of liver histology include routine laboratory tests and radiological evaluation. The purpose of our study was to determine the utility of a simplified scoring system based on routinely evaluated ultrasound features for the evaluation of chronic liver disease and correlate it with the histological findings. For this cross-sectional analytical study the data was collected prospectively by nonprobability purposive sampling technique. The ultrasound variables/parameters and their assigned scoring system that was a modified version adopted from published literature were evaluated. Sensitivity, specificity, positive and negative predictive values of the liver morphological score and combined score of …

Effect Of Mobile Phone Short Message Service On Adherence Rates To Antihypertensives At The Family Medicine Clinic, Barbara Karau

Master of Medicine in Internal Medicine

Background: Systemic arterial hypertension is the main modifiable risk factor for development of cardiovascular disease, which is the number one cause of death in high income countries and is increasingly becoming a cause of concern in Sub-Saharan Africa (1). Awareness, management and overall control of hypertension in Sub-Saharan Africa is poor (2,3). Poor control stems from various causes; one being patient non-adherence with medication, a factor amenable to modification. The use of mobile health for behavioural change from low resource settings is gaining widespread use in management of communicable diseases (4,6). Mobile phone has the potential to significantly influence patients …

Hepatic Artery Pseudoaneurysm Mimicking Mirizzi Syndrome, Zahid Anwar, Raza Sayani, Darakshan Kanwal, Mohammed Ali, Mohammed Anwar Saeed

Department of Radiology

Acute cholecystitis leading to development of a pseudoaneurysm of the hepatic artery is a very rare complication; however, a pseudoaneurysm resulting in gallbladder neck compression with dilatation of intrahepatic duct giving a Mirizzi syndrome like presentation is virtually unreported to the best of our knowledge. We report a case of a 60 years male patient who presented in emergency department with right hypochondrial pain and mild jaundice. Initial diagnosis of hepatic artery pseudoaneurysm causing compression of neck of gallbladder and common bile duct was made on ultrasound examination. This was resulting in gross distention of gallbladder and mild dilatation of …

Recumbent Syncope Mimicking Nocturnal Seizures, Maria Siddiqi, S. Nizam Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

A fifty seven year old man presented to the emergency at the University hospital with a 3 month history of episodes of arousals from sleep with groaning and deviation of head to his right side. These were followed by a period of “confusion” that lasted for a “couple of minutes”. He had a witnessed “convulsion” in the hospital during this last visit and was loaded with one gram of phenytoin. A computed tomography (CT) scan of the head three months ago was reported as normal. Neurology was consulted for further investigations and long-term management

An Unusual Presentation Of Neurononopathic Gauchers Disease., Prem Chand, Shahnaz Ibrahim, Bushra Habib, Farida Jan

Pakistan Journal of Neurological Sciences (PJNS)

A six years old male child presented with tremor, ataxia, speech apraxia, supranuclear gaze palsy and hepatosplenomegaly. There was no history of seizures and psycho-cognitive abnormalities. The clinical and bone marrow findings were consistent with Gaucher's disease type 3.

KEY WORDS: Gauchers disease, Enzyme replacement therapy, Gene therapy, Bone marrow transplant.

Dementia In Pakistan: National Guidelines For Clinicians, Arsalan Ahmad, Khurram Owais, Maimoona Siddiqui, Kayser Mamun, Faiza Rao, Abdul Wahab Yousufzai

Pakistan Journal of Neurological Sciences (PJNS)

Dementia refers to a range of disorders characterized by declining memory, multiple cognitive deficits and eventual mortality due to progressive and irreversible brain damage¹. Disease entities comprising dementia characteristically affect mainly the geriatric population. Together, they constitute a major component of global disease burden in general and geriatric disease burden in particular². In 2005, it was estimated that 24.3 million people in the world were living with dementia; 4.6 million cases have been added each year ever since³. Overall, dementia contributes 11.3% of years of life lived with disability, making it a major contributor …

Dementia – The Next Impending Epidemic Knocking On Our Door – Are We Ready?, Ismail A. Khatri, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Late-onset dementias are life-shortening diseases of largely unknown cause. Predictions of the number of persons living with dementia by 2050 have spawned alarming headlines forecasting a “tsunami” of dementia cases that will overwhelm families and health care systems and impose unbearable economic burdens [Whalley].

Varied Presentation Of Celiac Disease In Pakistani Adults, Zaigham Abbas, Sajjad Raza, Javed Yakoob, Shahab Abid, Saeed Hamid, Hasnain Shah, Wasim Jafri

Section of Gastroenterology

he objective of this retrospective study was to evaluate presentation of celiac disease in adults. It included 77 patients, 41 (53.2%) males with median age 26 years and median body mass index of 18 (16 â�� 22) kg/m2. Typical presentation with gastrointestinal symptoms was seen in 76.6%. Atypical presentation with extra intestinal complaints in 7.8% and silent presentation in 15.6%. Major symptoms were diarrhea in 64.9%, weight loss 36.4%, abdominal pain 35.1%, vomiting 32.5%, pallor 24.7%, and weakness 13%. Iron deficiency was documented in 20.8%, B12 deficiency in 9.1%, folic acid deficiency in 6.5% and vitamin D deficiency in 10.4%. …

Changing Trends Of Hepatitis B Seromarkers Amongst Pakistani Population: A Laboratory-Based Review, Afia Zafar, Erum Khan, Muhammad Shoaib Khan, Bushra Moiz, Wasim Jafri

Section of Gastroenterology

Objective:

To study the changing trends of hepatitis B markers tested at Aga Khan University Hospital clinical laboratory according to the internationally recognised classification of hepatitis B profile.

Methods:

The retrospective study involved analysis of laboratory records of hepatitis B profiles of all patients collected from January 2001 to December 2008 at the Aga Khan University Hospital\'s clinical laboratory. Patients with complete profile tested were categorised according to the Centre for Diseases Control classification of hepatitis B profile. SPSS 16 was used for statistical analysis. R

Results:

A total of 185,825 patients had serological markers for hepatitis B tested. Mean-age …

Mri Guided Functional Neurosurgery At L.G.H: The Beginning Of A New Era, Khalid Mahmood

Pakistan Journal of Neurological Sciences (PJNS)

Lahore General Hospital has the credit of being pioneer of “Functional Neurosurgery in Pakistan” when Prof. Bashir Ahmad started the Department of Neurosurgery at LGH in 1966. Prof. BashirAhmad, Prof. Nazir Ahmad and Late Prof. Javed MajidMian had done lot of work and performedThalamotomiesfor Parkinsoniantremors

Needle Stick Injuries--Risk And Preventive Factors: A Study Among Health Care Workers In Tertiary Care Hospitals In Pakistan., Asad Ali Khan Afridi, Ameet Kumar, Raza Sayani

Community Health Sciences

BACKGROUND:

Health care workers (HCWs) are at substantial risk of acquiring blood borne infections such as HIV, Hepatitis-B and Hepatitis-C through needle stick injuries (NSIs). This study aimed to assess the proportion of NSIs and their associated factors among HCWs and also to identify the areas in which preventive efforts might be directed to protect against this occupational hazard.

METHODOLOGY:

A cross-sectional study was conducted in two tertiary care hospitals of Pakistan representing both private and public health sector. A total of 497 HCWs (doctors and nurses) were interviewed using a structured questionnaire. Data was collected from January to May …

Professionalism In Medical Students At A Private Medical College In Karachi, Pakistan, Zain-Ul- Abedeen Sobani, Muhammad Masaud Mohyuddin, Syed Abdul Saeed, Fahd Farooq, Kanza Noor Qaiser, Faiz Gani, Nida Shahab Bham, Ahmed Raheem, Mohammad Asim Beg, Vikram Mehraj, Hasanat Sharif, Mughis Sheerani, Rukhsana Wamiq Zuberi

Department for Educational Development

Objective: To determine levels of professionalism in undergraduate medical students at a private medical college and assess how changes emerge during their training.

Methods: The study was conducted at Aga Khan University, a tertiary care teaching hospital, during November and December 2011. Freshmen, Year 3 and Year 5 students were requested to fill out a questionnaire. It was designed to assess the participants\' levels of professionalism and how they perceived the professional environment around them by incorporating previously described scales. The questionnaire was re-validated on a random sample of practising clinicians at the same hospital. SPSS 17 was used for …

Hip Fracture Surgery: Does Type Of Anesthesia Matter?, Rizwan Haroon Rashid, Adil Aijaz Shah, Amarah Shakoor, Shahryar Noordin

Department of Surgery Docs

Background: Hip fracture surgery is a common procedure, and the geriatric population with its multiple comorbid conditions is at most at risk of developing anesthesia-related complications. Data on the impact of type anesthesia on postoperative morbidity and mortality is limited.The effects of regional and general anesthesia on postoperative outcomes need to be clearly elucidated.

Methods: In this study, all patients who underwent dynamic hip screw (DHS) fixation for intertrochanteric fractures, between January 2005 and December 2010, at the Aga Khan University Hospital, were included. Patients were divided into two groups; group A included those patients who received general anesthesia, and …

Hiv-1 Autologous Antibody Neutralization Associates With Mother To Child Transmission, Elly Baan, Anthony De Ronde, Martijn Stax, Rogier W. Sanders, Stanley Luchters, Joseph Vyankandondera, Joep M. Lange, Georgios Pollakis, William A. Paxton

Population Health, East Africa

The HIV-1 characteristics associated with mother to child transmission (MTCT) are still poorly understood and if known would indicate where intervention strategies should be targeted. In contrast to horizontally infected individuals, exposed infants possess inherited antibodies (Abs) from their mother with the potential to protect against infection. We investigated the HIV-1 gp160 envelope proteins from seven transmitting mothers (TM) whose children were infected either during gestation or soon after delivery and from four non-transmitting mothers (NTM) with similar viral loads and CD4 counts. Using pseudo-typed viruses we tested gp160 envelope glycoproteins for TZM-bl infectivity, CD4 and CCR5 interactions, DC-SIGN capture …

Benign Granulomatous Polyp Obstructing The Bronchus., Saulat H. Fatimi, Ali Khawaja, Ranish Deedar-Ali-Khawaja, Mehar Hoda, Salima Ahmed Bhimani

Department of Surgery Docs

Abstract

Inflammatory endobronchial polyps are rarely encountered. We report a case of a 14 years old girl with a benign granulomatous polyp originating in the bronchus. Computed tomography scan showed an intraluminal soft tissue opacity while fiberoptic bronchoscopy revealed a large soft tissue mass completely occluding the left lower lobe. Rigid bronchoscopy under general anaesthesia identified a fleshy mass in the left main stem bronchus which was excised via bronchoscopy. The histopathology showed benign polyp with non-specific inflammation. The patient's symptoms improved subsequently and no recurrence was reported till two years of follow-up

Abdominal Tuberculosis With Massive Jejunal Haemorrhage, Abdul Rehman Alvi, Tanveer Ui Haq, Amyn Pardhan

Department of Surgery Docs

ABSTRACT Jejunum is a rare site of involvement in intestinal tuberculosis (TB) and massive lower gastrointestinal haemorrhage is an even rare reported condition. The authors report a 15-year-old female student, who presented with fever, anaemia, hypoalbunemia and developed massive lower gastrointestinal haemorrhage during hospital stay. The diagnosis of abdominal TB was established on tissue biopsy; tissue culture was positive for Mycobacterium TB. Optimal outcome was achieved with aggressive resuscitation, repeated mesenteric angio-embolization and anti-tuberculosis chemotherapy

Cochlear Implant In A Patient With Mondini's Deformity Of The Cochlea: Pilot Patient In Pakistan, Sadaf Qadeer Ahmed, Montasir Junaid, Zainul Abedeen Sobani, N Naila, Mohammad Sohail Awan

Department of Surgery Docs

Abstract

Autosomal-recessive genes account for about 80% of the patients of non-syndromic deafness, and a major portion of those lead to cochlear pathology. Given the strong cultural practice of consanguineous marriages and the lack of awareness regarding screening modalities, a high prevalence of hereditary pre-lingual deafness is seen in Pakistan. Considering the situation, cochlear implant surgery was introduced by Aga Khan University Hospital (AKUH), Karachi, Pakistan, in 2003. Recently we decided to expand the profile and services available and conducted the first ever cochlear implant on an anatomically-challenged cochlea. The case report relates to the experience of our pilot patient …

Frequency And Predisposing Factors Of Pharyngocutaneous Fistula After Total Laryngectomy, Asif Ali Arain, Mubasher Ikram, Shabbir Akhtar, Muhammad Shaheryar Ahmed Rajput, Mohammad Adeel, Moaz Maqbool Choudhary

Section of Otolaryngology, Head & Neck Surgery

Objective

The objective of our study was to determine the frequency and predisposing factors of pharyngocutaneous fistula in postlaryngectomy patients.

Materials and methods

Charts of those patients who were treated with total laryngectomy for laryngeal carcinoma in our department from 2000 to 2008 were reviewed. Total 77 patients were included in the study. The variables studied for the development of pharyngocutaneous fistula (PCF) after total laryngectomy were: age and gender, diabetes mellitus, post-operative hemoglobin, ischemic heart disease, chronic obstructive pulmonary disease, tumor characteristics including tumor site, stage, differentiation and extension into pyriform sinus, pre-operative radiotherapy, pre-operative chemotherapy, pre-operative tracheostomy and …

Toluidine Blue: Yet Another Low Cost Method For Screening Oral Cavity Tumour Margins In Third World Countries, Montasir Junaid, Anwar Suhail, Beena Umer, Mubasher Ikram, Zain-Ul-Abedeen Sobani, Naeem Sultan Ali, Ahmad Nawaz

Section of Otolaryngology, Head & Neck Surgery

Objective: To use toluidine blue intra-operatively to identify tumour involved margins after the removal of oral cavity squamous cell carcinoma, and to compare the findings with those of final histopathology.
Methods: The study was conducted at the Aga Khan University Hospital from December 1, 2009, to March 14, 2010, and comprised 56 consecutive patients with biopsy-proven squamous cell carcinoma of oral cavity regardless of grade and stage of tumour. Intra-operatively toluidine blue was used on the resected tumour margins and the staining patterns were assessed. Results were then compared with the final histopathology report.
Results: A total of 11(19.64%) margins …

Unintentional Childhood Poisoning, Epidemiology And Strategies For The Prevention And Policy Change In Pakistan, Omer Ul Hassan, Hasana Qadri, Umer Mir, Bilal Ahmed

Department of Medicine

Poisoning is the fifth leading cause of unintentional injuries among young children. Agents most commonly ingested by young children include medicines, cleaning substances, hydrocarbons, pesticides and cosmetics. Children with less educated fathers, living in more crowded conditions and from lower income families are more predisposed to unintentional poisoning. Unsafe storage of medicines, chemicals and other hazardous substances is one of the leading reasons for childhood poisoning. Knowledge of parents and caregivers about prevention of poisoning may be the basis to prevent subsequent injuries. This paper is a review of the epidemiology of unintentional poisonings among young children (less than five …

Wilson's Disease: Experience At A Tertiary Care Hospital., Om Parkash, Adil Ayub, Wasim Jafri, Syed H Shah, Saeed Hamid

Department of Medicine

Wilson's disease (WD) is a rare autosomal recessive disorder of copper metabolism. Data regarding WD is not available from Pakistan. A cross-sectional study was conducted at The Aga Khan University Hospital, Karachi, and all patients admitted with primary and secondary diagnosis of Wilson's disease were added. A total of 47 patients were seen; 68% (n = 32) were male. The mean age was 26.6 ± 9.97 years. Most of the patients presented with hepatic, (n = 22, 46.8%), neurological, (n = 17, 36.2%) and psychiatric (n = 8, 17%) symptoms. Mean ceruloplasmin level was 0.17 ± 0.13 g/dl; it was < 0.25 g/dl in 39 (86.6%) patients. Serum copper (Cu) was reduced in 32 (68.1%) patients and 24-hr-urinary Cu was raised in 22 (47.6%) patients. Slit lamp examination for Kayser-Fleischer (KF) rings was done on 15 (31.9%) patients and 9 (60%) of them had KF rings. Mean serum aspartate transaminase (AST) / alanine transaminases (ALT) ratio was 1.92 and median alkaline phosphatase / total bilirubin ratio was 79.30 (IQR 35.05; 166.50).

Self-Perceived Health Among School Going Adolescents In Pakistan: Influence Of Individual, Parental And Life Style Factors?, Asad Ali Khan Afridi, Komal Motwani, Saleem Khawaja, Adeel Khoja, Zafar Fatmi, Iqbal Azam Syed, Muhammad Masood Kadir

Department of Medicine

BACKGROUND: Adolescents are at substantial risk of acquiring behaviors which might influence their health status. This study was aimed to assess the proportion of school going adolescents (both males and females) with poor self-perceived health and its associated factors.

METHODOLOGY: A cross-sectional study was conducted in three major cities of Pakistan i.e. Karachi, Lahore and Quetta. From each city, six (6) secondary schools were randomly selected (3 public and 3 private). Pre-tested, self-administered questionnaire was distributed to students. Binary logistic regression analysis was conducted to determine independent factors associated with poor self-perceived health.

RESULTS: Approximately 29% adolescents (119/414) reported poor …

Clear: The Intraventricular Haemorrhage Thrombolysis Trial., Anjum Akhtar, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Research Fatigue Among Injecting Drug Users In Karachi, Pakistan, Aysha Zahidie, Arshad Altaf, Adeel Ahsan, Tanzil Jamali

Community Health Sciences

Background

Karachi is the largest metropolis of Pakistan and its economic hub attracting domestic migrants for economic opportunities. It is also the epicenter of HIV epidemic in the country. Since 2004, one pilot study and four behavioral and biological surveillance rounds have been conducted in Karachi. In addition many student research projects have also focused on key risk groups including injection drug users (IDUs). As a result of this extra ordinary exposure of same kind of questions, IDUs know how to respond to high value questions related to sharing of needles or unsafe sexual practices. The purpose of the study …

Corrigendum For “Acute Aortic Valve Rupture From Infective Endocarditis”, Julia Ansari, Gurkaran Singh Garcha, Henry Huang, Faisal G. Bakaeen, Salim S. Virani, Hani Jneid

Office of the Provost

No abstract provided.

Progressive Hair Coil Strangulation Of Penis, Shahzad Ms, Mohammed Shamim

Section of General Surgery

Strangulation of penis by hair strands is a well-known, but uncommon clinical entity. We report two cases occurring in circumcised boys causing progressive painless disfigurement of penis with strands of hair coiled around the penile shafts, strangulating the penis. Primary repair was done in one case and delayed primary repair was done in the other, both with satisfactory results.