Medicine and Health Sciences Commons^™

Psychiatry, Syed Ahmer

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neuroradiology, Zafar Sajjad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Abstracts 13th Annual Meeting Pakistan Society For Neurology March 23-24, 2007 Lahore, 13th Annual Meeting Pakistan Society For Neurology

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Analysis Of Amniotic Fluid Specimens For Common Chromosome Disorders Using Interphase Fluorescence In Situ Hybridization, Tariq Moatter, Zahida Khilji, Farzana Murad, Shama Munim

Department of Pathology and Laboratory Medicine

Objective: The aim of the study was to examine the usage of multi colour FISH technology as an adjunct to conventional cytogenetics for the prenatal diagnosis of aneuploidy in interphase nuclei from high risk pregnancies.
Methods: Amniotic fluid samples were collected for interphase FISH analysis using DNA probes for chromosomes 13, 18, 21, X and Y. All the probes were directly labeled with fluorescent molecules. Fluorescent signals were observed under a microscope. A minimum of 100 nuclei with defined hybridization signals were counted for each probe.
Results: Seventy-eight amniotic fluid samples were received for FISH analysis. The average age of …

Postoperative Sore Throat After Elective Surgical Procedures, Aliya Ahmed, Shemaila Abbasi, Hasham Bin Ghafoor, Muhammad Ishaq

Department of Anaesthesia

Postoperative sore throat is a common complication of anaesthesia and can lead to dissatisfaction after surgery. Many factors can contribute to postoperative sore throat and the incidence varies with the method of airway management Methods: In this prospective observational study elective gynaecological and general surgical patients were interviewed 24 hours postoperatively to determine the presence of sore throat. Information collected included demographic data, surgical procedure, duration of surgery, airway device used and position of patient during surgery. This study was done over a period of 3 months. Results: 312 patients were interviewed. 81(26%) patients suffered with sore throat postoperatively. 28% …

Cost Effectiveness Of Screening Of All Newly Recruited Employees For Diabetes At A Tertiary Care Hospital, Niloufer Sultan Ali, Ali Khan Khuwaja

Department of Anaesthesia

Diabetes Mellitus is a disease which remains asymptomatic for long duration of time and usually diagnosed either when gets complicated or by routine or opportunistic screening. The practice of universal screening is not recommended, particularly in constraint resources . However, we embarked with a study to assess the yield of recommended screening for Type 2 diabetes in all the newly recruited employees at a tertiary care hospital in Karachi. Methods: All the information required for this study was collected from medical records of all newly recruited employees of nursing services department of a tertiary care hospital of Karachi, Pakistan, over …

Acute Puerperal Uterine Inversion: Case Report, Evan Sequeira, Y. Patel

Obstetrics and Gynaecology, East Africa

Acute puerperal uterine inversion is a rare but potentially fatal obstetric emergency in which the uterine fundus collapses into the uterine cavity. Maternal mortality is high unless the condition is recognised and quickly corrected. The duration of time elapsed from moment of diagnosis to that of correction, along with rapid resuscitation measures are of utmost importance in its prognosis. A recent case managed successfully is described followed by a short review of the literature.

Pharmacy Newsletter : April 2007, Pharmacy Department

Department of Pharmacy Archives

Content:

• Calcium and Vitamin D intake in Women
• Overview of managing intractable hiccups
• Facts about therapeutic drug monitoring
• Drug interaction update

Quadruple Therapy Using Esomeprazole, Furazolidone, Amoxicillin-Clavulanate, And Colloidal Bismuth Subcitrate In Patients Who Failed To Eradicate H-Pylori With Triple Therapy, Z Abbas, Javed Yakoob, Shahab Abid, Wasim Jafri

Section of Gastroenterology

No abstract provided.

Granular Cell Tumors Of The Urinary Bladder, Farhat Abbas, Amanullah Memon, Tanya Siddiqi, Naila Kayani Naila Kayani, Nazim Ali Ahmad

Department of Surgery Docs

Abstract

BACKGROUND:

Granular cell tumors (GCTs) are extremely rare lesions of the urinary bladder with only nine cases being reported in world literature of which one was malignant. Generally believed to be of neural origin based on histochemical, immunohistochemical, and ultrastructural studies; they mostly follow a clinically benign course but are commonly mistaken for malignant tumors since they are solid looking, ulcerated tumors with ill-defined margins.

MATERIALS AND METHODS:

We herein report two cases of GCTs, one benign and one malignant, presenting with gross hematuria in a 14- and a 47-year-old female, respectively.

RESULTS:

Histopathology revealed characteristic GCTs with positive …

Collecting Duct Carcinoma: An Incidental Finding In A Non Functional Kidney Secondary To Nephrolithiasis, Asim Qureshi

Department of Pathology and Laboratory Medicine

A nephrectomy specimen was sent to the laboratory for end stage renal disease secondary to nephrolithiasis. Initial sections incidentally revealed a tumor infiltrating the normal renal tissue. Further workup including cytochemical and immuno-histochemical stains confirmed it to be collecting duct carcinoma.

Postoperative Wound Leak And Anterior Chamber Reaction In Patients Undergoing Phacoemulsification Cataract Surgery With Sutured And Sutureless Corneal Incisions, Tanveer Anjum Chaudhry, Muhammad Shahzad Shamim, Sameer Khan, Khabir Ahmad

Department of Surgery Docs

Purpose: To compare the rates of significant post operative wound leak and anterior chamber (AC) reaction in patients undergoing phacoemulsification cataract surgery with sutured and sutureless corneal incisions. Material and Methods: All eyes scheduled to have phacoemulsification surgery by two surgeons at two centers were selected. The first group of eyes underwent phacoemulsification surgery with 3.25 mm superior and superior-temporal clear corneal incisions. The incision was sutured using a single 10/0 nylon suture. The second group of eyes underwent an identical surgery, but the incision was not sutured. Patients were followed up at 24 hours, and 1 week and evaluated …

Perioperative Management Of Pheochromocytoma: Anaesthetic Implications, Aliya Ahmed

Department of Anaesthesia

Pheochromocytoma is a catecholamine producing tumour that can cause severe hypertension and other systemic disturbances. The perioperative management of pheochromocytoma remains a complicated anaesthesia challenge requiring intensive preoperative preparation and vigilant intraoperative and postoperative care. In this article the perioperative management of pheochromocytoma is reviewed by first summarizing its pathophysiology, clinical aspects and diagnosis, then highlighting the preoperative optimization of the patient and finally describing the intraoperative and postoperative anaesthetic management in the light of the current information.

Endoscopic Management Of Biliary Leaks After Open And Laparoscopic Cholecystectomy, Mohammad Salih, Saeed Hamid, Hasnain Ali Shah, Zaigham Abbas, Wasim Jafri

Section of Gastroenterology

Objective: To evaluate the diagnostic and therapeutic efficacy of ERCP in the management of biliary leaks.Methods: The study recruited 35 out of total 436 ERCP patients with post surgical biliary leaks, who presented to our department between January 1, 2001 and September 30, 2004. Unsuccessful ERCP and/or completely transected CBD injuries were handed over to surgery.Results: ERCP was successful in 33 (94%) patients. Of these 25 (75%) had cystic stump leaks, 3 (9%) had transected CBD, 2 (6%) had leakage from gall bladder (GB) bed, 2 (6%) had persistently draining T-tube with retained CBD stones and one (3%) patient had …

Bleomycin Induced Pneumonitis: A Case Successfully Managed With High-Dose Steroids, Shahid Javed Husain, Ali Bin Sarwar Zubairi, Muhammad Irfan

Section of Pulmonary & Critical Care

No abstract provided.

Total Parotidectomy Under Local Anesthesia: A Novel Technique, Kamran Shahid, Bilal Karim Siddiqui, Muhammad Hammad Tahir, Salman Bin Ayub, Ghulam Murtaza Memon, Adnan Yousuf, Arif Hussain, Osmani, Abdul Karim Siddiqui

Department of Biological & Biomedical Sciences

Parotidectomy is a common procedure usually done for a parotid mass necessitating a histological diagnosis. Operation is normally performed under General anesthesia with a nerve stimulator to facilitate facial nerve stimulation. We describe a new technique with reports of three cases, making total parotidectomy under local anesthesia possible. The ascending cervical branch of cervical plexus and the auriculotemporal nerve were anesthetized by bupivacaine 0.25% (2mg/kg) and lignocaine with adrenaline 7 mg/kg. Effective onset of anesthesia was within 15-25 minutes and the operations lasted between 2-3 hours without any complications. This offers advantage in high-risk patients where general anesthesia is contraindicated. …

Revolution Next -The Multidetector Ct, Saba Sohail

Department of Radiology

No abstract provided.

Characteristics And Outcome Of Patients With Drug Overdose At A Tertiary Care Hospital In Karachi., Muhammad Shahid, Junaid Patel, Haider Naqvi Aga Khan University, Muhammad Shoaib Khan

Department of Emergency Medicine

No abstract provided.

Anesthetic Deaths In A Developing Country, Mueenullah Khan, Fauzia A. Khan

Department of Anaesthesia

It is important to ascertain the contribution of anesthesia to perioperative mortality in order to enable improvement in the safety and quality of care. Scanty literature regarding anesthetic mortality from developing countries is available. We present data regarding anesthesia related mortality in a university hospital in a developing country. We reviewed all patient deaths occurring between 1992-2003 occurring within 24 hours of anesthesia, as part of departmental quality assurance activity. The aim of study was to identify any contributing factors associated with mortality, and to compare our data with similar studies from developed and developing countries. 111,289 cases were handled …

Mediastinal Parathyroid Adenoma Causing Primary Hyperparathyroidism, Farhat Abbas, Syed Raziuddin Biyabani, Amanullah Memon, Jamsheer Jehangir Talati

Section of Urology

An ectopically placed parathyroid adenoma in the anterior mediastinum is a rare cause of persistent or recurrent primary hyperparathyroidism (PHPT) and is recognized as an important cause of failed primary neck exploration. We encountered 3 such cases amongst 70 surgically treated patients with PHPT (4.3%) over a 20-year period. In 2 cases, the offending adenoma could be removed at first exploration whereas in the 3rd case, it was successfully removed with mediastinal exploration after 2 failed neck explorations. In established cases of PHPT with equivocal preoperative localization studies or negative neck explorations, an ectopically placed parathyroid adenoma should be considered …

Clinical, Biochemical And Ultrasonographic Features Of Infertile Women With Polycystic Ovarian Syndrome, Fauzia Haq, Omar Aftab, Javed Rizvi

Department of Obstetrics & Gynaecology

Objective: To evaluate and compare the clinical, biochemical and ultrasonic features of infertile women with PCOS from the two infertility centers of Karachi, The Aga Khan University Hospital and Concept Fertility Centre.
Study Design: Cross-sectional, analytical study. Place and Duration of Study: The Aga Khan University Hospital, and Concept Fertility Centre, Karachi, Pakistan, from January 2003 till December 2004.
Patients and Methods: Patients attending the Infertility Clinics of Aga Khan University Hospital, Karachi and Concept Fertility Centre, Karachi, were evaluated for their clinical features. Complete biochemical evaluation was performed by day 2 FSH, LH, serum prolactin, serum testosterone and fasting …

Family Systems: Perceptions Of Elderly Patients And Their Attendents Presenting At A University Hospital In Karachi, Pakistan, Ahmed Itrat, Ather Mohammed Taqui, Fahd Qazi, Waris Qidwai

Department of Family Medicine

Objective:

To know the present status of family systems in Pakistan, changes they are undergoing and implications of such trends on health of the elderly population.

Methods:

A cross-sectional study was carried out at the out-patient clinics, AgaKhan University Hospital, using convenience sampling method. Verbal informed consent was taken from the participants. The questions included demographic profile, satisfaction with current family system, opinions about changing trends of family systems, and their implications on health. Analysis was done using SPSS 13.0.

Results:

Four hundred subjects aged 65 and above were interviewed, out of which 226 (56.5%) were living in the …

An Unusual Abdominal Mass: Case Report, H. Saidi, U. Mohammed, M. Machoki

General Surgery, East Africa

The causes of intra-abdominal masses associated with chronic abdominal pain range from the benign to malignant; common to bizarre and some raise major medical legal issues. We present a case of a 40-year old African lady who presented with chronic right-sided abdominal pain with an associated mass on the right mid-abdomen. She had had a Caesarian section one year prior to presentation. Antecedent history of surgery and typical imaging features enabled a preoperative diagnosis of abdominal mass secondary to retained surgical gauze.The case illustrates the fallibility of the men and women in the operating theatres and the vital role of …

Tramadol Versus Nalbuphine In Total Intravenous Anaesthesia For Dilatation And Evacuation, Khalid Maudood Siddiqui, Ursula Chohan

Department of Anaesthesia

Objective: To compare the results of Tramadol with Nalbuphine for dilatation and evacuation with total intravenous anaesthesia technique.Methods: A total of 70 patients (35 in each group) were included in this prospective, double blind randomized study. Intravenous tramadol 1.5 mg/kg and nalbuphine 0.1 mg/kg were compared in total intravenous anaesthesia (TIVA) using a propofol infusion in patients undergoing dilatation and evacuation (D and E). Changes in haemodynamic variables greater than 20% from the base line values were noted.Results: There was no difference found in haemodynamic parameters. There was statistically significant difference found (p < 0.05) in postoperative recovery between the two groups.CONCLUSION: Quality of analgesia was better in nalbuphine group but both drugs provide suitable analgesic supplementation to TIVA.

Pakistani Physicians And The Repatriation Equation, Saad Shafqat, Anita K. M. Zaidi

Section of Neurology

In Pakistan, students who are accepted into medical school are congratulated — only half-jokingly — on three counts: that they will become doctors, that they will become certified by the American Board of Medical Specialties, and that they will soon be living in the United States.

Bleomycin Induced Pneumonitis: A Case Successfully Managed With High-Dose Steroids, Shahid Javed Husain, Ali Bin Sarwar Zubairi, Muhammad Irfan

Department of Medicine

No abstract provided.

Prevalence Of Gastric Varices And Results Of Sclerotherapy With N-Butyl 2 Cyanoacrylate For Controlling Acute Gastric Variceal Bleeding., Mumtaz J Khan, Shahid Majid,, Syed H Shah, Kashif Hameed, Ashfaq Ahmed, Saeed Hamid, Wasim Jafri

Department of Medicine

Aim: To study the prevalence, predictors and control of bleeding following N-butyl 2 cyanoacrylate (NBC) sclerotherapy of gastric varix (GV).

Methods: We analyzed case records of 1436 patients with portal hypertension, who underwent endoscopy during the past five years for variceal screening or upper gastrointestinal (GI) bleeding. Fifty patients with bleeding GV underwent sclerotherapy with a mean of 2 mL NBC for control of bleeding. Outcome parameters were primary hemostasis (bleeding control within the first 48 h), recurrent bleeding (after 48 h of esophagogastro-duodenoscopy) and in-hospital mortality were analyzed.

Results: The prevalence of GV in patients with portal hypertension was …

Non-Cardiac Surgery In Patients With Prosthetic Heart Valves: A 12 Years Experience, Raja Parvez Akhtar, Abdul Rehman Abid, Hasnain Zafar, Syed Javed Raza Gardezi, Abdul Waheed, Jawad Sajid Khan

Section of General Surgery

Objective: To study patients with mechanical heart valves undergoing non-cardiac surgery and their anticoagulation management during these procedures.
Study Design: It was a cohort study.
Place and Duration of Study : The study was conducted at the Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore and Department of Surgery, Services Institute of Medical Sciences, Lahore, from September 1994 to June 2006.
Patients and Methods: Patients with mechanical heart valves undergoing non-cardiac surgical operation during this period, were included. Their anticoagulation was monitored and anticoagulation related complications were recorded.
Results: In this study, 507 consecutive patients with a mechanical …

Three Pregnancies With Mechanical Heart Valve And No Follow-Up In 10 Years, Raja Parvez Akhtar, Abdul Rehman Abid, Hasnain Zafar

Section of General Surgery

Anticoagulation and proper INR (International Normalized Ratio) monitoring is essential for patients having mechanical heart valves; it is vital in these patients in order to prevent lethal complications such as valve thrombosis and systemic embolism. In pregnancy, it becomes even more important as pregnancy itself is a hypercoagulable state. This report describes a female patient having undergone mitral valve replacement with a Starr Edward metallic prosthesis. She came back to the operating surgeon after 10 years of valve replacement with a history of three uneventful healthy deliveries and no follow-up and INR monitoring during this period.

Spectrum Of Intracranial Pathology: Tumors Versus Infections At A Tertiary Care Hospital, Muhib Alam Khan, Sukaina Aijazali Panju, Ather Enam

Section of Neurosurgery

Introduction: Aga Khan University Hospital Neurosurgery Department has evolved into a high-volume centre for treatment of neurosurgical diseases. We aimed to compare the relative outcomes of intracranial tumors and CNS infections seen at our facility.
Methods: Hospital records of patients admitted under the neurosurgery service between 1994-2003 were evaluated. Cases with a principal diagnosis of an intracranial lesion were identified for further study. Demographic, clinical,and surgical variables were extracted from the medical record. Length of hospital stay, ICU utilization, and in-hospital mortality were the primary outcome indicators. Data were analyzed through descriptive statistics and comparisons of meansand proportions. …