Medicine and Health Sciences Commons^™

Persistent Hyperplastic Primary Vitreous, V Bari, M Murad

Department of Radiology

No abstract provided.

Critical Appraisal Of Endometriosis Management For Pain And Subfertility, N F. Zuberi, J H. Rizvi

Department of Obstetrics & Gynaecology

Objective: To critically appraise current best available management of pain and subfertility ascribable to endometriosis.
Methods: Medline and specialist computer databases were searched along with reference lists of known reviews and primary articles to identify cited articles not captured by electronic searches. We included all studies pertaining to treatment of pain and subfertility ascribable to endometriosis.
Discussion: Medical and surgical management options for pain and subfertility are presented as Evidence-based inquiries for critically appraised topics. Each problem is presented as an answerable question followed by assessment of literature search for level of evidence. This is followed by critical appraisal of …

Association Of Iron Deficiency Anaemia In Children Of 1-2 Years Of Age With Low Birth Weight, Recurrent Diarrhoea Or Recurrent Respiratory Tract Infection - A Myth Or Fact?, Niloufer Sultan Ali, Rukhsana Wamiq Zuberi

Department for Educational Development

No abstract provided.

Incidental Diagnosis Of Diseases On Un-Enhanced Helical Computed Tomography Performed For Ureteric Colic, Nazim A. Ahmad, M Hammad Ather, Jeffrey Rees

Section of Urology

Background: Patients presenting in the emergency room with flank pain suggestive of acute ureteric colic may have alternative underlying conditions mimicking ureteric stones. An early diagnosis and appropriate treatment for other causes of flank pain is important. The majority of centers around the world are increasingly using un-enhanced helical CT (UHCT) for evaluation of ureteric colic. This study was conducted to determine the incidence and spectrum of significant incidental diagnoses established or suggested on UHCT performed for suspected renal/ureteric colic.Methods: Urologist and radiologist reviewed 233 consecutive UHCT, performed for suspected renal/ureteral colic along with assessment of the medical records. Radiological …

Recent Applications Of Ultrasound Technology, Muhammad Imran Omar, Saba Sohail

Department of Radiology

No abstract provided.

Male Breast Cancer, N Kayani, M N. Khan, Y Bhurgri, S Gill, M I. Nasir, T Siddiqui

Department of Pathology and Laboratory Medicine

Objective: To review cases of male breast cancer.
Settings: Histopathology Section, Department of Pathology, The Aga Khan University, Karachi.
Method: Fifty one cases of male breast cancer specimens, received during a period of 10 years, routinely processed and stained with Haematoxylin and Eosin were analyzed. Special stains and Immunohistochemistry were used in difficult cases.
Results: Male breast cancer affected individuals in the sixth and seventh decades of life with a mean age of 56.2 years. Infiltrating ductal carcinoma (IDC) was the predominant type. Skin involvement was seen in 27.45% of the cases. Breast lump was the most common presenting symptom …

Breast Diseases: A Histopathological Analysis Of 3279 Cases At A Tertiary Care Center In Pakistan, M. S. Siddiqui, Naila Kayani, Shahid Pervez, S. A. Aziz, S. Muzaffar, Z. Setna, M. Israr, S. H. Hasan, M. S. Gill

Department of Pathology and Laboratory Medicine

Objective: To know the frequency of breast diseases in Pakistani females.

Methods: A retrospective analysis of 3279 breast specimens received over a period of 4 years (1 993-1996) at the department of pathology, the Aga Khan University Hospital.

Results: Out of a total of 3279 breast specimens, common breast lesions included infiltrating duct carcinoma 37%, followed by fibro adenoma 16.95%, fibrocystic change13.96%, mastitis 6.83% and duct ectasia 5.33%. Majority of the cases of infiltrating duct carcinoma were encountered in the 5th and 6th decades of life. Tumour size was 2 or >2 cms. in 93% of cases and 40% of …

Radiologic Feeding Gastrostomy Placement: Experience In 23 Patients, T U. Haq, S M F Mosharraf, B Ahmad, K Munir, J Yaqoob, U Usman

Department of Radiology

Objective: To evaluate the safety, efficacy and complications of percutaneous gastrostomy catheter placementunder flouro guidance for long-term enteral feeding.MATERIALS AND Methods: Between April 1998 to May 2002, 23 patients who had percutaneous gastrostomy catheter placement were retrospectively reviewed. Clinical indications for catheter placement included patients with neurologic disease, head and neck malignancy, and pulmonary disease patients. Placement of 12 - 14 Fr gastrostomy catheter was then accomplished with the Seldinger technique. The technical success, procedural complications were recorded.Results: Twenty seven procedures, including revisions, were performed. The success rate for catheter placement was 100%. Revision was necessary in 7 (30%) instances …

Determination Of Delay In Burn Around Time (Tat) Of Stat Tests And Its Causes: An Akuh Experience., Fareena Bilwani, Imran Siddiqui, Sarosh Vaqar

Department of Pathology and Laboratory Medicine

Abstract

Objective: To evaluate the delay and reasons of delay of turnaround time (TAT) of stat tests in the section of clinical chemistry of the clinical laboratory. Setting: Clinical Laboratory, Aga Khan University Hospital, Karachi. Patients and Methods: In our study turn around time (TAT) of stat tests were analyzed. Turn around time was specified as the time from receipt of the sample till the final verification of results (sample receipt time to result verification time). Delays were categorized into 15 minutes, 16-30 minutes, 31 to 60 minutes and >60 minutes. It was also noted as to which time of …

Effect Of Acupressure On Postoperative Nausea And Vomiting In Laparoscopic Cholecystectomy, K Samad, G Afshan, R Kamal

Department of Anaesthesia

Objective: To evaluate the effectiveness of acupressure applied at meridian P6 point for prevention of nausea and vomiting in patients undergoing laparoscopic cholecystectomy.METHODOLOGY: A randomized double blind study was performed in 50 ASA I and II patients scheduled for laparoscopic cholecystectomy. Patients were divided into two groups; control and placebo. In the control group acupressure was applied at P6 point half an hour before surgery while in the placebo group the acupressure band was tied on meridian P6 point but the plastic bead was placed on the dosum of right forearm away from meridian P6 point. Patients were assessed for …

Attitudes Of Developing World Physicians To Where Medical Research Is Performed And Reported, John Page, Richard F. Heller, Scott Kinlay, Lynette Lim, Wang Qian, Zheng Suping, Supornchai Kongpatanakul, Murtaza Akhtar, Salah Khedr, William Macharia

Paediatrics and Child Health, East Africa

Background: Little is known about the influence of the site of research or publication on the impact of the research findings on clinical practice, particularly in developing countries. The International Clinical Epidemiology Network (INCLEN) is dedicated to improving the quality of health research in the Developing World through institutional capacity building for evidence based medicine, and provided the opportunity to examine the likely impact of research location and journal location on physicians' practice in a number of the participating countries.

Methods: Physicians from secondary and tertiary hospitals in six cities located in China, Thailand, India, Egypt and Kenya were enrolled …

The Art Of Practicing Scientific Medicine, Waris Qidwai

Department of Family Medicine

No abstract provided.

Utilization Of Services Of Homeopathic Practitioners Among Patients In Karachi, Pakistan, Waris Qidwai

Department of Family Medicine

BACKGROUND: The practice of homeopathy is becoming very popular. There is a need to study and understand as to why this is happening and to raise debate on the issue.
METHODS: The study was conducted on patients, visiting the Family Practice Centre, The Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the utilization of the services of homeopathic practitioners. The ethical requirements for conducting the study were met.
RESULTS: Three hundred and eighty-seven patients were surveyed. The study population included more women then men, with average age of 32.6 years. …

Use Of Home Remedies Among Patients Presenting To Family Physicians, Waris Qidwai, Sr Alim, Rh Dhanani, S Jehangir, A Nasrullah, A Raza

Department of Family Medicine

No abstract provided.

Use Of Folk Remedies Among Patients In Karachi, Pakistan, Waris Qidwai, Sr Alim, Rh Dhanani, S Jehangir, A Nasrullah, A Raza

Department of Family Medicine

BACKGROUND: The concept that food is medicine is being practiced in certain parts of the world, with positive outcomes on health of the population. We have such practice in Pakistan but it needs to be brought in line with the available scientific evidence.
METHODS: The study was conducted on 270 patients, visiting the Family Practice Center, the Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the use of folk remedies for medicinal uses.
RESULTS: Substantial use of folk remedies for different medical conditions has been documented. The remedies included cinnamon, ginger, …

Renovascular Hypertension: Factors Affecting The Outcome Following Surgical Revascularisation, Malik Anas Rabbani, Alia Zaidi, Syed Sohail Ali, Bushra Anas, Asmooni Younus, Syed Mansoor Shah

Section of Nephrology

This study was conducted at the Aga Khan University Hospital, Karachi, Pakistan to evaluate factors that affect outcome following revascularisation in patients with renovascular hypertension. We included all the patients diagnosed to have renovascular hypertension, confirmed by renal angiography, between July 1997 and September 2000. Of the total 15 patients, nine were males and six were females. Eleven patients received venous grafts, three received polytetraflouroethyline (PTFE) grafts while one patient underwent angioplasty and stenting. All were followed-up for a period of nine months (median) with the range from 2 to 84 months. A total of 33.3% of the study patients …

Unusual Presentations Of Wegener's Granulomatosis: Pitfalls In Early Diagnosis, Syed Mansoor Ahmed Shah, Malik Anas Rabbani, Ambreen Gul, Aasim Ahmad

Section of Nephrology

Wegener's Granulomatosis (WG) is a disorder characterized by necrotizing granulomatous vasculitis that primarily affects the upper and lower respiratory tracts and the kidneys. Although the cause is unknown, there is strong evidence that this is an autoimmune disease and immunosuppressive therapy with cyclophosphamide and corticosteroids efficiently relieves the symptoms and, prevents relapses. We report on four cases of WG that presented with unusual features. The first patient presented with vague joint pain, blackish discoloration of the skin and leg ulcers. The second patient presented as fever of unknown origin and gingival hyperplasia. The third patient presented with hearing loss while …

Aids, Orphans, And Development In Sub-Saharan Africa: A Review Of The Dilemma Of Public Health And Development, Joe Lugalla

Institute for Educational Development, East Africa

HIV/AIDS is having devastating consequences on families, young children, and other vulnerable social groups. In this paper, I review the impact of HIV/AIDS on families and development in sub-Saharan Africa. I begin by showing the magnitude of the problem and the factors that have led to rapid spread of HIV/AIDS in this sub-continent. I discuss gender inequality, poverty, social inequality, and globalization, and show how these facilitate the rapid spread of the epidemic. I show how AIDS is creating a mass of orphans on the one hand, and how it is impacting development and creating new public health contradictions on …

Renal Cortical Necrosis: A Case Series Of Nine Patients & Review Of Literature, Syed Sohail Ali, Syed Zulfiqar Rizvi, Suhail Muzaffar, Aasim Ahmad, Akhtar Ali, Sheema H. Hassan

Department of Biological & Biomedical Sciences

Background: The purpose of this study is to review cases of renal cortical necrosis (RCN) which we came across during a period of five years, confirmed on needle biopsy specimens, with literature available so far.
Methods: All renal biopsy records between January 1996 to December 2001 at the Aga Khan University Hospital, Karachi, Pakistan were reviewed to identify patients with histologically proven renal cortical necrosis. Seven patients were also referred by the department of Nephrology, Lady Reading Hospital, Peshawar, Pakistan. Patients' medical records were reviewed for demographic, clinical, and follow up data.
Results: There were total of nine patients identified …

Male Condom Use In Tanzania: Results From A National Survey, Joe Lugalla, Saidi Kapinga

Institute for Educational Development, East Africa

Objective: To determine factors associated with male condom use in Tanzania.

Methods: Data from the 1996 Tanzania Demographic and Health Survey (TDHS) was used.

In this survey, a national representative sample of sexually active men (N= 1898) and women (N=7027) were interviewed to obtain information about potential predictors of sexual practices and condom use.

Results: Two hundred and ninety (4.1%) women and 288 (15.2%) men had used condoms during their last sexual encounter. Men aged 20-24 years and women aged 15-19 years reported the highest rate of condom use. In both men and women, condom use increased with increasing level …

Age, Temperature, And Parasitaemia Predict Chloroquine Treatment Failure And Anaemia In Children With Uncomplicated Plasmodium Falciparum Malaria, D.H. Hamer, W.B. Macleod, E. Addo-Yobo, C.P Duggan, B. Estrella, W.W. Fawzi, J.K. Konde-Lule, V. Mwanakasale, Zul Premji, F. Sempertegui, F.P. Ssengooba, K. Yeboah-Antwi, J.L. Simon

Pathology, East Africa

The prevalence of chloroquine-resistant Plasmodium falciparum malaria has been increasing in sub-Saharan Africa and parts of South America over the last 2 decades, and has been associated with increased anaemia-associated morbidity and higher mortality rates. Prospectively collected clinical and parasitological data from a multicentre study of 788 children aged 6-59 months with uncomplicated P. falciparum malaria were analysed in order to identify risk factors for chloroquine treatment failure and to assess its impact on anaemia after therapy. The proportion of chloroquine treatment failures (combined early and late treatment failures) was higher in the central-eastern African countries (Tanzania, 53%; Uganda, 80%; …

Bidirectional Cavopulmonary Shunt For Cyanotic Heart Disease: Surgical Experience From A Developing Country, G. Khan, S. S. Ali, Saulat H. Fatimi

Section of Cardiothoracic Surgery

Objective: The importance of bidirectional cavopulmonary anastomosis for palliation of complex cyanotic con-genital heart disease is widely recognized. This study was conducted to highlight our surgical experience withthis procedure in a developing country.
Methods: A retrospective study was conducted using medical records at the Aga Khan University Hospital,Karachi, Pakistan. Clinical findings at presentation, anatomical defects seen on transthoracic echocardiography,pre-operative McGoon index, cardiopulmonary bypass time, use of cardioplegia,post-procedure oxygen satura-tions and complications were evaluated.
Results: A total of 8 patients underwent bidirectional cavopulmonary anastomosis. There were 6 males (75%)and 2 females (25%). Ages and weights atoperation averaged 5.7 ± 3.7 …

The Prevalence Of Silent Kidney Stones: An Ultrasonographic Screening Study, Buchholz Niels-Peter, Farhat Abbas, R Khan, Jamsheer J. Talati, M Afzal, I Rizvi

Section of Urology

Objective: Silent and not yet discovered stones of the upper urinary tract are potentially dangerous, since in due course they may cause infection, obstruction and renal damage. The aim of this study was to determine the prevalence of such silent kidney stones in a representative Pakistani population of Karachi.
Subjects and Methods: We studied 201 consecutive subjects at our hospital who underwent additional kidney screening whilst undergoing abdominal ultrasound. All these subjects did not have a history or symptoms of urolithiasis.
Results: We found silent kidney stones in 3% of subjects. All stone bearers were males. Most stones were in …

Optimization Of Low Pre-Operative Hemoglobin Reduces Transfusion Requirement In Patients Undergoing Transurethral Resection Of Prostate, Hammad Ather, Nuzhat Faruqui, F. Abid

Section of Urology

Objective: To identify factors that influence peri-operative hemorrhage in view of reducing the need for transfusions in patients undergoing trans uretheral resection of prostate (TURP).
Methods: All patients undergoing TURP between January 1997 and December 1999 were identified using lCD 9CM coding and indexing system. Overall 430 patients were identified, however, 384 charts were included and reviewed for demographics, pre and intra-operative data and post-operative morbidity. Patients were divided into two groups on the basis of presence of significant hemorrhage.
Results: Overall 384 patients were analyzed. Nineteen patients had hemorrhage - group I whereas 365had no significant hemorrhage …

Are Our People Health Conscious? Results Of A Patients Survey In Karachi, Pakistan, Waris Qidwai, D Saleheen, S Saleem, M Andrades, Iqbal Azam

Department of Family Medicine

BACKGROUND: Life style is known to influence health and may be responsible for certain diseases. There is a need to document the life style on health among the Pakistani population.
METHODS: The study was conducted on patients visiting the Family Practice Center, the Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the life style on health. The ethical requirements for conducting the study were met.
RESULTS: 393 patients were surveyed. The majority were young married men, in either private or government service. Preference for consumption of fats/oils, sweets, spicy foods, …

Increased Risk Of Cervical Canal Infections With Intracervical Foley Catheter, S Siddiqui, Nf Zuberi, Afia Zafar, Rn Qureshi

Department of Obstetrics & Gynaecology

OBJECTIVE: To evaluate the effect of intracervical Foley catheter insertion, for the induction of labor, on cervical canal infection.
DESIGN: A prospective interventional study with paired analysis.
PLACE AND DURATION OF STUDY: The study was conducted in the department of Obstetrics and Gynecology at the Aga Khan University, Karachi, between June 1 and August 31, 2002.
SUBJECTS AND METHODS: In 45 women undergoing cervical ripening with intracervical Foley catheter for the induction of labour at term, cervical swabs were taken for culture and sensitivity before its insertion and again after its spontaneous expulsion or removal.
RESULTS: Intracervical …

Communication Skills Of Family Physicians In A Doctor-Patient Consultation, Waris Qidwai, Si Karim, Fm. Irfan

Department of Family Medicine

No abstract provided.

Physical Exercise As A Key Health Determinant Among Patients, Waris Qidwai, Danish Saleheen, Sadia Saleem, Marie Andrades, Iqbal Azam

Department of Family Medicine

No abstract provided.

Patient Complaints Among Emergency Room Patients At A Teaching Hospital In Karachi, Waris Qidwai, Muhammad Baqir, Syed Sohail Ali, Semi Ayub

Department of Family Medicine

OBJECTIVES: To study the chief presenting complaints among patients presenting to the Emergency Medical services.
SETTING: This study was conducted at the Emergency Room of Aga Khan University Hospital, Karachi during March and April, 2003.
METHODS: A survey was carried out by the study investigators. This survey included patients who were not very sick and were selected at random. Demographic profiles of the respondents were noted. EPI-info and SPSS computer software programs were used for analysis of the results.
RESULTS: One hundred patients were surveyed. The majority was relatively young, married men and women, well educated and …

Perceptions On Bioethics Among Patients Presenting To Family Physicians At A Teaching Hospital In Karachi, Waris Qidwai, Hafeez Qureshi, Syed Sohail Ali, Mahboob Alam, Syed Lgbal Azam

Department of Family Medicine

Objective: To study the perceptions on bioethics among patients presenting to family physicians at a teaching hospital in Karachi, Pakistan Study design: Questionnaire based cross sectional survey
Settings: The study was carried out at the family practice center, the Aga Khan University Hospital, Karachi Main outcome measures: Perceptions on the broad principles of bioethics
Results: Majority of the respondents were young and well educated and better placed socioeconomically. Respondents reported the moral duties of a physician and their reaction in the event of the death of a close relative due to a doctor`s negligence. The majority agreed …