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Full-Text Articles in Medicine and Health Sciences

Impact Of Covid-19 On The Pre And Post Analytical Clinical Laboratory Testing Processes- A Performance Evaluation Study Using Six Sigma, Sibtain Ahmed, Farhat Jahan, Muhammad Umer Naeem Effendi, Farooq Ghani Oct 2021

Impact Of Covid-19 On The Pre And Post Analytical Clinical Laboratory Testing Processes- A Performance Evaluation Study Using Six Sigma, Sibtain Ahmed, Farhat Jahan, Muhammad Umer Naeem Effendi, Farooq Ghani

Department of Pathology and Laboratory Medicine

Background: The aim of this study was to determine the impact of COVID-19 pandemic on the total testing process using six sigma metrics based on a comparison of pre and during pandemic periods.
Material & methods: The study duration was over 12 months, 6 months before and 6 months after the COVID-19 onset in Pakistan in March 2020 after the recognition of the first case, using quality indicators (QIs). QIs were chosen from a model of QIs recommended by the CAP. Analysis was performed using Six Sigma calculators and QIs were expressed in percentage (%) and Sigma value were computed. …


Higher Entropy Observed In Sars-Cov-2 Genomes From The First Covid-19 Wave In Pakistan, Najia Karim Ghanchi, Asghar Nasir, Kiran I. Masood, Syed Hani Abidi, Syed Faisal Mahmood, Akber Kanji, Safina Abdul Razzak, Waqasuddin Khan, Saba Shahid, Maliha Yameen, Ali Raza, Javaria Ashraf, Zeeshan Ansar Ahmed, Mohammad Buksh Dharejo, Nazneen Islam, Zahra Hasan, Rumina Hasan Aug 2021

Higher Entropy Observed In Sars-Cov-2 Genomes From The First Covid-19 Wave In Pakistan, Najia Karim Ghanchi, Asghar Nasir, Kiran I. Masood, Syed Hani Abidi, Syed Faisal Mahmood, Akber Kanji, Safina Abdul Razzak, Waqasuddin Khan, Saba Shahid, Maliha Yameen, Ali Raza, Javaria Ashraf, Zeeshan Ansar Ahmed, Mohammad Buksh Dharejo, Nazneen Islam, Zahra Hasan, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background: We investigated the genome diversity of SARS-CoV-2 associated with the early COVID-19 period to investigate evolution of the virus in Pakistan.
Materials and methods: We studied ninety SARS-CoV-2 strains isolated between March and October 2020. Whole genome sequences from our laboratory and available genomes were used to investigate phylogeny, genetic variantion and mutation rates of SARS-CoV-2 strains in Pakistan. Site specific entropy analysis compared mutation rates between strains isolated before and after June 2020.
Results: In March, strains belonging to L, S, V and GH clades were observed but by October, only L and GH strains were present. The …


Establishing Reference Interval For Thyroid-Stimulating Hormone In Children Below Two-Year Ages In Pakistani Population, Siraj Muneer, Imran Siddiqui, Hafsa Majid, Lena Jafri, Khadija N Humayun, Sibtain Ahmed, Aysha Habib Khan Jul 2021

Establishing Reference Interval For Thyroid-Stimulating Hormone In Children Below Two-Year Ages In Pakistani Population, Siraj Muneer, Imran Siddiqui, Hafsa Majid, Lena Jafri, Khadija N Humayun, Sibtain Ahmed, Aysha Habib Khan

Department of Pathology and Laboratory Medicine

Introduction: Reference intervals (RIs) of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) are age, assay and population specific. Currently, the age and assay-specific RIs for TSH are not available for children under two years of age. This study aimed to establish reference intervals for serum concentrations of TSH and FT4 in healthy children aged 1-24 months as per CLSI C28-A3 guidelines.
Methods: This prospective cross-sectional study was conducted in children from 1 to 24 months visiting the clinical laboratory for serum vitamin D testing but without any recent illness, hospitalization, medication and history of maternal thyroid diseases from August 2018 …


Indirect Determination Of Serum Creatinine Reference Intervals In A Pakistani Pediatric Population Using Big Data Analytics, Sibtain Ahmed, Jakob Zierk, Imran Siddiqui, Aysha Habib Khan Jul 2021

Indirect Determination Of Serum Creatinine Reference Intervals In A Pakistani Pediatric Population Using Big Data Analytics, Sibtain Ahmed, Jakob Zierk, Imran Siddiqui, Aysha Habib Khan

Department of Pathology and Laboratory Medicine

Background: The indirect methods of reference intervals (RI) establishment based on data mining are utilized to overcome the ethical, practical challenges and the cost associated with the conventional direct approach.
Aim: To generate RIs for serum creatinine in children and adolescents using an indirect statistical tool.
Methods: Data mining of the laboratory information system was performed for serum creatinine analyzed from birth to 17 years for both genders. The timeline was set at six years from January 2013 to December 2018. Microsoft Excel 2010 and an indirect algorithm developed by the German Society of Clinical Chemistry and Laboratory Medicine's Working …


A Cross Sectional Evaluation Of The Corona-Score For Swift Identification Of Sars-Cov-2 Infection At A Tertiary Care Hospital In Pakistan, Sibtain Ahmed, Muhammad Umer Naeem Effendi, Zeeshan Ansar Ahmed, Imran Siddiqui, Lena Jafri Jul 2021

A Cross Sectional Evaluation Of The Corona-Score For Swift Identification Of Sars-Cov-2 Infection At A Tertiary Care Hospital In Pakistan, Sibtain Ahmed, Muhammad Umer Naeem Effendi, Zeeshan Ansar Ahmed, Imran Siddiqui, Lena Jafri

Department of Pathology and Laboratory Medicine

Background: The Corona-Score is one of the first and most widely used predictive model for coronavirus 2 (SARS-CoV-2) infection. The purpose of this study was to validate the performance of Corona-Score in a cohort of Pakistani patients pursuing care for suspected infection.
Methods: After seeking institution's ethical committee exemption, results of serum lactate dehydrogenase (LDH), C-reactive protein (CRP), ferritin, absolute lymphocyte and neutrophil counts, chest x-ray findings and demographics of suspected COVID-19 cases with respiratory symptoms were recouped from electronic medical record. The pre-validated score as proposed by Kurstjens S et al., was calculated. The subjects were divided into SARS-CoV-2 …


Plasmodium In The Bone Marrow: Case Series From A Hospital In Pakistan, 2007-2015, Muhammad Shariq Shaikh, Basim Ali, Mahin Janjua, Ayesha Akbar, Syed Arish Haider, Bushra Moiz, Ahmed Raheem Buksh, John Kevin Baird, Mohammad Asim Beg Jun 2021

Plasmodium In The Bone Marrow: Case Series From A Hospital In Pakistan, 2007-2015, Muhammad Shariq Shaikh, Basim Ali, Mahin Janjua, Ayesha Akbar, Syed Arish Haider, Bushra Moiz, Ahmed Raheem Buksh, John Kevin Baird, Mohammad Asim Beg

Department of Pathology and Laboratory Medicine

Background: Malaria is a life-threatening, multisystem disease caused by the plasmodial parasite with a global incidence of approximately 229 million annually. The parasites are known to have unique and crucial interactions with various body tissues during its life cycle, notably the liver, spleen, and recent work has shown the bone marrow to be a reservoir of infection.
Methods: This study is a case series of patients in whom examination of bone marrow revealed malarial parasites. A retrospective record review of 35 parasite-positive bone marrow specimens examined at Aga Khan University Hospital (AKUH), Karachi, Pakistan, over the years 2007 to 2015 …


Chikungunya Outbreak In Karachi Pakistan 2016-2017: An Analysis Of Viral Isolates, Dhani Prakoso, Kelli Barr, Kehkashan Imtiaz, Joveria Farooqi, Erum Khan, Maureen Long May 2021

Chikungunya Outbreak In Karachi Pakistan 2016-2017: An Analysis Of Viral Isolates, Dhani Prakoso, Kelli Barr, Kehkashan Imtiaz, Joveria Farooqi, Erum Khan, Maureen Long

Department of Pathology and Laboratory Medicine

In December 2016 physicians in Karachi, Pakistan,witnessed an increase in patients presenting with febrile illness and severe polyarthralgia. Subsequently, chikungunya virus (CHIKV)) was isolated from three patients. This virus was sequenced and compared with other isolates of CHIKV obtained in India and Pakistan during recent outbreaks. Phylogenetic analysis indicated that the Karachi isolates were most similar to the East Central South African CHIKV lineage and showed sequence homology to isolates obtained in other parts of Pakistan and India. More importantly, two of the CHIKV isolates had a nucleotide substitution in the E1 gene corresponding to an amino acid change at …


Molecular Surveillance Of Drug Resistance: Plasmodium Falciparum Artemisinin Resistance Single Nucleotide Polymorphisms In Kelch Protein Propeller (K13) Domain From Southern Pakistan, Najia Karim Ghanchi, Bushra Qurashi, Hadiqa Raees, Mohammad Asim Beg Apr 2021

Molecular Surveillance Of Drug Resistance: Plasmodium Falciparum Artemisinin Resistance Single Nucleotide Polymorphisms In Kelch Protein Propeller (K13) Domain From Southern Pakistan, Najia Karim Ghanchi, Bushra Qurashi, Hadiqa Raees, Mohammad Asim Beg

Department of Pathology and Laboratory Medicine

Background: K13 propeller (k13) polymorphism are useful molecular markers for tracking the emergence and spread of artemisinin resistance in Plasmodium falciparum. Polymorphisms are reported from Cambodia with rapid invasion of the population and almost near fixation in south East Asia. The study describes single nucleotide polymorphisms in Kelch protein propeller domain of P. falciparum associated with artemisinin resistance from Southern Pakistan.
Methods: Two hundred and forty-nine samples were collected from patients with microscopy confirmed P. falciparum malaria attending Aga Khan University Hospital during September 2015-April 2018. DNA was isolated using the whole blood protocol for the QIAmp DNA Blood Kit. …


Need For Clinical Guidelines For Management Of Osteoporosis And Way Forward For Pakistan, Aysha Habib Khan, Manju Chandran Apr 2021

Need For Clinical Guidelines For Management Of Osteoporosis And Way Forward For Pakistan, Aysha Habib Khan, Manju Chandran

Department of Pathology and Laboratory Medicine

No abstract provided.


Determination Of Reference Interval (Ri) Of Spot Urinary Oxalate To Creatinine Ratio In Children Of Pakistani Origin Under Six Years Of Age: A Cross-Sectional Study, Syed Bilal Hashmi, Lena Jafri, Jamsheer Jehangir Talati, Hafsa Majid, Saqib Hamid Qazi, Aysha Habib Khan Mar 2021

Determination Of Reference Interval (Ri) Of Spot Urinary Oxalate To Creatinine Ratio In Children Of Pakistani Origin Under Six Years Of Age: A Cross-Sectional Study, Syed Bilal Hashmi, Lena Jafri, Jamsheer Jehangir Talati, Hafsa Majid, Saqib Hamid Qazi, Aysha Habib Khan

Department of Pathology and Laboratory Medicine

Background: The gold standard screening method of hyperoxaluria in children is using 24-hour urine collection. Urine collection may be cumbersome and challenging for children. Reference intervals (RI) of oxalate for the Pakistani population are not readily available. Therefore we aimed to determine the oxalate to creatinine ratio (Ox: Cr) for Pakistani children <6 years of age.
Materials and methods: A cross-sectional study was conducted at Aga Khan University from June 2018 to October 2019. Random urine samples from apparently healthy children < 6 years were collected and stored at -30°C until analysis after adding 6M HCl. Oxalate was measured on Micro lab 300 using a kit based on oxalate oxidase principle, while creatinine was measured by kinetic Jaffe reaction. Data was analyzed by EP evaluator and SPSS 23. Ox: Cr ratio was calculated and reported with 90% confidence interval (CI) and interquartile range (IQR).
Results: The mean age of study subjects (n=120) was 29 ±22.3 months with an M: F ratio of 1:1. Children of various ethnicities …


Hajdu Cheney Syndrome Due To Notch2 Defect - First Case Report From Pakistan And Review Of Literature, Sibtain Ahmed, Aahan Arif, Saadia Abbas, Muhammad Osama Khan, Salman Kirmani, Aysha Habib Khan Jan 2021

Hajdu Cheney Syndrome Due To Notch2 Defect - First Case Report From Pakistan And Review Of Literature, Sibtain Ahmed, Aahan Arif, Saadia Abbas, Muhammad Osama Khan, Salman Kirmani, Aysha Habib Khan

Department of Pathology and Laboratory Medicine

Introduction and importance: Hajdu Cheney Syndrome (HCS) is a rare skeletal disease characterized by severe, progressive focal bone loss with osteoporosis, variable craniofacial, vertebral anomalies and distinctive facial features. It is inherited as an autosomal dominant disease although sporadic cases have been described in literature. Identifying these cases in clinical practice is important for proper diagnosis and management.
Case presentation: We report a case of a 36-year-old male patient presented at metabolic bone disease clinic at the Aga Khan University Hospital with history of multiple fragility fractures and juvenile osteoporosis since childhood. DNA sequence analysis of the NOTCH2 coding sequence …