Medicine and Health Sciences Commons^™

Scaling Up Primary Health Services For Improving Reproductive, Maternal, And Child Health: A Multisectoral Collaboration In The Conflict Setting Of Afghanistan, Jai K. Das, Nadia Akseer, Shafiq Mirzazada, Omarwalid Noorzada, Corinne E. Armstrong, Kashif Mukhtar, Ahmed Jan Naeem, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Azygos Anterior Cerebral Artery Causing Bifrontal Infarcts: A Case Report, Abdul Khaliq, Palwasha Gul, Pari Gul

Pakistan Journal of Neurological Sciences (PJNS)

The azygos anterior cerebral artery (AACA) is an uncommon anatomical variant. There is absence of the anterior communicating artery (ACom) and bilateral anterior cerebral arteries (ACA) form a common trunk and travels superiorly in the interhemispheric fissure. It can result in bilateral frontal infarcts in case of thromboembolism. Therefore its correct diagnosis is of grave importance for better patient clinical outcome. Cerebrovascular infarction is a common condition, however simultaneous symmetrical bilateral infarction secondary to arterial occlusion is a rare entity. We report a case of a 50 years male with thromboembolic event in azygos anterior cerebral artery resulting in bifrontal …

Challenges & Barriers For Neuro Rehabilitation In Developing Countries, Muhammad Naveed Babur, Maria Liaqat

Pakistan Journal of Neurological Sciences (PJNS)

People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it.

Radiological And Clinical Outcomes In Patients Undergoing Anterior Cervical Discectomy And Fusion: Comparing Titanium And Peek (Polyetheretherketone) Cages, Muhammad Junaid, Mamoon Ur Rashid, Syed Sarmad Bukhari, Mamoon Ahmed

Section of Neurosurgery

Objectives: To study clinical and radiological outcomes in patients who had undergone the procedure of anterior cervical discectomy and fusion with titanium or PEEK (polyetheretherketone) cages for cervical disc prolapse.
Methods: This is a retrospective/non-randomized study which was conducted at the Combined Military Hospital Peshawar. Study interval was four years from 1st October, 2010 to 31st September, 2014. Total number of included patients were 149. All of the patients had undergone the procedure of anterior cervical discectomy and fusion with titanium or PEEK (polyetheretherketone) cages. All of the patients had plain MRI cervical spine done for diagnosis of anterior cervical …

Neuromyelitis Optica (Nmo); A Case Report, Saad Waheed, Jawad Hussian, Yasir Saood, Aqsa Shehzadi

Pakistan Journal of Neurological Sciences (PJNS)

Devic’s disease or syndrome also known as Neuromyelitis optica (NMO) which is a demyelinating central nervous system (immune-mediated) ailment that predominantly targets the optic nerves and spinal cord. NMO-IgG seropositivity & longitudinally extensive spinal-cord lesions typically represents the Devic’s disease & differentiates it from Multiple Sclerosis (MS).Treatment for NMO is based upon its presentation such as for acute phase(steroids, IVIG etc), prevention of relapse (steroid sparing immunosuppression etc) and symptom based therapy (e.g spasticity etc). Here, we present a case of NMO in a young female (26 years old), married patient who presented to us with total vision loss, urinary …

Bone Graft Donor Site Infection With A Rare Organism, Aeromonas Hydrophila: A Typical Location, Presentation And Organism With 2 Years Follow-Up: Case Report, Obada Hasan, Wajiha Khan, Muneeba Jessar, Aly Zaheer Pathan, Riaz Hussain Lakdawala

Section of Orthopaedic Surgery

Introduction: Aeromonas are Gram-negative bacilli often causing necrotizing fasciitis or sepsis in immunocompromised patients. Aeromonas Hydrophila is most often found in immunocompromised patients or those with burns or aquatic trauma. When patients present with a discharge and infection on bone graft donor site and progressive sepsis, an Aeromonas hydrophila infection should be considered in the differential diagnosis.
Presentation of Case: We report here a rare case of Aeromonas hydrophila with surgical site sep- sis/infection in an immunocompromised 69 years old female, with several comorbids. Here we are reporting infection on donor surgical graft site, sparing major surgical site with the …

Synovial Sarcoma Of Cervicodorsal Spine: A Case Report, Wali Umer Shah, Syeda Dania Shujaat, Naseeb Ullah, Salman Mansoor

Section of Neurology

Synovial sarcoma is a soft-tissue sarcoma. Its involvement of the spine is extremely rare. We report a 40 year old male who presented with shoulder pain and progressive weakness in all four limbs for six months with a visible, slowly growing bulge in his upper back. On examination he had quadriparesis and diffuse sensory deficit. MRI of the cervical spine showed a large soft tissue mass, iso to hypointense, extending into the neural canal, compressing the cord. The mass had a few internal areas of contrast enhancement with extension into the right paraspinal regions involving the vertebral bodies. Sub-periosteal spine …

Inherited Bleeding Disorders-Experience Of A Not-For-Profit Organization In Pakistan, Shabneez Hussain, Shahida Baloch, Azra Parvin, Akbar Najmuddin, Farhana Musheer, Mubashra Junaid, Rab Nawaz Memon, Fareeda Bhanbhro, Hayat Ullah, Bushra Moiz

Department of Pathology and Laboratory Medicine

Patient registry is a powerful tool for planning health care and setting groundwork for research. This survey reports a detailed registry of inherited bleeding disorders (IBD) and their management at a not-for-profit organization in a developing country to form the basis for planning development and research. We reviewed medical records of patients with IBD from 8 hemophilia treatment centers of Fatimid Foundation located in various cities. Information collected included sociodemographic data, diagnostic tests, severity of hemophilia A and B, number of bleeding episodes per year, site and frequency of hemarthrosis, and seropositivity for viral diseases. We analyzed 1497 patients from …

Cime Newsletter : May 2018, Cime

CIME Newsletter

- Microscopic Repair for Peripheral Nerve Surgery and Spinal Instrumentation Workshop
- SONAM Teaching Strategy Forum
- Clinical Skills Enhancement Programme for Hospital Based Healthcare Providers
- STEER Workshop (Strengthening Knowledge and Empowering Management of Diabetes) – A collaboration by CIME and Sanofi, Pakistan
- 1st International Hip & Knee Arthroplasty Symposium
- Hypertension Simulation Workshop
- Simulation Session on Crisis Resource Management
- RN Orientation Simulation Workshop
- Community Health Workers in Action!
- New! A guest column to help readers with their problems.
- Ophthalmoscopy Teaching Session for Medical Students

Seasonal Influence On Postoperative Complications After Total Knee Arthroplasty, Azeem Tariq Malik, Muhammad Shahid Khan, Arif Ali M, Syed Hamza Mufarrih, Shahryar Noordin

Section of Orthopaedic Surgery

Purpose: This study is aimed at investigating whether inpatient complications and surgical site infections (SSIs) occurred more commonly in patients undergoing total knee arthroplasty (TKA) during the summer season.
Materials and Methods: A total of 725 patients who underwent unilateral or bilateral TKA were included in this study. A total of 241 patients (33.2%) underwent TKA between May and August. Our outcomes of interest were the incidence of postoperative complications and length of stay.
Result: May-August surgeries were associated with a higher risk of postoperative inpatient complications (p=0.003). May-August surgeries (odds ratio [OR], 2.13; 95% confidence interval [CI], 1.18 …

The Loose End: Neurology Without Rehabilitation, Ahmad Zaheer Qureshi, Farooq Azam Rathore

Pakistan Journal of Neurological Sciences (PJNS)

In recent years, successive therapies for previously untreatable neurological conditions have been introduced in clinical practice and these advance interventions have remarkably changed the landscape of neurosciences1,2 .But, rehabilitation of the functional impairments caused by neurological diseases is often overlooked or sometimes even neglected. In other words, the role of a comprehensive and early multidisciplinary rehabilitation in neurological disease is unrecognized and poorly understood even among neurologists and neurosurgeons. Usually, lifesaving neurosurgical management or solving a diagnostic riddle in neurology is attributed to successful patient management; however in reality, this is the first step in establishing a care plan for …

Acute Disseminated Encephalomyelitis In A Middle Age Female, Hina Mushtaq, Maria Qureshi, Irfan Ahsan

Pakistan Journal of Neurological Sciences (PJNS)

Acute disseminated encephalomyelitis (ADEM) is an autoimmune condition that predominately involve demyelination of the white matter of the brain and spinal cord. It resembles other acute demyelinating syndromes like multiple sclerosis and most often presents in childhood.This is a case of a 52-year woman, presented with lower limb weakness, confusion and spasticity throughout the body with no preceding illness. CSF showed increased proteins with no oligoclonal bands. MRI Brain showed abnormal high intensity areas in bilateral parietal, periventricular region, with no contrast enhancement. She was given 1gram iv methylprednisolone based on the diagnosis of ADEM and responded well.

Acute Onset Of Quadriplegia Secondary To Hypoparathyroidism: Mimicker Of Aman Variant Of Gbs, Syeda Saba Zaidi, Tahira Siddiqui, Sarwar Jamil Siddiqui

Section of Neurology

Acute onset of quadriplegia is a rare phenomenon seen with hypocalcemia due to hypoparathyroidism. We describe a 33-year gentleman who presented with weakness of all four limbs and areflexia. ECG showed QT abnormality. Nerve conduction study revealed normal sensory and significantly low motor CMAP amplitudes in both the upper and lower extremities. This nerve conduction study can be seen in acute motor neuropathy of various etiologies, among which GBS is the most worrisome. Our patient found to have low calcium and parathyroid hormone level. His symptoms improved after calcium replacement. Occurrence of quadriplegia in hypoparathyroidism, and its improvement after correction …

Mobile Critical Care Recovery Program (M-Ccrp) For Acute Respiratory Failure Survivors: Study Protocol For A Randomized Controlled Trial, Sikandar Khan, Ashok Biju, Sophia Wang, Sujuan Gao, Omar Irfan, Amanda Harrawood, Stephanie Martinez, Anthony Perkins, Frederick W. Unverzagt, Sue Lasiter

Medical College Documents

Background: Patients admitted to intensive care units (ICU) with acute respiratory failure (ARF) face chronic complications that can impede return to normal daily function. A mobile, collaborative critical care model may enhance the recovery of ARF survivors.
Methods: The Mobile Critical Care Recovery Program (m-CCRP) study is a two arm, randomized clinical trial. We will randomize 620 patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation in a 1:1 ratio to one of two arms (310 patients per arm) – m-CCRP intervention versus attention control. Those in the intervention group will meet with a care coordinator after …

Factors Deterring Dentistry, Medical, Pharmacy, And Social Science Undergraduates From Pursuing Nursing As A Healthcare Career: A Cross-Sectional Study In An Asian University, Ling Ting Wu, Wenru Wang, Eleanor Holroyd, Violeta Lopez, Sok Ying Liaw

School of Nursing & Midwifery, East Africa

Background: Globally more registered nurses need to be recruited to meet the needs of aging populations and increased co-morbidity. Nursing recruitment remains challenging when compared to other healthcare programs. Despite healthcare students having similar motivation in joining the healthcare industry, many did not consider nursing as a career choice. This study aims to identify the deterrents to choosing nursing among healthcare undergraduates by examining the differences in the factors influencing healthcare career choices and nursing as a career choice.

Methods: A cross sectional study was conducted using a 35-parallel items instrument known as Healthcare Career Choice and Nursing Career Choice …

Fmic Annual Report 2018 | English, French Medical Institute For Mothers And Children

FMIC Reports

No abstract provided.

Urinary Retention In Unilateral Total Knee Arthroplasty: Comparison Between Continuous Epidural Analgesia And Single-Shot Femoral Nerve Block, Ausaf Ahmed Khan, Robyna Irshad Khan

Department of Anaesthesia

Objective: To compare the frequency of urinary retention and requirement of bladder catheterization in patients undergoing total knee arthroplasty while receiving either continuous epidural analgesia or single-shot femoral nerve block.
Study design: Randomized controlled study.
Place and duration of study: Operating Rooms of Aga Khan University Hospital, Karachi, from January 2014 to January 2015.
Methodology: Patients were randomized in two groups of 30 each, i.e. epidural group (group E) or femoral nerve block group (group F). Baseline parameters were recorded. Postoperatively, patients were followed for upto 24 hours to collect the data regarding urinary retention. Final outcome was taken at …