Medical Specialties Commons^™

Causes, Magnitude And Management Of Burns In Under-Fives In District Hospitals In Dar Es Salaam, Tanzania., M. Justin-Temu, G. Rimoy, Zul Premji, G. Matemu

Pathology, East Africa

Objectives: To determine the causes, magnitude and management of burns in children under five years of age who were admitted in the district hospitals of Dar es Salaam City, Tanzania.

Methods: In this study, a total of 204 under fives were enrolled. Questionnaires were used to elicit if the parent/caretaker had the knowledge of the cause of the burns, what was done immediately after burn injury, first aid given immediately after burn, source of the knowledge of first aid and when the child was taken to the hospital. Also the questionnaire was cited with data on the management of burns …

The Content Of African Diets Is Adequate To Achieve Optimal Efficacy With Fixed-Dose Artemether-Lumefantrine: A Review Of The Evidence, Zul Premji, S. Abdulla, B. Ogutu, A. Ndong, C.O. Falade, I. Sagara, N. Mulure, O. Nwaiwu, G. Kokwaro

Pathology, East Africa

A fixed-dose combination of artemether-lumefantrine (AL, Coartem®) has shown high efficacy, good tolerability and cost-effectiveness in adults and children with uncomplicated malaria caused by Plasmodium falciparum. Lumefantrine bioavailability is enhanced by food, particularly fat. As the fat content of sub-Saharan African meals is approximately a third that of Western countries, it raises the question of whether fat consumption by African patients is sufficient for good efficacy. Data from healthy volunteers have indicated that drinking 36 mL soya milk (containing only 1.2 g of fat) results in 90% of the lumefantrine absorption obtained with 500 mL milk (16 g fat). African …

Conclusions And Recommendations Of A Who Expert Consultation Meeting On Iron Supplementation For Infants And Young Children In Malaria Endemic Areas [Conclusions Et Recommandations À L'Issue De La Consultation De L'Oms Sur La Lutte Contre La Carence Martiale Chez Le Nourrisson Et Le Jeune Enfant Dans Les Pays D'Endémie Palustre], L. Allen, R.E. Black, N. Brandes, G. Brittenham, G. Chazot, C Chunming, J. Crawley, B. De Benoist, N. Dalmiya, I. Darnton-Hill, K. Dewey, S. El-Arifeen, O. Fontaine, C. Geissler, H. Haberle, P. Harvey, J. Hasler, C. Hershko, R. Hurrell, M.A. Juma, B. Lonnerdal, B. Lozoff, S. Lynch, H. Martines Salgado, E. Mclean, J. Metz, S. Oppenheimer, Zul Premji, A. Prentice, M. Ramsan, C. Ratledge, R. Stoltzfus, J. Tielsch

Pathology, East Africa

This article presents the results of an expert consultation meeting aimed at evaluating the safety and public health implications of administering supplemental iron to infants and young children in malaria-endemic areas. Participants at this meeting that took place in Lyon, France on June 12-14, 2006 reached consensus on several important issues related to iron supplementation for infants and young children in malaria-endemic areas. The conclusions in this report apply specifically to regions where malaria is endemic.

Embolization Of An Intracranial Arteriovenous Malformation Followed By Immediate Surgical Resection: A Case Report, Imaad Ur Rehman, Tanveer Ul Haq, Rashid Jooma, Muhammad Azeemuddin, Zafar Sajjad

Department of Radiology

Intracranial arteriovenous malformations (AVMs) are now a recognized entity because of improvements in imaging diagnosis. They are relatively uncommon but can cause serious neurological symptoms or death. We report a case of a 22- year-old man who presented with left parietal hemorrhage and on cerebral angiography was found to have a small AVM in the left middle cerebral artery (MCA) territory. Glue embolization followed by immediate surgical resection of the AVM was carried out, resulting in complete cure.

Role Of Video-Eeg Monitoring In Themanagement Of Intractable Seizures Andnon-Epileptic Spells, Mughis Sheerani, Ali Hassan, Ameer Jan, Royala Zaka

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Fluorosis: A Rare Cause Of Spinal Cordcompression, Maimoona Siddiqui, Azra Zafar, M. Salman, Yaseen Pathan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurosurgical Training In Pakistan, Syed Ather Enam

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurology, Ayeesha K. Kamal

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

14thannual Meeting Pakistan Society For Neurologyapril 5-6, 2008peshawar, Pakistan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Prognosis Of Hospitalized New-Onset Systolic Heart Failure In Indo-Asians--A Lethal Problem, Fahim H. Jafary, Mahesh Kumar, Irfan E. Chandna

Section of Cardiology

Background: Systolic heart failure (SHF), particularly when requiring hospital admission carries a poor prognosis. There is a paucity of data in Indo-Asians on outcomes of SHF, among whom the burden of cardiovascular disease is consistently rising. The purpose of this study was to determine the frequency and predictors of mortality and morbidity amongst patients admitted with new-onset SHF at a tertiary care hospital in Pakistan.

Methods and Results: Hospital charts of 196 patients with a diagnosis of new or recent onset (!3 months) SHF (ejection fraction [EF] !40%) were reviewed. Patients who died during the admission, those with life-limiting concomitant …

Breast Cancer In Pakistan - Awareness And Early Detection, Saba Sohail, Shams Nadeem Alam

Department of Radiology

No abstract provided.

Vasculitic Neuropathy Secondary Topolyarteritis Nodosa In Association Withhepatitis B Antigenemia, Azra Zafar, Farrukh Shohab Khan, Syed Mehfooz Alam, Feroza Saleem

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neuroradiology, Zafar Sajjad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Psychiatry, Syed Ahmer

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Etiology And Disturbance Of Consciousnessin Stroke: A Hospital-Based Study, Hamzullah Khan, Muhammad Zarif

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Traumatic Carotid-Cavernous Fistula:Clinical Presentation And Outcome, Atta A. Bhatti, S. Soulat Raza, Ehsan Bari, S. Ather Enam, Tanveer Ul Haq, Zafar Sajjad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Glucose-6-Phosphate Dehydrogenase (G6pd) Screening In Pakistani Neonates: To Be Or Not To Be, Bushra Moiz

Department of Pathology and Laboratory Medicine

No abstract provided.

Longitudinal Tracking Of Cytokines After Acute Exposure To Tuberculosis: Association Of Distinct Cytokine Patterns With Protection And Disease Development, Rabia Hussain, Najeeha Talat, Firdaus Shahid, Ghaffar Dawood

Department of Pathology and Laboratory Medicine

Household contacts (HCs) of patients with tuberculosis (TB) are at higher risk of infection as well as the development of active disease. Longitudinal tracking of antigen-specific cytokines after acute exposure may significantly advance our understanding of the dynamic changes in cytokine patterns associated with disease establishment. To achieve this objective, we carried out a prospective cohort study with healthy HCs after exposure to TB. The patterns of cytokines (gamma interferon [IFN-gamma] and interleukin 10 [IL-10]) in response to mycobacterial antigens (culture filtrate [CF] proteins) and nonspecific mitogens (phytohemagglutinin [PHA] and lipopolysaccharide [LPS]) were assessed at 0, 6, 12, and 24 …

Outcome Of Triple Procedure In Older Children With Developmental Dysplasia Of Hip (Ddh), Masood Umer, Haq Nawaz, Pashtoon Murtaza Kasi, Mahmood Ahmed

Department of Surgery Docs

Objective: To evaluate the radiographic and functional results of the triple procedure (open reduction, femoral shortening and Salter's Osteotomy) in the treatment of Developmental Dysplasia of the Hip (DDH) disease in older children. Methods: This case-series comprising 23 patients (29 hips) underwent the triple procedure of open reduction, femoral shortening and Salter osteotomy, at Aga Khan University Hospital between June 1995 and June 2005. Patients were classified pre-operatively according to the Tonnis class. Postoperative functional evaluation was performed using Modified MacKay's scoring system and radiographic assessment using Severin's scoring method. Results: The mean age of patients at presentation was 6.84 …

Laryngeal Mask Airway Insertion Anaesthesia And Insertion Techniques, Abdul Monem, Fauzia A. Khan

Department of Anaesthesia

Laryngeal Mask Airway has gained wide acceptance for routine airway management, difficult airway and in emergency situations. The classical method of insertion was recommended by Dr Brain. Over the years various induction and insertion techniques have been described with variable results. Combination of induction agents with narcotics, with or without small dose muscle relaxants has been found to be very effective. There is less also lesser incidence of mucosal trauma with partially inflated cuff. Insertion with cuff facing laterally or backwards and rotating it forwards into position has also been described. A review of various options and their advantages and …

Bullet-Induced Synovitis As A Cause Of Secondary Osteoarthritis Of The Hip Joint: A Case Report And Review Of Literature, A Rehman, Masood Umer, Yasir J Sepah, Muhammad A Wajid

Department of Surgery Docs

Abstract

BACKGROUND:

With increasing prevalence of gunshot injuries we are seeing more patients with retained bullet fragments lodged in their bodies. Embedded lead bullets are usually considered inert after their kinetic energy has dissipated hence these are not removed routinely. However, exposure of any foreign body to synovial fluid may lead to rapid degradation and hence result in systemic absorption, causing local and systemic symptoms. We present the case of a thirty year old man who came to our out patient department with a history of progressive, severe hip pain ten years after a gun shot injury to his right …

Cheilitis Glandularis Progressing To Squamous Cell Carcinoma In An Hiv-Infected Patient: Case Report, F. M. A. Butt, M. L. Chindia, F. S. Rana, A. Ashani

Pathology, East Africa

Cheilitis glandularis (CG), is a rare inflammatory minor salivary gland disease affecting the lower lip.The hallmarks of which include progressive enlargement and eversion of the lower labial mucosa resulting in the obliteration of the mucosal vermillion interface. A case is presented of a 47-year-old HIV-infected woman who initially manifested clinical features of CG with a typical histopathology picture of a non-specific sialadenitis while a second biopsy performed six months later revealed well differentiated squamous cell carcinoma (SCC). She is symptom free one year following excision and radiotherapy treatment.

Perforated Appendicitis: Accuracy Of Ct Diagnosis And Correlation Of Ct Findings With The Length Of Hospital Stay, Asma Hina Siddiqui, Shaista Afzal

Department of Radiology

Objective: To determine the sensitivity and specificity of CT findings in the differentiation of perforated from nonperforated appendicitis and correlate CT diagnosis with the length of hospital stay.STUDY Design: An analytical study.PLACE AND DURATION OF STUDY: This study was conducted at Radiology Department of Aga Khan University Hospital, Karachi, from January 2004 to June 2005.PATIENTS AND Methods: The study included 70 patients who presented with right lower quadrant abdominal pain and underwent pre-operative CT scan followed by appendectomy. Patients were divided into two groups of having perforated and nonperforated appendicitis on the basis of CT scan findings. The surgical and …

A Decade Of Cardiothoracic Surgery At A Tertiary Care Hospital In Karachi, Pakistan, Fahad Javaid Siddiqui, Shahid Ahmed Sami

Section of Cardiothoracic Surgery

Objective: The medical records at Aga Khan University were reviewed to analyze the trends, mortality and patients characteristics of cardiothoracic surgeries in the last decade.METHOD: The medical records of all adult cardiac, thoracic and combined cardiothoracic operations performed during January 1995 to December 2004 at the Aga Khan University Hospital were reviewed. Data were retrieved and analyzed for trends, patient characteristics, and procedure mortality.Results: From January 1995 - December 2004, 4553 cases were eligible for the study, of which 73% were males and 9.4% were children. Male to female ratio changed from 1.3:1 to 3:1 from childhood to adulthood. Number …

Patient's Outcome Of Bladder Cancer Managed By Radical Cystectomy With Lymphadenectomy At A University Hospital, Muhammad Hammad Ather, Anila Jamshaid, Zaheer Alam, Khurrum M. Siddique, M Nasir Sulaiman

Section of Urology

Objective: To study the impact of tumour staging and nodal metastases in predicting 5- year's survival after radical cystectomy and bilateral pelvic lymphadenectomy for primary bladder cancer.
Methods: During the period 1995 to 2005, 58 patients underwent radical cystectomy and bilateral pelvic lymphadenectomy and urinary diversion at a University hospital. Patients were identified using medical indexing coding system (ICD 9CM) using standard key words. The patient records were analyzed and follow up data updated. Disease specific survival, death or recurrence was taken as end point.
Results: Out of 58 patients, 50 (86%) were males and 8 (14%) females with a …

Ancient Schwannoma Presenting As A Thoracic Mass, Muhammad Z Tahir, Saulat H. Fatimi, S. Ather Enam

Department of Surgery Docs

Abstract

BACKGROUND:

Ancient schwannoma is a rare variant of schwannoma, histologically showing atypical features that may result in erroneous diagnosis of a malignant tumor. There are only few reported cases in literature.

CASE DESCRIPTION:

We report a case of a 34-year-old man who was found to have giant mediastinal tumor. He underwent thoracotomy to remove the mass, which was proven to be ancient schwannoma on histopathology.

CONCLUSIONS:

Clinical and radiological findings are important aids for further consideration of surgical removal of these potentially respectable tumors with good outcome.

Audit Of An Acute Pain Service In A Tertiary Care Hospital In A Developing Country, Muhammad Qamarul Hoda, Mohammad Hamid, Fauzia Anis Khan

Department of Anaesthesia

The first anaesthesia based acute pain service (APS) was introduced in Pakistan at the Aga Khan University Hospital in July 2001, with the aim of patient safety and satisfaction. The American Society of Anesthesiologist task force guidelines were used for the introduction of APS. APS has managed 6810 patients during four and half years period. Common analgesic techniques used, were intravenous infusion (50%), patient controlled intravenous analgesia (18%) and epidural infusions (30%). Common reported side effects were nausea and vomiting with intravenous infusion (10%) and PCIA (10%) while motor block was noticed with epidural infusion (29%). This article aims to …

Comparison Of Two Sedation Techniques In Patients Undergoing Surgical Procedures Under Regional Anaesthesia, Aliya Ahmed, Fauzia Anis Khan, Aziza Hussain

Department of Anaesthesia

Objective: Intraoperative comfort and patient satisfaction during surgical procedures under regional anaesthesia can be improved with the use of supplemental intravenous sedation. The authors conducted a study to compare two sedation techniques for surgical procedures performed under regional anaesthesia, i.e., midazolam and pethidine combination compared with midazolam and tramadol combination.Methods: Forty adult American Society of Anaesthesiologists (ASA) grade 1-111 patients, aged between 40-65 years undergoing surgery under regional anaesthesia (sub-arachnoid block) were included. The patients were randomly divided into two groups. All patients received standardized premedication, intraoperative monitoring and oxygen therapy. Group A patients received midazolam 0.03 mg/kg followed by …

Epidural Anaesthesia During Labour For A Patient With Congenital Complete Heart Block: A Case Report, Abdul Monem, Ursula Chohan, Mohammed Ali

Department of Anaesthesia

We report labour pain management in a full-term pregnant patient with Congenital Complete Heart Block. She delivered uneventfully under routine monitoring with facilities for pacing at hand. She previously had an uneventful normal delivery and a D&E, both outside our hospital. Only findings were a low heart rate of 45-50 beats per minute. She never had syncopal attacks. She had a good effort tolerance on ETT. Her ejection fraction was 60% on Echocardiogram. She was given a single shot low dose spinal with fentanyl followed by epidural insertion. She successfully delivered through mid-cavity forceps in about 2.5 hours. The only …

Eltrombopag For The Treatment Of Chronic Idiopathic Thrombocytopenic Purpura, James Bussel, Bhabita Mayer, Nicole Stone, Michael Arning, Drew Provan, Mansoor Saleh

Haematology and Oncology, East Africa

Background: The pathogenesis of chronic idiopathic thrombocytopenic purpura (ITP) involves antibody-mediated platelet destruction and reduced platelet production. Stimulation of platelet production may be an effective treatment for this disorder.

Methods: We conducted a trial in which 118 adults with chronic ITP and platelet counts of less than 30,000 per cubic millimeter who had had relapses or whose platelet count was refractory to at least one standard treatment for ITP were randomly assigned to receive the oral thrombopoietin-receptor agonist eltrombopag (30, 50, or 75 mg daily) or placebo. The primary end point was a platelet count of 50,000 or more per …