Open Access. Powered by Scholars. Published by Universities.®

Medical Specialties Commons

Open Access. Powered by Scholars. Published by Universities.®

Aga Khan University

Discipline
Keyword
Publication Year
Publication
Publication Type
File Type

Articles 7021 - 7050 of 7543

Full-Text Articles in Medical Specialties

Peer Review Audit Of Trauma Deaths In A Developing Country, Aa Jat, Mr Khan, Hasnain Zafar, Aj Raja, Q Hoda, R Rehmani, Rh Lakdawala, S. Bashir Jan 2004

Peer Review Audit Of Trauma Deaths In A Developing Country, Aa Jat, Mr Khan, Hasnain Zafar, Aj Raja, Q Hoda, R Rehmani, Rh Lakdawala, S. Bashir

Section of General Surgery

OBJECTIVES: Peer review of trauma deaths can be used to evaluate the efficacy of trauma systems. The objective of this study was to estimate teh proportion of preventable trauma deaths and the factors contributing to poor outcome using peer review in a tertiary care hospital in a developing country.
METHODS: All trauma deaths during a 2-year period (1 January 1998 to 30 December 1998) were identified and registered in a computerized trauma registry, and the probability of survival was calculated for all patients. Summary data, including registry information and details of prehospital, emergency room, and definitive care, were provided to …


Extradural Granulocytic Sarcoma Causing Acute Paraparesis, Arshad A. Siddiqui, Naim-Ur Rehman Jan 2004

Extradural Granulocytic Sarcoma Causing Acute Paraparesis, Arshad A. Siddiqui, Naim-Ur Rehman

Section of Neurosurgery

A case of 9 years old female presenting with rapidly progressive paraparesis during remission phase of acute myeloblastic leukemia is reported. Radiological imaging revealed an extradural mass in the upper dorsal spine producing significant cord compression. The patient showed a dramatic neurological recovery after spinal cord decompression and subsequently treated with appropriate chemotherapy and local radiotherapy.


Barriers To Smoking Cessation: Results Of A Survey Among Family Practice Patients, Waris Qidwai Jan 2004

Barriers To Smoking Cessation: Results Of A Survey Among Family Practice Patients, Waris Qidwai

Department of Family Medicine

Background and Objectives: Tobacco smoking is a major public health problem. We have studied barriers to smoking cessation among family practice patients.
Methods: It was a questionnaire based survey, conducted at Family Pr actice Center, Aga Khan University Hospital, Karachi, Pakistan, in July 2003. A trained volunteer administered the questionnaire that included data on demographic profile of the patient and information barriers to smoking cessa tion.Ethical requirement including the administration of written informed consent and the provision of confidentiality were ensured. SPSS computer software was used for data management.
Results: A total of 100 patients were interviewed, of which …


Level Of Preparedness Of Patients For Medical Emergency, Waris Qidwai, Ss Ali, M Baqir, S Ayub Jan 2004

Level Of Preparedness Of Patients For Medical Emergency, Waris Qidwai, Ss Ali, M Baqir, S Ayub

Department of Family Medicine

No abstract provided.


Evidence Based Medicine: Transforming Research Into Practice, Waris Qidwai Jan 2004

Evidence Based Medicine: Transforming Research Into Practice, Waris Qidwai

Department of Family Medicine

No abstract provided.


Structured Feedback From Students In Tutorial Teaching, Waris Qidwai Jan 2004

Structured Feedback From Students In Tutorial Teaching, Waris Qidwai

Department of Family Medicine

No abstract provided.


Boerhaave's Syndrome: A Diagnostic Dilemma In The Emergency Room, Ab Zubairi, I Khalid, Saulat H. Fatimi, J Hussain, N Salahuddin Jan 2004

Boerhaave's Syndrome: A Diagnostic Dilemma In The Emergency Room, Ab Zubairi, I Khalid, Saulat H. Fatimi, J Hussain, N Salahuddin

Department of Medicine

Boerhaave's syndrome is a potential lethal condition which presents not only a diagnostic but also a therapeutic challenge. Errors in diagnosis are usually caused by unawareness of its varied and atypical presentations. All clinicians need to be aware of this lethal disease, its frequent unusual presentations and the importance of early diagnosis.


Maximum Tolerable Dose Of Cyclophosphamide And Azathioprine In Pakistani Patients With Primary Renal Disease, S S. Ali, M A. Rabbani, S S M Moinuddin, Salim S. Virani, F Farooque, A Salam, A Ahmad Jan 2004

Maximum Tolerable Dose Of Cyclophosphamide And Azathioprine In Pakistani Patients With Primary Renal Disease, S S. Ali, M A. Rabbani, S S M Moinuddin, Salim S. Virani, F Farooque, A Salam, A Ahmad

Section of Nephrology

Objective: The immunosuppressive regimens, at present, mainly rely on western guidelines that were derived from studies conducted in western populations. No such study exists for South Asian population, which is home to almost two billion people different in both genetics and environment from west. Locally derived thresholds for side effects markedly different from western figures may warrant re-adjustment of current local immunosuppressive regimens that are at present based largely on western guidelines. In order to define optimum dose for Cyclophosphamide (CYC) and Azathioprine (AZA) based immunosuppressive therapy, we conducted this study to find out maximum tolerable doses of azathioprine (AZA) …


Therapeutic Efficacy Of Sulfadoxine-Pyrimethamine And Prevalence Of Resistance Markers In Tanzania Prior To Revision Of Malaria Treatment Policy: Plasmodium Falciparum Dihydrofolate Reductase And Dihydropteroate Synthase Mutations In Monitoring In Vivo Resistance, K. Mugittu, M. Ndejembi, A. Malisa, M. Lemnge, Zul Premji, A. Mwita, W. Nkya, J. Kataraihya, S. Abdulla, H.-P. Beck, H. Mshinda Jan 2004

Therapeutic Efficacy Of Sulfadoxine-Pyrimethamine And Prevalence Of Resistance Markers In Tanzania Prior To Revision Of Malaria Treatment Policy: Plasmodium Falciparum Dihydrofolate Reductase And Dihydropteroate Synthase Mutations In Monitoring In Vivo Resistance, K. Mugittu, M. Ndejembi, A. Malisa, M. Lemnge, Zul Premji, A. Mwita, W. Nkya, J. Kataraihya, S. Abdulla, H.-P. Beck, H. Mshinda

Pathology, East Africa

Prior to the 2001 malarial treatment policy change in Tanzania, we conducted trials to assess the efficacy of sulfadoxine-pyrimethamine (SP) and the usefulness of molecular markers in monitoring resistance. A total of 383 uncomplicated Plasmodium falciparum malaria patients (between 6 and 59 months old) were treated with SP and their responses were assessed. Mutations in the P. falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) genes in admission day blood samples were analyzed. Results indicated that 85.6% of the patients showed an adequate clinical response, 9.7% an early treatment failure, and 4.7% a late treatment failure. The quintuple mutant genotype …


Oral Contrast-Enhanced Ct Cholangiography--An Initial Experience, I Naseem, J Rees Jan 2004

Oral Contrast-Enhanced Ct Cholangiography--An Initial Experience, I Naseem, J Rees

Department of Radiology

Objective: To describe our experience of CT (Computed tomographic) Cholangiography examination for detection of choledocholithiasis at the Aga Khan University Hospital (AKUH) Karachi Pakistan.Methods: Seven patients underwent helical CT cholangiography for suspected choledocholithiasis. Iopanoic acid (6 grams) was administered orally 8-12 hours before acquisition of a helical CT cholangiogram. Three-dimensional reconstructions and curved multiplanar reformations were generated from a set of axial source images.Results: Our patients had no adverse reactions to iopanoic acid. The degree of biliary opacification was sufficient to perform three-dimensional and curved planar reformations in 5 patients. In two patients, the biliary tree was not opacified. Both …


Mammographic Criteria For Determining The Diagnostic Value Of Microcalcifications In The Detection Of Early Breast Cancer, M Yunus, N Ahmed, I Masroor, J Yaqoob Jan 2004

Mammographic Criteria For Determining The Diagnostic Value Of Microcalcifications In The Detection Of Early Breast Cancer, M Yunus, N Ahmed, I Masroor, J Yaqoob

Department of Radiology

Objective: To evaluate the importance of microcalcifications in the detection of breast carcinoma in conventional mammography.Methods: This prospective study was carried out at Aga Khan University Hospital (AKUH). Mammograms of 68 patients with microcalcifications were evaluated. Craniocaudal and oblique views of both breasts were acquired on routine basis with cone compression and magnified views when required.Results: Among 68 patients with microcalcifications, 61 (89%) had clustered microcalcifications while 7 patients (10.29%) had scattered microcalcifications. Microcalcifications can occur in benign and malignant diseases. While evaluating clustered microcalcifications, few criteria have been established to determine malignant clustered microcalcifications, these include specific and nonspecific …


Role Of Estrogens In The Secondary Hormonal Manipulation Of Hormone Refractory Prostate Cancer, Khurram M. Siddiqui, Farhat Abbas, Syed Raziuddin Biyabani, Muhammad Hammad Ather, Jamsheer J. Talati Jan 2004

Role Of Estrogens In The Secondary Hormonal Manipulation Of Hormone Refractory Prostate Cancer, Khurram M. Siddiqui, Farhat Abbas, Syed Raziuddin Biyabani, Muhammad Hammad Ather, Jamsheer J. Talati

Section of Urology

Objective: To evaluate the role of Estrogens (Honvan) in the secondary hormonal manipulation of patients with hormone refractory prostate cancer (HRCP). Methods: Twelve patients diagnosed as hormone refractory prostate cancer received intravenous estrogens for six days (Fosfestrol, a synthetic phosphorylated estrogen derivative), followed by a maintenance oral dose of 120 mg thrice daily as second line hormonal treatment. During the treatment they were given deep venous thrombosis prophylaxis. Their stage at initial presentation, primary treatment, mode of androgen ablation, prostate specific antigen (PSA) level, duration of remission prior of HRPC status, PSA doubling time before and after estrogen treatment were …


Is An Excretory Urogram Mandatory In Patients With Small To Medium-Sized Renal And Ureteric Stones Treated By Extra Corporeal Shock Wave Lithotripsy?, Hammad Ather, Nuzhat Faruqui, Sobia Akhtar, M Nasir Sulaiman Jan 2004

Is An Excretory Urogram Mandatory In Patients With Small To Medium-Sized Renal And Ureteric Stones Treated By Extra Corporeal Shock Wave Lithotripsy?, Hammad Ather, Nuzhat Faruqui, Sobia Akhtar, M Nasir Sulaiman

Section of Urology

Background: An intravenous urogram (IVU) has traditionally been considered mandatory before treating renal and ureteric stones by extracorporeal shock wave lithotripsy (ESWL). This study was designed to see whether there is a difference in complications and the need for ancillary procedures in patients managed by ESWL for renal and ureteric calculi, according to preoperative imaging technique.
Methods: This retrospective study compared 133 patients undergoing ESWL from January 2001 to July 2002. Patients were divided into three groups according to the preoperative imaging technique used: i) IVU; ii) non-contrast enhanced helical computed tomography (UHCT); and iii) ultrasound (US) + X-ray …


Pulmonary Infiltrates During Chemotherapy-Induced Febrile Neutropenia: Incidence, Patterns And Outcomes, N. Gangat, M.A.A. Khan, M. Mujib, Mohammad Khurshid Jan 2004

Pulmonary Infiltrates During Chemotherapy-Induced Febrile Neutropenia: Incidence, Patterns And Outcomes, N. Gangat, M.A.A. Khan, M. Mujib, Mohammad Khurshid

Section of Haematology/Oncology

OBJECTIVE: To analyze the incidence, etiologies, radiographic patterns, and clinical outcomes of adult leukemics with prolonged febrile neutropenia and pneumonia.
METHODS: A retrospective study was conducted at a tertiary care hospital. The medical records of adult patients with acute myeloid leukemia diagnosed between January 1989 and June 2000 and undergoing induction chemotherapy were included. Only the patients who presented with a pulmonary infiltrate, secondary leukemia (e.g., transformed chronic myeloid leukemia underlying myelodysplastic syndrome, or disease following alkylating agent therapy) were included and those developing infiltrates following consolidation chemotherapy were excluded.
RESULTS: A total of 124 patients were admitted …


Congenital Duodenal Diaphragm In Eight Children, Akhtar Nawaz, Hilal Matta, Alic Jacobsz, Omar Trad, Ahmed H. Al Salem Jan 2004

Congenital Duodenal Diaphragm In Eight Children, Akhtar Nawaz, Hilal Matta, Alic Jacobsz, Omar Trad, Ahmed H. Al Salem

Department of Obstetrics & Gynaecology

Background: Congenital duodenal obstruction (CDO) is a common and usually easy to diagnose cause of intestinal obstruction in the newborn, except when the cause of the obstruction is a duodenal diaphragm. We describe our experience with eight children who had intrinsic duodenal obstruction secondary to a duodenal diaphragm.
Methods: The medical records of 22 children with the diagnosis of congenital intrinsic duodenal obstruction were reviewed for age at diagnosis, sex, gestation, birth weight, clinical features, associated anomalies, method of diagnosis, treatment and outcome. Operative findings and procedures were obtained from the operative notes.
Results: Eight of the 22 children (36.4%) …


Reversible Obstructive Sleep Apnea And Right Heart Failure Due To Massive Tonsillar Hypertrophy, Mehnaz Atiq, Fatima Masood, Mubasher Ikram, Raana Haqqee Jan 2004

Reversible Obstructive Sleep Apnea And Right Heart Failure Due To Massive Tonsillar Hypertrophy, Mehnaz Atiq, Fatima Masood, Mubasher Ikram, Raana Haqqee

Section of Otolaryngology, Head & Neck Surgery

Obstructive sleep apnea is a relatively common but under diagnosed clinical entity in children. Adenotonsillar hypertrophy is the most common cause for upper airway obstruction in pediatric patients. If the obstruction to upper airways is not relieved, then the child can develop obstructive sleep apnea and its consequences. Treatment is simply to remove the obstruction thereby restoring patency of upper airways


Analysis Of Cervical Smears In A Muslim Population, Shahnaz Wasti, Waleed Ahmed, Abbas Jafri, Behram Khan, Rizwan Sohail, Sheema Hassan Jan 2004

Analysis Of Cervical Smears In A Muslim Population, Shahnaz Wasti, Waleed Ahmed, Abbas Jafri, Behram Khan, Rizwan Sohail, Sheema Hassan

Department of Obstetrics & Gynaecology

Background: Screening for cancer of the cervix remains a neglected health care issue in Pakistan. To provide baseline data for future efforts to improve screening, we conducted a retrospective analysis of cervical smears taken in the obstetrics and gynaecological clinics of the Aga Khan University Hospital, Karachi, Pakistan.
Method: We collected data on cervical smear cytology for cervical smears taken from January 1, 1990 to December 31,1996. We assessed risk factors for dysplasia, including age, age at first marriage, and number of pregnancies.
Results: The overall prevalence of abnormal smears in our study was 0.5%. Of 20,995 cervical smears, 12,451 …


Patients' Views About Physicians' Spiritual Role In Medical Practice, Waris Qidwai, Arsalan Tayyab Jan 2004

Patients' Views About Physicians' Spiritual Role In Medical Practice, Waris Qidwai, Arsalan Tayyab

Department of Family Medicine

OBJECTIVE: To study patient perceptions with regard to spirituality in medical practice.
DESIGN: A questionnaire-based survey.
PLACE AND DURATION OF STUDY: Family Practice Center of Aga Khan University Hospital, Karachi, Pakistan, during July 2003.
SUBJECTS AND METHODS: Family practice patients were interviewed using a questionnaire which included data on demographic profile of the patient and perceptions on spirituality in medical practice. The study investigators administered the questionnaire without using systematic randomization. Ethical requirements including the administration of a written informed consent and the provision of confidentiality were ensured. SPSS computer software was used for data management.
RESULTS …


Knowledge, Attitude And Practice Regarding Obesity Among Patients, At Aga Khan University Hospital, Karachi, Waris Qidwai, Iqbal Azam Jan 2004

Knowledge, Attitude And Practice Regarding Obesity Among Patients, At Aga Khan University Hospital, Karachi, Waris Qidwai, Iqbal Azam

Department of Family Medicine

BACKGROUND: Obesity is a major public health problem and responsible for significant morbidity and mortality among our patients. It is important to study the knowledge, attitude and practices with regard to obesity among patients, in order to devise interventional strategies.
METHODS: Patients visiting the out-patient clinics of Aga Khan University Hospital, Karachi, were included in the study. The interview was questionnaire-based and recorded the demographic profile of the patients and questions relevant to the objective of the study. The ethical requirements for the study were met. SPSS computer software was used for data management. A hundred patients were surveyed. …


Consequences Of A Medical Emergency Among Emergency Room Patients, Waris Qidwai, Ali Ss, M Baqir, Shahana Ayub Jan 2004

Consequences Of A Medical Emergency Among Emergency Room Patients, Waris Qidwai, Ali Ss, M Baqir, Shahana Ayub

Department of Family Medicine

Objective: To study the consequences of a medical emergency among Emergency Room patients, at a teaching hospital in Karachi, Pakistan.
Design: A questionnaire-based survey
Settings: Emergency Room of Aga Khan University Hospital in Karachi, Pakistan. Main outcome measures: Consequences of a medical emergency in terms of impact on employment, financial position, family life, social life, recreational life, self-confidence and psyche.
Results: A hundred patients were surveyed. Emergency Room patients feel that they will not have a major impact on their job or employment, as a result of the medical emergency but it will have adverse financial consequences. The …


A Need To Change Behavior And Attitudes In Medical Practice, Waris Qidwai Jan 2004

A Need To Change Behavior And Attitudes In Medical Practice, Waris Qidwai

Department of Family Medicine

No abstract provided.


Perception About Family Physicians: Results Of A Survey Of Patients Visiting Specialist Clinics For Treatment, S. A. Huda, Z. A. A. Samani, Waris Qidwai Jan 2004

Perception About Family Physicians: Results Of A Survey Of Patients Visiting Specialist Clinics For Treatment, S. A. Huda, Z. A. A. Samani, Waris Qidwai

Department of Family Medicine

Objective: To study the perceptions about Family Medicine among patients visiting Specialist Physicians for treatment.
Methods: A questionnaire based survey was conducted at the Specialist Clinic, Aga Khan University Hospital, Karachi, Pakistan, in June 2004. Trained volunteers administered the questionnaire among patients visiting Specialist Physicians for treatment. Confidentiality was ensured to all patients and written informed consent was taken as part of the ethical requirements for the conduct of the study. SPSS computer software and Microsoft Excel were used for data management.
Results: A total of 100 patients visiting the Specialist Clinic were interviewed, of which fifty four …


Ever Increasing Need For Family Physicians, Waris Qidwai Jan 2004

Ever Increasing Need For Family Physicians, Waris Qidwai

Department of Family Medicine

No abstract provided.


Awareness Of The Process Of Informed Consent Among Family Practice Patients In Karachi, H. Bhurgri, Waris Qidwai Jan 2004

Awareness Of The Process Of Informed Consent Among Family Practice Patients In Karachi, H. Bhurgri, Waris Qidwai

Department of Family Medicine

Objective: To study the awareness of 'Informed Consent', among patients presenting to Family Physicians.
Methods: A cross-sectional study was carried out at the Community Health Centre, Aga Khan University Hospital, Karachi in July 2002. Written Consent was taken and confidentially was assured
Results: Out of the 100 patients interviewed, 80 agreed to participate in the study, forty-four men and thirty-six women. Approximately half the participants (45%) were graduates and 40% had less than five years of school education. The awareness of the process of 'informed consent' was observed in only 20% of the respondents, all in the educational …


The Hippocratic Oath: Has It Ceased To Be Relevant?, Waris Qidwai Jan 2004

The Hippocratic Oath: Has It Ceased To Be Relevant?, Waris Qidwai

Department of Family Medicine

The Greek physician Hippocrates (460-377 B.C) is traditionally regarded as the founder of medicine, scientific discipline and medical ethics.The Hippocratic Oath, taken by ancient and medieval doctors, requires high ethical standards from medical doctors. Its principles are considered important in professional and ethical education of medical doctors even today. The Hippocratic Oath has survived, with over-riding power, the test of time since it addresses the intrinsic nature of medicine. Even those who know little of it or reject parts of it acknowledge it to be a symbol of the values of medicine. It has been argued that it is its …


Distribution Of Lower Urinary Tract Symptoms (Luts) In Adult Women, M Andrades, R Paul, A Ambreen, S Dodani, Rh Dhanani, Waris Qidwai Jan 2004

Distribution Of Lower Urinary Tract Symptoms (Luts) In Adult Women, M Andrades, R Paul, A Ambreen, S Dodani, Rh Dhanani, Waris Qidwai

Department of Family Medicine

OBJECTIVE: To determine the distribution of lower urinary tract symptoms in adult women and the frequency with which the women consulted a health care provider for their symptoms.
DESIGN: Cross-sectional analytical study.
PLACE AND DURATION OF STUDY: Community Health Center of Aga Khan University Hospital from November 1st to 30th, 2002.
SUBJECTS AND METHODS: A trained interviewer administered a structured questionnaire to women patients or attendants aged 18 years and older coming to the center.
RESULTS: Fifty-two percent of the study subjects reported having at least one or more urinary complaints in the past. Stress incontinence …


A Young Man With Hoarseness Of Voice, Waris Qidwai, S. Rehman Jan 2004

A Young Man With Hoarseness Of Voice, Waris Qidwai, S. Rehman

Department of Family Medicine

A 45 year-old driver presented with a two months history of hoarseness, fever, productive cough, anorexia and weight loss. He chewed tobacco. He was previously seen and treated without benefit by a family Physician and two ear, nose and throat consultants. Crackles were heard in the left scapular region. An X-Ray of the chest showed a right apical cavity, perihilar infiltrates and blunting of left costophrenic angle. His sputum smear showed acid fast bacilli. A high index of suspicion for tuberculosis is recommended while dealing with such cases. Complete recovery of patient's voice with anti-tubercular therapy confirmed it was a …


Banti's Syndrome: Case Report And Review Of Literature, S. N. Waqar, S. Jindhani, N. S. Baig, M. A. Waqar, Faisal Wasim Ismail, Muhammad Tariq Jan 2004

Banti's Syndrome: Case Report And Review Of Literature, S. N. Waqar, S. Jindhani, N. S. Baig, M. A. Waqar, Faisal Wasim Ismail, Muhammad Tariq

Section of Internal Medicine

No abstract provided.


Increased Expression Of Hla Dr2 In Acquired Aplastic Anemia And Its Impact On Response To Immunosuppressive Therapy, M. Usman, Salman Adil, Tariq Moatter, F. Bilwani, S. Arian, Mohammad Khurshid Jan 2004

Increased Expression Of Hla Dr2 In Acquired Aplastic Anemia And Its Impact On Response To Immunosuppressive Therapy, M. Usman, Salman Adil, Tariq Moatter, F. Bilwani, S. Arian, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To study the frequency of HLA DR2 status of patients with aplastic anemia and their response to immunosuppressive therapy at a tertiary care hospital.
Methods: Thirty eight consecutive patients of acquired aplastic anemia were evaluated with respect to demographic features, severity of HLA DR2 status and response outcome to immunosuppressive therapy.
Results: The mean age of the patients was 24.6 years + 16.4 with a male to female ratio of 2.8:1. Positivity of HLA DR2 was markedly high in acquired aplastic anemia patients. Twenty four (65%) out of 38 patients as compared to 45 (15%) of …


Polycythemia Vera And Idiopathic Erythrocytosis: Comparison Of Clinical And Laboratory Parameters, M. Usman, F. Bilwani, G. N. Kakepoto, Salman Adil, R. Sajid, Mohammad Khurshid Jan 2004

Polycythemia Vera And Idiopathic Erythrocytosis: Comparison Of Clinical And Laboratory Parameters, M. Usman, F. Bilwani, G. N. Kakepoto, Salman Adil, R. Sajid, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Objective: To evaluate the various clinical and laboratory parameters of Polycythemia vera and idiopathic erythrocytosis in order to differentiate between two entities at the Aga Khan University Hospital.
Methods: Twenty six patients of polycythemia vera and 34 patients of idiopathic erythrocytosis were analyzed with respect to clinical features and laboratory findings.
Results: Patients with idiopathic erythrocytosis were males with a mean age of 41 years and no splenomegaly. Patients with polycythemia were older males and females with splenomegaly, red cell count of mor than 6.5 million/cmm, haematocrit 55%, leucocytosis, thrombocytosis and low erythropoietin level.
Conclusion: Based …