Medical Specialties Commons^™

A Comparison Of Morphine And Nalbuphine For Intraoperative And Postoperative Analgesia, F N. Minai, F A. Khan

Department of Anaesthesia

Introduction: Short acting narcotics are not available in Pakistan and the supply of drugs like morphine and pethidine is short and erratic; therefore there is a need for investigating acceptable alternatives for analgesia, to be used for balanced anaesthesia.Objective: We studied the agonist-antagonist narcotic nalbuphine compared to morphine, for intra and postoperative pain relief in total abdominal hysterectomies.Methods: In a randomised double blind trial, fifty ASA I and II patients in two groups of twenty five each were given equianalgesic doses of morphine and nalbuphine. Hemodynamic stability, intraoperative analgesia, recovery profiles, incidence of side effects and need for postoperative supplements …

Risk Factors For Cardiovascular Disease In School Children--A Pilot Study., A. K. Khuwaja, Zafar Fatmi, W. B. Soomro, N. K. Khuwaja

Community Health Sciences

OBJECTIVE:

To assess the frequencies of risk factors for cardiovascular disease in school children. The information may help in designing interventions aimed at modifying unhealthy lifestyle in children, which may reduce the later incidence of cardiovascular disease in adults.

METHODS:

A cross-sectional study was conducted on 206 students (ages 14-18 years), enrolled in higher secondary school. Students were interviewed about their lifestyles, family history of cardiovascular disease and its risk factors. Moreover, they were assessed for height, weight and blood pressure.

RESULTS:

Twenty nine percent of the children were physically inactive, 31% were taking unhealthy diet daily, 21% were overweight …

Laparoscopic Appendicectomy At The Aga Khan Hospital, Nairobi, S. C. Patel, G. F. Jumba, S. Akmal

General Surgery, East Africa

Objective: To evaluate our experience of laparoscopic appendicectomy at the Aga Khan Hospital, Nairobi over a six year period from the inception of the technique and to assess its advantages and disadvantages.

Design: Case series study.

Setting: The Aga Khan Hospital, Nairobi.

Patients: One hundred and six cases operated on from May 1996 to June 2002. Main outcome measures: Clinical presentation, age and sex demographics, average hospital stay, operating time, intra-operative and post-operative complications and outcome.

Results: There was a female preponderance with a female to male ratio of 2:3:I. Mean age was 30.6 years. There was a slightly more …

Treatment Failure Of Tuberculosis Due To Concomitant Pathology, Z A. Qasim, A R. Sarwari, S M. Jilani

Section of Pulmonary & Critical Care

No abstract provided.

Peritumoral Cystic Meningioma, Arshad A. Siddiqui, Junaid Asharaf, Ahmed Ali Shah

Section of Neurosurgery

A case of 39 years old male is described who presented with headache, right-sided focal fits and decreased power in the right hand. CT scan brain showed a left fronto-parietal cystic lesion with centrolateral intramural nodule with homogenous enhancement. At surgery, the extra-axial lesion with cyst containing xanthochromic fluid had a well-defined capsule that could easily be separated from the peri-lesional cortical surface. The dural-based nodule with its cyst wall was resected in toto. The histopathology of mural nodule was reported as meningioma while the cyst wall histology revealed meningothelial cells.

Diagnosis Of Pulmonary Embolism With Helical Ct Scan, M U. Usman, V Bari, Javed Yakoob, Murad M. Khan Dr.

Department of Radiology

Objective: To determine the role of helical C.T. scan in the diagnosis of pulmonary embolism.SETTING: Radiology department, Aga Khan University Hospital. One year prospective study May 2001 to May 2002.Methods: Sixty patients suspected of having pulmonary embolism were included in this study. Helical C.T. scan chest was performed from aortic arch to lung bases with intravenous contrast medium. Images were acquired in mediastinal and lung windows. Image interpretation was performed on the console and hard copies for main branch and segmental thrombus.Results: Fifteen patients were diagnosed of having pulmonary embolism on C.T. scan. Clinical correlation and follow up with pulmonary …

Isolated Congenital Bilateral Absence Of Vas Deferens (Cbavd): A Rare Anomaly And Diagnostic Dilemma, M Moazzam, Syed Raziuddin Biyabani, C K. Jadoon

Section of Urology

No abstract provided.

What Is Wrong With Medical Audit?, J H. Rizvi

Department of Obstetrics & Gynaecology

No abstract provided.

Tuberculosis Diagnosis And Treatment Practices Of Private Physicians In Karachi, Pakistan, J Khan, A Malik, H Hussain, N K. Ali, F Akbani, S J. Hussain, G N. Kazi, S F. Hussain

Section of Pulmonary & Critical Care

In a densely populated urban area of Karachi, Pakistan, a questionnaire survey was made of the knowledge and practices of 120 private general practitioners about the diagnosis and treatment of tuberculosis (TB). The majority knew that cough, fever and weight loss were the main symptoms of TB, but less than half knew that blood in sputum, poor appetite and chest pain were associated with the disease. Only 58.3% of physicians used sputum microscopy for diagnosing TB and 35.0% used it as a follow-up test. Only 41.7% treated TB patients themselves, the remaining referring their patients to specialists. Around 73.3% of …

The Frequency Of Iga Nephropathy At A Single Center In Pakistan, S. Muzaffar, N. S. Azad, N. Kayani, Shahid Pervaz, A. Ahmed, S. H. Hasan

Department of Pathology and Laboratory Medicine

Objectives: To detect the prevalence of IgA nephropathy in Pakistani patients, as no significant published data from this part of the developing world is available in the international literature for reference.

Method: The study was conducted in a university hospital on 105 consecutive renal biopsy specimens. Direct immunofluorescence microscopy was performed using antibodies specific for the heavy chains of IgG, IgA, IgM, C3 and fibrinogen.

Results: Seventy-nine (79) cases were classified as glomerulopathies, out of which 10 cases (12.65%) were diagnosed as IgA nephropathy, among which one case was that of Henoch- Schonlein purpura. The age range was 6 to …

General Physicians' Perspective Of Sleep Apnea From A Developing Country, Syed Fayyaz Hussain, Sumaiya Zahid, Raana Haqqee, Javaid Ahmed Khan

Section of Pulmonary & Critical Care

To assess the knowledge of general physicians about the diagnosis and management of obstructive sleep apnea (OSA), a self-administered questionnaire, containing 15 questions, was distributed to 160 doctors attending a pulmonary CME program in March 2002. After 15 minutes of response time, the questionnaires were collected. The data were entered and analyzed using SPSS (Version 10.0) software. One hundred and twenty (75%) questionnaires were returned. Only 41% of responders had ever read an article about OSA and 36% had suspected it at least once in their practice. The majority (61-77%) of responders were aware of the common symptoms of OSA, …

Experience In 118 Consecutive Patients Undergoing Ct-Guided Stereotactic Surgery Utilizing The Cosman-Robert-Wells (Crw) Frame, G. R. Sharma, H. Siddiqui, Rashid Jooma

Section of Neurosurgery

Aims: To evaluate the efficacy of CT-guided neurosurgical procedures done on patients operated by this modality.
Methods: Between January 1997 and March 2000, 118 patients undergoing CT-guided stereotactic procedures were recruited to the study. The CRW III stereotactic system (Radionics, USA) and the TSX-00ZA CT Scanner (Toshiba, Japan) were used for all the procedures in the series. These procedures were directed to symptomatic brain lesions or for the treatment of Parkinsonian tremor.
Results: Of 118 patients, 109 had intra-cranial lesions and 9 had Parkinson's Disease. The stereotactic procedures performed on these patients were: biopsies in 62, guided mini-craniotomies in 22, …

Outbreak Of Sars, Ambreen Shakil, Muhammad Imran Omar, Saba Sohail

Department of Radiology

No abstract provided.

Radiosurgery For The Control Of Glomus Jugulare Tumours, Muhammad Ehsan Bari, A A. Kemeny, D M C Forster, M W. Radatz

Section of Neurosurgery

Objective: To ascertain the efficacy of stereotactic radiosurgery (gamma knife) for the control of glomus jugulare tumours.
Method: Between March 1994 and December 1997 we treated eight patients of glomus jugulare tumour with radiosurgery. These patients have been followed for more than four years (range 52 to 97 months). The age of the patients ranged between 32-64 years (mean 53 years). The male: female ratio was 3:5. Three patients had previously undergone surgery and one had unsuccessful embolization. The dose applied to tumour margin ranged between 16-25 Gy (median 25 Gy). Patients were followed up with yearly MRI scans and …

The Effect Of Proteinases (Keratinases) In The Pathogenesis Of Dermatophyte Infection Using Scanning Electron Microscope, Azam J. Samdani, Yaseer Al-Bitar

Department of Medicine

Objective: To study the inter-relationship between the stratum corneum of host and the fungal microorganisms using scanning electron microscopy for a complete understanding of the host parasite relationship.

Setting: The patients attended the outpatients of Department of Dermatology, King Abdul Aziz Hospital Makkah. The isolation & identification was carried out at the Department of Mycology University Hospital of Wales, Cardiff, U.K.

Material and Methods: Skin surface biopsies were obtained from two patients suffering from tinea cruris infection. One patient was infected with Trichophyton rubrum and the other with Epidermophyton floccosum strains.

Results: The scanning electron microphotographs obtained from two patients …

Morbidity Spectrum In The Veterans, Muhammad Imran Omar, Saba Sohail

Department of Radiology

No abstract provided.

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.