Medical Specialties Commons^™

Impaired Splenic Function In Systemic Amyloidosis: Diagnostic Importance Of Peripheral Blood Film, F. Bilwani, Salman Adil, G. N. Kakepoto, Mohammad Khurshid, A. Ahmed

Department of Pathology and Laboratory Medicine

We describe case of a 40 year old male, who went on to developed systemic amyloidosis 3 years after the diagnosis of chronic renal failure. The diagnosis of systemic amyloidosis was suspected upon a routine examination of periheral blood film showing features of hyposlenism. We would like to highlight the importance of examination of pheripheral blood film in patients with renal failure for the diagnosis of extensive systemic amyloidosis which occasionally leads to functional hyposplenism, recognized by the presence of abnormal red cell morphology and reduced splenic uptake on isotope scan¹.

Anatomical Variations Of Internal Jugular Vein As Seen By "Site Rite Ii" Ultrasound Machine--An Initial Experience In Pakistani Population, Hameedullah, M. A. Rauf, Fazal Hameed Khan

Department of Anaesthesia

Objective: To determine the anatomical variations of the internal jugular vein (IJV) in Pakistani adult population with the help of Site Rite II ultrasound machine.
Material and Method: The right IJV relation to the carotid artery was visualized at four different landmarks (angle of the mandible, thyroid cartilage, cricoid cartilage, and the supraclavicular area). Size of IJV in comparison to carotid artery was also seen.
Results: In 49 cases the IJV was found in aberrant relation to carotid artery at the angle of the mandible (p value
Conclusion:Care should be taken while cannulating IJV at the angle of the …

Acute Haemolysis In Childhood Falciparum Malaria, H. Ekvall, P. Arese, F. Turrini, K. Ayi, F. Mannu, Zul Premji, A. Bjorkman

Pathology, East Africa

Acute haemolysis associated with clinical episodes of high-level Plasmodium falciparum parasitaemia was studied in 20 children from an holoendemic area (coastal Tanzania). The change in blood haemoglobin (Hb) concentration ranged from -46 to +5 g/L during the 72-h observation period and was linearly related to maximum parasitaemia. Balance studies between loss of blood Hb, increase in plasma Hb and appearance of Hb in the urine indicated that extravascular clearance of red cells was the predominant mode of erythrocyte clearance. Most subjects, however, showed minor signs of intravascular haemolysis. The plasma Hb was ≪1% of blood Hb and haemoglobinuria was detected …

Hemoglobin Concentration In Children In A Malaria Holoendemic Area Is Determined By Cumulated Plasmodium Falciparum Parasite Densities, H. Ekvall, Zul Premji, S. Bennett, A. Bjorkman

Pathology, East Africa

In malaria holoendemic areas children are anemic, but the exact influence of falciparum malaria on hemoglobin (Hb) concentration remains largely unsettled. Prospective data were therefore collected in children < 24 months of age during five months in a Tanzanian village. Children with mean asymptomatic parasitemia ≥ 400/μl had lower median Hb levels during the study than those with mean density < 400/μl. The difference was 9.7 g/L (95% confidence interval [CI] 2.8-17). In children with one or more clinical malaria episodes, the median Hb was 8.3 g/L (95% CI 0.9-16) lower than those without episode. If early treatment failure was recorded, the immediate effect on Hb was particularly important with a mean drop of 17 g/L. Interestingly, at study-end the Hb concentration represented a function of the area under the parasitemia curve (AUPC) during the previous five months, adjusting for age. In conclusion, stepwise deterioration in median Hb levels was found by asymptomatic parasitemia, clinical malaria episode, and most significantly, treatment failure.

Foreign Body Granuloma After Craniotomy For Tumor: A Diagnostic Dilemma, Ashfaq A. Razzaq, M. K. N. Chishti

Section of Neurosurgery

No abstract provided.

Job's Syndrome, M A. Yousafzai, K Nasim, S Q. Nizami

Department of Paediatrics and Child Health

No abstract provided.

Histological Pattern Of Ovarian Neoplasma., Zubair Ahmad, Naila Kayani, Sheema H. Hasan, Suhail Muzaffar, Muhammad Shafiq Gill

Department of Pathology and Laboratory Medicine

Abstract

Objective: To see the morphological pattern of benign and malignant ovarian neoplasms. Method: Retrospective study of all consecutive cases of ovarian neoplasms diagnosed at Aga Khan University Hospital between 1st January 1993 and 30th September 1998. Setting: The Section of Histopathology, AKUH, Karachi. Observation: Of 855 ovarian tumours 506 (59.18%) were benign and 349(40.81%) malignant. Surface epithelial - stromal tumours comprised 63.50% of all tumours. Benign cystic teratoma was the commonest benign tumour (35.17% of all benign tumours) and serous cystadenocarcinoma was the commonest malignant tumour (33.33% of all malignant tumours). Mucinous cystadenocarcinomas are more common in our population …

Granular Cell Tumor Of The Breast: An Uncommon Lesion That Mimics Carcinoma, S Muzafar, M S. Siddiqui, Naila Kayani, I K. Lodhi, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

No abstract provided.

Retinoblastoma Tells The Story Of Our Health Care System, Irshad Soomro, Muhammad Nadeem Khan, Suhail Muzaffar, Naila Kayani, Shahid Pervez, Akbar Shah Hussainy, Rashida Ahmed, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:

To review cases of retinoblastoma.

Setting:

Department of Pathology Aga Khan University Hospital Karachi.

Method:

Twenty three specimens from cases of retinoblastoma received over a period of eight years were routinely processes and stained with haematoxylin and Eosin stain Other stains were used for tuberculosis and melanin. Immunochemistry was resorted to in undifferentiated tumors.

Results:

Over 60% cases of retinoblastoma were diagnosed after 5 years and nine cases showed involvement of opti-nerve.

Conclusion:

Late diagnosis of retinoblastoma effects the stage of the tumors and the prognisis.

Human Subject Research, Ethics And The Developing World, F Moazam

Department of Surgery Docs

No abstract provided.

Gram Negative Meningitis Resulting From Rupture Of A Spinal Epidural Abscess Into The Subarachnoid Space, S Lodhi, T Mozaffar, A R. Sarwari

Section of Neurology

No abstract provided.

Endocrine Cell Dysplasia (Nesidioblastosis): A Relatively Unrecognized Entity In Pakistan?, Nasim Sabir, Irshad Nabi Soomro, Zafar Nazir, Abdul Jabbar, Sheema Hasan

Section of Paediatric Surgery

Nesidioblastosis is quantitative as well as qualitative abnormality of pancreatic endocrine cells. There is scattering of small endocrine cell clusters arranged haphazardly rather than the peripheral location within the lobule^1,2. Islet contours are irregular, tailing off into parenchyma³. These islets are present in intimate association with ducts forming ductuloinsular complexes¹ We recently encountered a new born baby with signs and symptoms of endocrine cell dysplasia.

A Comparative Study Of Positive Pressure Ventilation Via Laryngeal Mask Airway And Endotracheal Tube, A Idrees, F A. Khan

Department of Anaesthesia

Objective: To investigate the use of Laryngeal Mask Airway (LMA) and its comparison with the endotracheal tube for positive pressure ventilation.SETTING: A tertiary care teaching hospital.Methods: Fifty adult ASA I and II patients undergoing peripheral limb surgery were randomly allocated to 2 groups for LMA or endotracheal tube insertion. A standardized anaesthetic technique was used. The groups were then compared regarding haemodynamic changes on insertion as well as removal of LMA and ETT and any complications that occurred were noted.Results: The haemodynamic response to insertion was significantly attenuated (p < 0.05) in LMA group as compared to ETT group. The cardiovascular response to extubation was not significantly different between the groups. A higher incidence of coughing and mild hypoxaemia at extubation was noted in ETT group as compared to LMA group (p < 0.05) and blood was detected in 4 cases after LMA removal.CONCLUSION: It is concluded that the use of LMA during positive pressure ventilation is safe in selected cases. There is an attenuated haemodynamic response to insertion of LMA as compared to endotracheal tube which will be beneficial in certain patients e.g., those with ischaemic heart disease, vascular disease and hypertensives.

Non-Small Cell Lung Cancer: Disease Spectrum And Management In A Tertiary Care Hospital, M R. Khan, S B. Hasan, S A. Sami

Department of Surgery Docs

Objectives: To review the spectrum of presentation and the surgical management of Non Small Cell Lung Cancer (NSCLC) and the role of various diagnostic modalities in predicting the post-operative stage and the correlation of the post-operative stage with the chances of recurrence.SETTINGS: The Aga Khan University Hospital, Karachi--a tertiary care referral center in Paksitan.Methods: This is a retrospective study of medical records of all the patients who were managed at the Aga Khan University Hospital (AKUH) between 1988 and 1998. The patients with a diagnosis of lung cancer were identified using the ICD-9-CM coding system and the data was analyzed …

Dna Ploidy Analysis Of Borderline Epithelial Ovarian Tumours, Saba Lodhi, Sabeen Najam, Shahid Pervez

Department of Pathology and Laboratory Medicine

Objective: Borderline epithelial ovarian tumors not uncommonly pose a great difficulty to surgical pathologists as morphologically they may show very similar features as those of malignant epithelial tumors except invasion. However it is important to separate these from their invasive counterparts because of their superior prognosis. Recently, attention has been focussed on the prognostic value of flow cytometric analysis of DNA ploidy in borderline epithelial ovarian tumors. The purpose of this study is to investigate whether flow cytometric analysis of cellular DNA content acts as a useful adjunct to the histopathological diagnosis of borderline malignancy.

Materials and Methods: Fifteen histologically …

Clinical Spectrum Of Systemic Lupus Erythematosus At The Aga Khan University Hospital., K. Sulaiman, N. Sohail, A. A. Sheikh, F. Raza, F. Shahzad, A. Siddique, T. Shakir, Fauziah Rabbani

Community Health Sciences

BACKGROUND:

Systemic lupus erythematosus is a disease of unknown etiology, which at onest may involve only one organ system or be multisystemic. The aim of our study is to determine the clinical presentation of SLE patients presenting to AKUH to establish whether guidelines laid down about this disease are in agreement with our experience.

METHODS:

A retrospective log review was carried out at AKUH, based on data obtained from 165 files of individuals admitted to the hospital over a period of 12 years with a confirmed diagnosis of SLE.

RESULTS:

From the sample size of 165, 143 (86.7%) were females …

Why Has So Little Changed In Maternal And Child Health In South Asia?, Z A. Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Low Serum Alpha 1 Antitrypsin In Duodenal Ulcer--A Family Study, Anjum Shahid, Sarwar J, Zuberi Mohammad A, Waqar,Huma Qureshi Waqar,Huma Qureshi Waqar,Huma Qureshi, Anwar Ali Siddiqui, Taranum Sultana

Department of Biological & Biomedical Sciences

No abstract provided.

Surgical Management Of Penile Cancer: Report Of Two Cases, M Amjad Noor, Muhammad Hammad Ather, M Nasir Sulaiman, Farhat Abbas

Section of Urology

No abstract provided.

Genetic Diversity Of Beta-Thalassemia Mutations In Pakistani Population, B Khateeb, T Moatter, A M. Shaghil, S Haroon, G N. Kakepoto

Department of Pathology and Laboratory Medicine

Background:
beta-thalassemia is one of the most common inherited single gene disorder in Pakistan. It is characterized by reduced or absent beta-globin gene expression resulting in abnormal maturation and survival of red blood cells. Due to high prevalence of this disease in the local population, it has become important for the health care providers to encourage people to utilize laboratory facilities for carrier and prenatal genetic testing.
Objective:
To study the frequency of beta-thalassemia mutations in Pakistani population.
Setting:
A tertiary care teaching hospital.
Methods:
Blood samples of 72 couples and chorionic villus (CV) biopsy specimen collected at the Aga …

The Minds Of Mothers: Maternal Mental Health In An Urban Squatter Settlement Of Karachi., Fauziah Rabbani, Furqan Farooq Raja

Community Health Sciences

BACKGROUND:

Community-based information on maternal mental health in developing countries is meager and nearly non-existent in Pakistan.

OBJECTIVE:

To determine the proportion of probable cases of women with mental disorders and examine the associated conditions and risk factors which contribute to maternal mental ill-health.

METHODS:

With convenient sampling 260 mothers in an urban squatter settlement of Karachi were interviewed. The tools consisted of a household questionnaire collecting information on basic demographic and other characteristics and the Aga Khan University Anxiety and Depression Scale (AKUADS), an instrument to assess psychiatric morbidity.

RESULTS:

The proportion of probable cases of mental disorder was …

Genitourinary Tuberculosis: A Profile Of 55 In-Patients, N P. Buchholz, S Salahuddin, R Haque

Section of Urology

Objective: To outline the pattern and trends in major cases of genito-urinary tuberculosis (GUTB) which require hospital treatment.
Method: We retrospectively reviewed 55 patients with proven GUTB who were treated as in-patients in a major referral hospital in Pakistan.
Results: The male/female ratio was 3:1. Prevailing symptoms were lower urinary tract symptoms, flank pain, gross hematuria and fever. A urine culture was positive for tuberculosis (TB) in 57%, bladder biopsies in 54%. For renal TB, intravenous urogram (IVU) and ultrasound were suggestive in about 50% of cases. Ultrasound was very helpful in the diagnosis of testicular TB. Patients underwent surgery …

Genetic Analysis Of Cystic Fibrosis In Pakistan: A Preliminary Report, Z A. Bhutta, T Moattar, U Shah

Department of Paediatrics and Child Health

Objective: Evaluation of the incidence of common delta F508 mutation in a cohort of Pakistani children with Cystic Fibrosis (CF).
Methodology: The presence of the CFTR gene mutation at position 508 (delta F508) was evaluated in 15 consecutively presenting children with CF, proven by clinical features and an unequivocally positive sweat chloride test. The DNA from mononuclear cells was extracted and the delta F508 mutation assessed by the amplification refractory mutation system using the polymerase chain reaction.
Results: The delta F508 mutation was found in 9 cases (60%), of which 5 were homozygous for the disorder.
Conclusion: In this preliminary …

A Comparison Of Dissection-Method And Diathermy Tonsillectomies, Muneeb Ahmed, Adil Abbas Khan, Tanya Siddiqi, Mubasher Ikram, M Yousuf Mian

Section of Otolaryngology, Head & Neck Surgery

Objective: To compare the dissection and diathermy methds of tonsillectomy and evaluate their advantages and disadvantages during surgery and convalescence.
Methods and Setting: Patients who had tonsillectomy at Aga Khan University Hospital, between January 1994-December 1997.
Results: Four year retrospective analysis was done of 200 patients who underwent tonsillectomy by either electrocautery or dissection method. One hundred and eleven underwent tonsillectomy by electrocautery and the other 79 had their tonsils removed by dissection-method and 2 had a combination of both. The average intra­operative blood loss was 10 ml with cautery and 65 ml with dissection method. The average operative time …

Tibial Plateau Fractures: A New Classification Scheme, Raja Muhammad Shahzad Khan, Shuja Hassan Khan, Agha Jamil Ahmad, Muhammad Umar

Section of Orthopaedic Surgery

Fractures of the tibial plateaus are common injuries. Various classification schemes have been used to describe these injuries. Although each system has its own purpose, the simpler systems do not allow comparison with more complex divisions. The problem is compounded by the variable use of adjectives that describe these fractures. A comprehensive classification of tibial plateau fractures should group fractures that are similar in topography, morphology, and pathogenesis, requiring similar treatment, and having a similar prognosis. Fracture dislocations and standard tibial plateau fractures should be incorporated into a single classification to avoid the use of two complementary classifications. Any such …

Cerebellopontine Angle Medulloblastoma, Naim-Ur-Rahman, A Jamjoom, M Al-Rayess, Z A. Jamjoom

Section of Neurosurgery

No abstract provided.

Incidence And Pattern Of Thrombocy To Penia In Cardiac Surgery Patients, S Bashir, S M. Shah, I Babar

Department of Anaesthesia

No abstract provided.

Association Of Epstein Barr Virus (Ebv) With Nasopharyngeal Carcinoma (Npc), S H. Shah, I N. Soomro, S Haroon, T Moatter

Department of Pathology and Laboratory Medicine

Aim:
To observe the frequency of nasopharyngeal carcinoma (NPC) and its association with Epstein Barr Virus (EBV) infection.
Setting:
This study included consecutive cases of nasopharyngeal carcinoma, which were diagnosed in the Department of Pathology at the Aga Khan University Hospital, Karachi in the period of two years (1996-97).
Methods:
These tumors were initially evaluated on H&E stained sections. The tumors showing evidence of keratinization were excluded from the study. The Epstein Barr Virus was detected with the help of Polymerase chain reaction in formalin fixed, paraffin embedded tissue sections.
Results:
During the study period, seventeen cases of nasopharyngeal carcinoma …

Audit Of Lymph Node Biopsies In Suspected Cases Of Lymphoproliferative Malignancies: Implications On Tissue Diagnosis And Patient Management, Mohammad Zeeshan Qamar, Mehrukh Mujib, Shahid Pervez

Department of Pathology and Laboratory Medicine

Aims: To carry out an audit ascertaining the importance of condition of lymph node specimen, submission of clinical history including site of biopsy and imrnunohistochemcial studies on conclusiveness of diagnosis made.

Methodology: Computer records of the Aga Khan University Hospital, Histopathology Laboratory were used to analyze all cases of lymphoproliferative malignancies presented at the hospital from 1992 to 1998.

Results: Out of a total of 466 cases studied, in 283 (61%) the lymph nodes were fragmented. The site of biopsy was mentioned in 361 (77.5%) cases with the cervical region forming the most common site (56.5%). A clinical history was …

Pilomatrixoma And Pilomatrix Carcinoma Deceptively Similar But Distinct Entities, T S. Khan, A Khan

Department of Surgery Docs

No abstract provided.