Medical Specialties Commons^™

Bone And Renal Stone Disease In Patients Operated For Primary Hyperparathyroidism In Pakistan: Is The Pattern Of Disease Different From The West?, Syed Raziuddin Biyabani, Jamsheer J Talati

Section of Urology

Objective: To document the clinical presentation of primary hyperparathyroidism (PHPT) in a developing country and note differences from the West.
Setting: A tertiary care teaching hospital.
Method: The records of 37 patients operated for PHPT between January 1986 and December 1997 were reviewed. Symptoms, laboratory parameters and histopathology results were analyzed.
Results: Surgery for PHPT accounted for 0.055% of 67,566 operative procedures performed in the Department of Surgery during the 12 year period. The mean age of our patients was 38.4±13.2 years (range 17 to 73 years). Ninety percent of patients were less than 60 years old and 51% less …

Telomere, Telomerase And Digestive Cancer, Javed Yakoob, Hu Guo-Ling, Fan Xue-Gong, Zhang Zheng

Section of Gastroenterology

No abstract provided.

Facial Nerve Palsy Unusual Complication Of Percutaneous Angiography And Emoblization For Juvenile Angiofibroma, Mubasher Ikram, Kamaluddin Khan, Moazzam Murad, Tanveer Ui Haq

Section of Otolaryngology, Head & Neck Surgery

Juvenile angiofibrorna is a locally invasive, vascular and non-encapsulated neoplasm occurring almost exclusively in adolescent males. Although histologically benign, these tumors are highly aggressive and are associated with significant morbidity and occasional mortality. It has marked tendency to recur if not completely removed1 . As the tumor is highly vascular, surgely is frequently accompanied by significant intraoperative hemorrhage, which may contribute to incomplete removal and additional morbidity and mortality2 . Roberson (1972) was first to advocate pre-operative angiography and embolization of major feeding vessels as an adjunct therapeutic method in addition to surgery, to facilitate complete excision of the tumOr …

Aspergillosis Of The Sphenoid Sinus With The Involvement Of The Clivus, Mubasher Ikram, S.S.M. Hussain, R Ahmad

Section of Otolaryngology, Head & Neck Surgery

Introduction: Fungal infections of the nose and paranasal sinuses are frequent in this part of the world. One aspect of the increased frequency is the improved clinical, radiological and pathological diagnostic methods that are now available. Aspergillus is the commonest infecting fungus of the nose and the paranasal sinus1 . It is mainly a saprophytic spore producing fungus and can cause invasive and non-invasive infections. The initial report of fungal paranasal infection largely dealt with immunocompromised individuals as distinct from the allergic fungal infection. Aspergillosis confined to the sphenoid sinus is uncommon with only 34 cases having been reported in …

Morphological Pattern And Frequency Of Thyroid Tumors, S H. Shah, S Muzaffar, I N. Soomro, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:
The present study was done to evaluate the frequency of thyroid cancer and to find out the prevalence of histological types of thyroid tumor with respect to age and sex group.
Setting:
This study included consecutive cases of malignant tumors of thyroid gland, which were diagnosed in the Department of Pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997).
Methods:
These cases were evaluated on H & E stained sections from paraffin embedded 10% buffered formalin fixed tissue blocks. Special stains and immunohistochemical analysis were performed whenever required.Results: A total of 8541 malignant …

Fine Needle Aspiration Cytology (Fnac) In The Management Of Thyroid Pathology - The Aga Khan University Hospital Experience, Mubasher Ikram, Jamil Hyder, Sohail Muzaffar, Sheema H. Hasan

Section of Otolaryngology, Head & Neck Surgery

Objective: To report the efficacy of FNAC in patients with thyroid disease.
Methods: Between January 1990 and December 1994 the records of all patients treated surgically for thyroid disease at ENT Head and Neck Surgery of Aga Khan University were reviewed. All the patients had pre­operative FNAC as the first line of evaluation and the histopathologist examined post-operative thyroid specimen.
Results: Forty-five patients (36 female and 9 male) had thyroid surgery. In 26 patients out of 45, FNAC was conclusive in diagnosing the nature of disease, while in 19 patients the FNAC was inconclusive because of the presence of follicular …

Views About Women's Mental Health: Study In A Squatter Settlement Of Karachi., Fauziah Rabbani

Community Health Sciences

OBJECTIVE:

Mental health of women is globally receiving particular attention. This study assessed community's view on certain aspects of women's mental health prior to introducing an intervention.

SETTING:

The study was conducted in an urban squatter settlement located in District West of Karachi in 1997 where the Aga Khan University has set up a Primary Health Care program in partnership with the communities.

METHODS:

Using convenient sampling, door to door household survey was conducted by medical students.

RESULTS:

Two hundred and eighty one residents were interviewed. Respondents were asked to list contributory factors which lead to mental distress in women. …

Dysphagia In Hereditary Sensory Autonomic Neuropathy Type Iv, U Shah, M Arshad, T Mozaffar

Department of Paediatrics and Child Health

No abstract provided.

Acute Urinary Retention: A Primary Manifestation Of Chronic Lymphocytic Leukemia And Organ Confined Prostate Cancer, Muhammad Hammad Ather, Amanullah Memon

Section of Urology

No abstract provided.

Economic Development And Health Status Among The Poor In Squatter Settlements Of Karachi., Fauziah Rabbani, Anwer T. Merchant

Community Health Sciences

OBJECTIVE:

Socioeconomic status is an important determinant of health outcome measures. This study examines and presents some of the important health outcomes amongst the higher and lower socioeconomic groups within the urban poor.

SETTING:

Data analysis is based on a Health and Demographic Survey conducted in urban squatter settlements of Karachi in 1996.

METHODS:

A structured questionnaire was administered to all households in the catchment area. The indicator used to assess economic status is ownership of assets.

RESULTS:

Comparison between the two economic levels shows that the lower socio-economic group was more likely to experience child mortality, (CI; 1.02-1.29, p …

Clinico-Morphological Pattern And Frequency Of Bone Cancer, Sajid H. Shah, Suhail Muzaffar, Irshad N. Soomro, Shahid Pervez, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

Objective:

The present study was done to find out the frequency of malignant tumors of bone and to categorize the prevelence of various histological types of osseous malignancies with respect to age, sex and site of origin.

Setting:

This study included consecutive cases of malignant bone tumors, which were diagnosed in the department of pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997).

Methods:

These tumors were initially evaluated on H & E stained section from paraffin embedded tissue blocks. Special stains and immunohistochemical analysis was performed whenever required.

Results:

A total of 169 …

Immunohistochemical Evaluation Of Small Round Cell Tumors Of Childhood, Sajid H. Shah, Irshad N. Soomro, M. Shahid Siddiqui, Shahid Pervez, Sheema H. Hassan

Department of Pathology and Laboratory Medicine

Objective:

This study was done to evaluate the pediatric undifferentiated small round cell tumors with immunohistochemical staining.

Setting:

The present study included consecutive cases of small round cell tumors which were diagnosed in children (<15 years) in the section of Histopathology at the Aga Khan University Hospital, Karachi during the period of two years.

Methods:

The group of undifferentiated small round cell tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, formalin fixed, paraffin embedded tissue blocks.

Results:

The category of undifferentiated small round cell tumors included rhabdomyosarcoma (23.2%), primitive neuroectodermal tumor (17.9%), non-Hodgkin’s lymphoma (16.1%), neuroblastoma (14.2%), Ewing’s sarcoma (10.7%) in order of frequency. Osteosarcoma (Small cell variant), retinoblastoma and medulloblastoma comprised …

Carotid Doppler Ultrasonography In Young Stroke Patients, A A. Razzaq, B A. Khan, C K. Jadoon, S M. Baig

Section of Neurology

Background: The present study focuses on the role of carotid doppler ultrasonography (CDUS) in the diagnosis and management of carotid stenosis in young stroke patients.

Methods: The findings of carotid doppler in 45 ischemic stroke patients between 15-45 years of age were reviewed retrospectively. The variables of interest for this study included risk factors for atherosclerotic disease, primary abnormality detected on carotid doppler ultrasonography (ulceration vs. stenosis), degree of stenosis and the type of plaque (soft vs. calcified).

Results: The prevalence of hypertension and diabetes was 50% and 35% respectively. The rate of carotid stenosis in the …

Clinico-Morphological Pattern Of Intracranial Tumors In Children, Sajid H. Shah, Irshad N. Soomro, Akbar S. Hussainy, S H. Hassan

Department of Pathology and Laboratory Medicine

Objective:
The objective of present study was to observe the histopathological pattern of intracranial tumors in children (< 15 yrs) and to correlate the site of lesion along with the histological diagnosis.
Setting:
The study included consecutive cases of intracranial tumors diagnosed in children (< 15 yrs.) in the section of histopathology at the Aga Khan University Hospital, Karachi during the period of three years.
Methods:
The initial histological evaluation of these lesions was performed on H and E stained section of paraffin embedded tissue. Special stains and immunohistochemical analysis was done whenever indicated.
Results:
During the study period, fifty-four cases of intracranial tumors were diagnosed in children. The age ranged from 1-1/2 years to 4 years with male to female ratio of 1.1:1. Astrocytoma comprised 39% of all intracranial tumors of childhood. Medulloblastoma …

Ct And Mr Imaging In Young Stroke Patients, A A. Razzaq, B A. Khan, S Baig

Section of Neurology

Background: This study investigates the role of CT and MR imaging in the diagnosis and management of young stroke patients.

Methods: CT scan findings of 108 patients and MR findings of 30 patients between 15-45 years of age were reviewed retrospectively. The variables included the territory of infarct on CT and MR imaging, the cortical distribution and size of infarct.

Results: About 80% of the patients had infarcts of the carotid territory and 20% the vertebro-basilar distribution. More than half of the infarcts were cortical (56%). The yield of MR imaging was much higher for deeper structures such …

Dealing With Irritable Bowel Syndrome, Z Abbas

Section of Gastroenterology

No abstract provided.

Why Physicians And Lay People Smoke And How Can It Be Reduced?, S B. Memon, A M. Memon

Section of Pulmonary & Critical Care

Objective: The objective of this study was to find out the level of knowledge the physicians and lay people have pertaining to the effect of cigarettes, why certain physicians smoke and what measures could be applied to reduce the rate of smoking.

Methods: A questionnaire was administered to the one hundred physicians who smoke, one hundred non-smoking physicians and one hundred lay people who smoke to determine their attitude towards this addition. Subjects were chosen using convenience sampling. The physicians were picked from six hospitals of Karachi.

Results: When the smoking physicians were asked what could motivate them …

Trauma Outcome: Review Of Results In Urban Hospital In Southern Pakistan, Hasnain Zafar, Fuad Abid, Asad Jamil Raja, Mushtaq Ahmed, Faheem Nanajani, Yousuf Kamal Mirza

Section of General Surgery

No abstract provided.

Myelofibrosis In Severe Vitamin D Deficiency Rickets, Mehnaz Atiq, Zehra Fadoo, Fouzia Naz, Mohammad Khurshid

Department of Paediatrics and Child Health

Vitamin D deficiency is prevalent in infants and children in the underdeveloped countries¹. Infants with mild deficiency tend to present with complications like hypocalcemic seizures whereas occurrence of pathological features in advanced rickets is well elucidated². Secondary myeloflbrosis has been reported as a complication of severe rickets and in these children anemia, myeloid metaplasia and bone marrow aplasia strongly suggested myelofibrosis. Despite the high prevalence of rickets in the Indo-Pakistan subcontinent, there has been no report on this complication.We present a case of severe clinical rickets who had developed secondary myelofibrosis with hepatosplenomegaly. The purpose of …

Results Of Faculty Evaluation At The Aga Khan University, Karachi, Pakistan, Rashida Ahmed, Mohammad Khurshid, Zoon Naqvi

Section of Haematology/Oncology

Objective: The aim of the retrospective correlational analysis was to identify the attributes valued most by students for assessing the overall effectiveness of a teacher.
Methods: Responses of the students to the two versions of evaluation questionnaires, each attempting to assess 4 and 8 characteristics respectively on a scale of 1-5 were included in the analysis. The third and fourth year students, at the end of each course/module completed a total of 2110 evaluation forms, which were studied.
Results: The over all effectiveness of the teacher showed statistically significant correlation of .914 and .895 with ability to communicate ideas effectively …

Effect Of Prepregnancy Body Mass Index And Gestational Weight Gain On Birth Weight, S S. Merchant, I A. Momin, A A. Sewani, N F. Zuberi

Department of Obstetrics & Gynaecology

Objective: Nutritional status of women has been considered an important prognostic indicator of birth outcome. The study aims to show the effect of various prepregnancy Body Mass Index (BMI) categories and corresponding gestational weight gain on newborn birth weight.
Methods: Two hundred women were included in the study. These women had regular antenatal visits and later delivered at The Aga Khan University Hospital (AKUH) between the period January 1, 1996 to December 31, 1997.
Results: For women with prepregnancy BMI < 19., mean birth weight of newborns was lower for those gaining < 12.5 kg than those gaining > 12.5 kg (P < 0.001). Women who started their pregnancy with BMI 19.8-26 and gained weight above expected range gave birth to high birth weight babies (P = 0.009). Gestational weight gain did not have a significant association with birth weight for women having prepregnancy BMI > 26.
Conclusion: Efforts should be made to attain adequate prepregnancy weight to reduce the likelihood of low …

Sexual Knowledge And Practice In Pakistani Young Men, Waris Qidwai

Department of Family Medicine

Background: There is a shortage of scientific data on the subject of sexuality from Pakistan. We decided to document misconceptions among Pakistani young men, regarding masturbation and nocturnal emissions and to make a case for sex education in the country.
Objective: To study the knowledge, attitude and practice of Pakistani young men as regards masturbation and nocturnal emissions and to see any associations with demographic factors like age, marital status, occupation, level of education and socio economic status.
Method: A questionnaire was developed, based on the objectives of the study. It was administered to 188 men between the ages 18-30 …

Home-Care Of The Dying, Riaz Qureshi

Department of Family Medicine

No abstract provided.

Autoimmune Hemolytic Anemia In Visceral Leishmaniasis, Salman Adil, Mohammad Khurshid, Lkram A. Burney

Department of Pathology and Laboratory Medicine

A case of an 8-month old male child, who presented with lgG mediated Coomb’s positive hemolytic anemia and visceral leishmaniasis is presented. The hemolytic anemia resolved following the treatment of leishmaniasis. Although various other mechanisms of anemia have been described, so far the association between IgG-mediated hemolytic anemia and visceral leishmaniasis has not been reported.

Anaesthetic Management Of Patients With Phaeochromocytoma And Uncontrolled Blood Pressure, Ursula Chohan, Fazal Hameed Khan

Department of Anaesthesia

No abstract provided.

Current Clinical Efficacy Of Chloroquine For The Treatment Of Plasmodium Falciparum Infections In Urban Dar Es Salaam, United Republic Of Tanzania, Zul Premji, C. Makwaya, J.N. Minjas

Pathology, East Africa

Reported is the use of a 14-day WHO protocol, which takes into account the clinical, parasitological and haematological responses to antimalarial drugs, to determine the efficacy of chloroquine in the treatment of uncomplicated malaria in young children (n = 200) in urban Dar es Salaam. Chloroquine failure was found in 43% of the children. Of these, 12.5% were considered to be early treatment failures and were given a single dose of sulfadoxine-pyrimethamine. Fever subsided in all children treated with sulfadoxine-pyrimethamine and there were no parasitological failures. In addition, children treated with sulfadoxine-pyrimethamine because of early treatment failure with chloroquine had …

Poor Performance Of Health And Population Welfare Programmes In Sindh: Case Studies In Governance Failure, Mehtab S. Karim, Shehla Zaidi

Community Health Sciences

Over the past few years, the issue of what is meant by “good governance” has generated increasing attention and debate both at the national and international level [Streeten (1997)]. The role of state and how that role is to be exercised is appearing high on the agenda of politicians, policy-makers and academicians in the developing world. Governance has been defined by the World Bank as “the manner in which power is exercised in the management of the country’s economic and social resources” [World Bank (1994)]. The somewhat narrow scope of this definition has been broadened in recent years to “the …

Protocol For Management Of Hypertension By Family Practitioners, Badar Sabir Ali, R Qureshi, R H. Dhanani

Department of Family Medicine

No abstract provided.

Moyamoya Disease Presenting With Intracranial Haemorrhage, Ali Akbar, Aftab Qureshi, Rashid Jooma

Section of Neurosurgery

No abstract provided.

Primary Cutaneous Actinomycosis, Anjum Kanjee, Zamaz Wahid, Shahid Pervez

Department of Pathology and Laboratory Medicine

No abstract provided.