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Aga Khan University

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Articles 7411 - 7440 of 7543

Full-Text Articles in Medical Specialties

Audit Changes Clinical Practice! Impact On Rate Of Justification Of Hysterectomy Indication, Khalid S. Khan, J H. Rizvi Aug 1995

Audit Changes Clinical Practice! Impact On Rate Of Justification Of Hysterectomy Indication, Khalid S. Khan, J H. Rizvi

Department of Obstetrics & Gynaecology

After performing a baseline audit in 1986-89, an ongoing quality assurance process was initiated in January, 1990 and all hysterectomies performed over the next 2 year period were analyzed. Hysterectomy indications were divided into two groups: one in which the uterine specimen was expected to show pathology and another in which no pathology was expected. The hysterectomy was considered justified in the former if the pathology report verified the indication or showed a significant alternate pathology. In the latter, validation criteria showing documentation of certain prerequisite diagnostic procedures performed before reverting to hysterectomy, were used to ascertain justification. The overall …

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Constitutive Alzheimer's-Type Tau Epitopes In A Neuritogenic Rat Cns Cell Line, Mary P. Lambert, Shasta Sabo, Chi Zhang, S. Ather Enam, William L. Klein Jul 1995

Constitutive Alzheimer's-Type Tau Epitopes In A Neuritogenic Rat Cns Cell Line, Mary P. Lambert, Shasta Sabo, Chi Zhang, S. Ather Enam, William L. Klein

Section of Neurosurgery

Paired helical filaments (PHFs) of Alzheimer's disease (AD) largely comprise hyperphosphorylated forms of the cytoskeletal protein tau. AD-type tau phosphoepitopes, detected by various monoclonal antibodies, are absent from normal adult neurons, but recent studies have shown that their expression may contribute to neuritogenesis and axon differentiation in the developing nervous system. Therefore, we have examined a brain nerve cell line that is spontaneously neuritogenic for possible expression of AD-type tau epitopes. The neuritogenic rat brain cell line B103 was found to constitutively produce two AD-related epitopes of tau, detected by cellular immunofluorescence studies with the PHF-1 and Alz-50 monoclonal antibodies. …

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Are Non-Diabetic Women With Abnormal Glucose Screening Test At Increased Risk Of Pre-Eclampsia, Macrosomia And Caesarian Birth?, Khalid S. Khan, Firasat A. Hashmi, J H. Rizvi Jul 1995

Are Non-Diabetic Women With Abnormal Glucose Screening Test At Increased Risk Of Pre-Eclampsia, Macrosomia And Caesarian Birth?, Khalid S. Khan, Firasat A. Hashmi, J H. Rizvi

Department of Obstetrics & Gynaecology

To determine, in non-diabetic women, the relationship of abnormal glucose screening test, with the incidence of pre-eclampsia, macrosomia and caesarian delivery, from 1988-92, 5646 consecutive women attending antenatal clinic were screened with a glucose challenge test (GCT) on their first visit (usually at 16-20 weeks); those with risk factors i.e., history of unexplained perinatal loss, macrosomia or family member with diabetes and an initial abnormal screening test were rescreened at 28-32 weeks, In 482 cases the GCT was abnormal (plasma glucose value was >140 mg% 2 hours after 75g glucose challenge). Of these, 292 had one or more abnormal critical …

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Ciprofloxacin In Multi-Resistant Infections In Childhood: An Audit, D M. Khan, Z A. Bhutta Jun 1995

Ciprofloxacin In Multi-Resistant Infections In Childhood: An Audit, D M. Khan, Z A. Bhutta

Department of Paediatrics and Child Health

Ciprofloxacin is a new orally administrable fluoroquinolones, with considerable efficacy against multiresistant organisms. Its use in the paediatric age group however, is controversial because of the risk of potential articular toxicity. We retrospectively reviewed ciprofloxacin usage over a 32 week periods (June, 1991-September, 1993) in paediatric inpatients at The Aga Khan University Hospital. Ciprofloxacin was used in 21 cases, singly in 11 (52%) and in combination with other antibiotics in a further 10 (48%). The response to therapy was adjudged as 'good' or 'fair' in 13 (62%) cases. Ciprofloxacin was the only sensitive antibiotic in 4 (19%) and resistance to …

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Diagnostic Evaluation Of Pleural Effusion And The Role Of Needle Pleural Biopsy, S F. Hussain, S Mujahid, J A. Khan May 1995

Diagnostic Evaluation Of Pleural Effusion And The Role Of Needle Pleural Biopsy, S F. Hussain, S Mujahid, J A. Khan

Section of Pulmonary & Critical Care

No abstract provided.

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A Change Of Il-2 And Il-4 Production In Patients With Helicobactor Pylori Infection, X. G. Fan, Javed Yakoob, X. J. Fan, P. W. N. Keeling Apr 1995

A Change Of Il-2 And Il-4 Production In Patients With Helicobactor Pylori Infection, X. G. Fan, Javed Yakoob, X. J. Fan, P. W. N. Keeling

Section of Gastroenterology

Helicobactor pylori is the most common cause of gastroduodenal inflammation. However, the exact immune pathogenesis is not fully understood. To look for evidence of the immunological mechanism in H. pylori associated disease, we measured cytokine interleukin-2 (IL-2) and IL-4 levels produced by peripheral blood lymphocytes (PBL) and gastric biopsies in 20 subjects with or without H. pylori infection. H. pylori can stimulate IL-2 and IL-4 production from PBL in H. pylori negative as well as H. pylori positive individuals. The spontaneous IL-2 production by PBL and gastric biopsies was greater (p < 0.0025, <0.001)in H. pylori negative individuals than that in H. pylori infected patients. Increased IL-4 levels from PBL in H. pylori infected patients were found in the presence of H. pylori (p < 0.0025). An increased spontaneous production of IL-4 from gastric biopsies was also observed in H. pylori infected patients (p < 0.025). In conclusion, an enhanced type 2 cytokine production was observed in H. pylori infected patients, which may be responsible for H. pylori chronic infection.

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Cholera Admissions In Adults 1989-1994: A Hospital Based Study, Z Abbas, S M. Jafri, S Abid, H Khan Apr 1995

Cholera Admissions In Adults 1989-1994: A Hospital Based Study, Z Abbas, S M. Jafri, S Abid, H Khan

Section of Gastroenterology

In order to gain insight into the distribution of cholera over the years and proportion of monthly admissions under our adult medical services, we scrutinized our records of hospital discharges between 1989 and 1994. Only culture positive cases were included. Each year most of the cases of cholera are admitted between May and November with almost disease free interval from December to April. In 1992 admission rate was 4.24/1000 medical admissions which increased to 12.65 in 1993 and 13.73 in 1994. Though the Vibrio cholerae 01 Ogawa was the major isolate upto May, 1993, Vibrio cholerae non-01 serogroup 0139 dominated …

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Thrombolytic Therapy In Acute Myocardial Infarction In Pakistan., M. Asad Karim, Ata Ata-Ur- Rehman Qureshi, Syed Faisal Mahmood, J. Akhter Mar 1995

Thrombolytic Therapy In Acute Myocardial Infarction In Pakistan., M. Asad Karim, Ata Ata-Ur- Rehman Qureshi, Syed Faisal Mahmood, J. Akhter

Department of Medicine

To characterize features of acute myocardial infarction (AMI) in a Pakistani population, and assess the role of thrombolysis in our country, we studied 194 consecutive admitted patients with enzyme positive AMI. Males were affected three times more frequently; women, although affected less, had a higher incidence of complications than men. Premature coronary artery disease (CAD) was present in 50% patients presenting with AMI. An unusually high incidence of anterior wall myocardial infarction (39%) was seen. Complications were frequent with a predominance of LV failure symptoms. Cardiogenic shock was associated with a very high mortality, in excess of 93%. Streptokinase (SK) …

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Microwave Oven--Not Only For Cooking, S Pervez Mar 1995

Microwave Oven--Not Only For Cooking, S Pervez

Department of Pathology and Laboratory Medicine

No abstract provided.

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Pneumonia Caused By Nocardia Caviae In A Healthy Neonate, Perween Mufti, Bushra Jamil Jan 1995

Pneumonia Caused By Nocardia Caviae In A Healthy Neonate, Perween Mufti, Bushra Jamil

Department of Medicine

Nocardia infections have been associated with patients of Aids, chronic granulomatous disease, recipient of organ transplant and malignancy Pulmonary nocardiosis in neo­nates is an unusual infection. A case of neonatal pulmonary nocardiosis mimicking miliaiy tuberculosis has been reported in the past. We report another case of pulmonary nocardiosis in a neonate presenting as consolidation with pleural effusion and cavitation.

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Severe Thrombocytopenia In A Man With Prostatic Cancer, Saeed Hamid, Ata Khan, Haleem Khan, Roger Sutton, Ikram A. Burney, Mohammad Khurshid Jan 1995

Severe Thrombocytopenia In A Man With Prostatic Cancer, Saeed Hamid, Ata Khan, Haleem Khan, Roger Sutton, Ikram A. Burney, Mohammad Khurshid

Department of Medicine

A 66 year old gentleman was diagnosed to have metastatic adenocarcinoma of the prostate in 1990, following a CT scan of the abdomen and trans-uretheral resection of prostate (TLJRP). He was started on estrogen therapy (Fos­festerol sodium). Two years later he presented to the emer­gency room with breathlessness and edema of the left ann of a week’s duration. He admitted to persistence of symptoms of pmstatism and was found to have bilateral axillary lymphade­nopathy and pitting edema of the left arm. A doppler scan revealed left subclavian vein thrombosis. The patient was started on i.v. heparin and was maintained on …

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Effectiveness Of Percutaneous Nephrostomy In Reversing Obstructive Renal Failure, I Ahmed, I H. Rizvi, A Aslam, M N. Ahmed, Y A. Hussain Jan 1995

Effectiveness Of Percutaneous Nephrostomy In Reversing Obstructive Renal Failure, I Ahmed, I H. Rizvi, A Aslam, M N. Ahmed, Y A. Hussain

Department of Radiology

A retrospective analysis of 34 patients of obstructive renal failure, initially managed by percutaneous nephrostomy was performed. Pre procedure blood biochemical profile was compared with upto one week follow-up of blood chemistry. There was a decline of 71.1% and 56.08% (P-values 0.0001 and 0.0028) in the mean values of serum creatinine and blood urea nitrogen respectively at 7 days after the procedure. Improvement in blood biochemical profile was solely dependent on performance of percutaneous nephrostomy.

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Case Of Pelvic Relapse In A Child Suffering From Acute Lymphoblastic Leukemia, Karim Qamruddin, Sheema Hasan, Mohammad Khurshid Jan 1995

Case Of Pelvic Relapse In A Child Suffering From Acute Lymphoblastic Leukemia, Karim Qamruddin, Sheema Hasan, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

We describe here a case of an eight years old child suffering from acute lymphoblastic leukemia. She developed pelvic infiltration of leukemic cells while in bone marrow remission and receiving maintenance chemotherapy: She also developed leukemic infiltration of Central Nervous System and died of complications resulting from massive pelvic relapse. With greater number of children in bone marrow and CNS remission, the issue ofpossible greater predisposition to extramedullary relapse has been discussed. The need for greater vigilance towards pelvic surveillance has been stressed.

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Diagnosis Of Genetic Defects By Chromosomal Analysis, Farooq Ghani, Siddiqua Maniac, Zahida Khilji, Mohammad Azim, Mohammad Khurshid Jan 1995

Diagnosis Of Genetic Defects By Chromosomal Analysis, Farooq Ghani, Siddiqua Maniac, Zahida Khilji, Mohammad Azim, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

Of 901 karyotypes performed over a period of 4 years, genetic anomalies were detected in 162 cases. Down’s syndrome (trisomy 21) was the most common (168.8%) genetic disorder followed by Turner’s syndrome, Philadelphia chromosome, Klinefelter's syndrome, Edward’s syndrome (trisomy 18) and Patau’s syn­drome (trisomy 13). All the three trisomies were detected very early in life. Mean age at the time of diagnosis for Turner’s syndrome was 13.3 years, allowing a timely hormone replacement therapy to improve secondary sexual characters. Patients with Klinefelter's syndrome were diagnosed late (mean age 23.6 years), which greatly reduced their chances of an effective therapy to …

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Hiv-I Infection In A Family Blood Donor, S A Mujeeb, Naila Kayani, Mohammad Khurshid Jan 1995

Hiv-I Infection In A Family Blood Donor, S A Mujeeb, Naila Kayani, Mohammad Khurshid

Department of Pathology and Laboratory Medicine

No abstract provided.

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Seroprevalence Of Toxoplasma Gondii In Domestic Animals In Pakistan, M Zaki Jan 1995

Seroprevalence Of Toxoplasma Gondii In Domestic Animals In Pakistan, M Zaki

Department of Pathology and Laboratory Medicine

The seroprevalence of Toxoplasma gondii infections among food animals in South-West Pakistan was measured by serological examination using a commercial latex agglutination test (LAT). In all 262 blood samples, from 100 cattle, 40 sheep, 58 goats and 64 chickens, were collected from the city abattoir. Titers considered diagnostically significant (> or = 1:64) were detected in 25% of cattle and 2.5% of sheep. None of the goats and chickens presented seropositivity for anti-toxoplasma antibodies. The study suggests the need for further investigations to determine the impact of these findings on the human population.

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Effect Of Alcohol On The Postnatal Development Of Cerebellar Cortex In Rat Ii: Ultrastructural Study, Mansoor Saleh, Saadia Sayed, Entesar Saber Jan 1995

Effect Of Alcohol On The Postnatal Development Of Cerebellar Cortex In Rat Ii: Ultrastructural Study, Mansoor Saleh, Saadia Sayed, Entesar Saber

Haematology and Oncology, East Africa

In The present work, it was found that alcohol produced distinct changes in both Purkinje and granule cells during postnatal development. On the fifth day, the apical cones of the Purkinje cells were less developed and the cells showed an occasional somnatic spines but no somatic processes. At 21 days and adult stage these cells including their dendrites showed marked degenerative changes. The nuinber of basket cell axon synapses on Purkinje cell soma was reduced. There was also a reduction in the amount of basket fibers contributing to the pinceau around the intial seginent of the Purkinje cell axons. The …

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Phase Ii Trial Of Murine Monoclonal Antibody D612 Combined With Recombinant Human Monocyte Colony-Stimulating Factor (Rhm-Csf) In Patients With Metastatic Gastrointestinal Cancer, Mansoor Saleh, Michael Khazaeli, Richard Wheeler, Pat Bucy, Tiepe Liu, Michael Everson, David Mun, Jeff Schlom Jan 1995

Phase Ii Trial Of Murine Monoclonal Antibody D612 Combined With Recombinant Human Monocyte Colony-Stimulating Factor (Rhm-Csf) In Patients With Metastatic Gastrointestinal Cancer, Mansoor Saleh, Michael Khazaeli, Richard Wheeler, Pat Bucy, Tiepe Liu, Michael Everson, David Mun, Jeff Schlom

Haematology and Oncology, East Africa

In a Phase II study, 14 patients with metastatic gastrointestinal cancer received the mAb D612 (40 mg/m2, days 4, 7, and 11) in combination with recombinant human monocyte colony-stimulating factor [(rhM-CSF) 80 ug/kg/days 1-14]. The combined treatment was well tolerated and resulted in characteristic biological activity associated with each of the agents. Thus, 10 of 14 patients experienced D612-associated secretory diarrhea, which responded to the prostaglandin inhibitor Indomethacin in 5 of 7 patients. rhM-CSF therapy was associated with peripheral mono- cytosis (peak absolute monocyte count, 1444 ±394/mm3) and thrombocytopenia (nadir count, 78 ±10/nim '). Monocyte surface marker analysis revealed a …

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Cd16+ Monocytes In Patients With Cancer: Spontaneous Elevation And Pharmacologic Induction By Recombinant Human Macrophage Colony- Stimulating Factor, Mansoor Saleh, Goldman Samuel, Lobuglio Albert, Beall Arthur, Sabio Hernan, Mccord Melissa, Minasian Lori, Alpaugh Katherine, Weiner Louis, Munn David Jan 1995

Cd16+ Monocytes In Patients With Cancer: Spontaneous Elevation And Pharmacologic Induction By Recombinant Human Macrophage Colony- Stimulating Factor, Mansoor Saleh, Goldman Samuel, Lobuglio Albert, Beall Arthur, Sabio Hernan, Mccord Melissa, Minasian Lori, Alpaugh Katherine, Weiner Louis, Munn David

Haematology and Oncology, East Africa

The small subset of circulating monocytes that express the maturation- associated CD16 antigen has recently been reported to be elevated in patients with bacterial sepsis. We now show that this novel CD16+ monocyte population is also spontaneously expanded in patients with cancer. We studied 14 patients with metastatic gastrointestinal carcinoma enrolled in a clinical trial of recombinant human macrophage colony-stimulating factor (rhMCSF) plus monoclonal antibody D612. We found that before any cytokine treatment, 12 of 14 patients constitutively displayed significant elevations in both the percentage and the absolute number of CD16+ monocytes, as compared with both normal subjects and ill …

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Changes In Malaria Associated Morbidity In Children Using Insecticide Treated Mosquito Nets In The Bagamoyo District Of Coastal Tanzania, Zul Premji, P. Lubega, Y. Hamisi, E. Mchopa, J. Minjus, W. Checkley, C. Shiff Jan 1995

Changes In Malaria Associated Morbidity In Children Using Insecticide Treated Mosquito Nets In The Bagamoyo District Of Coastal Tanzania, Zul Premji, P. Lubega, Y. Hamisi, E. Mchopa, J. Minjus, W. Checkley, C. Shiff

Pathology, East Africa

A community based malaria control intervention using insecticide treated mosquito nets (IMN) has been implemented and tested in 13 villages of the Yombo Division, Bagamoyo District in the Coastal Region, Tanzania, an area holoendemic for P. falciparum malaria. Following extensive sociological research into local perceptions of malaria, the programme was implemented. It was decided by consensus that village mosquito net committees would be the appropriate local level implementers. These were formed and provided with IMN's which were sold to villagers at subsidised cost. The income was invested for use by the committees for sustaining the activity. Use patterns were determined …

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Ileocaecal Tuberculosis: A Pictorial Essay Of Various Appearances On Small Bowel Enema, M Y. Shaikh, T U. Haq, U M. Islam, Z A. Khan Dec 1994

Ileocaecal Tuberculosis: A Pictorial Essay Of Various Appearances On Small Bowel Enema, M Y. Shaikh, T U. Haq, U M. Islam, Z A. Khan

Department of Radiology

No abstract provided.

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Inherited Metabolic Disorders In Pakistan: Presentation, Diagnosis And Outcome Of Congenital Hyperammonemias, P Mufti, I Ahmed Oct 1994

Inherited Metabolic Disorders In Pakistan: Presentation, Diagnosis And Outcome Of Congenital Hyperammonemias, P Mufti, I Ahmed

Department of Paediatrics and Child Health

A total of 21 patients were admitted to Aga Khan University Hospital with suspected congenital hyperammonemias during the period 1989 to 1992. There were 11 patients with acidosis and 10 patients were without acidosis. Prominent clinical manifestations included positive family history (76%), onset in the first week of life (67%) and neurological manifestations (76%). Of patients with hyperammonemia and acidosis, 4 had severe metabolic acidosis with anion gap of 30mEq/L and above. Of patients with hyperammonemia without acidosis, 4 had ammonia level ranging from 1600-2000 mg/dl. Diagnosis was confirmed in only 1 patient and that was also done abroad. Overall …

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Arthritis Of Leprosy, T Gibson, Q Ahsan, K Hussein Oct 1994

Arthritis Of Leprosy, T Gibson, Q Ahsan, K Hussein

Section of Internal Medicine

An inflammatory polyarthritis has been previously described in leprosy but accounts of the clinical characteristics have varied. All patients with joint symptoms admitted to a leprosy centre over 5 months were examined by a rheumatologist. Of 48 acute admissions, 20 (42%) had a symmetrical polyarthritis affecting the wrists and fingers. This was strikingly similar to RA in appearance. The arthritis occurred exclusively in patients with reactions mainly during anti-mycobacterial treatment. The clinical features of the joint disorder were identical in Type I (associated with alterations in immune status) and Type II (erythema nodosum leprosum) reactions. Synovial tissue from one patient …

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Peculiar Histopathological Features Of Giardiasis In Distal Duodenal Biopsies, Z Abbas, A A. Qureshi, H Sheikh, S M. Jafri, A H. Khan Sep 1994

Peculiar Histopathological Features Of Giardiasis In Distal Duodenal Biopsies, Z Abbas, A A. Qureshi, H Sheikh, S M. Jafri, A H. Khan

Department of Pathology and Laboratory Medicine

Histological changes in 20 Giardia positive duodenal biopsies (Group A) were compared with 50, Giardia negative duodenal biopsies (Group B), taken during the same period. Stool examinations in Group B were negative for Giardia. Surface epithelium, villous and crypt architecture and cellular infiltrates were examined and compared between the groups. Atrophic changes in the villi were more common in Group A as compared to B(P < 0.0001). Intraepithelial neutrophil infiltration (P < 0.001), infiltration of the lamina propria with plasma cells (P < 0.5), and presence of eosinophils in the lamina propria (P < 0.001) were significant findings in group A. Some of the changes were related to the density of Giardia colonization e.g., the goblet cell depletion (P < 0.05) and the density of plasma cell infiltration in lamina propria (P < 0.01). Erosions and ulcerations were less commonly seen in group A. Thus we conclude that giardiasis manifests its peculiar features in the distal duodenal mucosa and a biopsy of this region is an important diagnostic tool for detection of this disease.

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Dysplasia And Surveillance In Ulcerative Colitis, S M. Jafri Sep 1994

Dysplasia And Surveillance In Ulcerative Colitis, S M. Jafri

Section of Gastroenterology

No abstract provided.

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Ureterorenoscopy In Children, K Rasheed, A Memon Aug 1994

Ureterorenoscopy In Children, K Rasheed, A Memon

Section of Paediatric Surgery

No abstract provided.

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Immunohistochemistry In Tumour Diagnosis--Who Actually Needs It?, S Pervez Aug 1994

Immunohistochemistry In Tumour Diagnosis--Who Actually Needs It?, S Pervez

Department of Pathology and Laboratory Medicine

No abstract provided.

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Immunohistochemical Estrogen Receptor Determination In Human Breast Carcinoma: Correlation With Histologic Differentiation And Age Of The Patients, Shahid Pervez, S. Shaikh, F. Aijaz, S. A. Aziz, M. Naqvi, Sheema H. Hasan Jun 1994

Immunohistochemical Estrogen Receptor Determination In Human Breast Carcinoma: Correlation With Histologic Differentiation And Age Of The Patients, Shahid Pervez, S. Shaikh, F. Aijaz, S. A. Aziz, M. Naqvi, Sheema H. Hasan

Department of Pathology and Laboratory Medicine

An immunohistochemical assay for the measurement of estrogen receptor (ER) has been evaluated on 290 consecutive human breast biopsy and mastectomy specimens in the year 1992 at The Aga Khan University Hospital laboratories. Immunohistochemical localization of estrogen receptor on frozen/paraffin section was scored in a semi-quantitative fashion incorporating both the intensity and the distribution of specific staining. Histologic grading of the tumour was performed according to Bloom’s method. In this study, 21% of the tumours were estrogen receptor negative, 15% were weak positive, 25% intermediate positive and 39% strong positive. Fifty percent of the well differentiated tumours showed strong ER …

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Intestinal Obstruction In Adults At The Aga Khan University Hospital, S Q. Hasnain, M Ahmed Jun 1994

Intestinal Obstruction In Adults At The Aga Khan University Hospital, S Q. Hasnain, M Ahmed

Department of Surgery Docs

During the period January, 1987 to June, 1991, 208 adults with mechanical bowel obstruction were managed at The Aga Khan University Hospital (AKUH). Post-operative adhesions accounted for 34% of the cases and were the most frequent cause of intestinal obstruction. External hemia (16%), malignancy (13.5%) and tuberculous stricture (10%) were the next most frequent causes. The predominance of adhesive intestinal obstruction at AKUH shows a trend towards a Western disease pattern. Socioeconomic status was a significant determinant of the cause of obstruction. The proportion of self paying to welfare patients was significantly lower in tuberculous obstruction as compared with adhesive …

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Cryptic Disseminated Tuberculosis: An Often Missed Diagnosis, A Jabbar Apr 1994

Cryptic Disseminated Tuberculosis: An Often Missed Diagnosis, A Jabbar

Section of Pulmonary & Critical Care

No abstract provided.

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