Internal Medicine Commons^™

Poor Glycaemic Control Is The Major Factor Associated With Increased Frequency Of Gastrointestinal Symptoms In Patients With Diabetes Mellitus, Shahab Abid, Wasim Jafri, Firdous Jahan, Fauziah Rabbani, Najmul Islam, Masood H. Khan, Rana Masood

Department of Medicine

Objective:To compare the GI symptoms in diabetic patients with controls and its relationship with the complications, duration of diabetes and glycaemic control. Methods:Consecutive patients were prospectively enrolled in to two groups. Group I (diabetic patients) and Group II (non-diabetic, Controls). Patient's characteristics, demographic profiles and GI symptoms were evaluated on a questionnaire. Groups were compared for differences in various GI symptoms. Group I was further analyzed for the relationship between GI symptoms with complications, duration of diabetes andglycaemic control.
Results:Atotal of 514 patients were enrolled 250 were diabetics (group I) and 264 were non-diabetics (groupII). Mean age …

Spectrum And Outcome Of Infections In Systemic Lupus Erythematosus Patients, Bushra Jamil, Sobia Rafi, Hammad Hussain, Khizar Hameed

Department of Medicine

No abstract provided.

Spectrum Of Neurological Involvement In Adult Patients With Bacterial Endocarditis, Faisal Wasim Ismail, Muhammad Tariq, Mahboob Alam, Raymond A Smego

Section of Internal Medicine

Objective: To describe the spectrum of neurological involvement, and document in-hospital mortality in adult patients with bacterial endocarditis.
Design: Descriptive, non-interventional.
Place and duration of study: Department of Gastroenterology, The Aga Khan University Hospital, Karachi from November 1999 to October 2002.
Patients and methods: Patients were enrolled from the emergency and outpatient departments, using purposive, non-probability sampling, provided they fulfilled pre-defined inclusion and exclusion criteria. Case records of patients admitted to hospital with a diagnosis of bacterial endocarditis were prospectively analyzed. Data was entered and analyzed on SPSS 11. Frequency, Mean, Mode and Percentage were calculated.
Results: Neurological complications were …

Characteristics Of Patients With Guillain Barre Syndrome At A Tertiary Care Centre In Pakistan, 1995-2003, Mohammad Yawar Yakoob, Aisha Rahman, Bushra Jamil, Nadir Ali Syed

Department of Medicine

Objective: To study the clinical presentation, hospital course and outcome of patients admitted with Guillain Barre Syndrome (GBS) to a tertiary care hospital in Karachi, Pakistan.
Methods: The charts of patients conforming to International Classification of Diseases (ICD) code 9.0, for GBS, from September 1995 to January 2003 were reviewed. Clinical data was recorded on a standardized questionnaire, which included patients' age, sex, antecedent events, neurological signs and symptoms and ventilation requirement. The hospital course was analyzed, including nosocomial infections, therapy given and the functional status of patients, using the Rankin scale (0-6). Standard SPSS 11.5 software (Windows) …

Survival Of Patients Treated With Intra-Aortic Balloon Counterpulsation At A Tertiary Care Center In Pakistan - Patient Characteristics And Predictors Of In-Hospital Mortality., Fahim H. Jafary, Sohail A. Khan, Haresh Kumar, Numaan F. Malik, K. Kazmi, Sajid Dhakam, Azam Shafquat, Aamir Hameed, Javed Tai, Najaf Nadeem

Department of Medicine

BACKGROUND: Intra-aortic balloon counterpulsation (IABC) has an established role in the treatment of patients presenting with critical cardiac illnesses, including cardiogenic shock, refractory ischemia and for prophylaxis and treatment of complications of percutaneous coronary interventions (PCI). Patients requiring IABC represent a high-risk subset with an expected high mortality. There are virtually no data on usage patterns as well as outcomes of patients in the Indo-Pakistan subcontinent who require IABC. This is the first report on a sizeable experience with IABC from Pakistan.

METHODS: Hospital charts of 95 patients (mean age 58.8 (+/- 10.4) years; 78.9% male) undergoing IABC between 2000-2002 …

Wilson's Disease: A Review, A Hassan, F Masood

Section of Internal Medicine

No abstract provided.

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.

Abscesses In The Liver: Amoebic Or Pyogenic?, Bushra Jamil, Saeed Hamid

Department of Medicine

No abstract provided.

Bacterial Isolates From Neutropenic Febrile Pediatric Patients And Their Sensitivity Patterns To Antibiotics, F N. Bhatti, I A. Burney, M I. Moid, T Siddiqui

Section of Internal Medicine

Patients on cytotoxic therapy often develop neutropenia and fever. Our interest was to identify the common pathogens isolated from such patients and to study the sensitivity patterns of these organisms to the antibiotics used in their treatment. Thus, guidelines can be established by hospitals to identify which antibiotics can be used in the treatment of these patients when the results of cultures and sensitivities are not available. We conducted a retrospective study of neutropenic pediatrics presenting to AKUH from July, 1990 to June, 1996. A total of 153 isolates in 35 different patients were studied. Samples for culture were taken …

The Association Of Hla-Drb Genes And The Shared Epitope With Rheumatoid Arthritis In Pakistan, K Hameed, S Bowman, E Kondeatis, R Vaughan, T Gibson

Section of Internal Medicine

The association of particular HLA-DR alleles and the shared epitope with rheumatoid arthritis (RA) is now well established. The strength of these links varies between races. Furthermore, the proposition that the presence of the shared epitope is indicative of severe disease has been more difficult to sustain in non-Europeans. This study examines the frequency of HLA-DR and HLA-DRB1 amongst Pakistanis for the first time. Using the polymerase chain reaction (PCR) and sequence-specific oligonucleotide probes (PCR-SSOP) and primers (PCR-SSP), HLA-DR phenotype and genotype frequencies were ascertained in 86 RA hospital out-patients and 79 healthy controls matched for age, gender and ethnicity. …

Ultrastructure Of The May-Hegglin Anomaly, T Siddiqui

Section of Internal Medicine

Ultrastructural features of the leucocytes in two patients suffering from the May-Hegglin anomaly were studied using electron microscopy. In both the cases, electron dense material parallel to the long axis of the inclusions were noted. Platelet ultrastructure was normal. A review of the literature indicates that the May-Hegglin anomaly is a heterogeneous condition both ultrastructurally and clinically.

An Epidemic Of Dengue Fever In Karachi--Associated Clinical Manifestations, J A. Qureshi, N J. Notta, N Salahuddin, V Zaman, J A. Khan

Section of Internal Medicine

Dengue is a mosquito borne disease with worldwide distribution. Depending on virulence factors and host immune status, infection can manifest as a severe but non fatal viral syndrome or a rapidly progressive and a frequently fatal haemorrhagic fever. During the course of an outbreak of viral fever in Karachi, Pakistan from June, 1994 to September, 1995, we studied 145 cases admitted at the Aga Khan University Hospital. 43% of the cases were between the age group of 20-30 years, majority of these being male (75%). Amongst the clinical signs and symptoms, the most frequent findings were fever, vomiting and abdominal …

Chemotherapy-Induced Non-Hodgkin's Lymphoma In A Patient With Hodgkin's Disease--A Case Report, I A. Burney, I A. Malik

Section of Internal Medicine

Modern chemotherapy and radiation treatment of Hodgkin’s disease has resulted in overall cure rates in excess of 60%1 . However, the greatly improved survival rates have also led to increasing incidence of long-term side-effects of these treatment modalities2 . The most serious consequence is the occurrence of second cancer3 . We report a case of non-Hodgkin’s lymphoma occurring in a patient who was previously treated for Hodgkin’s disease.

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.

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 …

The Diagnosis Of Poncet's Disease, K Hameed, M Karim, N Islam, T Gibson

Section of Internal Medicine

Two cases of polyarthritis in young people with extra-articular tuberculosis are described. The clinical features were consistent with the concept of Poncet's disease. After synovial biopsy one patient proved to have tuberculous peripheral arthritis. This observation raised doubts about the diagnosis in the other patient. Multiple joints may be simultaneously infected with Mycobacterium tuberculosis and Poncet's disease, if it exists, should not be entertained in the absence of synovial biopsy.

Bacterial Isolates In Neutropenic Febrile Patients, M Karim, W Khan, B Farooqi, I Malik

Section of Internal Medicine

One hundred consecutive patients with documented bacteremia and neutrophil count of 0.5 x 10(9)/L or below were retrospectively studied to determine the pattern of infection at the Aga Khan University Hospital in Karachi. These included patients with primary haematologic malignancies presenting with low counts, and those patients with cancer who developed neutropenia as a result of chemotherapy. The gram negative organism pseudomonas aeruginosa was the most common bacterial organism isolated constituting 31% of all positive blood cultures. Gram positive organisms were frequently isolated comprising 24% of all isolates of which 15% were Staph.aureus. Staph. epidermidis was not isolated in this …