Search PubMed⌕ Search

Biomedical subjects

M Khurshid

Publications and source records attributed to M Khurshid.

At least 37 records · Page 2Linked to original sources
PubMed2001

Epidemiological features of aplastic anaemia in Pakistan.

OBJECTIVE: To complete the data on the demographic features of patients diagnosed to have aplastic anemia at a single institution over a 7.5 years period. METHODS: Demographic information was retrieved from the patients medical records retrospectively as well as prospectively of those patients who presented with features of aplastic anaemia. Their diagnosis was confirmed by performing a complete blood count and bone marrow trephine. RESULTS: One hundred and forty four patients were diagnosed to have aplastic anemia; there were 106 males and 38 females. Their ages ranged from 2 to 75 years, with a median of 17 years, 112 (77.7%) patients were below the age of 30 years. Severe aplastic anemia (SAA) was seen in 74 (51.4%), very severe (VSAA) in 24 (16.7%) and non-severe aplastic anemia (NSAA) in 46 (31.9%) patients. No obvious cause could be established for 74.3%. Thirteen patients admitted using drugs known to cause AA and one was a radiographer (9%). Out of 44 patients tested, 7 (15.9%) were found to have either hepatitis B virus markers or antibody to hepatitis C at the time of diagnosis of AA. However it was difficult to establish a cause and effect relationship with either drugs or viruses. CONCLUSION: Aplastic anaemia is found to occur mostly in young males. The most common type was idiopathic severe aplastic anaemia.

Adolescent↗
PubMed1999

Results of faculty evaluation at the Aga Khan University, Karachi, Pakistan.

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 and clarity and organisation of the lectures. Whereas the knowledge of subject and the successful use of teaching aids showed a correlation of .658 and .637 with a statistical significance of P < .01. CONCLUSION: Students need a basic outline of what they have to learn and guidance to plan their studies.

Education, Medical↗
PubMed1999

Prevalence of hepatitis G virus in Pakistani children with transfusion dependent beta- thalassemia major.

We ought to obtain data on the prevalence of the newly discovered tranfusion transmittable hepatitis G virus in polytransfused b- thalassemia major children. Each individual had received multiple blood transfusions, from 12 to 36 per year. No documentation of prior hepatic infection was available. Serum samples were collected prospectively from the randomly selected subjects and were analyzed for HGV RNA by polymerase chain reaction using primer specific for two different regions of the HGV genome. Among the 100 individuals examined 21 were positive for HGV RNA. Four patients had evidence of dual infection, both HGV RNA and HCV RNA were isolated from their sera. While in one sample presence of both HGV RNA and HBV DNA was established. Only one child was positive for hepatitis E antibodies. The sera of 10 children were reactive for hepatitis B surface antigen whereas 35 individuals were positive for hepatitis C virus antibody. The ALT levels were variable in HGV infected children. Four out of 16 (25%) showed peak ALT levels of 218 IU/I, 8/16 (50%) children demonstrated slightly elevated ALT levels whereas 25% individuals showed normal ALT levels. Alkaline Phosphatase levels were elevated in 90% of the children and 20% patients of this series also had higher GGT levels. The observed AP levels were not statistically different among HGV, HGV/HCV or HGV/HBV groups. Even though the ALT levels were deranged in the children with HGV alone but none of the children had demonstrated symptoms of liver disease, their direct and total bilirubin levels were normal and no complain of jaundice was recorded. In conclusion, our findings suggested that like other blood borne hepatic viruses, HGV is also prevalent in the high risk group of multiple transfused patients in Pakistan but our results support the absence of any causal relationship between HGV and hepatitis.

Blood Transfusion↗
PubMed1998

HIV antibody seroprevalence and associated risk factors in sex workers, drug users, and prisoners in Sindh, Pakistan.

OBJECTIVE: To determine prevalence of HIV infection and risk behaviors in commercial sex workers (CSWs), drug users, and prisoners in Sindh, Pakistan. METHODS: A medical clinic was established in a "red-light" district of Karachi. Eighty-one CSWs who registered at the clinic between November 1993 and June 1994 were provided HIV counseling and testing and administered a risk factor questionnaire. Next, 316 male drug users were tested for HIV-1 antibody from April to July 1994. Finally, a voluntary serosurvey of HIV-1 and HIV-2 and risk behaviors of 3525 prisoners in Sindh was conducted between July 1994 and December 1994. Abbott Recombinant HIV third-generation enzyme-linked immunosorbent assay (ELISA) and confirmatory testing with Western blot analysis were used in all three groups. RESULTS: None of 81 CSWs tested for HIV-1 antibody were positive. None of 316 drug users tested positive for HIV-1 antibody. Of 3441 male prisoners, 1 was HIV-1 infected, and of 84 female prisoners, 1 was HIV-1 infected. No prisoner was positive for HIV-2 antibody. DISCUSSION: The prevalence of HIV in CSWs, drug users, and prisoners in Sindh is low at present. Intervention programs implemented at this stage can make an impact in HIV prevention.

Adolescent↗
PubMed1998

The spectrum of bacterial infections in febrile neutropenic patients: effect on empiric antibiotic therapy.

The aim of this retrospective analysis was to look at the spectrum of bacterial isolates and their resistance patterns to the commonly used antibiotics in the setting of febrile neutropenia. A total of 127 bacteria were isolated from patients with acute leukemias, lymphoproliferative disorders, aplastic anaemia and various solid tumours. Fifty-four percent organisms were gram negative; while the rest were gram positive. E. coli, pseudomonas aeruginosa, staphylococcus aureus, enterococcus and streptococci were the commonly isolated organisms. Forty-eight percent organisms were isolated from blood, 16% from urine, 13% from wounds and superficial abscesses and 11% from respiratory tract. E. coli exhibited a great degree of resistance to the commonly used antibiotics, such as pipericillin (70%), ofloxacin (50%) and aztreonam (50%). Pseudomonas and klebsiella also showed varying degree of resistance against the antibiotics. Staphylococcus aureus and staphylococcus epidermidis were almost universally resistant to penicillin and showed a variable degree of resistance to other antibiotics too. Compared to the previous reports, the pattern of bacterial isolates and their resistance to antibiotics has changed over the past years. Aminoglycosides and third generation cephalosporins seem to be the choice of antibiotics for the upfront management of febrile neutropenic patients.

Acute Disease↗
PubMed1998

Role of serum angiotensin converting enzyme in sarcoidosis.

This study was conducted to determine the role of Serum Angiotensin Converting Enzyme (SACE) as a marker in the differential diagnosis of pulmonary diseases and prognosis of sarcoidosis. A retrospective analysis of 113 medical records of patients at The Aga Khan University Hospital, with laboratory investigation for SACE was performed. Among 113 patients, 51 cases were found to have sarcoidosis, 44 of them had SACE levels greater than 52 IU/L (mean ACE 104.44). SACE levels were also found elevated in other clinical conditions like tuberculosis (mean 58.64 IU/L), but the enzyme level were less (p 0.04) than those found in sarcoidosis (mean (92.97 IU/L). SACE activity was found to be considerably lower in other chronic lung diseases such as, fibrosing alveolitis (mean 43.98 IU/L), interstitial lung disease (mean 42.11 IU/L) and chronic obstructive lung disease (mean 40.85 IU/L). Twenty patients of sarcoidosis, who received steroid treatment subsequently showed a decline in the SACE levels. SACE is a useful marker in differential diagnosis as 37.2% cases of sarcoidosis compared to only 9.09% of tuberculosis had SACE levels greater than 100 IU/L. In addition, our data also suggest that serum ACE is useful for the diagnosis as well as monitoring prognosis in sarcoidosis.

Adult↗
PubMed1997

Classification and immunophenotyping of acute leukemias: a prospective study.

Over a period of 3-1/2 years, 86 cases of acute leukemia were analyzed by immunohistochemical (IHC) means on ficoll separated cytospin preparations of peripheral blood and/or bone marrow samples. Antibodies included in the panel were specific against Tdt, HLA-DR, CD19/CD20/CD22, CALLA (CD10), CD2, CD11C as well as against Ig heavy chains. Of 86 cases analyzed, 48 cases were of ALL, (25 of common pre-B ALL, 15 of pre-B/NULL and 8 of T ALL phenotype), twenty-four (24) out of 86 cases were of non-lymphoblastic (AML/AMML) type. In six cases, there was suggestion of a mixed lineage, while in 8 cases there was inconclusive diagnosis. Mean age was lower in common ALL sub-set of ALL as compared to pre-B/NULL group (i.e., 8 vs 12 years), while in non-lymphoblastic group it was 36 years. T cell phenotype was invariably seen in young adults, who usually presented with a mediastinal mass.

Adult↗
PubMed1996

Lipids and membranes in the organic matrix of urinary calcific crystals and stones.

The ultrastructure of the organic matrix of demineralized urinary stones was examined by standard transmission and scanning electron microscopy as well as after malachite green-glutaraldehyde fixation. Crystal ghosts of both calcium oxalate and calcium phosphate were made of amorphous material and were dispersed in a matrix containing amorphous, fibrillar, and membranous substances. Malachite green positive material was seen to be associated with the ghosts, as well as with the membranous and fibrillar components of the organic matrix. Calcium oxalate and calcium-phosphate crystals, induced in human urine in vitro were also found to be associated with an organic matrix containing lipids and proteins. It is suggested that the intimate association between crystals and lipids is a result of the involvement of cellular membranes in the nucleation of these crystals.

Calcium Phosphates↗
PubMed1996

Epidemiology of blood-borne viruses: a study of healthy blood donors in Southern Pakistan.

There are only a few published reports regarding the prevalence of hepatitis B virus, hepatitis C virus and human immunodeficiency virus in Pakistani blood donors. The true extent of the prevalence of these viral infections in healthy adults in unclear. We examined blood donors attending the Aga Khan University Hospital and blood donation camps in the cities of Karachi and Hyderabad, Pakistan for the presence of hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (anti-HCV) and human immunodeficiency virus (anti-HIV). Relationship of anti HCV to the surrogate marker alanine aminotransferase (ALT) was also examined. Prevalence of HBsAg was found to be 2.28% (1,173/51,257), anti HCV was 1.18%(198/16,705) and that of anti HIV to be 0.02% (10/51,257). Higher rate of prevalence of HBsAg and anti HCV was observed in the younger age group of 21 to 30 years. Male to female ratio for HBsAg was 2.5:1 and for anti HCV 1:1. Seropositivity for HBsAg was significantly greater than anti HCV (p < 0.0001). No clear relationship was found between high ALT (>55 U/l) and anti HCV positivity. Further examination of seropositive samples for HIV revealed only one donor to be positive by Western blot also. Prevalence of hepatitis B and C in the adult blood donor population in Southern Pakistan is higher than western countries but is similar to regional countries. This study also suggested that high ALT is not a useful surrogate marker for hepatitis C virus. Prevalence of HIV in this donor population is very low and is comparable to the western countries.

Adult↗
PubMed1996

Pulmonary tuberculosis in a BCG vaccinated area: relationship of disease severity with immunological and hematological parameters and drug resistance patterns.

Clinical hematological and immunological parameters were studied in a group of 145 pulmonary patients with active tuberculosis, from a defined area of Karachi (Kharadar) belonging to the lower socioeconomic strata. Although clinical symptomatology could not differentiate the extent of lung involvement, a majority (69.6%) of the patients were diagnosed radiologically as having moderately advanced pulmonary disease. The peak number of patients were in their second decade of life. No differences were observed in the extent of disease based on age or gender. All hematological parameters for the group were in the normal ranges except for low levels of hemoglobin (9.58 +/- 1.55 SD; normal range 12-14 mg/dl) and a high ESR (90 +/- 31 SD; normal range 0-13 mm/hour). A negative correlation of PPD skin test induration (r = 0.21, p = 0.02), and a positive correlation of total white blood cell (r = 0.20; p = 0.015) was observed with the amount of lung tissue involved. The resistance amongst the strains for the four first line anti-tuberculosis agents was found to be: isoniazid = 27.4%; ethambutol = 14.5%; rifampicin = 11.29% and streptomycin = 12.9%. Multi-drug resistance to the most commonly prescribed combination (rifampicin and ethambutol) was 8.06%. Drug resistance patterns to individual drugs were comparable with resistance patterns observed in strains from greater Karachi at The Aga Khan Hospital during the same period. Such studies should provide improved rationale for patients diagnosis and treatment.

Adolescent↗
PubMed1995

Crimean Congo-haemorrhagic fever treated with oral ribavirin.

Crimean-Congo Haemorrhagic Fever (CCHF) is an often-lethal haemorrhagic fever caused by a tick-borne virus. There are no published data on ribavirin treatment of CCHF-infected patients, despite established in-vitro and in-vivo sensitivity. We report three health workers--two surgeons and a hospital worker--infected with CCHF virus in Pakistan who were treated with oral ribavirin 4 g/day for four days, then 2.4 g/day for six days. Intravenous ribavirin was unavailable. All three patients were severely ill with low platelet and white-cell counts, raised aspartate transaminase and evidence of impaired haemostasis. Based on published reports, all had an estimated probability of death of 90% or more. The patients became afebrile, and their haematological and biochemical abnormalities returned to normal within 48 h of ribavirin treatment; all made a complete recovery, and developed IgG and IgM antibody to CCHF virus. Our experience with ribavirin treatment is encouraging, but does not constitute evidence of efficacy. Given the difficulties in gathering adequate treatment data, we propose a consensus protocol for both intravenous and oral treatment of CCHF. This protocol could be distributed to key medical personnel in areas endemic for CCHF and used to provide a firm basis for effective treatment recommendations.

Acute Disease↗
PubMed1995

Effect of general anaesthesia and surgery on neutrophil function.

The effects of general anaesthesia and surgical trauma on neutrophil function were studied in 60 female ASA 1 and 2 patients undergoing anaesthesia for gynaecological surgery. Patients were divided into three groups depending on the degree of trauma and duration of surgery. Group 1 (n = 15) were patients for dilatation and curettage (minor surgical trauma) and were given 2% halothane. Group 2 (n = 30) had laparoscopic surgery (moderate surgical trauma) and received either 0.5% halothane or 1% enflurane. Group 3 (n = 15) were those having hysterectomy (major surgical trauma) and received 0.5% halothane for a longer duration. Venous samples were taken 30 min before anaesthesia (control value), 10 min after induction of anaesthesia, 10 min after the start of surgery, 30 min after the end of anaesthesia and 24 h later. Phagocytic index, nitroblue tetrazolium reduction test, total leucocyte count, and differential leucocyte counts were performed on each sample. Data were analysed by paired t-test to compare findings in the same patient and by unpaired t-test for differences between groups. Anaesthesia with halothane 0.5% to 2% caused a dose-related depressant effect on leucocyte function which reversed. Enflurane 1% on the other hand caused significantly greater depression of leucocyte function compared with 0.5% halothane which persisted during the recovery period and recovered on the first postoperative day. Total leucocyte counts also showed a fivefold increase in the major surgery groups.

Adolescent↗