A new look at fertility in Pakistan and its implication for the family planning program.
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Age Distribution↗
Biomedical subjects
M R Khan
Publications and source records attributed to M R Khan.
Complications and outcome of disease in patients admitted to the intensive care unit of a diarrhoeal diseases hospital in Bangladesh.
A retrospective analysis of the medical records of 1970 patients admitted to the intensive care unit of the Clinical Research Centre in Dhaka, Bangladesh was made, to identify various complications and outcome. All patients were admitted with a history of diarrhoea. Children under 5 years old comprised 90% of these patients. 75% of these seriously ill patients recovered; 21% died; the remaining 4% were referred to other facilities for specialized treatment or left the hospital against advice. The principal causes of death were recorded as septicaemia (79%) and pneumonia (28%); multiple conditions contributing to the death were present in 90% of patients. None of the 405 deaths could be attributed to dehydration. Severe malnutrition was noted as an associated underlying disorder contributing to the death of 74% of the children. Recognition of these complications or illnesses in seriously ill diarrhoeal patients, and their timely and energetic management, are vital in achieving a low hospital mortality.
Adolescent↗
Osteoarticular complications of childhood brucellosis: a study of 57 cases in Saudi Arabia.
Fifty-seven (36%) of a cohort of 157 children with brucellosis from Saudi Arabia had arthritis. Most gave a history of contact with farm animals or drinking unpasteurized milk. Associated features included pyrexia, arthralgia, hepatosplenomegaly, and lymphadenopathy. A subacute presentation with peripheral oligoarthritis predominantly affecting hips or knees was common. Specific chemotherapy resulted in rapid defervescence followed by slower resolution of the arthritis. Children with osteoarticular brucellosis had a higher relapse rate and a longer hospital stay. Supervised combination chemotherapy for at least 6 weeks was effective in preventing relapse. A brucellar etiology should be considered in any child from an endemic area who has osteoarticular manifestations.
Arthritis, Infectious↗
Conversion from laparoscopic to open cholecystectomy: multivariate analysis of preoperative risk factors.
BACKGROUND: Laparoscopic cholecystectomy has become the gold standard in the treatment of symptomatic cholelithiasis. Some patients require conversion to open surgery and several preoperative variables have been identified as risk factors that are helpful in predicting the probability of conversion. However, there is a need to devise a risk-scoring system based on the identified risk factors to (a) predict the risk of conversion preoperatively for selected patients, (b) prepare the patient psychologically, (c) arrange operating schedules accordingly, and (d) minimize the procedure-related cost and help overcome financial constraints, which is a significant problem in developing countries. AIM: This study was aimed to evaluate preoperative risk factors for conversion from laparoscopic to open cholecystectomy in our setting. SETTINGS AND DESIGNS: A case control study of patients who underwent laparoscopic surgery from January 1997 to December 2001 was conducted at the Aga Khan University Hospital, Karachi, Pakistan. MATERIALS AND METHODS: All those patients who were converted to open surgery (n = 73) were enrolled as cases. Two controls who had successful laparoscopic surgery (n = 146) were matched with each case for operating surgeon and closest date of surgery. STATISTICAL ANALYSIS USED: Descriptive statistics were computed and, univariate and multivariate analysis was done through multiple logistic regression. RESULTS: The final multivariate model identified two risk factors for conversion: ultrasonographic signs of inflammation (adjusted odds ratio [aOR] = 8.5; 95% confidence interval [CI]: 3.3, 21.9) and age > 60 years (aOR = 8.1; 95% CI: 2.9, 22.2) after adjusting for physical signs, alkaline phosphatase and BMI levels. CONCLUSION: Preoperative risk factors evaluated by the present study confirm the likelihood of conversion. Recognition of these factors is important for understanding the characteristics of patients at a higher risk of conversion.
Adult↗
Antibiotics--a soil microbiologist's viewpoint.
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Anti-Bacterial Agents↗
Diffuse pulmonary calcinosis and multiple soft tissue calcification in renal failure patient with pathological femoral fracture.
The rare occurrence of diffuse pulmonary calcinosis is described with case illustration of a patient who presented with a pathological femoral fracture during end-stage renal failure. Associated metastatic soft tissue calcification with parathyroid hyperplasia requiring parathyroidectomy was observed. Roentgenologic evidence of hyperparathyroidism with osteitis fibrosa cystica and a high product of the calcium and phosphate values were indications for the parathyroidectomy. Recent literature review of pulmonary calcinosis and multiple soft tissue calcification is also presented.
Calcinosis↗