Objective: To evaluate outcome of diagnostic kidney biopsy in patients with renal allograft dysfu... more Objective: To evaluate outcome of diagnostic kidney biopsy in patients with renal allograft dysfunction at a tertiary care hospital. Study Design: Retrospective observational study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Jan 2014 to Jan 2020. Methodology: A consolidate registry review was carried to formulate this study. The registry data exists at our center containing information about the graft dysfunction (manifesting as proteinuria, deranged urea and creatinine or urine sediment abnormalities) and other major indications which warrant probing with biopsy. The histopathological diagnosis of these biopsies is confirmed from the nephro-pathology registry before finalization of diagnosis. Results: A total of 94 diagnostic kidney biopsies were performed in patients with graft dysfunction. Out of 94 biopsies, 80 (85.1%) patients were male while 14 (14.9%) were female patients. The most frequent single cause for graft dysfunction was Cell Medi...
Objective: To observe the efficacy of blind obturator nerve block by Labat technique for preventi... more Objective: To observe the efficacy of blind obturator nerve block by Labat technique for prevention of obturator jerk during transurethral resection of bladder tumor performed under spinal anesthesia. Study Design: Descriptive Study. Material and Methods: This was a single center based study conducted at tertiary care military hospital for a period of thirty months. Fifty five patients were recruited in the study, after identifying the location of bladder growth in the lateral wall on ultrasound USG and confirming its exact site on cystoscopic examination. Those eliciting obturator jerk during transurethral resection of bladder tumor (TURBT) were included and ONB was performed using 2% lidocaine via blind technique of Labat. TURBT was restarted and presence of obturator jerk was recorded if evoked (primary outcome). Results: Median age was 67.3 ± 8 years with majority (72.7%) in the age group between 61 to 80 years. Male female ratio was 7:1. Fifty (90%) patients presented with soli...
Objective: To assess live donor nephrectomy for development of hypertension. Study Design: Retros... more Objective: To assess live donor nephrectomy for development of hypertension. Study Design: Retrospective observational study. Place and Duration of Study: The study was conducted at Armed Forces Institute of Urology (AFIU) Rawalpindi, from May 2016 to May 2020. Methodology: All consenting kidney donors for live renal transplant were introduced with the process. Baseline blood pressure at time of workup of donation and annually afterwards after transplant on follow up examinations using retrospective data analysis of donor’s workup and follow up was used. Comparison of 1,2,3 and 4-year occurrence of hypertension among (normotensive) donors with 1,2,3 and 4-year of donation using estimates from Framingham Hypertension Risk Score. Results: A total of 79 donors with a completed annual follow-up rate of up to100 % during a 4-year period. The average age at donation was 33.96 ± 10.23 SD years; 50 donors (63.4%) were women. Overall 27% (22 out of 79) of all live donors developed post donat...
Objective: To assess the correlation of medical professionalism score of final year medical stude... more Objective: To assess the correlation of medical professionalism score of final year medical students with theiracademic results of the final professional examination. Study Design: Correlational study. Place and Duration of Study: Army Medical College, Rawalpindi, from Mar to Nov 2019. Methodology: Final year medical students were enrolled by non-probability consecutive sampling. Their medical professionalism score was calculated using the Penn State College of Medicine-Professionalism Questionnaire (PSCOM-PQ). All the aspects of accountability, altruism, excellence, duty, honour/integrity and respect were noted using the questionnaire. Thirty points from the questionnaire were used, calculating the maximum value of 150. After the final professional examination, their academic results were procured. The strength of the relationship between medical professionalism score and academic results of final year professional examination was assessed using the Pearson correlation coefficient....
Background: To study various etiological factors associated with acute kidney injury during pregn... more Background: To study various etiological factors associated with acute kidney injury during pregnancy and their outcome Methods: In this cross sectional descriptive study, previously healthy ladies who developed AKI during pregnancy (n=88) were included .AKI was defined as per AKINs criteria i.e. Increase in serum creatinine by > 0.3mg/dl within 48 hours from previously normal base line values or urine volume <0.5ml/kg/h for 6 hours or more was labelled as AKI. These patients were worked up for likely causes of AKI and followed up for up to three months postdelivery. Cases with persistent azotemia for more than three months were labelled as chronic kidney disease Results: Mean age of the patients was 26.3 + 7.06 years. A total of twenty seven (31%) patients presented with AKI in 1st trimester, eleven patients (12%) were diagnosed in second and twenty nine (33%) were diagnosed with AKI in 3rd trimester. During postpartum period 24% developed AKI. Septic abortion was commonest c...
Objective: To study if concept mapping (CM) is a useful learning approach to enhance meaningful l... more Objective: To study if concept mapping (CM) is a useful learning approach to enhance meaningful learning in final year medical students compared to traditional methods in an undergraduate medical college to improve learning of puberty disorders in Gynaecology. Study Design: Quasi experimental study. Place and Duration of Study: Army Medical College Rawalpindi, from Dec 2016 to Mar 2017. Methodology: The final year MBBS class was randomized into 2 groups of 100 each that were taught disorders of puberty using interactive lectures of 50 students. One was taught “disorders of puberty” by traditional lecture and the second by CM. There was Delphi agreement of the content of lecture and method of interaction by the faculty of Gynaecology. Multiple Choice Questions (MCQs), Extended matching Questions (EMQs) and Short Answer Questions (SAQs) were used to assess deep learning two days after lecture. Scores were compared individually and overall between the two groups to assess student‟s lea...
Objective: To find out the effect of computer based animations on learning of Physiology.Study De... more Objective: To find out the effect of computer based animations on learning of Physiology.Study Design: Randomized control trial.Place and Duration of Study: Army Medical College Rawalpindi, from Jan to Sep 2016.Material and Methods: Sixty students of first year MBBS class were selected through simple random sampling and then randomly assigned into two groups of 30 each; group I and II. A pre-test was given to both the groups to assess their basal knowledge about the systems to be taught. In 1st teaching session, experimental group was taught with and control without animations. In 2nd teaching session, control group became experimental and previously experimental group became control. After both the teaching sessions MCQ tests of C2, C3 and C4 level were given to the groups and marks obtained were compared.Results: There were 20 (33.3%) male and 40 (66.7%) female students with mean age of 18.92 ± 0.56 years. Comparison of pre-test scores confirmed that basal level of knowledge was e...
Objective: To identify the prevalence of mobile phone use in class rooms and the distraction they... more Objective: To identify the prevalence of mobile phone use in class rooms and the distraction they cause. Study Design: Mixed method transformational study conducted in pragmatic paradigm. Place and Duration of Study: Army Medical College, Rawalpindi, from 1st Mar 2017 to 31st Mar 2017. Material and Methods: Focus group discussions were conducted employing three expressive students from each of the three classes. These discussions were used to develop themes which were then utilized to formulate a questionnaire. The validity of the questionnaire was confirmed by two expert medical educationists. The survey was conducted by distributing the self-answering questionnaire among the students. Simple descriptive statistics were then used to analyze the cross sectional data thus collected using SPSS version 20. Results: A total of 300 forms were distributed of which 235 (78.33%) were retrieved. Ninety one (38.72%) were from 3rd year, 82 (34.89%) from 4th year and 62 (26.38%) from final year...
Journal of Ayub Medical College, Abbottabad : JAMC, 2018
BACKGROUND It's estimated that almost 2.2% of the world's inhabitants suffer from hepatit... more BACKGROUND It's estimated that almost 2.2% of the world's inhabitants suffer from hepatitis C virus (HCV). The most common cause of chronic liver disease in haemodialysis centres is due to HCV. In 1993, it was first described by Bukh and colleagues that HCV viremia can occur without any detectable antibodies to the HCV. Keeping this in mind the purpose of this cross-sectional study was to assess the frequency of HCV in haemodialysis patients by PCR who are serologically negative for HCV. METHODS This cross-sectional study was conducted from 1st June to 31st December 2016 on all haemodialysis patients at MH Rawalpindi. Epidemiological data for gender, age, duration on haemodialysis, cause of chronic renal failure and any associated risk factor for acquiring hepatitis C infection was asked. Patients undergoing haemodialysis were investigated by fourth generation ELISA for Anti HCV antibodies, HCV DNA polymerase chain reaction, HCV genotype (where required) and liver function t...
Objective: To determine frequencies of various acute complications in patients undergoing hemodia... more Objective: To determine frequencies of various acute complications in patients undergoing hemodialysis.Study Design: Descriptive cross-sectional study.Place and Duration of Study: Department of Nephrology Military Hospital (MH) Rawalpindi, from Jan 2016 till Mar 2016.Material and Methods: A total of 150 patients who underwent haemodialysis at MH were enrolled in the study after informed consent on justification of inclusion and exclusion criteria. The patients were evaluated for the frequency of various intra-dialytic complications and data were analysed using SPSS version 19.Results: Out of the 150 enrolled patients, males were 125 (83.33%) and females were 25 (16.67%). A total of 2520 haemodialysis session were performed. Hypotension was the most frequently observed complication during 318 (12.62%) dialysis sessions, followed by hypertension in 208 (8.25%) and fever in 193 (7.66%) sessions. Other complications were muscle cramps in 116 (4.60%), shivering in 94 (3.73%), headache in...
Objective: To analyze the clinical characteristics, management and outcome of renal cell carcinom... more Objective: To analyze the clinical characteristics, management and outcome of renal cell carcinoma (RCC) and its variants in patients treated at CMH Peshawar, from Aug 2011 to Aug 2014. Study Design: Retrospective descriptive. Place and Duration of Study: Combined Military Hospital (CMH) Peshawar, from Aug 2011 to Aug 2014. Material and Methods: All patients who underwent nephrectomy for renal masses at our institution between Aug 2011 and Aug 2014 were included in the study. The demographic distribution, symptoms, tumour characteristics, operative findings and histopathology reports were extracted from the hospital records and analysed via SPSS version 20.0. Results: Among 27 patients male to female ratio was 1.25:1. Mean age was 55.5 ± 11.7 years. Flank pain was the commonest symptom reported. Mean maximum diameter of the tumour was 13.6 ± 4.6 cm. All the tumours were malignant and most common histopathological type was conventional/clear cell RCC. All patients were treated by rad...
Objective: To evaluate under graduate medical students’ perceptions on medical errors and patient... more Objective: To evaluate under graduate medical students’ perceptions on medical errors and patient safety. Study Design: Descriptive cross sectional study. Place and Duration of Study: Army Medical College from Dec 2014 to Jan 2015. Material and Methods: The 4x simulation role play patient safety sessions of 15 minutes each took place in the lecture hall conducted on fourth-year medical students selected during a whole-class academic sessions in Dec 2014 and Jan 2015. Participants in these sessions were given clinical scenario after taking the informed written consent. After the role play, students were given the same questionnaire. Responses to each item were added using a like rt scale. Results: Most of the students agreed after the role play sessions that they had a good understanding of common medical errors. Conclusion: Medical students in Army Medical College had knowledge of medical errors as being a barrier between what is thought better and what is being available.
Objective: To evaluate outcome of diagnostic kidney biopsy in patients with renal allograft dysfu... more Objective: To evaluate outcome of diagnostic kidney biopsy in patients with renal allograft dysfunction at a tertiary care hospital. Study Design: Retrospective observational study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Jan 2014 to Jan 2020. Methodology: A consolidate registry review was carried to formulate this study. The registry data exists at our center containing information about the graft dysfunction (manifesting as proteinuria, deranged urea and creatinine or urine sediment abnormalities) and other major indications which warrant probing with biopsy. The histopathological diagnosis of these biopsies is confirmed from the nephro-pathology registry before finalization of diagnosis. Results: A total of 94 diagnostic kidney biopsies were performed in patients with graft dysfunction. Out of 94 biopsies, 80 (85.1%) patients were male while 14 (14.9%) were female patients. The most frequent single cause for graft dysfunction was Cell Medi...
JBUMDC 2013; 3(1): 16-19 Page 16 INTRODUCTION: Patients with End Stage Renal Disease undergo hemo... more JBUMDC 2013; 3(1): 16-19 Page 16 INTRODUCTION: Patients with End Stage Renal Disease undergo hemodialysis through AV fistula on regular basis, which is a preferred access site1. Thereby, its dysfunction, mainly inflow and outflow stenosis is not uncommon as well. Earlier, quite a number of studies2,3 had been done which assessed the accuracy of various arteriovenous detection tools separately, in comparison with the gold standard i.e. angiography.Heye4 conducted a study in which he assessed the diagnost ic value of 64MDCTangiography in evaluation of arteriovenous fistula stenosis detection,when compared with DSA(Digital Subtraction Angiography).Another study assessed the accuracy of doppler ultrasound in detection of inflow stenosis when compared with angiography. This study showed that Doppler ultrasound has 91% sensitivity in inflow stenosis detection5. To highlight the importance of physical examination in arteriovenous fistula detection, a study a showed that it had 85% sensitiv...
IntroductionSerological surveys are valuable tools to evaluate the extent of disease transmission... more IntroductionSerological surveys are valuable tools to evaluate the extent of disease transmission, measuring preventive effectiveness and proportion of asymptomatic individuals. This age-stratified, serological survey was aimed to measure the COVID-19 distribution and determinants in district Islamabad of Pakistan.MethodologyThree-stage cluster sampling, using population proportionate to size technique, starting with a random number was used. A structured, pretested questionnaire was used after taking informed written consent, to gather demographic, risk factor information.ResultsSeroprevalence was found 16.5% (AR: 16.5%/100,000). The mean age was 35 (±16 Years). The majority were male (64%), self-employed (29%), and had primary level education (33%). The highest seroprevalence was found in the 21-30 years age group (24.8%) while the 41-50 years age group showed the highest attack rate (112.9/100,000 population). The proportion of the population tested that were asymptomatic was 69%...
Objective: To determine the prevalence of patterns of CKD-MBD in dialysis patients at a tertiary ... more Objective: To determine the prevalence of patterns of CKD-MBD in dialysis patients at a tertiary care hospital and analyze its relationship with various socio demographic factors. Study Design: Analytical cross sectional study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jul 2017 to Dec 2017. Methodology: The sample population comprised of 100 patients undergoing hemodialysis and blood samples of calcium, phosphate, alkaline phosphatase and intact PTH were obtained from these patients. CKD-MBD was classified on the basis of biochemical abnormalities and their relationship with age, gender, marital status, smoking history, dialysis count per week, dialysis duration was assessed.Results: Out of 82 patients consisting of 62 males and 20 females, the mean age was 49.8 ± 16 years, 68% of dialysis patients had biochemical abnormalities of which 73% showing high turn over bone disease and 26.8% showing low turnover bone disease (adynamic and osteomalacia). ...
Pakistan Armed Forces Medical Journal, Apr 1, 2017
Objective: To determine frequencies of various acute complications in patients undergoing hemodia... more Objective: To determine frequencies of various acute complications in patients undergoing hemodialysis. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of Nephrology Military Hospital (MH) Rawalpindi, from Jan 2016 till Mar 2016. Material and Methods: A total of 150 patients who underwent haemodialysis at MH were enrolled in the study after informed consent on justification of inclusion and exclusion criteria. The patients were evaluated for the frequency of various intra-dialytic complications and data were analysed using SPSS version 19. Results: Out of the 150 enrolled patients, males were 125 (83.33%) and females were 25 (16.67%). A total of 2520 haemodialysis session were performed. Hypotension was the most frequently observed complication during 318 (12.62%) dialysis sessions, followed by hypertension in 208 (8.25%) and fever in 193 (7.66%) sessions. Other complications were muscle cramps in 116 (4.60%), shivering in 94 (3.73%), headach...
Objectives: To evaluate the influence of carnitine therapy on skeletal myopathy, cardiomyopathy, ... more Objectives: To evaluate the influence of carnitine therapy on skeletal myopathy, cardiomyopathy, heart failure, anemia and nutritional markers in an End Stage Renal Disease (ESRD) population. Design, Setting and Participants: We conducted a prospective cohort study at Nephrology Department, PNS SHIFA, Karachi. A total of 35 patients were included. Blood sampling, two dimensional echocardiography imaging and quality of life (QOL) 36-item short form (SF36) survey was done at baseline, 3 months and at 6 months. At the end of 6 months data was collected and analyzed using SPSS 20. Results: The age of the subjects was (mean + SD) 46.55 ±16.64 with a male to female ratio of 2:1.There was statistically significant improvement at three and six months in QOL assessment SF36 questionnaire-based Physical Component Summary (PCS) and Mental Component Summary (MCS) (p<0.001 and 0.001), Haematocrit (p<0.02 and 0.004), pre and post dialysis serum urea (p<0.051 and 0.077) and (p<0.037 an...
Objective: To evaluate outcome of diagnostic kidney biopsy in patients with renal allograft dysfu... more Objective: To evaluate outcome of diagnostic kidney biopsy in patients with renal allograft dysfunction at a tertiary care hospital. Study Design: Retrospective observational study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Jan 2014 to Jan 2020. Methodology: A consolidate registry review was carried to formulate this study. The registry data exists at our center containing information about the graft dysfunction (manifesting as proteinuria, deranged urea and creatinine or urine sediment abnormalities) and other major indications which warrant probing with biopsy. The histopathological diagnosis of these biopsies is confirmed from the nephro-pathology registry before finalization of diagnosis. Results: A total of 94 diagnostic kidney biopsies were performed in patients with graft dysfunction. Out of 94 biopsies, 80 (85.1%) patients were male while 14 (14.9%) were female patients. The most frequent single cause for graft dysfunction was Cell Medi...
Objective: To observe the efficacy of blind obturator nerve block by Labat technique for preventi... more Objective: To observe the efficacy of blind obturator nerve block by Labat technique for prevention of obturator jerk during transurethral resection of bladder tumor performed under spinal anesthesia. Study Design: Descriptive Study. Material and Methods: This was a single center based study conducted at tertiary care military hospital for a period of thirty months. Fifty five patients were recruited in the study, after identifying the location of bladder growth in the lateral wall on ultrasound USG and confirming its exact site on cystoscopic examination. Those eliciting obturator jerk during transurethral resection of bladder tumor (TURBT) were included and ONB was performed using 2% lidocaine via blind technique of Labat. TURBT was restarted and presence of obturator jerk was recorded if evoked (primary outcome). Results: Median age was 67.3 ± 8 years with majority (72.7%) in the age group between 61 to 80 years. Male female ratio was 7:1. Fifty (90%) patients presented with soli...
Objective: To assess live donor nephrectomy for development of hypertension. Study Design: Retros... more Objective: To assess live donor nephrectomy for development of hypertension. Study Design: Retrospective observational study. Place and Duration of Study: The study was conducted at Armed Forces Institute of Urology (AFIU) Rawalpindi, from May 2016 to May 2020. Methodology: All consenting kidney donors for live renal transplant were introduced with the process. Baseline blood pressure at time of workup of donation and annually afterwards after transplant on follow up examinations using retrospective data analysis of donor’s workup and follow up was used. Comparison of 1,2,3 and 4-year occurrence of hypertension among (normotensive) donors with 1,2,3 and 4-year of donation using estimates from Framingham Hypertension Risk Score. Results: A total of 79 donors with a completed annual follow-up rate of up to100 % during a 4-year period. The average age at donation was 33.96 ± 10.23 SD years; 50 donors (63.4%) were women. Overall 27% (22 out of 79) of all live donors developed post donat...
Objective: To assess the correlation of medical professionalism score of final year medical stude... more Objective: To assess the correlation of medical professionalism score of final year medical students with theiracademic results of the final professional examination. Study Design: Correlational study. Place and Duration of Study: Army Medical College, Rawalpindi, from Mar to Nov 2019. Methodology: Final year medical students were enrolled by non-probability consecutive sampling. Their medical professionalism score was calculated using the Penn State College of Medicine-Professionalism Questionnaire (PSCOM-PQ). All the aspects of accountability, altruism, excellence, duty, honour/integrity and respect were noted using the questionnaire. Thirty points from the questionnaire were used, calculating the maximum value of 150. After the final professional examination, their academic results were procured. The strength of the relationship between medical professionalism score and academic results of final year professional examination was assessed using the Pearson correlation coefficient....
Background: To study various etiological factors associated with acute kidney injury during pregn... more Background: To study various etiological factors associated with acute kidney injury during pregnancy and their outcome Methods: In this cross sectional descriptive study, previously healthy ladies who developed AKI during pregnancy (n=88) were included .AKI was defined as per AKINs criteria i.e. Increase in serum creatinine by > 0.3mg/dl within 48 hours from previously normal base line values or urine volume <0.5ml/kg/h for 6 hours or more was labelled as AKI. These patients were worked up for likely causes of AKI and followed up for up to three months postdelivery. Cases with persistent azotemia for more than three months were labelled as chronic kidney disease Results: Mean age of the patients was 26.3 + 7.06 years. A total of twenty seven (31%) patients presented with AKI in 1st trimester, eleven patients (12%) were diagnosed in second and twenty nine (33%) were diagnosed with AKI in 3rd trimester. During postpartum period 24% developed AKI. Septic abortion was commonest c...
Objective: To study if concept mapping (CM) is a useful learning approach to enhance meaningful l... more Objective: To study if concept mapping (CM) is a useful learning approach to enhance meaningful learning in final year medical students compared to traditional methods in an undergraduate medical college to improve learning of puberty disorders in Gynaecology. Study Design: Quasi experimental study. Place and Duration of Study: Army Medical College Rawalpindi, from Dec 2016 to Mar 2017. Methodology: The final year MBBS class was randomized into 2 groups of 100 each that were taught disorders of puberty using interactive lectures of 50 students. One was taught “disorders of puberty” by traditional lecture and the second by CM. There was Delphi agreement of the content of lecture and method of interaction by the faculty of Gynaecology. Multiple Choice Questions (MCQs), Extended matching Questions (EMQs) and Short Answer Questions (SAQs) were used to assess deep learning two days after lecture. Scores were compared individually and overall between the two groups to assess student‟s lea...
Objective: To find out the effect of computer based animations on learning of Physiology.Study De... more Objective: To find out the effect of computer based animations on learning of Physiology.Study Design: Randomized control trial.Place and Duration of Study: Army Medical College Rawalpindi, from Jan to Sep 2016.Material and Methods: Sixty students of first year MBBS class were selected through simple random sampling and then randomly assigned into two groups of 30 each; group I and II. A pre-test was given to both the groups to assess their basal knowledge about the systems to be taught. In 1st teaching session, experimental group was taught with and control without animations. In 2nd teaching session, control group became experimental and previously experimental group became control. After both the teaching sessions MCQ tests of C2, C3 and C4 level were given to the groups and marks obtained were compared.Results: There were 20 (33.3%) male and 40 (66.7%) female students with mean age of 18.92 ± 0.56 years. Comparison of pre-test scores confirmed that basal level of knowledge was e...
Objective: To identify the prevalence of mobile phone use in class rooms and the distraction they... more Objective: To identify the prevalence of mobile phone use in class rooms and the distraction they cause. Study Design: Mixed method transformational study conducted in pragmatic paradigm. Place and Duration of Study: Army Medical College, Rawalpindi, from 1st Mar 2017 to 31st Mar 2017. Material and Methods: Focus group discussions were conducted employing three expressive students from each of the three classes. These discussions were used to develop themes which were then utilized to formulate a questionnaire. The validity of the questionnaire was confirmed by two expert medical educationists. The survey was conducted by distributing the self-answering questionnaire among the students. Simple descriptive statistics were then used to analyze the cross sectional data thus collected using SPSS version 20. Results: A total of 300 forms were distributed of which 235 (78.33%) were retrieved. Ninety one (38.72%) were from 3rd year, 82 (34.89%) from 4th year and 62 (26.38%) from final year...
Journal of Ayub Medical College, Abbottabad : JAMC, 2018
BACKGROUND It's estimated that almost 2.2% of the world's inhabitants suffer from hepatit... more BACKGROUND It's estimated that almost 2.2% of the world's inhabitants suffer from hepatitis C virus (HCV). The most common cause of chronic liver disease in haemodialysis centres is due to HCV. In 1993, it was first described by Bukh and colleagues that HCV viremia can occur without any detectable antibodies to the HCV. Keeping this in mind the purpose of this cross-sectional study was to assess the frequency of HCV in haemodialysis patients by PCR who are serologically negative for HCV. METHODS This cross-sectional study was conducted from 1st June to 31st December 2016 on all haemodialysis patients at MH Rawalpindi. Epidemiological data for gender, age, duration on haemodialysis, cause of chronic renal failure and any associated risk factor for acquiring hepatitis C infection was asked. Patients undergoing haemodialysis were investigated by fourth generation ELISA for Anti HCV antibodies, HCV DNA polymerase chain reaction, HCV genotype (where required) and liver function t...
Objective: To determine frequencies of various acute complications in patients undergoing hemodia... more Objective: To determine frequencies of various acute complications in patients undergoing hemodialysis.Study Design: Descriptive cross-sectional study.Place and Duration of Study: Department of Nephrology Military Hospital (MH) Rawalpindi, from Jan 2016 till Mar 2016.Material and Methods: A total of 150 patients who underwent haemodialysis at MH were enrolled in the study after informed consent on justification of inclusion and exclusion criteria. The patients were evaluated for the frequency of various intra-dialytic complications and data were analysed using SPSS version 19.Results: Out of the 150 enrolled patients, males were 125 (83.33%) and females were 25 (16.67%). A total of 2520 haemodialysis session were performed. Hypotension was the most frequently observed complication during 318 (12.62%) dialysis sessions, followed by hypertension in 208 (8.25%) and fever in 193 (7.66%) sessions. Other complications were muscle cramps in 116 (4.60%), shivering in 94 (3.73%), headache in...
Objective: To analyze the clinical characteristics, management and outcome of renal cell carcinom... more Objective: To analyze the clinical characteristics, management and outcome of renal cell carcinoma (RCC) and its variants in patients treated at CMH Peshawar, from Aug 2011 to Aug 2014. Study Design: Retrospective descriptive. Place and Duration of Study: Combined Military Hospital (CMH) Peshawar, from Aug 2011 to Aug 2014. Material and Methods: All patients who underwent nephrectomy for renal masses at our institution between Aug 2011 and Aug 2014 were included in the study. The demographic distribution, symptoms, tumour characteristics, operative findings and histopathology reports were extracted from the hospital records and analysed via SPSS version 20.0. Results: Among 27 patients male to female ratio was 1.25:1. Mean age was 55.5 ± 11.7 years. Flank pain was the commonest symptom reported. Mean maximum diameter of the tumour was 13.6 ± 4.6 cm. All the tumours were malignant and most common histopathological type was conventional/clear cell RCC. All patients were treated by rad...
Objective: To evaluate under graduate medical students’ perceptions on medical errors and patient... more Objective: To evaluate under graduate medical students’ perceptions on medical errors and patient safety. Study Design: Descriptive cross sectional study. Place and Duration of Study: Army Medical College from Dec 2014 to Jan 2015. Material and Methods: The 4x simulation role play patient safety sessions of 15 minutes each took place in the lecture hall conducted on fourth-year medical students selected during a whole-class academic sessions in Dec 2014 and Jan 2015. Participants in these sessions were given clinical scenario after taking the informed written consent. After the role play, students were given the same questionnaire. Responses to each item were added using a like rt scale. Results: Most of the students agreed after the role play sessions that they had a good understanding of common medical errors. Conclusion: Medical students in Army Medical College had knowledge of medical errors as being a barrier between what is thought better and what is being available.
Objective: To evaluate outcome of diagnostic kidney biopsy in patients with renal allograft dysfu... more Objective: To evaluate outcome of diagnostic kidney biopsy in patients with renal allograft dysfunction at a tertiary care hospital. Study Design: Retrospective observational study. Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Jan 2014 to Jan 2020. Methodology: A consolidate registry review was carried to formulate this study. The registry data exists at our center containing information about the graft dysfunction (manifesting as proteinuria, deranged urea and creatinine or urine sediment abnormalities) and other major indications which warrant probing with biopsy. The histopathological diagnosis of these biopsies is confirmed from the nephro-pathology registry before finalization of diagnosis. Results: A total of 94 diagnostic kidney biopsies were performed in patients with graft dysfunction. Out of 94 biopsies, 80 (85.1%) patients were male while 14 (14.9%) were female patients. The most frequent single cause for graft dysfunction was Cell Medi...
JBUMDC 2013; 3(1): 16-19 Page 16 INTRODUCTION: Patients with End Stage Renal Disease undergo hemo... more JBUMDC 2013; 3(1): 16-19 Page 16 INTRODUCTION: Patients with End Stage Renal Disease undergo hemodialysis through AV fistula on regular basis, which is a preferred access site1. Thereby, its dysfunction, mainly inflow and outflow stenosis is not uncommon as well. Earlier, quite a number of studies2,3 had been done which assessed the accuracy of various arteriovenous detection tools separately, in comparison with the gold standard i.e. angiography.Heye4 conducted a study in which he assessed the diagnost ic value of 64MDCTangiography in evaluation of arteriovenous fistula stenosis detection,when compared with DSA(Digital Subtraction Angiography).Another study assessed the accuracy of doppler ultrasound in detection of inflow stenosis when compared with angiography. This study showed that Doppler ultrasound has 91% sensitivity in inflow stenosis detection5. To highlight the importance of physical examination in arteriovenous fistula detection, a study a showed that it had 85% sensitiv...
IntroductionSerological surveys are valuable tools to evaluate the extent of disease transmission... more IntroductionSerological surveys are valuable tools to evaluate the extent of disease transmission, measuring preventive effectiveness and proportion of asymptomatic individuals. This age-stratified, serological survey was aimed to measure the COVID-19 distribution and determinants in district Islamabad of Pakistan.MethodologyThree-stage cluster sampling, using population proportionate to size technique, starting with a random number was used. A structured, pretested questionnaire was used after taking informed written consent, to gather demographic, risk factor information.ResultsSeroprevalence was found 16.5% (AR: 16.5%/100,000). The mean age was 35 (±16 Years). The majority were male (64%), self-employed (29%), and had primary level education (33%). The highest seroprevalence was found in the 21-30 years age group (24.8%) while the 41-50 years age group showed the highest attack rate (112.9/100,000 population). The proportion of the population tested that were asymptomatic was 69%...
Objective: To determine the prevalence of patterns of CKD-MBD in dialysis patients at a tertiary ... more Objective: To determine the prevalence of patterns of CKD-MBD in dialysis patients at a tertiary care hospital and analyze its relationship with various socio demographic factors. Study Design: Analytical cross sectional study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jul 2017 to Dec 2017. Methodology: The sample population comprised of 100 patients undergoing hemodialysis and blood samples of calcium, phosphate, alkaline phosphatase and intact PTH were obtained from these patients. CKD-MBD was classified on the basis of biochemical abnormalities and their relationship with age, gender, marital status, smoking history, dialysis count per week, dialysis duration was assessed.Results: Out of 82 patients consisting of 62 males and 20 females, the mean age was 49.8 ± 16 years, 68% of dialysis patients had biochemical abnormalities of which 73% showing high turn over bone disease and 26.8% showing low turnover bone disease (adynamic and osteomalacia). ...
Pakistan Armed Forces Medical Journal, Apr 1, 2017
Objective: To determine frequencies of various acute complications in patients undergoing hemodia... more Objective: To determine frequencies of various acute complications in patients undergoing hemodialysis. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of Nephrology Military Hospital (MH) Rawalpindi, from Jan 2016 till Mar 2016. Material and Methods: A total of 150 patients who underwent haemodialysis at MH were enrolled in the study after informed consent on justification of inclusion and exclusion criteria. The patients were evaluated for the frequency of various intra-dialytic complications and data were analysed using SPSS version 19. Results: Out of the 150 enrolled patients, males were 125 (83.33%) and females were 25 (16.67%). A total of 2520 haemodialysis session were performed. Hypotension was the most frequently observed complication during 318 (12.62%) dialysis sessions, followed by hypertension in 208 (8.25%) and fever in 193 (7.66%) sessions. Other complications were muscle cramps in 116 (4.60%), shivering in 94 (3.73%), headach...
Objectives: To evaluate the influence of carnitine therapy on skeletal myopathy, cardiomyopathy, ... more Objectives: To evaluate the influence of carnitine therapy on skeletal myopathy, cardiomyopathy, heart failure, anemia and nutritional markers in an End Stage Renal Disease (ESRD) population. Design, Setting and Participants: We conducted a prospective cohort study at Nephrology Department, PNS SHIFA, Karachi. A total of 35 patients were included. Blood sampling, two dimensional echocardiography imaging and quality of life (QOL) 36-item short form (SF36) survey was done at baseline, 3 months and at 6 months. At the end of 6 months data was collected and analyzed using SPSS 20. Results: The age of the subjects was (mean + SD) 46.55 ±16.64 with a male to female ratio of 2:1.There was statistically significant improvement at three and six months in QOL assessment SF36 questionnaire-based Physical Component Summary (PCS) and Mental Component Summary (MCS) (p<0.001 and 0.001), Haematocrit (p<0.02 and 0.004), pre and post dialysis serum urea (p<0.051 and 0.077) and (p<0.037 an...
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Papers by Sohail Sabir