Papers by Asfandyar Sheikh
JPMA. The Journal of the Pakistan Medical Association, 2013
Infectious agents and cancer, 2013
c-Met is a receptor tyrosine kinase that encodes protein such as hepatocyte growth factor recepto... more c-Met is a receptor tyrosine kinase that encodes protein such as hepatocyte growth factor receptor (HGFR). Inappropriate activity of c-Met can cause wide variety of carcinomas. c-Met inhibitor are relatively new class of small molecules that inhibit the enzymatic activity of c-Met tyrosine kinase. Met inhibitors divided into two main classes: class I (SU-11274-like) and class II (AM7-like). The use of c-Met inhibitors with other therapeutic agents could be crucial for overcoming potential resistance as well as for improving overall clinical benefit. Met pathway inhibitors might be used in combination with other treatments, including chemo-, radio-or immunotherapy
JPMA. The Journal of the Pakistan Medical Association, 2013
JPMA. The Journal of the Pakistan Medical Association, 2013
Madam, emergency departments (EDs) in Karachi are becoming more crowded than the quintessential f... more Madam, emergency departments (EDs) in Karachi are becoming more crowded than the quintessential fish markets. A large portion of this can be attributed to the cloud of brutality that seems to cover most of the city. However, an aspect that often goes neglected, relates to an array of psychiatric conditions, collectively known as "Factitious Disorders." These disorders are characterized by deliberate production or exaggeration of symptoms. 1 J Pak Med Assoc
Archives of public health = Archives belges de santé publique, 2013
Background: The Expanded Program on Immunization (EPI) was initiated by World Health Organization... more Background: The Expanded Program on Immunization (EPI) was initiated by World Health Organization (WHO) in 1974 in order to save children from life threatening, disabling vaccine-preventable diseases (VPDs). In Pakistan, this program was launched in 1978 with the main objectives of eradicating polio by 2012, eliminating measles and neonatal tetanus by 2015, and minimizing the incidence of other VPDs. However, despite the efforts of government and WHO, this program has not received the amount of success that was desired. Hence, the objectives of this study were to elucidate the main reasons behind not achieving the full immunization coverage in Pakistan, the awareness of children's attendant about the importance of vaccination, their attitudes, thoughts and fears regarding childhood immunization, and the major hurdles faced in pursuit of getting their children vaccinated. Methods: This was an observational, cross-sectional, questionnaire-based study conducted during a one year period from 4th January, 2012 to 6th January, 2013 at the pediatric outpatient clinics of Civil Hospital (CHK) and National Institute of Child Health (NICH). We attempted to interview all the parents who could be approached during the period of the study. Thus, convenience sampling was employed. The parents were approached in the clinics and interviewed after seeking informed, written consent. Those patients who were not accompanied by either of their parents were excluded from the study. The study instrument comprised of three sections. The first section consisted was concerned with the demographics of the patient and the parents. The second section dealt with the reasons for complete vaccination or under-vaccination. The last section aimed to assess the knowledge, attitudes and beliefs of the respondents. Results: Out of 1044 patients, only 713(68.3%) were fully vaccinated, 239(22.9%) were partially vaccinated while 92(8.8%) had never been vaccinated. The vaccination status showed statistically significant association with ethnicity, income, residence, number of children and paternal occupation (p < 0.05 for all). The most common provocative factor for vaccination compliance was mass media (61.9%). The most common primary reason for non-vaccination was lack of knowledge (18.1%), whereas the most common secondary reason for non-vaccination was religious taboos (31.4%). Majority of the respondents demonstrated poor knowledge of EPI schedules or VPDs. However, most believed that there was a need for more active government/NGO involvement in this area. Conclusion: The most common primary reason for non-vaccination, i.e. lack of knowledge, and the most common secondary reason, i.e. religious taboos, imply that there is dire need to promote awareness among the masses in collaboration with NGOs, and major religious and social organizations.
International archives of medicine, 2013
Although cricket has origins in the British Empire, it is followed as a religion in South Asia, p... more Although cricket has origins in the British Empire, it is followed as a religion in South Asia, probably due to the influence of the former during their rule. The sport is equally popular among all groups of the society, and is not subject to gender or age constraints. It marks the epitome of reverence and is considered a battle for self-esteem, not only for those playing, but for those watching as well. The intensity of emotional attachment with this sport renders certain public health benefits as well as drawbacks to the general masses.
JPMA. The Journal of the Pakistan Medical Association, 2013
Madam, as the world's population continues to expand, the rate of addictive habits and the diseas... more Madam, as the world's population continues to expand, the rate of addictive habits and the diseases associated with them are also increasing. The use of addictive substances is becoming a major health concern amongst the Asian children. In South Asian countries like Pakistan, with a current population of 190 million, 1 addictive habits show a progressive upward climb. Addiction to substances like betel quid, areca nut, areca palm, betel palm, cigarette smoking and crushed areca/betel nut (gutka) is becoming very common in Pakistan, especially in Karachi. The more frequently abused substance is betel quid, which is the leaf of a vine, the Piper betel. In Pakistan, betel quid (tam baku wala paan) is betel leaf filled with areca nut (a psychoactive agent), tobacco, spices and slaked lime. The leaf is chewed by more than 10% of the people worldwide who are mostly uneducated and belong to the low socioeconomic class. 2 J Pak Med Assoc
JPMA. The Journal of the Pakistan Medical Association, 2013
Indian journal of endocrinology and metabolism, 2013
Italian Journal of …, 2012
Birth defects are defined as those conditions that are substantially determined before or during ... more Birth defects are defined as those conditions that are substantially determined before or during birth and which are recognizable in early life. They are an important cause of morbidity and mortality in infants. The main objective of the study was to determine the association of certain risk factors with birth defects occurring in pediatric patients seeking care in Civil Hospital, Karachi.
El Mednifico Journal, 2013
Infectious Agents and …, 2012
The Hedgehog (Hh) proteins comprise a group of secreted proteins that regulate cell growth, diffe... more The Hedgehog (Hh) proteins comprise a group of secreted proteins that regulate cell growth, differentiation and survival. Inappropriate activation of the Hh signaling pathway has been implicated in the development of a variety of cancers. Hedgehog pathway inhibitors are a relatively new class of therapeutic agents that act by targeting the proteins involved in the regulation of Hh pathway (PTCH, SMO and Gli). Together, they serve as exciting new prospects, with a bright future, both alone or as an adjuvant to the more traditional anti-cancer drugs.
Globalization …, 2012
Physician migration, also known as "brain drain," results from a combination of a gap in the supp... more Physician migration, also known as "brain drain," results from a combination of a gap in the supply and demand in developed countries and a lack of job satisfaction in developing countries. Many push and pull factors are responsible for this effect, with media and internet playing their parts. Large-scale physician migration can pose problems for both the donor and the recipient countries, with a resulting reinforcement in the economic divide between developed and developing countries. The main objectives of our study were to determine the prevalence of migration intentions in medical undergraduates, to elucidate the factors responsible and to analyze the attitudes and practices related to these intentions.
Patient Safety in …, 2012
Background: The duty of a doctor to take care presumes the person who offers medical advice and t... more Background: The duty of a doctor to take care presumes the person who offers medical advice and treatment to unequivocally possess the skills and knowledge to do so. However, a sense of responsibility cannot be guaranteed in the absence of accountability, which in turn requires a comprehensive medical law system to be in place. Such a system is almost non-existent in Pakistan. Keeping the above in mind, we designed this study to assess the knowledge, attitudes and practices of surgeons regarding malpractice at a tertiary care center in Pakistan.
Medical Hypotheses, 2012
Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune disorder involving mainly synovi... more Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune disorder involving mainly synovial joints. It can progress to a severely debilitating form with pulmonary, renal and cardiovascular involvement. Currently, disease-modifying antirheumatic drugs (DMARDs) remain the gold standard pharmacological therapy for RA (along with nonsteroidal anti-inflammatory drugs and corticosteroids). However, DMARDs are more or less ineffective in the late phase of the disease and adverse effects often limit their use. Studies show that serum levels of vascular endothelial growth factor (VEGF) remain elevated throughout the course of RA. In experimental models, the administration of pro-angiogenic cytokines, such as VEGF or FGF, has been shown to increase the severity of the disease. Therefore, anti-angiogenic drugs such as bevacizumab (which is already being used as an anti-tumor agent) may play a significant role in longstanding RA. However, adverse effects such as hypertension, gastro-intestinal perforation and the high cost of bevacizumab are major concerns. A recent study suggests that itraconazole, an antifungal drug, has a role in selectively inhibiting angiogenesis and growth of tumor in non-small cell lung cancer. Hence, this drug may be beneficial in the treatment of RA, especially in the later phase when other modalities have failed, or as an adjuvant. To test our hypothesis, we propose a randomized, double-blinded trial in patients with longstanding RA. The control group receives the standard DMARD therapy plus placebo, while the case group receives itraconazole in addition to DMARD therapy. Serum and synovial VEGF levels, in both the control group and the case group, are compared and their correlation with the symptoms is judged. If the VEGF levels are lower and/or the symptoms are less severe in the case group, our hypothesis will be confirmed. Multi-institutional efforts are needed to confirm this hypothesis, as it is relatively new and trial data is limited.
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Papers by Asfandyar Sheikh