Background: Super-enhancers are clusters of active enhancers densely occupied by the Mediators, t... more Background: Super-enhancers are clusters of active enhancers densely occupied by the Mediators, transcription factors and chromatin regulators, control expression of cell identity and disease associated genes. Current studies demonstrated the possibility of multiple factors with important roles in super-enhancer formation; however, a systematic analysis to asses the relative contribution of chromatin and sequence features of super-enhancers and their constituents remain unclear. In addition, a predictive model that integrates various types of data to predict super-enhancers has not been established. Results: Here, we integrated diverse types of genomic and epigenomic datasets to identify key signatures of super-enhancers and their constituents and to investigate their relative contribution. Through computational modelling, we found that Cdk8, Cdk9 and Smad3 as new key features of super-enhancers along with many known. Comprehensive analysis of these features in embryonic stem cells ...
Cerebrotendinous xanthomatosis is a rare, autosomal recessive, inherited lipid storage disease ch... more Cerebrotendinous xanthomatosis is a rare, autosomal recessive, inherited lipid storage disease characterized by accumulation of cholestanol and cholesterol in most tissues. The disease is caused by mutations in the sterol 27-hydroxylase gene, leading to a block in bile synthesis, with accumulation of substrates for this enzyme, including cholesterol, resulting in an increase in the conversion of cholesterol to cholestanol. A 26-year-old woman presented with gradually increasing bilateral ankle swelling. She had a history of bilateral cataracts and left-sided hemiparesis. She had mental retardation, with a history of delayed milestone development. Her serum cholesterol levels were elevated. Aspiration of both ankle swellings revealed histiocytes and many foreign body giant cells. There were numerous rectangular to rhomboid crystals in the background. Very few articles are available on the cytologic features of tendinous xanthomas; hence we tried to highlight these features.
In this study, a novel bio-inspired computing approach is developed to analyze the dynamics of no... more In this study, a novel bio-inspired computing approach is developed to analyze the dynamics of nonlinear singular Thomas-Fermi equation (TFE) arising in potential and charge density models of an atom by exploiting the strength of finite difference scheme (FDS) for discretization and optimization through genetic algorithms (GAs) hybrid with sequential quadratic programming. The FDS procedures are used to transform the TFE differential equations into a system of nonlinear equations. A fitness function is constructed based on the residual error of constituent equations in the mean square sense and is formulated as the minimization problem. Optimization of parameters for the system is carried out with GAs, used as a tool for viable global search integrated with SQP algorithm for rapid refinement of the results. The design scheme is applied to solve TFE for five different scenarios by taking various step sizes and different input intervals. Comparison of the proposed results with the state of the art numerical and analytical solutions reveals that the worth of our scheme in terms of accuracy and convergence. The reliability and effectiveness of the proposed scheme are validated through consistently getting optimal values of statistical performance indices calculated for a sufficiently large number of independent runs to establish its significance.
Abstract A new aromatic diamine monomer {4-amino [4-(diphenylamino) phenyl] anilino} phenyl amine... more Abstract A new aromatic diamine monomer {4-amino [4-(diphenylamino) phenyl] anilino} phenyl amine (DPA-4) were synthesized in high yield and purity.{4-amino [4-(diphenylamino) phenyl] anilino} phenyl amine (DPA-4) monomer were reacted with Tetra ...
Jpma the Journal of the Pakistan Medical Association, Mar 1, 2010
Objective: To assess the the efficacy and early and late complications of Argon-YAG combined lase... more Objective: To assess the the efficacy and early and late complications of Argon-YAG combined laser iridotomy in the outpatient department of a tertiary care hospital. Methods: This was a prospective observational study conducted at Aga Khan University Hospital Karachi, Pakistan. After detailed history taking and clinical examination, patients who had goniscopically evident closed angles and a positive provocative test were selected for laser iridotomy. They underwent iridotomy using Argon laser followed by YAG laser. The main outcome measures were patency of iridotomy at 6 months, angle grading at 6 months and early and late complications. Results: Overall 40 eyes of 30 patients underwent iridotomy. Of these 18 (60%) were female. At presentation, 26, 10, 2 and 2 eyes had primary angle closure glaucoma (PACG), prodromal stage of PACG, chronic angle closure glaucoma, and seculusio papillae with iris bombe secondary to uveitis, respectively. All the 40 iridotomies were patent at 6 months follow up. Majority of the eyes with primary acute angle closure glaucoma, and prodromal angle closure glaucoma had their angles opened from Grade 0 and Grade I to Grade III. At 6 months, 30(75%) eyes had a good control of intraocular pressure (IOP). Intraoperative complication, encountered were microhyphaema in 14 eyes and 2 developed corneal burns. Postoperative complications were transient rise of IOP in 18 eyes and post-laser iritis in 32 eyes, but they responded to recommended treatment. Conclusions: Iridotomy with Argon laser followed by Nd-YAG laser was associated with good clinical outcome and fewer complications in eyes with PACG (JPMA 60:220; 2010).
There is a need to optimize water-nitrogen (N) applications to increase seed cotton yield and wat... more There is a need to optimize water-nitrogen (N) applications to increase seed cotton yield and water use efficiency (WUE) under a mulch drip irrigation system. This study evaluated the effects of four water regimes [moderate drip irrigation from the third-leaf to the boll-opening stage (W1), deficit drip irrigation from the third-leaf to the flowering stage and sufficient drip irrigation thereafter (W2), pre-sowing and moderate drip irrigation from the third-leaf to the boll-opening stage (W3), pre-sowing and deficit drip irrigation from the third-leaf to the flowering stage and sufficient drip irrigation thereafter (W4)] and N fertilizer at a rate of 520 kg ha(-1) in two dressing ratios [7:3 (N1), 2:8 (N2)] on cotton root morpho-physiological attributes, yield, WUE and the relationship between root distribution and dry matter production. Previous investigations have shown a strong correlation between root activity and water consumption in the 40-120 cm soil layer. The W3 and especia...
ABSTRACT A B S T R A C T This work presents the introduction of an organic compound methyl methan... more ABSTRACT A B S T R A C T This work presents the introduction of an organic compound methyl methane sulfonate (MMS) for the first time in fabrication of polystyrene based proton exchange membrane (PEM) by plasma polymerization process. The membrane is fabricated by co-polymerizing styrene and MMS in capacitively coupled continuous RF plasma. The chemical composition of the plasma polymerized polymer membrane is investigated using Fourier Transform Infrared Spectroscopy which reveals the formation of composite structure of styrene and MMS. The surface morphology studied using AFM and SEM depicts the effect of higher partial pressure of MMS on surface topography of the membrane. The proton transport property of the membrane studied using electrochemical impedance spectroscopy shows the achievement of maximum proton conductivity of 0.141 S cm À1 which is comparable to Nafion 117 membrane. Fuel cell performance test of the synthesized membrane shows a maximum power density of 500 mW cm À2 and current density of 0.62 A cm À2 at 0.6 V. ã
JPMA. The Journal of the Pakistan Medical Association, 2010
To assess the the efficacy and early and late complications of Argon-YAG combined laser iridotomy... more To assess the the efficacy and early and late complications of Argon-YAG combined laser iridotomy in the outpatient department of a tertiary care hospital. This was a prospective observational study conducted at Aga Khan University Hospital Karachi, Pakistan. After detailed history taking and clinical examination, patients who had goniscopically evident closed angles and a positive provocative test were selected for laser iridotomy. They underwent iridotomy using Argon laser followed by YAG laser. The main outcome measures were patency of iridotomy at 6 months, angle grading at 6 months and early and late complications. Overall 40 eyes of 30 patients underwent iridotomy. Of these 18 (60%) were female. At presentation, 26, 10, 2 and 2 eyes had primary angle closure glaucoma (PACG), prodromal stage of PACG, chronic angle closure glaucoma, and seculusio papillae with iris bombe secondary to uveitis, respectively. All the 40 iridotomies were patent at 6 months follow up. Majority of the...
The Euro Heart Survey on diabetes and heart has demonstrated high prevalence of latent glucose ab... more The Euro Heart Survey on diabetes and heart has demonstrated high prevalence of latent glucose abnormalities in non-diabetic patients with coronary artery disease (CAD) in the European population. The aim of our survey was to assess the prevalence of latent abnormal glucose regulation in adult non-diabetic CAD patients in India. Seven centers distributed across India recruited 350 patients. The diagnosis of CAD was done by coronary angiography showing >50% stenosis in any major epicardial coronary artery or its branches. Oral glucose tolerance test (OGTT) and fasting glucose levels were used to characterize glucose metabolism. Venous plasma glucose was measured before (fasting) and 2 hours after ingestion of glucose. Impaired fasting glucose (IFG) was defined as OGTT (0 minute)>or=100 mg/dl but <126 mg/dl and OGTT (2 hours)<140 mg/dl. Impaired glucose tolerance (IGT) was defined as OGTT (0 minute)<126 mg/dl and OGTT (2 hours)>or=140 mg/dl but <200 mg/dl. Of the ...
Therapeutic advances in endocrinology and metabolism, 2016
The value of sulphonylureas in the long-term treatment of type II diabetes has been questioned. T... more The value of sulphonylureas in the long-term treatment of type II diabetes has been questioned. The potential benefits of an antidiabetic drug must be carefully weighed against the risk of developing hazardous adverse effects like hypoglycaemia. We present drug-induced hypoglycaemia in a 77-year-old Pakistani male who had hypertension, type II diabetes and renal parenchymal disease (grade I), presented to the emergency department complaining of a 1-day history of fever, loose motions and drowsiness. His fever was low grade, intermittent, and not associated with rigors and chills. He had four episodes of watery stools for 1 day, with no associated vomiting but with drowsiness. He was aphasic, unable to walk and did not recognize his family members. The patient was taken to his local doctor who found him to be hypoglycaemic, with a blood sugar of 45 mg/dl. He was managed with intravenous (IV) dextrose and referred to the hospital. Hypoglycaemia is perhaps the most widespread and under...
Journal of Ayub Medical College, Abbottabad : JAMC
Primary Hyperparathyroidism (HPT) is an inappropriate hyper secretion of parathyroid hormone (PTH... more Primary Hyperparathyroidism (HPT) is an inappropriate hyper secretion of parathyroid hormone (PTH). Primary HPT is caused by parathyroid adenoma in 80-85% of patients. Clinical manifestations are kidney stones, abdominal groans, painful bones, psychic moans, and fatigue overtones. Ultrasonography is widely used in suspected cases for localization of parathyroid adenoma. There is considerable intra-observer variation and it is difficult for ultrasound alone to differentiate parathyroid lesion form that of thyroid. Dual phase Tc-99m MIBI scinitigraphy for detection of parathyroid adenomas has sensitivity and specificity values ranging from 82% to 100% and from 89% to 100%, respectively. Percutaneous ethanol injection for parathyroid glands can be applied effectively in selected cases when surgery is unadvisable either for technical reasons (e.g., recurrence ofhyperplastic glands in the neck after subtotal surgery or intrathyroideal parathyroid tumors or the poor clinical state of the ...
A cross-sectional study was carried out among HCPs in Northwest General Hospital &amp;amp;amp... more A cross-sectional study was carried out among HCPs in Northwest General Hospital &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Research Centre, Hayatabad Peshawar, Pakistan. The purpose of this study was to investigate knowledge, awareness and attitude of HCPs towards influenza vaccination. A total of N=170 questionnaires were distributed among the staff. There was a 97% response rate to this survey (n=165). The median age of the respondents was 30 years and most of them, 98 (59.0%), were from age group of 24-30 years. The majority of the HCPs that participated in this study were male 106 (64.2%), and by profession, the majority were physicians 77 (46.7%), followed by pharmacists and nurses. A majority 114 (69.1%) believed that it was not compulsory for HCPs to get vaccinated for influenza. Top three identified barriers to vaccination were: not everyone is familiar with the availability of the influenza vaccination at their institution (Relative importance weight factors (RIWF)=0.71), due to needle fear I do not like to get vaccinated (RIWF=0.70) and it is not compulsory for healthcare professionals to get vaccinated for influenza (RIWF=0.64). The logistic regression analysis has revealed association for job experience and profession with the most of the eleven knowledge item. However, when overall sum of eleven items were tested to identify the factors affecting the knowledge score, along with profession (-0.215 [-0.389 to 0.040]; p=0.016) and job experience (0.823 [0.521-1.125]; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) HCPs age (-0.409 [-0.755 to -0.064]; p=0.020) was found to be another significant factor affecting the total knowledge score of HCPs. Overall, scoring of the correct responses revealed that nurses have better knowledge and understanding about influenza and the influenza vaccination (6.5±0.8, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001*), followed by pharmacists (6.3±1.14) and physicians. In spite of the published guidelines and recommendations, a very low percentage of the healthcare professionals in our hospital were vaccinated against influenza, and the barriers to vaccination were prevalent. Various strategies, including arranging seminars regarding awareness about vaccinations, are required to improve the knowledge and overall outcomes.
Background: Super-enhancers are clusters of active enhancers densely occupied by the Mediators, t... more Background: Super-enhancers are clusters of active enhancers densely occupied by the Mediators, transcription factors and chromatin regulators, control expression of cell identity and disease associated genes. Current studies demonstrated the possibility of multiple factors with important roles in super-enhancer formation; however, a systematic analysis to asses the relative contribution of chromatin and sequence features of super-enhancers and their constituents remain unclear. In addition, a predictive model that integrates various types of data to predict super-enhancers has not been established. Results: Here, we integrated diverse types of genomic and epigenomic datasets to identify key signatures of super-enhancers and their constituents and to investigate their relative contribution. Through computational modelling, we found that Cdk8, Cdk9 and Smad3 as new key features of super-enhancers along with many known. Comprehensive analysis of these features in embryonic stem cells ...
Cerebrotendinous xanthomatosis is a rare, autosomal recessive, inherited lipid storage disease ch... more Cerebrotendinous xanthomatosis is a rare, autosomal recessive, inherited lipid storage disease characterized by accumulation of cholestanol and cholesterol in most tissues. The disease is caused by mutations in the sterol 27-hydroxylase gene, leading to a block in bile synthesis, with accumulation of substrates for this enzyme, including cholesterol, resulting in an increase in the conversion of cholesterol to cholestanol. A 26-year-old woman presented with gradually increasing bilateral ankle swelling. She had a history of bilateral cataracts and left-sided hemiparesis. She had mental retardation, with a history of delayed milestone development. Her serum cholesterol levels were elevated. Aspiration of both ankle swellings revealed histiocytes and many foreign body giant cells. There were numerous rectangular to rhomboid crystals in the background. Very few articles are available on the cytologic features of tendinous xanthomas; hence we tried to highlight these features.
In this study, a novel bio-inspired computing approach is developed to analyze the dynamics of no... more In this study, a novel bio-inspired computing approach is developed to analyze the dynamics of nonlinear singular Thomas-Fermi equation (TFE) arising in potential and charge density models of an atom by exploiting the strength of finite difference scheme (FDS) for discretization and optimization through genetic algorithms (GAs) hybrid with sequential quadratic programming. The FDS procedures are used to transform the TFE differential equations into a system of nonlinear equations. A fitness function is constructed based on the residual error of constituent equations in the mean square sense and is formulated as the minimization problem. Optimization of parameters for the system is carried out with GAs, used as a tool for viable global search integrated with SQP algorithm for rapid refinement of the results. The design scheme is applied to solve TFE for five different scenarios by taking various step sizes and different input intervals. Comparison of the proposed results with the state of the art numerical and analytical solutions reveals that the worth of our scheme in terms of accuracy and convergence. The reliability and effectiveness of the proposed scheme are validated through consistently getting optimal values of statistical performance indices calculated for a sufficiently large number of independent runs to establish its significance.
Abstract A new aromatic diamine monomer {4-amino [4-(diphenylamino) phenyl] anilino} phenyl amine... more Abstract A new aromatic diamine monomer {4-amino [4-(diphenylamino) phenyl] anilino} phenyl amine (DPA-4) were synthesized in high yield and purity.{4-amino [4-(diphenylamino) phenyl] anilino} phenyl amine (DPA-4) monomer were reacted with Tetra ...
Jpma the Journal of the Pakistan Medical Association, Mar 1, 2010
Objective: To assess the the efficacy and early and late complications of Argon-YAG combined lase... more Objective: To assess the the efficacy and early and late complications of Argon-YAG combined laser iridotomy in the outpatient department of a tertiary care hospital. Methods: This was a prospective observational study conducted at Aga Khan University Hospital Karachi, Pakistan. After detailed history taking and clinical examination, patients who had goniscopically evident closed angles and a positive provocative test were selected for laser iridotomy. They underwent iridotomy using Argon laser followed by YAG laser. The main outcome measures were patency of iridotomy at 6 months, angle grading at 6 months and early and late complications. Results: Overall 40 eyes of 30 patients underwent iridotomy. Of these 18 (60%) were female. At presentation, 26, 10, 2 and 2 eyes had primary angle closure glaucoma (PACG), prodromal stage of PACG, chronic angle closure glaucoma, and seculusio papillae with iris bombe secondary to uveitis, respectively. All the 40 iridotomies were patent at 6 months follow up. Majority of the eyes with primary acute angle closure glaucoma, and prodromal angle closure glaucoma had their angles opened from Grade 0 and Grade I to Grade III. At 6 months, 30(75%) eyes had a good control of intraocular pressure (IOP). Intraoperative complication, encountered were microhyphaema in 14 eyes and 2 developed corneal burns. Postoperative complications were transient rise of IOP in 18 eyes and post-laser iritis in 32 eyes, but they responded to recommended treatment. Conclusions: Iridotomy with Argon laser followed by Nd-YAG laser was associated with good clinical outcome and fewer complications in eyes with PACG (JPMA 60:220; 2010).
There is a need to optimize water-nitrogen (N) applications to increase seed cotton yield and wat... more There is a need to optimize water-nitrogen (N) applications to increase seed cotton yield and water use efficiency (WUE) under a mulch drip irrigation system. This study evaluated the effects of four water regimes [moderate drip irrigation from the third-leaf to the boll-opening stage (W1), deficit drip irrigation from the third-leaf to the flowering stage and sufficient drip irrigation thereafter (W2), pre-sowing and moderate drip irrigation from the third-leaf to the boll-opening stage (W3), pre-sowing and deficit drip irrigation from the third-leaf to the flowering stage and sufficient drip irrigation thereafter (W4)] and N fertilizer at a rate of 520 kg ha(-1) in two dressing ratios [7:3 (N1), 2:8 (N2)] on cotton root morpho-physiological attributes, yield, WUE and the relationship between root distribution and dry matter production. Previous investigations have shown a strong correlation between root activity and water consumption in the 40-120 cm soil layer. The W3 and especia...
ABSTRACT A B S T R A C T This work presents the introduction of an organic compound methyl methan... more ABSTRACT A B S T R A C T This work presents the introduction of an organic compound methyl methane sulfonate (MMS) for the first time in fabrication of polystyrene based proton exchange membrane (PEM) by plasma polymerization process. The membrane is fabricated by co-polymerizing styrene and MMS in capacitively coupled continuous RF plasma. The chemical composition of the plasma polymerized polymer membrane is investigated using Fourier Transform Infrared Spectroscopy which reveals the formation of composite structure of styrene and MMS. The surface morphology studied using AFM and SEM depicts the effect of higher partial pressure of MMS on surface topography of the membrane. The proton transport property of the membrane studied using electrochemical impedance spectroscopy shows the achievement of maximum proton conductivity of 0.141 S cm À1 which is comparable to Nafion 117 membrane. Fuel cell performance test of the synthesized membrane shows a maximum power density of 500 mW cm À2 and current density of 0.62 A cm À2 at 0.6 V. ã
JPMA. The Journal of the Pakistan Medical Association, 2010
To assess the the efficacy and early and late complications of Argon-YAG combined laser iridotomy... more To assess the the efficacy and early and late complications of Argon-YAG combined laser iridotomy in the outpatient department of a tertiary care hospital. This was a prospective observational study conducted at Aga Khan University Hospital Karachi, Pakistan. After detailed history taking and clinical examination, patients who had goniscopically evident closed angles and a positive provocative test were selected for laser iridotomy. They underwent iridotomy using Argon laser followed by YAG laser. The main outcome measures were patency of iridotomy at 6 months, angle grading at 6 months and early and late complications. Overall 40 eyes of 30 patients underwent iridotomy. Of these 18 (60%) were female. At presentation, 26, 10, 2 and 2 eyes had primary angle closure glaucoma (PACG), prodromal stage of PACG, chronic angle closure glaucoma, and seculusio papillae with iris bombe secondary to uveitis, respectively. All the 40 iridotomies were patent at 6 months follow up. Majority of the...
The Euro Heart Survey on diabetes and heart has demonstrated high prevalence of latent glucose ab... more The Euro Heart Survey on diabetes and heart has demonstrated high prevalence of latent glucose abnormalities in non-diabetic patients with coronary artery disease (CAD) in the European population. The aim of our survey was to assess the prevalence of latent abnormal glucose regulation in adult non-diabetic CAD patients in India. Seven centers distributed across India recruited 350 patients. The diagnosis of CAD was done by coronary angiography showing >50% stenosis in any major epicardial coronary artery or its branches. Oral glucose tolerance test (OGTT) and fasting glucose levels were used to characterize glucose metabolism. Venous plasma glucose was measured before (fasting) and 2 hours after ingestion of glucose. Impaired fasting glucose (IFG) was defined as OGTT (0 minute)>or=100 mg/dl but <126 mg/dl and OGTT (2 hours)<140 mg/dl. Impaired glucose tolerance (IGT) was defined as OGTT (0 minute)<126 mg/dl and OGTT (2 hours)>or=140 mg/dl but <200 mg/dl. Of the ...
Therapeutic advances in endocrinology and metabolism, 2016
The value of sulphonylureas in the long-term treatment of type II diabetes has been questioned. T... more The value of sulphonylureas in the long-term treatment of type II diabetes has been questioned. The potential benefits of an antidiabetic drug must be carefully weighed against the risk of developing hazardous adverse effects like hypoglycaemia. We present drug-induced hypoglycaemia in a 77-year-old Pakistani male who had hypertension, type II diabetes and renal parenchymal disease (grade I), presented to the emergency department complaining of a 1-day history of fever, loose motions and drowsiness. His fever was low grade, intermittent, and not associated with rigors and chills. He had four episodes of watery stools for 1 day, with no associated vomiting but with drowsiness. He was aphasic, unable to walk and did not recognize his family members. The patient was taken to his local doctor who found him to be hypoglycaemic, with a blood sugar of 45 mg/dl. He was managed with intravenous (IV) dextrose and referred to the hospital. Hypoglycaemia is perhaps the most widespread and under...
Journal of Ayub Medical College, Abbottabad : JAMC
Primary Hyperparathyroidism (HPT) is an inappropriate hyper secretion of parathyroid hormone (PTH... more Primary Hyperparathyroidism (HPT) is an inappropriate hyper secretion of parathyroid hormone (PTH). Primary HPT is caused by parathyroid adenoma in 80-85% of patients. Clinical manifestations are kidney stones, abdominal groans, painful bones, psychic moans, and fatigue overtones. Ultrasonography is widely used in suspected cases for localization of parathyroid adenoma. There is considerable intra-observer variation and it is difficult for ultrasound alone to differentiate parathyroid lesion form that of thyroid. Dual phase Tc-99m MIBI scinitigraphy for detection of parathyroid adenomas has sensitivity and specificity values ranging from 82% to 100% and from 89% to 100%, respectively. Percutaneous ethanol injection for parathyroid glands can be applied effectively in selected cases when surgery is unadvisable either for technical reasons (e.g., recurrence ofhyperplastic glands in the neck after subtotal surgery or intrathyroideal parathyroid tumors or the poor clinical state of the ...
A cross-sectional study was carried out among HCPs in Northwest General Hospital &amp;amp;amp... more A cross-sectional study was carried out among HCPs in Northwest General Hospital &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Research Centre, Hayatabad Peshawar, Pakistan. The purpose of this study was to investigate knowledge, awareness and attitude of HCPs towards influenza vaccination. A total of N=170 questionnaires were distributed among the staff. There was a 97% response rate to this survey (n=165). The median age of the respondents was 30 years and most of them, 98 (59.0%), were from age group of 24-30 years. The majority of the HCPs that participated in this study were male 106 (64.2%), and by profession, the majority were physicians 77 (46.7%), followed by pharmacists and nurses. A majority 114 (69.1%) believed that it was not compulsory for HCPs to get vaccinated for influenza. Top three identified barriers to vaccination were: not everyone is familiar with the availability of the influenza vaccination at their institution (Relative importance weight factors (RIWF)=0.71), due to needle fear I do not like to get vaccinated (RIWF=0.70) and it is not compulsory for healthcare professionals to get vaccinated for influenza (RIWF=0.64). The logistic regression analysis has revealed association for job experience and profession with the most of the eleven knowledge item. However, when overall sum of eleven items were tested to identify the factors affecting the knowledge score, along with profession (-0.215 [-0.389 to 0.040]; p=0.016) and job experience (0.823 [0.521-1.125]; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) HCPs age (-0.409 [-0.755 to -0.064]; p=0.020) was found to be another significant factor affecting the total knowledge score of HCPs. Overall, scoring of the correct responses revealed that nurses have better knowledge and understanding about influenza and the influenza vaccination (6.5±0.8, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001*), followed by pharmacists (6.3±1.14) and physicians. In spite of the published guidelines and recommendations, a very low percentage of the healthcare professionals in our hospital were vaccinated against influenza, and the barriers to vaccination were prevalent. Various strategies, including arranging seminars regarding awareness about vaccinations, are required to improve the knowledge and overall outcomes.
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Papers by Aziz Khan