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1.
J Pak Med Assoc ; 72(2): 253-259, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35320172

RESUMO

OBJECTIVE: To quantify the depiction of violence and vulgarity in television programmes for children, and to assess the perception and practices of parents and children about television programmes meant for children. METHODS: We conducted this mixed-methods cross-sectional study in Karachi, Pakistan in the months of August-September 2018, after approval from the ethics review board of Dow University of Health Sciences, Karachi. First, a content analysis of over 102 hours of various television programmes meant for children was performed in the light of the guidelines set out by the World Health Organisation, the United States Federal Communication Commission and the Pakistan Electronic Media Regulatory Authority. Seven trained researchers sampled the children prime time throughout a week, including the weekends, using a structured tally sheet. Subsequently, interviews were conducted with dyad of parent-children from the employees' list of a public-sector university. A questionnaire was also administered to assess the practices and perceptions of the parents-children dyad about the programmes. Data was analysed using SPSS 24. RESULTS: Of the 173 subjects, 84(48.6%) were parents and 89(51.4%) were children. The mean age of the children was 9.8±3.7 years. Content analysis comprised 6130 minutes, of which 5442(88.8%) had depictions of violence and vulgarity. Depiction of violence and vulgarity was prevalent on television channels that were watched the most, but there was no significant difference in this regard (p=0.238). Of the parents, 68(81%) expressed concern over the effect of screen time and content on the mental health of their children. CONCLUSIONS: Television programmes meant for children were found to be inappropriate with seriously high proportion of violence and vulgarity in their contents.


Assuntos
Pais , Televisão , Adolescente , Criança , Estudos Transversais , Humanos , Pais/psicologia , Inquéritos e Questionários , Violência
2.
J Pak Med Assoc ; 72(1): 194-198, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35099470

RESUMO

OBJECTIVE: To assess the perception and attitude towards prostate cancer and its screening practices in Pakistan. METHODS: The cross-sectional study was conducted at Ruth Pfau Civil Hospital, Karachi June to October 2019, and comprised male subjects aged >40 years with no prior diagnosis of prostate cancer who were enrolled from the community. Data was collected using a structured questionnaire which was available in English and Urdu languages. Data was analysed using SPSS 23. RESULTS: Of the 383 subjects, 144(37.6%) were aged 40-49 years, 302(78.9%) were married, 120(31.3%) had received education up to the secondary level, and 204(53.3%) earned. CONCLUSIONS: The level of knowledge regarding prostate cancer and its screening practices was poor, and the attitude towards its screening was negative.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias da Próstata , Estudos Transversais , Humanos , Masculino , Paquistão/epidemiologia , Percepção , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/epidemiologia
3.
Pak J Med Sci ; 37(1): 93-98, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33437257

RESUMO

BACKGROUND & OBJECTIVES: The Chikungunya virus (CHIKV) transmitted to the humans through Aedes species of the mosquitoes. In December 2016, a severe outbreak reported from Pakistan. However, there is no vaccine or anti-viral treatment currently available so host immune response against CHIKV gained significant interest. Therefore, this study was conducted to identify the mutations in CHIKV E2 region of currently circulating Pakistani strains & determine their potential immunogenicity in Pakistani population. METHODS: It was a cross sectional study in which a total of 60 CHIKV PCR positive samples were collected from Molecular Department of Pathology, Dow University of Health Sciences (DUHS), Karachi during November 2017 to February 2018. CHIKV E2 gene was amplified by PCR & sequenced. Sequences were analyzed by using bioinformatic tools followed by epitope prediction in E2 sequences by In-silico immunoinformatic approach. RESULTS: Several single nucleotide variations (SNVs) were identified in Pakistani isolates with six novel mutations in E2 sequences. Immunoinformatic analyses showed more proteasomal sites, CTL & B-Cell epitopes in Pakistani strains with respect to S27 prototype with 69.4% population coverage against these epitopes in Pakistan. The study also identified key mutations responsible for generation of unique epitopes and HLA restriction in Pakistani isolates. The strain specific mutations revealed the current outbreak was caused by ESCA.IOL lineage of CHIKV. CONCLUSION: The evolution of E2 protein in Pakistani strains has increased its immunogenicity in comparison to ancestral s27 strain. The identification of most immunogenic and conserved epitopes with high population coverage has high potential to be used in vaccine development against these local strains.

4.
J Med Virol ; 93(6): 3714-3729, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33289144

RESUMO

INTRODUCTION: HBV can evolve under selection pressure exerted by drugs and/or host immunity, resulting in accumulation of escape mutations that can affect the drug or the immune activity. Hepatitis delta virus (HDV) coinfection is also known to exert selection pressure on HBV, which leads to selective amplification of certain mutations, especially in genes that are required for HDV pathogenesis, such as HBsAg. However, little is known about the function of these mutations on HBV or HDV life cycle. The purpose of this study is to determine mutations selectively amplified in the backdrop of HDV, and how these mutations affect processing of CD4- and CD8-T cell epitopes. METHODS: HBsAg was successfully amplified from 49/50 HBV mono- and 36/50 coinfected samples. The sequences were used to identify mutations specific to each study group, followed by an in silico analysis to determine the effect of these mutations on (1) proteasomal degradation, (2) MHC-I and MHC-II biding, and (3) processing of T-cell epitopes. RESULTS: HBV-HDV coinfected sequences exhibited certain unique mutations in HBsAg genes. Some of these mutations affected the generation of proteasomal sites, binding of HBsAg epitopes to MHC-I and -II ligands, and subsequent generation of T- cell epitopes. CONCLUSION: These observations suggest that HBV selectively amplifies certain mutations in the backdrop of HDV coinfection. Selective amplification of these mutations at certain strategic locations might not only enable HBV to counteract the inhibitory effects of HDV on HBV replication but also facilitate its survival by escaping the immune response.


Assuntos
Apresentação de Antígeno/genética , Coinfecção/virologia , Epitopos de Linfócito T/imunologia , Evolução Molecular , Antígenos de Superfície da Hepatite B/genética , Vírus da Hepatite B/genética , Vírus Delta da Hepatite/genética , Mutação , Apresentação de Antígeno/imunologia , Linfócitos T CD8-Positivos/imunologia , Feminino , Genótipo , Hepatite B/virologia , Hepatite D/virologia , Humanos , Masculino , RNA Viral
5.
Int J Law Psychiatry ; 74: 101647, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33246231

RESUMO

The present study explored awareness and opinions pertaining to mental health legislation in Pakistan in the context of the United Nation Convention on Rights of People with Disabilities (UNCRPD) through a mixed method research design. In the quantitative arm of the study, a structured questionnaire examined awareness and opinions of key stakeholders pertaining to national mental health legislation. In the qualitative arm, face-to-face interviews further elaborated stakeholders perspectives pertaining to these topics with thematic analysis conducted. Stakeholders demonstrated a good awareness of legislation pertaining to guardianship (83.0 %) appointment of property managers (89.7%) and salary or pension entitlements (89.2%). Compared to other stakeholders, patients had less understanding of processes pertaining to involuntary admission (χ2 = 20.54, p = 0.02) and appointing a guardian (χ2 = 34.67, p < 0.01). High consensus across stakeholders was noted for processes of involuntary detention (83.5%) and appointment of guardians or property managers (80.0%) albeit patients demonstrated less agreement on these topics (p <0.01). Minimal support was noted for an involuntary patient to be discharged solely on a psychiatrist's recommendation (25.4%). Thematic analysis indicated fifteen emergent themes: 1) Alienation/ Seclusion; 2) Capacity building; 3) Communication Gap; 4) Conflict of interests; 5) Discomfort at hospital; 6) Economic burden; 7) Government's liability; 8) Family involvement; 9) Imbalance; 10) Acceptance of Legal Incapacity; 11) Legal reforms; 12) Patient centred environment; 13) Quality assurance; 14) Under developed infrastructure and 15) Potential unethical practices. This study advocates for increased patient involvement in collaborative decision making with mental health professionals and the creation of more appropriate inpatient treatment environments.


Assuntos
Saúde Mental , Projetos de Pesquisa , Internação Compulsória de Doente Mental , Humanos , Tutores Legais , Paquistão
6.
Cureus ; 11(10): e5961, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31799097

RESUMO

Meningitis caused by Salmonella enteritidis is an uncommon infection, linked with great mortality and neurological problems, which makes prompt diagnosis and treatment very crucial. Patients of bacterial meningitis present with common symptoms such as headache, fever, altered level of consciousness, and neck rigidity. A positive gram stain or culture of cerebrospinal fluid (CSF) leads to its diagnosis. In this report, we present a case of a 16-year-old male with extensively drug-resistant (XDR) Salmonella typhi meningitis, which was not responsive to initial medical intervention. He was treated with meropenem, imipenem, azithromycin, and metronidazole. Immediate tracheostomy and intubation were performed in the surgical intensive care unit (ICU), as the patient had developed stridor, shortness of breath, tachypnea, tachycardia, and had severely decreased O2 saturation of 60%. As far as treatment is concerned, third-generation cephalosporins are considered the treatment of choice. In addition, the use of fluoroquinolones and carbapenems, mainly meropenem, has also been described as a therapeutic alternative.

7.
Environ Monit Assess ; 191(12): 770, 2019 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-31768655

RESUMO

Appropriate clinical waste management is a critical concern in today's era. Resource-constrained countries agonize greatly over this issue in order to mitigate inappropriate clinical waste management practices. The goal of this study is to assess factors behind inappropriate waste management of small clinics in resource-constrained countries. We tested the hypothesis that negligence of government, knowledge and awareness, and financial burden are three key factors behind inappropriate solid waste management of small clinics. A two-phase survey including a pilot study and a main study was conducted for exploratory factor analysis and confirmatory factor analysis, respectively, in the fourth largest city of Pakistan, i.e., Hyderabad. One sample t test was used to validate the hypothesis, the correlation between the three key factors, and the location of the clinics were established. These factors were found to have a contribution to inappropriate waste management of small clinics. The hypothesis was then validated, and all three factors were found to have no significant variation in responses with the contrast of three types of clinic locations, namely, low-, medium-, and high-income areas. Responses were almost identical and bear equal significance from all locations, the financial burden factor is at the highest, the second factor is the negligence of government, and the third factor is that of knowledge and awareness. This study highlights the factors that are usually neglected and can help to improve solid waste management of small clinics in resource-constrained countries.


Assuntos
Instituições de Assistência Ambulatorial , Resíduos Sólidos , Gerenciamento de Resíduos , Instituições de Assistência Ambulatorial/economia , Instituições de Assistência Ambulatorial/organização & administração , Instituições de Assistência Ambulatorial/normas , Monitoramento Ambiental , Análise Fatorial , Humanos , Paquistão , Projetos Piloto , Gerenciamento de Resíduos/economia , Gerenciamento de Resíduos/normas
8.
Cureus ; 11(9): e5618, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31696011

RESUMO

Laurence-Moon-Bardet-Biedl syndrome (LMBBS), a rare autosomal recessive defect, mostly occurs in children born from consanguineous marriages. The major features of this syndrome are cone-rod dystrophy, polydactyly, obesity, learning disabilities, hypogonadism in males, renal anomalies, nystagmus, speech disorders, developmental delay, polyuria/polydipsia, ataxia, and poor coordination/clumsiness. In this report, we present a case of a 19-year-old man with pain and swelling of the left ankle and knee joints because of which he could not walk, with an onset of loose stools since a week. He presented with multiple non-itchy hyperpigmented macules on his face and back, polydactyly in his left foot, central obesity, proteinuria, macrocytic anemia, low intelligence quotient, reduced power in the left lower limb, reduced plantar reflexes, nystagmus, pigmented black lesions in the temporal retina on fundoscopy, a micropenis, absent pubic and axillary hair, and a small scrotum containing testes. The patient was diagnosed with LMBBS.

9.
Artigo em Inglês | MEDLINE | ID: mdl-31652534

RESUMO

Thousands of small clinics in Pakistan are generating dispersed medical waste, unlike large hospitals, small clinic waste management is often ignored. This study was conducted on 135 small clinics in Hyderabad, Pakistan, with the aim to determine small clinics' waste management practices in contrast to rules, level of knowledge, the environmental impact of disposal methods, and motivating factor analysis to understand the current situation from multiple perspectives. Overall, the waste generation rate was calculated to be 2.01 kg/clinic/day and the hazardous waste generation rate was 0.89 kg/clinic/day, whereas the general waste generation rate was 1.12 kg/clinic/day. The hazardous waste generation rate percentage is found to be higher than those found in large hospitals by 20%. The waste management practice among surveyed clinics was deplorable; none of the clinics were completely following hospital waste management rules of 2005 and thus the absence of proper segregation, storage, transportation, and disposal was commonly encountered during the study. Clinic staff possessed low level of knowledge and awareness, and acquired no training about waste management practice and rules, moreover, frequent employee turnover was noticed too. Additionally, two hypotheses were checked for creditability of motivating factors with an exploratory factor analysis to check their contribution to motivating clinic staff to practice sound healthcare waste management. Out of 10 indicators, nine were found in support of the hypotheses. Hence, it was discovered that active government involvement and financial support in providing training and inspecting small clinics could help in improving the condition. The findings of the present study can play a vital role in documenting evidence, and for policymakers and governments to plan solid waste management of small clinics and other healthcare facilities.


Assuntos
Instalações de Saúde , Eliminação de Resíduos de Serviços de Saúde/métodos , Urbanização , Resíduos Perigosos/análise , Humanos , Paquistão , Gerenciamento de Resíduos/métodos
10.
Health Secur ; 17(5): 372-383, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31593511

RESUMO

Laboratory-acquired infections (LAIs), an occupational illness, are defined as all infections acquired through laboratory or laboratory-related activities. A report published in 1898 described an LAI resulting from Corynebacterium diphtheriae being transmitted through mouth pipetting. Despite all efforts, LAIs continue, especially in developing countries like Pakistan, which has been fighting to curb many infectious diseases. As reflected in the published literature, the biosafety culture is severely lacking in many laboratories, and there are no data available from Pakistan on LAIs. Our objective was to ascertain the frequency and rate of LAIs in various labs with versatile portfolios in relation to biosafety and biosecurity practices in Karachi. Ours is a descriptive multicenter cross-sectional study conducted in 30 laboratories located in Karachi from November 2017 to April 2018. Data were collected from laboratories including the university hospital labs, research labs, animal labs, and biomedical labs. Out of 30 facilities, half (n = 15) were clinical/biomedical laboratories, 16.6% (n = 5) were university hospital laboratories, 26.6% (n = 8) were R&D laboratories, and 6.6% (n = 2) were animal laboratories. Needle stick was found to be the most common injury, followed by animal bite/scratch, cut on mucous membrane, falling of personnel, and burn injury.


Assuntos
Contenção de Riscos Biológicos/métodos , Contenção de Riscos Biológicos/normas , Infecção Laboratorial/epidemiologia , Doenças Profissionais/epidemiologia , Estudos Transversais , Fidelidade a Diretrizes , Guias como Assunto , Humanos , Laboratórios/classificação , Paquistão/epidemiologia , Prevalência , Medição de Risco , Gestão de Riscos , Inquéritos e Questionários
11.
Waste Manag Res ; 37(9): 863-875, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31266407

RESUMO

Healthcare waste encompasses a significant quantity of hazardous substances. Poor healthcare waste management can result in serious environmental and human health risks. Asian developing countries are densely populated, and some are highly resource constrained. These countries commonly fail to practice appropriate healthcare waste management. Moreover, facilities in these countries extensively lack proper waste segregation, collection, safe storage, transportation, and disposal. This mini-review recapitulates key issues of healthcare waste management confronting Asian developing countries. Regulations, legislation, and policies are found to be recent, and their implementation varies from one another. Variation in waste generation rate is common. Contradictory methods of waste measurement used by researchers leave these variations questionable. The absence of waste management training programmes roots ignorance among staff and handlers, which leads to unsafe waste handling and causes different health risks. Unsafe and illegal recycling of hazardous waste is a threat to human health, also landfilling is often confused with open dumping, causing environmental damage. Outdated incineration plants need to be replaced with autoclaving, steam sterilisation, and comparatively reasonable new practice of pyrolysis to avoid the emission of toxic gases. The significance of proper healthcare waste management cannot be ignored, especially in Asian developing countries; substantial improvements are required in order to protect the environment and human health from serious risks.


Assuntos
Eliminação de Resíduos de Serviços de Saúde , Gerenciamento de Resíduos , Ásia , Países em Desenvolvimento , Resíduos Perigosos , Humanos
12.
Health Secur ; 17(3): 229-239, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31206321

RESUMO

Dual-use research poses a significant challenge for scientists in the biomedical field and for global health security in general. As the scientific knowledge and materials required for the development of biological agents become progressively more accessible and inexpensive, there is an increased need to understand and improve the governance of scientific research. Prevention of the misuse of facilities, equipment, agents, and scientific knowledge requires high levels of awareness of the concept of dual-use research, starting with early-career scientists and graduate students. In this study, the attitudes and level of awareness of postgraduate students in Pakistan toward the issues surrounding dual-use research were assessed through a survey containing both quantitative and qualitative questions in 32 universities in 4 provinces, federal area, and Azad Jammu and Kashmir regions of Pakistan; 933 students responded. Most (58.2%) had never heard of dual-use research of concern (DURC), while 18.5% had heard the term but were unsure of its meaning. Irrespective of prior knowledge, a higher percentage of students (68.6%) felt an obligation to report research misuse. Considering the need for DURC training, 94.1% of the respondents agreed that the principal investigator should take the responsibility to train students on DURC at the start of a research project. When experimental results having dual-use potential, 69.1% indicated they would publish with limited protocol, with 43.5% indicating they would publish the limited protocol only if there was a way for scientists to access their data. The survey results revealed limited DURC awareness among researchers across Pakistan. However, the respondents, although not formally educated about DURC, were quite aware of its impact. The information gained in this survey will be valuable in addressing country-specific awareness and training needs.


Assuntos
Pesquisa Biomédica/ética , Disseminação de Informação/ética , Estudantes/psicologia , Pesquisa Biomédica/normas , Bioterrorismo/prevenção & controle , Contenção de Riscos Biológicos/ética , Estudos Transversais , Humanos , Paquistão , Medidas de Segurança/ética , Medidas de Segurança/normas , Inquéritos e Questionários
13.
J Air Waste Manag Assoc ; 69(7): 823-833, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30831059

RESUMO

This study aimed to investigate the effects on the environment of small clinics solid waste management by applying a life cycle analysis approach. Samples were collected from 371 private clinics situated in densely populated areas of Hyderabad, Pakistan. The solid waste from surveyed clinics was categorically quantified on daily basis for 30 consecutive days. The functional unit for waste was defined as 1 tonne. System limitations were defined as landfilling, incineration, composting, material recovery, and transportation of solid waste. The treatment and disposal methods were assessed according to their greenhouse gas emission rate. For the evaluation, three different scenarios were designed. The second scenario resulted in the highest emission value of 1491.78 kg CO2 eq/tonne of solid waste due to mixed waste incineration, whereas the first scenario could not offer any saving because of uncovered landfilling and 67.5% higher transport fuel consumption than the proposed network. The proposed third scenario was found to be a better solution for urban clinics solid waste management, as it resulted in savings of 951.38 kg CO2 eq/tonne of solid waste. This integrated design is practicable by resource-constrained economy. This system consists of composting, material recovery, and incineration of hazardous waste. The proposed system also includes a feasible transportation method for urban area collection networks. The findings of the present study can play a vital role in documenting evidence and for policymakers to plan the solid waste management of clinics, as previously no studies have been conducted on this particular case. Implications: This study aims to highlight the impact of small clinics solid waste management scenarios on the environment in a developing country's urban area. Life cycle analysis is used for comparison of greenhouse gase emission from different scenarios, including the purposed integrated method. Small clinics play a very important role in health care, and their waste management is a very serious issue; however, there are no previous studies on this particular case to the best knowledge of the authors. This study can be considered as forerunner effort to quantify the environmental footprint of small clinics solid waste in urban areas of a developing country.


Assuntos
Instituições de Assistência Ambulatorial , Dióxido de Carbono/análise , Gases de Efeito Estufa/análise , Resíduos Sólidos , Monitoramento Ambiental , Efeito Estufa , Paquistão , Gerenciamento de Resíduos/métodos
14.
Acta Haematol ; 141(2): 68-78, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30616235

RESUMO

BACKGROUND: Bibliometric analyses are a tool employed by researchers and funding agencies to establish the most important areas of research in a particular field, and to determine which foci need increased research attention. Such analyses have been published in a variety of clinical specialties; however, a detailed literature search showed that no such study has been done for "myeloid neoplasms." In order to bridge this gap, we conducted a citation analysis of the 100 most influential articles on myeloid neoplasms. METHODS: Two independent researchers extracted relevant articles from the Scopus database. These articles were then ranked in descending order of citations and a list of the top 100 original articles was made. A further, more detailed list was created containing significant discriminating characteristics. RESULTS: The top cited articles were published over a period of 47 years, with most of them being published in the 5-year interval of 2001-2005. The citations ranged from 636 to 4,039. The articles originated from 28 different countries. Most of the articles were published in high-impact journals. CONCLUSION: Our analysis sheds light on the quality of work and driving trends, listing the most cited and impactful guideline articles within this field and aiding clinicians.


Assuntos
Bibliometria , Transtornos Mieloproliferativos/patologia , Bases de Dados Factuais , Humanos , Transtornos Mieloproliferativos/metabolismo , Editoração
15.
Infez Med ; 26(4): 385-388, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30555146

RESUMO

Myiasis is a pathological condition in which there is a pestilence of fly larvae feeding on living or dead tissues. This disease is common in the tropics and subtropics of Africa and America and rarely affects humans. Our case report describes a five-year-old boy from Karachi, Pakistan with a history of extraction sockets and incisional biopsy of the left parotid lymph node. Lack of proper wound maintenance led to infestation of maggots both over the overlying skin of the left parotid region and the posterior oral cavity. The plan was wound debridement both outside and intra-orally under local anesthesia and the removal of maggots. A cotton swab impregnated with turpentine oil was placed on the wounds for a few minutes. The wounds were then properly debrided with pyodine and hydrogen peroxide. Around 15 to 16 maggots were extracted from the wound on the left parotid region using medical forceps whereas five maggots were extracted from the intraoral wound with the help of turpentine oil and forceps. This case demonstrates the importance of oral health and proper wound management, and also that myiasis, despite its distinctiveness, can be managed by promoting awareness of the disease and by suitable treatment methods.


Assuntos
Doenças da Boca/parasitologia , Miíase , Animais , Pré-Escolar , Humanos , Masculino , Doenças da Boca/diagnóstico , Doenças da Boca/terapia , Miíase/diagnóstico , Miíase/terapia , Paquistão
16.
Virol Sin ; 33(5): 410-417, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30311100

RESUMO

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a zoonotic pathogen capable of causing severe respiratory disease in humans. Although dromedary camels are considered as a major reservoir host, the MERS-CoV infection dynamics in camels are not fully understood. Through surveillance in Pakistan, nasal (n = 776) and serum (n = 1050) samples were collected from camels between November 2015 and February 2018. Samples were collected from animal markets, free-roaming herds and abattoirs. An in-house ELISA was developed to detect IgG against MERS-CoV. A total of 794 camels were found seropositive for MERS-CoV. Prevalence increased with the age and the highest seroprevalence was recorded in camels aged > 10 years (81.37%) followed by those aged 3.1-10 years (78.65%) and ≤ 3 years (58.19%). Higher prevalence was observed in female (78.13%) as compared to male (70.70%). Of the camel nasal swabs, 22 were found to be positive by RT-qPCR though with high Ct values. Moreover, 2,409 human serum samples were also collected from four provinces of Pakistan during 2016-2017. Among the sampled population, 840 humans were camel herders. Although we found a high rate of MERS-CoV antibody positive dromedaries (75.62%) in Pakistan, no neutralizing antibodies were detected in humans with and without contact to camels.


Assuntos
Anticorpos Antivirais/sangue , Camelus/virologia , Infecções por Coronavirus/veterinária , Monitoramento Epidemiológico/veterinária , Coronavírus da Síndrome Respiratória do Oriente Médio , Animais , Anticorpos Neutralizantes/sangue , Criança , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Nariz/virologia , Paquistão/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real , Estudos Soroepidemiológicos , Inquéritos e Questionários
17.
J Pak Med Assoc ; 68(8): 1267-1269, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30108401

RESUMO

28 years old, male patient was diagnosed with Metastatic Adrenocortical Carcinoma after extensive investigation. Patient's primary concern was only his right hip and right shoulder pain. On imaging investigations, the patient was diagnosed with Avascular Necrosis of the right hip joint. Further laboratory work-up for avascular necrosis showed Primary Hypercortisolism and eventually patient was found to have Adrenocortical Carcinoma base on CT and bone scan results, Avascular Necrosis usually presents with pain in the affected area, mostly involving shoulder, knee or hip joint. Among many of the causes of Avascular necrosis, one rare cause is hormone secreting Adreno cortical Carcinoma, a rare and a highly malignant tumour. Patients can present with Cushing's syndrome or can have atypical presentation like this patient. This patient did not have any symptoms related to malignancy such as loss of appetite and weight loss.


Assuntos
Neoplasias do Córtex Suprarrenal/complicações , Carcinoma Adrenocortical/complicações , Necrose da Cabeça do Fêmur/etiologia , Neoplasias do Córtex Suprarrenal/patologia , Carcinoma Adrenocortical/patologia , Adulto , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Humanos , Hidrocortisona/urina , Masculino , Necrose , Tomografia por Emissão de Pósitrons
18.
J Pak Med Assoc ; 67(11): 1753-1755, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29171575

RESUMO

TA 58-61, XXXX, hypotriploid chromosome was detected in the cytogenetics report of a 28 years old female patient, known case of B-cell Acute Lymphoblastic Leukaemia. On admission, the patient had normal physical examination findings and mental status, except history of fever spikes and generalized bone pains. The patient was admitted for induction of chemotherapy. Bone Marrow/Trephine biopsy report showed diffuse infiltration with blast cells with overall cellularity around 80-85% and suppressed normal haematopoiesis. Hypotriploid chromosome number in patients with B-cell Acute Lymphoblastic Leukaemia is a unique finding which, according to WHO classification of ALL, is an important prognostic factor itself and these cases have a favourable prognosis. There are only a few medical reports published about cases with similar presentations in Pakistan. Therefore, this case is very unique and further work should be done for better understanding of similar presentations and to find out more about its epidemiology.


Assuntos
Aberrações Cromossômicas , Leucemia-Linfoma Linfoblástico de Células Precursoras , Triploidia , Cariótipo Anormal , Adulto , Análise Citogenética , Feminino , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia
19.
J Pak Med Assoc ; 67(9): 1438-1440, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28924290

RESUMO

Turner Syndrome was diagnosed in a 45 years old female, known case of Acute Myeloid Leukaemia (AML) with maturation, on Bone Marrow biopsy. She presented with blurred vision, vertigo, exertional dyspnoea and insomnia. She did not show the typical features of Turner syndrome, but her cytogenetis confirmed the diagnosis. Bone marrow biopsy showed diffuse infiltration of blast cells with cellularity around 80-85% and haematopoietic suppression. Karyotype analysis showed: 45 X, -X, t (8; 21) (q22; q22) [According to The International System for Human Cytogenetic Nomenclature (ISCN)]. Turner syndrome is caused by partial or complete absence of second X chromosome in a female. It is known to have Cardiovascular and Reproductive complications but it is rare to find haematologic malignancies. There are few similar reported cases of AML associated with Turner syndrome, therefore this is a unique case presented to Jinnah Postgraduate Medical Center, Karachi, Pakistan and further research should be done to identify more similar cases to explore the prognostic significance of this association.


Assuntos
Leucemia Mieloide Aguda/diagnóstico , Síndrome de Turner/diagnóstico , Amenorreia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Medula Óssea/patologia , Citarabina/administração & dosagem , Daunorrubicina/administração & dosagem , Feminino , Humanos , Achados Incidentais , Cariótipo , Cariotipagem , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/patologia , Pessoa de Meia-Idade , Síndrome de Turner/complicações
20.
Asian Pac J Cancer Prev ; 17(7): 3117-22, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27509939

RESUMO

BACKGROUND: Healthcare research is a neglected discipline in Pakistan and research related to esophageal cancer (ranks 9th in Pakistani males and 5th in females) is no exception in this regard. Particularly, there are no data available to delineate the overall status of esophageal cancer epidemiological studies in Pakistan. This study describes the first ever effort to make a systematic quantification, in an attempt to provide a roadmap to all stakeholders for designing appropriate epidemiological, diagnostic and therapeutic strategies. MATERIALS AND METHODS: International (PubMed, ISI Web of Knowledge) and local (PakMedinet) scientific databases as well as Google search engine were searched using specified keywords to extract relevant publication. Well defined inclusion criteria were implemented to select publications for final analyses. All data were recorded by at least 3 authors and consensus data were entered into and analyzed for descriptive statistics (such as frequencies, percentages and annual growth rates) using Microsoft Excel and SPSS software. RESULTS: A total of 79 publications fulfilled the inclusion criteria including 20 publications for which full texts were not available. Of the 79 publications, 59 (74.6%) were original/research publications, 5 (6.3%) were case reports, 4 (5.1%) were research communications, 2 (2.5%) were review articles, 1 was (1.2%) correspondence and 8 (10.1%) were un defined categories. Only 13 <20%) cities of Pakistan contributed towards the 79 publications. On average, only 1.9 relevant publications/year were published from 1976 (year of first publication) to the present. Alarmingly, a decline in the annual growth at 4.1% was recorded in the last six years. CONCLUSIONS: Esophageal cancer research is largely unfathomed in Pakistan. Urgent/dramatic steps are required by all concerned to address this common (and under reported) cancer of Pakistan.


Assuntos
Neoplasias Esofágicas/epidemiologia , Pesquisa Biomédica/métodos , Feminino , Pesquisa sobre Serviços de Saúde/métodos , Humanos , Masculino , Paquistão/epidemiologia
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