Impact of humanities and social sciences curriculum in an undergraduate medical education programme.

Objective: To evaluate the impact of humanities and social sciences curriculum in an undergraduate medical education programme.

Methods: The qualitative study was conducted from May 2016 to May 2017 at a private medical college in Karachi where humanities and social sciences subject is an art of the undergraduate curriculum as a 6-week module at the start of Year 1 of the five-year programme. Focus group discussions were held with students from all the five years as well as with faculty related to humanities and social sciences, basic sciences and their clinical counterparts.

Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Background: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.

Methods: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013.

Strong BCL2 expression in Burkitt lymphoma is not uncommon in adults.

Background: The distinction between Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL) is not always easy, so much so that the WHO 2008 Blue Book has incorporated a provisional category of "B-cell lymphoma, unclassifiable with features intermediate between DLBCL and BL." One of the immunohistochemical (IHC) markers used at times to differentiate between the two is IHC expression of BCL2, which was initially believed to be consistently negative in BL. Later it was recognized that weak BCL2 expression is still compatible with the diagnosis of BL.

Characterization of genetic lesions in apoptosis-regulating and proliferation control genes in diffuse large B-cell non-Hodgkin's lymphoma.

Background: This study was conducted to analyze the frequency, expression patterns, and the impact of individual proteins BCL2, BCL6, and p53 on overall survival (OS) in adult, diffuse large B-cell lymphoma (DLBCL) patients. BCL2 gene was further investigated for potential alterations at the DNA level and correlated with OS.

Materials And Methods: A total of 117 adult well-characterized DLBCL cases were included.

'Nuclear grooves' in nodular hidradenoma: frequency and significance of an unrecognized histopatological feature.

Background: Nodular hidradenoma is a distinctive sweat gland neoplasm. In addition to the well-known histological and cytological features, we hereby describe for the first time nuclear grooving as a useful morphological feature to aid in its diagnosis.

Methods: All cases were analyzed for anatomic location, size, age, sex and histology, with attention focused mainly on the nuclear features.

A view of HIV--infection in Karachi.

A prospective study on the prevalence of HIV-I infection in Karachi, Pakistan was conducted over a period of six years (1986-1992). Over 15,000 individual samples and more than 32,000 donor units of individuals residing in Karachi at the time of sample collection were tested for HIV-I infection by our screening test EIA which revealed a positivity rate of 0.23% and 0.

Significance of immunohistochemical c-ErbB-2 product localisation pattern for prognosis in human breast cancer.

Breast cancer is an increasingly important cause of illness and death among women. In recent years several novel prognostic determinants of breast cancer have been identified, including c-ErbB-2. In this study, expression of c-ErbB-2 in breast carcinoma was correlated with axillary lymph node metastases and disease outcome.

DNA ploidy analyses in 218 consecutive Pakistani breast cancer patients: does it add anything?

An analysis was made to evaluate the significance of DNA ploidy in the biology and prognosis of breast carcinoma. This was done by estimating the correlation of DNA ploidy with other established prognostic markers of breast cancer, namely tumor size, tumor grade, lymph node metastasis and S-phase fraction. From 1995 up to year 2000 ploidy analysis was performed on 218 consecutive cases of infiltrating breast carcinoma by flow cytometry using formalin fixed paraffin embedded material.

Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: pooled analysis of randomized controlled trials.

Background: Zinc deficiency is prevalent in children in developing countries. Supplemental zinc provides therapeutic benefits in diarrhea.

Objective: We sought to measure the effect of supplemental zinc given with oral rehydration therapy during recovery from acute or persistent diarrhea.

The effect of grandmultiparity on pregnancy related complications: the Aga Khan University experience.

Background: Grandmultiparity has been associated with complications for both mother and the fetus.

Objective: To evaluate if grandmultiparity is a risk factor in the presence of adequate antenatal care.

Setting: A tertiary care teaching hospital.

Chronic subdural haematoma presenting with transient ischaemic attacks--a case report.

We report a middle-aged man who presented with repeated episodes of transient ischaemic attacks (TIA) in the setting of a chronic subdural haematoma. This case report discusses the various pathophysiologic mechanisms whereby such TIA may occur in chronic subdural haematoma. We also highlight the importance of cranial imaging in cases of TIA.

Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: pooled analysis of randomized controlled trials. Zinc Investigators' Collaborative Group.

Objectives: This study assessed the effects of zinc supplementation in the prevention of diarrhea and pneumonia with the use of a pooled analysis of randomized controlled trials in children in developing countries.

Study Design: Trials included were those that provided oral supplements containing at least one half of the United States Recommended Daily Allowance (RDA) of zinc in children <5 years old and evaluated the prevention of serious infectious morbidity through household visits. Analysis included 7 "continuous" trials providing 1 to 2 RDA of elemental zinc 5 to 7 times per week throughout the period of morbidity surveillance and 3 "short-course" trials providing 2 to 4 RDA daily for 2 weeks followed by 2 to 3 months of morbidity surveillance.

Haemolytic uraemic syndrome in childhood: an experience of 7 years at the Aga Khan University.

We reviewed the case records of all children admitted to the Aga Khan University Hospital (AKUH) with a diagnosis of Haemolytic Uremic Syndrome (HUS) over a 7 year period (July, 1988-June, 1995). A total of 33 patients were admitted to the Pediatric ward at (AKUH) with a median age of 16 months (range 4 months-9 years). 97% cases identified were of the classic variety and no familial case was identified.

Hepatitis A and cytomegalovirus infection precipitating acute hemolysis in glucose-6-phosphate dehydrogenase deficiency.

A 34-year-old man presented with acute hemolytic anemia secondary to acute viral hepatitis A and a coexisting acute cytomegalovirus infection. This association has not been described previously in patients with glucose-6-phosphate dehydrogenase deficiency and is the subject of this report.

Effects of first and second trimester vaginal bleeding on pregnancy outcome.

The effects of vaginal bleeding during first and second trimester on pregnancy outcomes was assessed in a hospital-based population of 268 non-diabetic women. The group of non-bleeders comprised 173 females whereas, there were 71 females with first and 24 with second trimester bleeding. Fetal loss (abortion) occurred in 34% of first trimester and 25% of second trimester bleeders.

Nutritional stress of reproduction. A cohort study over two consecutive pregnancies.

Background: The evaluation of nutritional stresses of reproduction is far more complex than perceived in the literature so far. The use of inappropriate outcome measures, the lack of adjustment for the complex inter-relationships among confounding variables, and the poverty of analytical models, has led to conflicting results. Our objective was to evaluate, using a new analytical framework, the maternal and fetal effects of the nutritional stress imposed by reproduction in a cohort of 278 women followed over two consecutive pregnancies.

Prevalence of chlamydial infection in females attending antenatal and family planning clinics in Karachi Pakistan.

A prospective study was undertaken to investigate the relative prevalence of Chlamydia trachomatis in asymptomatic pregnant women of 2 socioeconomic groups and those attending the family planning clinics. Group 1 consisted of women attending the antenatal clinics of the Aga Khan University Hospital which caters to the affluent strata of our society (n = 100). Group 2 comprised women attending the antenatal clinics of Lady Dufferin Hospital which provides free obstetric care to women belonging to the lower socioeconomic groups of Karachi (n = 100).

Is carcinoma breast a different disease in Pakistani population?

Carcinoma of the breast tends to be different in coloured and white races. Is this pattern also expressed in Pakistani population? To answer this query we carried out a retrospectively study of breast cancer on 193 cases who were divided into 2 groups i.e.

Neonatal sepsis in Karachi: factors determining outcome and mortality.

Neonatal sepsis is a major cause of morbidity and mortality among newborns in the developing world. In a consecutive cohort of 292 infants with culture proven neonatal sepsis, the mortality was 68 (22 per cent). We analysed the association of predisposing factors, clinical, and laboratory characteristics of the infected newborns with mortality by univariate methods and logistic regression analysis.

Enterobacter sepsis in the newborn--a growing problem in Karachi.

Enterobacter sepsis is commonly recognized as a hospital-acquired infection in childhood. In a five year prospective surveillance of neonatal sepsis at the Aga Khan University Hospital in Karachi, we identified Enterobacter sepsis in 28/292 (10%) cases, with an incidence of 0.7 per thousand births among inborn infants.