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Lahore, Pakistan

Assir M.Z.K.,Medical Unit 1 | Kamran U.,Medical Unit 1 | Ahmad H.I.,Jinnah Hospital Lahore | Bashir S.,Medical Unit 1 | And 3 more authors.
Transfusion Medicine and Hemotherapy | Year: 2013

Background: Scientific data regarding effects of platelet transfusion on platelet count in dengue-related thrombocytopenia is scanty. Methods: A single center, randomized non-blinded trial was conducted on adult patients with dengue fever and platelet counts less than 30,000/μl. Patients were randomized to treatment and control group. Treatment group received single donor platelets. Patients with post-transfusion platelet increment (PPI) ≥10,000/μl and/or corrected count increment (CCI) ≥5,000/μl 1 h post-transfusion were considered responders. Primary outcome was platelet count increments at 24 and 72 h. Results: 87 patients were enrolled, and 43 (48.2%) received platelet transfusion. Mean PPI and CCI at 1 h post-transfusion in the treatment group were 18,800/μl and 7,000/μl respectively. 22 (53.6%) patients in the treatment group were non-responders. Mean platelet increments at 24 and 72 h were higher in the treatment group as compared to the control group. Responders showed significantly higher increments when compared to non-responders and the control group at 24 h (p = 0.004 and p < 0.001, respectively) and 72 h (p = 0.001 and p < 0.001, respectively). Significant differences were found between non-responders and the control group at 24 h (p < 0.001), but not at 72 h (p = 0.104). Patients with lower baseline platelet count were more likely to be non-responders. Platelet transfusion neither prevented development of severe bleeding nor shortened time to cessation of bleeding. Three severe transfusion reactions and two deaths occurred in treatment group. Conclusion: In this trial, almost half the patients showed no response to a high-dose platelet transfusion. Platelet transfusion did not prevent development of severe bleeding or shorten time to cessation of bleeding and was associated with significant side effects. Therefore, platelet transfusion should not be routinely done in the management of dengue fever. © 2013 S. Karger GmbH, Freiburg.

Sohail N.,Allama Iqbal Medical College
Journal of the College of Physicians and Surgeons Pakistan | Year: 2013

Objective: To determine the relationship of stress and academic performance in first year medical students and to identify sources of stress, levels of stress and relevant coping strategies. Study Design: Mixed method sequential. Place and Duration of Study: Allama Iqbal Medical College, Lahore, from March to December 2010. Methodology: Survey questionnaire and in-depth interviews were carried out in the first year students with their consent. Two hundred and fifty students were surveyed, out of whom 120 students responded. Twelve students with their consent were interviewed. Non-probability purposive sampling was employed for both types of data collection. SPSS version 20 was used. The qualitative data generated through structured in-depth interviews, were analyzed by content analysis. Results: Low level of stress was found in 7.5% (score 150), moderate level of stress was present in 71.67% (score between 150 and 300), and high level of stress was observed in 20.83% (score 300) of the students. There is moderate negative (-0.583) and significant (p < 0.01) correlation between academic performance and sources of stress. Similarly there is moderate negative (-0.478) and significant (p < 0.01) correlation between academic performance and levels of stress. There was strong positive (0.799) and significant (p < 0.01), correlation between stress level and number of stress sources. Conclusion: The study showed a diversity of stress sources and a high level of stress in the medical students. The results also show that higher level of stress is associated with poor academic performance.

Assir M.Z.K.,Medical Unit 1 | Ahmad H.I.,Jinnah Hospital | Masood M.A.,Medical Unit 1 | Kamran U.,Medical Unit 1 | Yusuf N.W.,Allama Iqbal Medical College
Scandinavian Journal of Infectious Diseases | Year: 2014

Objective: We conducted this study to review deaths due to dengue fever (DF) during a large outbreak of DF in Lahore, Pakistan. Methods: We reviewed deaths due to DF at Jinnah Hospital Lahore between August and November 2011. Clinical and laboratory data were abstracted. The 2011 World Health Organization Regional Office for South-East Asia (WHO SEARO) guidelines were used to classify the disease. Results: Out of 128,634 probable DF patients who visited the outpatient department, 2313 patients were hospitalized; 1699 (73.3%) were male. RT-PCR was positive in 92 of 114 hospitalized patients (DENV-2 in 91 patients and DENV-3 in 1 patient). Sixty dengue-related deaths were reported; 41 (68.3%) were male. The mean age (± standard deviation) was 44 (± 20.5) y. The diagnosis at the time of presentation was DF in 5 (8.3%), dengue haemorrhagic fever without shock in 16 (26.6%), dengue shock syndrome in 20 (33%), and expanded dengue syndrome in 19 (31.7%) patients. Expanded dengue syndrome included encephalopathy in 12 (20%) patients, intracerebral bleed in 3 (5%), multiorgan failure in 3 (5%), and Guillain-Barré syndrome in 1 (1.6%). Twenty-nine (48.3%) patients had at least 1 comorbidity. Conclusion: Dengue shock syndrome and expanded dengue syndrome were the most common causes of death. © 2014 Informa Healthcare.

Raza M.H.,U.S. National Institutes of Health | Raza M.H.,University of Punjab | Riazuddin S.,University of Punjab | Riazuddin S.,Allama Iqbal Medical College | Drayna D.,U.S. National Institutes of Health
Human Genetics | Year: 2010

Stuttering is a common speech disorder with substantial genetic contributions. To better understand the genetic factors involved in stuttering, we performed a genome-wide linkage study in a newly-ascertained consanguineous stuttering family from Pakistan. A linkage scan in this family using parametric linkage analysis revealed significant linkage only on chromosome 3q13.2-3q13.33, with a maximum two-point LOD score of 4.23 under an autosomal recessive model of inheritance. © 2010 US Government.

Chen J.,U.S. National Institutes of Health | Ma Z.,U.S. National Institutes of Health | Jiao X.,U.S. National Institutes of Health | Fariss R.,U.S. National Institutes of Health | And 12 more authors.
American Journal of Human Genetics | Year: 2011

Congenital cataracts (CCs), responsible for about one-third of blindness in infants, are a major cause of vision loss in children worldwide. Autosomal-recessive congenital cataracts (arCC) form a clinically diverse and genetically heterogeneous group of disorders of the crystalline lens. To identify the genetic cause of arCC in consanguineous Pakistani families, we performed genome-wide linkage analysis and fine mapping and identified linkage to 3p21-p22 with a summed LOD score of 33.42. Mutations in the gene encoding FYVE and coiled-coil domain containing 1 (FYCO1), a PI(3)P-binding protein family member that is associated with the exterior of autophagosomes and mediates microtubule plus-end-directed vesicle transport, were identified in 12 Pakistani families and one Arab Israeli family in which arCC had previously been mapped to the overlapping CATC2 region. Nine different mutations were identified, including c.3755 delC (p.Ala1252AspfsX71), c.3858-3862dupGGAAT (p.Leu1288TrpfsX37), c.1045 C>T (p.Gln349X), c.2206C>T (p.Gln736X), c.2761C>T (p.Arg921X), c.2830C>T (p.Arg944X), c.3150+1 G>T, c.4127T>C (p.Leu1376Pro), and c.1546C>T (p.Gln516X). Fyco1 is expressed in the mouse embryonic and adult lens and peaks at P12d. Expressed mutant proteins p.Leu1288TrpfsX37 and p.Gln736X are truncated on immunoblots. Wild-type and p.L1376P FYCO1, the only missense mutant identified, migrate at the expected molecular mass. Both wild-type and p. Leu1376Pro FYCO1 proteins expressed in human lens epithelial cells partially colocalize to microtubules and are found adjacent to Golgi, but they primarily colocalize to autophagosomes. Thus, FYCO1 is involved in lens development and transparency in humans, and mutations in this gene are one of the most common causes of arCC in the Pakistani population. © 2011 The American Society of Human Genetics.

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