Jinnah Medical College Hospital

Karachi, Pakistan

Jinnah Medical College Hospital

Karachi, Pakistan

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Ishaq M.,Jinnah Medical College Hospital | Sualeh Muhammad J.,Jinnah Medical College Hospital | Sualeh Muhammad J.,Aga Khan University | Hameed K.,Ziauddin University
Modern Rheumatology | Year: 2013

Objectives: Our aim was to determine the frequency of restless leg syndrome (RLS) in rheumatoid arthritis (RA) patients from a low socioeconomic area of Pakistan and compare results with a control group to evaluate the effect of variables on RLS patients. Methods: A clinical observational study was carried out on 240 RA patients form low socioeconomic group. Controls (n = 210) were frequency-matched by age group to the RA patients. We evaluated the presence of RLS and collected information on characteristics believed to be correlated with RLS in the general population. Multiple logistic regression models were used to study the association between RLS and other risk factors such as age, smoking status, and obesity. Results: Among all rheumatic patients seen at our rheumatology clinic, 70.8 % were women. Our study shows that 20 % of RA patients were suffering from RLS compared with 10 % of the control group with other rheumatic diseases. Multivariate logistic regression adjusted for age, obesity, and smoking also showed that women with RA were more likely to have RLS than control patients. RLS was also significantly associated with increasing age, high body mass index, and smoking status. Conclusions: Approximately 20 % of RA patients were suffering from RLS. Hence, there is need of increase awareness of RLS among rheumatologists to enhance early RLS diagnosis and appropriate management of this treatable condition. © 2012 Japan College of Rheumatology.


Ishaq M.,Jinnah Medical College Hospital | Muhammad J.S.,Jinnah Medical College Hospital | Hameed K.,Ziauddin University | Mirza A.I.,Ziauddin University
Modern Rheumatology | Year: 2011

In order to compare the efficacy and toxicity of methotrexate and leflunomide for the treatment of rheumatoid arthritis, a double-blind randomized clinical trial was carried out at the Department of Medicine, Jinnah Medical College Hospital, Korangi, Karachi. The sample size was 240 patients and the duration of the study was 1 year. The patients enrolled were randomly divided into two groups (methotrexate and leflunomide). RA activity was clinically assessed by noting changes in the four primary (tender joint count, swollen joint count, physician and patient global assessment score) and three secondary (morning stiffness, pain intensity, HAQ) clinical efficacy end-points. Data were expressed as the mean ± SD. A P value of<0.05, calculated by paired t test, was considered significant. A total of 368 subjects were enrolled in this study. Of these, 128 subjects were withdrawn during the screening phase. Of the 240 subjects who were randomized and treated, 129 received leflunomide and 111 received methotrexate. The difference between the baseline and 12 month end-point measurements of all primary clinical efficacy end-points was significantly greater in methotrexate-treated than in leflunomide-treated subjects. Both leflunomide and methotrexate resulted in significant improvements in all secondary clinical efficacy end-points after 1 year of treatment. In both treatment groups, the most common reason for withdrawal during the treatment was adverse events. The results of this study indicate that both leflunomide and methotrexate are effective drugs for the long-term treatment of RA. It was concluded that methotrexate, which is a much cheaper drug than leflunomide, is the drug of choice, especially for patients who belong to low socioeconomic groups. © Japan College of Rheumatology 2010.


Zahra F.,Jinnah Postgraduate Medical Center | Kidwai S.S.,Jinnah Medical College Hospital | Siddiqi S.A.,Jinnah Medical College Hospital | Khan R.M.,Jinnah Medical College Hospital
Journal of the College of Physicians and Surgeons Pakistan | Year: 2012

Objective: To determine the frequency of newly diagnosed diabetes mellitus in acute ischaemic stroke patients. Study Design: Observational study. Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi, from June 2007- June 2008. Methodology: This study included adult patients (age > 30 years, both genders) with the diagnosis of acute ischaemic stroke. Patients who were known to have diabetes mellitus prior to stroke, had a non-lacunar stroke or were admitted to intensive care units for any reason were excluded. Detailed history and examination, fasting blood sugar, fasting lipid profile, a non-enhanced CT scan brain and electrocardiogram were done on every patient. Data were entered on a preformed proforma. The results were analyzed on SPSS version 10. Chi-square test was applied. P-value <0.05 was considered to be statistically significant. Results: A total of 250 patients were enrolled. The male: female ratio was 1: 0.9. Mean age was observed as 60.9±10.1 years. In total, 50 new cases of diabetes mellitus were identified (20%). Average fasting blood sugar in diabetic subjects was 148±10 mg/dl. The most common risk factors in the newly diagnosed diabetic subjects were hypertension 26 (52%), smoking 18 (36%) and hyperlipidemia 14 (28%). Atrial fibrillation and myocardial infarction were seen in 12 subjects (24%) and 9 subjects (18%) respectively. Conclusion: Twenty percent patients with acute ischaemic stroke had un-diagnosed diabetes. Therefore, it is advisable to screen acute stroke patients for diabetes to reduce their long-term morbidity and mortality.


Ishaq M.,Jinnah Medical College Hospital | Muhammad J.S.,Jinnah Medical College Hospital | Mahmood K.,Dow University of Health Sciences
Journal of the Pakistan Medical Association | Year: 2012

Objective: To find the causes and characteristics of uveitis and its subtypes among Pakistani population, and to create awareness that early diagnosis and treatment of uveitis requires a multi-disciplinary approach. Methods: The retrospective study involved 98 diagnosed uveitis patients. Data was analysed regarding associated systemic diseases, infections, ocular syndromes, anatomical localisation, age, and gender. Results: In 85% of the patients, a classified form of uveitis was observed: associated systemic diseases were found in 24%, the most frequent one being sarcoidosis (9.8%) and V-K-H syndrome (7.4%); ocular syndromes were present in 10%, the most frequent being birdshot retinochoroidopathy (6.1%) and pars planitis (3.7%); and infections in 48%, the most frequent being tuberculosis (50.6%) and hepatitis (4.9%). Among classified uveitis, posterior uveitis was found in 46%, intermediate uveitis in 10% and anterior uveitis in 7% of the patients. Panuveitis was diagnosed in 36% of cases. The remaining 1% showed extrauveal manifestations. Conclusions: Causes of uveitis vary considerably by geographic location around the world. Granulomatous diseases are the most frequent cause of uveitis in Pakistan. Hence, detailed and expensive investigations in our context are not justified in all patients. The data offer guidance to rheumatologists and consultant physicians to facilitate efficient diagnostic testing.


PubMed | King Faisal University, Aga Khan University and Jinnah Medical College Hospital
Type: | Journal: Surgery research and practice | Year: 2016

Background. Laparoscopic cholecystectomy is considered to be gold standard for symptomatic gall stones. As a routine every specimen is sent for histopathological examination postoperatively. Incidentally finding gall bladder cancers in those specimens is around 0.5-1.1%. The aim of this study is to identify those preoperative and intraoperative factors in patients with incidental gall bladder cancer to reduce unnecessary work load on pathologist and cost of investigation particularly in a developing world. Methods. Retrospective records were analyzed from January 2005 to February 2015 in a surgical unit. Demographic data, preoperative imaging, peroperative findings, macroscopic appearance, and histopathological findings were noted. Gall bladder wall was considered to be thickened if 3mm on preoperative imaging or surgeons comment (on operative findings) and histopathology report. AJCC TNM system was used to stage gall bladder cancer. Results. 973 patients underwent cholecystectomy for symptomatic gallstone disease. Gallbladder carcinoma was incidentally found in 11 cases. Macroscopic abnormalities of the gallbladder were found in all those 11 patients. In patients with a macroscopically normal gallbladder, there were no cases of gallbladder carcinoma. Conclusion. Preoperative and operative findings play a pivotal role in determining incidental chances of gall bladder malignancy.


Kidwai S.S.,Jinnah Medical College Hospital | Wahid L.,Jinnah Medical College Hospital | Siddiqi S.A.,Jinnah Medical College Hospital | Khan R.M.,MS Neuropharmacology | And 2 more authors.
BMC Research Notes | Year: 2013

Background: Musculoskeletal manifestations of diabetes in the upper limb are well recognized. No data has been available in this regard from Pakistan. Our aim was to find out the frequency of upper limb musculoskeletal abnormalities in diabetic patients. Methods. This was an observational study in which type 2 diabetes patients attending our diabetic clinic were enrolled along with age and gender matched controls. Data was analyzed on SPSS 16. Results: In total, 210 Type 2 diabetics (male 34.3%, female 65.7%) and 203 controls (male 35%, female 65%) were recruited. The mean age was 50.7± 10.2 years in diabetic group as compared to 49.5±10.6 years in the control group. The frequencies of hand region abnormalities were significantly higher in the diabetic subjects as compared to the controls (20.4%, p-value <0.001). Limited joint mobility (9.5% vs 2.5%), carpal tunnel syndrome (9% vs 2%), trigger finger (3.8% vs 0.5%), and dupuytren's contracture (1% vs 0%) were found more frequent as compared to controls (all p-values <0.05). In the shoulder region of diabetic subjects, adhesive capsulitis and tendonitis was found in 10.9% and 9.5% respectively as compared to 2.5% and 2% in control group [p- value <0.001]. A weak but positive relationship was observed between age and duration of diabetes with these upper limb abnormalities. However, no correlation was found between the frequencies of these abnormalities with control of diabetes. Conclusion: A higher frequency of upper limb musculoskeletal abnormalities was observed in Type 2 diabetic patients as compared to control group. © 2013 Kidwai et al.; licensee BioMed Central Ltd.


Farman M.T.,Jinnah Medical College Hospital | Khan N.,National Institute of Cardiovascular Diseases | Sial J.A.,Chandka Medical College Hospital | Saghir T.,National Institute of Cardiovascular Diseases | And 3 more authors.
Anadolu Kardiyoloji Dergisi | Year: 2015

Objective: To know the predictors of a successful outcome of percutaneous transvenous mitral commissurotomy (PTMC) other than described in the Wilkins scoring system. Methods: Two hundred fifty-eight consecutive patients were enrolled for this observational study in a tertiary care heart center of Pakistan who had a Wilkins score of ≤8. Patients with more than mild mitral regurgitation (MR) or having a clot in the left atrium were excluded. The Bonhoeffer multi-track system was used as a default technique. Successful PTMC was defined as achieving a mitral valve area (MVA) of ≥1.5 cm2 with no more than mild MR. Results: Out of 258 PTMC procedures, 197 were successful. The Bonhoeffer multi-track system was used in ~94% cases. Among unsuccessful procedures, 41 patients did not achieve the required valve area, and 21 patients developed more than mild MR, including those 8 patients who did not achieve the required valve area and had more than mild MR. Bigger mean annulus size (33.5±2.6 versus 32.8±2.1 mm; p=0.02) and preprocedure MVA (0.93±0.1 versus 0.87±0.1 cm2; p=0.002) had a significant effect on successful PTMC. Lower mean preprocedure systolic right ventricular pressure on echo (65.4±19.4 versus 75.3±18 mm Hg; p=0.000) and on cath (74±21.5 versus 81.5±24.6 mm Hg; p=0.002), lower grade of left ventricular dysfunction (p=0.04), and tricuspid regurgitation on echo (p=0.003) also had positive effects on the outcome. Conclusion: Bigger preprocedure mitral valve annulus size and mitral valve area, and better left and right ventricular hemodynamics are correlated with successful PTMC. © 2015 by Turkish Society of Cardiology.


Nazir L.,Jinnah Medical College Hospital | Husain A.,Jinnah Medical College Hospital | Haroon W.,Dastagir Medical Center | Shaikh M.I.,Jinnah Medical College Hospital | And 2 more authors.
Journal of the College of Physicians and Surgeons Pakistan | Year: 2012

A middle-aged lady presented with sudden onset of unilateral central retinal vein thrombosis after completing 6 months course of interferon and ribavirin for chronic hepatitis C infection. She had no risk factors and all her thrombophilia workup was normal, however, she was found to be dyslipidemic which may have contributed to atherosclerosis and predispose to thrombosis. Despite anticoagulation, her visual acuity deteriorated. This case illustrates the possibility of unpredictable visual complication of interferon. Frequent eye examination should be undertaken in patients having underlying risk factors like diabetes, hypertension or dyslipidemia undergoing interferon therapy.


Ishaq M.G.,Jinnah Medical College Hospital | Shabbir F.A.,Jinnah Medical College Hospital
Journal of Medical Case Reports | Year: 2011

Introduction. The simultaneous presence of Takayasu's arteritis and beta thalassemia trait is a rare combination. To the best of our knowledge, this is the first case report on Takayasu's arteritis and beta thalassemia presenting together. Case presentation. This is a case report of a 23-year-old Asian woman of Pakistani descent who presented with a headache, blurred vision and dizziness. Conclusion: The correct diagnosis of our patient was based on clinical suspicion, appropriate imaging studies, and deliberation of the differential diagnosis. The management of our patient depended on the correct diagnosis of both the diseases. © 2011 Ishaq and Shabbir; licensee BioMed Central Ltd.


PubMed | Jinnah Medical College, Aga Khan University and Jinnah Medical College Hospital
Type: Journal Article | Journal: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP | Year: 2016

Elasticated retractors, a recent advancement in surgical techniques, provide an enhanced and effective way of retraction during head and neck surgeries. These have been used for a number of procedures and are known for their effective retraction and minimizing surgical time span. This article highlights the authors experience and the pros and cons of this technique.

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