Liaquat National Medical College

Karachi, Pakistan

Liaquat National Medical College

Karachi, Pakistan

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Marri M.Z.,Liaquat National Medical College | Bashir M.Z.,Aga Khan University
Journal of the College of Physicians and Surgeons Pakistan | Year: 2010

Objective: To determine the pattern of homicidal deaths caused by rifled weapons in Peshawar as regards the parameters of age, gender, place of occurrence and the number and location of injuries on the body. Study Design: Descriptive study. Place and Duration of Study: The study was conducted at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar, from June 2005 to February 2006. Methodology: The subjects were selected from victims presenting for autopsy at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar. One hundred cases were selected where the weapon of offence was a rifled weapon and the manner of death was homicide on the basis of the police inquest, the autopsy and an interview with the relatives of the victim. After the autopsy, the findings were tabulated and analyzed. Results: Homicides predominantly occurred in young males residing in a rural locality. The peak incidence was between 20-29 years in males and in females the age group most prone was 30-39 years. Male to female ratio was 6:1. The chest (33.8%) followed by the head and abdomen were the areas primarily targeted. Conclusion: High velocity automatic weapons are primarily being used to kill young people in rural areas. Prevention can be through strict gun control laws coupled with education and awareness.


Edhi M.M.,Liaquat National Medical College | Aslam H.M.,Dow Medical College DUHS | Naqvi Z.,Liaquat National Hospital | Hashmi H.,Liaquat National Hospital
BMC Research Notes | Year: 2013

Background: Post partum hemorrhage is defined as blood loss of 500 ml or above. It is the most common cause of pre-mature mortality of women world wide. Our objective was to evaluate the most common etiology and method of management of Post partum Hemorrhage in a tertiary care hospital of Karachi. Findings. It was a cross sectional study conducted at Liaquat National Hospital Karachi, during the period of July 2011 to May 2012. Review include mode of delivery, possible cause of postpartum hemorrhage, supportive, medical and surgical interventions. All the women admitted with post partum hemorrhage or develop PPH in hospital after delivery were included in our study. Bleeding disorder and use of anticoagulants were set as exclusion criteria. Diagnosis was made on the basis of blood loss assessment which was made via subjective and objective evaluation.During the targeted months, out of total 1493 deliveries (26/1493 = 1.741%) 26 cases of post partum hemorrhage were reported with a mean age of 26.153 ± 7.37. No deaths were reported and all cases were referred and unbooked cases. All Patients were conscious, tachycardiac and hypotensive. Most of the women were suffering from hemorrhage during or after the birth of their 1st child. Primary post partum hemorrhage emerge as the most common type of post partum hemorrhage and uterine atony was detected as the most common cause of primary post partum hemorrhage. Retained products of conception was the most common cause of secondary post partum hemorrhage and hysterectomy was found to be the most frequent method of management of post partum hemorrhage. Conclusion: This study highlights the existing variable practices for the management of postpartum hemorrhage. Hemorrhage associated morbidity and mortality can be prevented by critical judgment, early referral and resuscitation by attendants. Introduction of an evidence-based management model can potentially reduce the practice variability and improve the quality of care. © 2013 Edhi et al.; licensee BioMed Central Ltd.


Zeeshan R.,Liaquat National Hospital | Irfan S.M.,Liaquat National Hospital | Sultan S.,Liaquat National Hospital | Bhimani S.,Liaquat National Medical College
Asian Pacific Journal of Cancer Prevention | Year: 2015

Background: Chronic lymphoid leukemia (CLL) is the most frequent type of adult leukemia. The Rai and Binet staging systems have been well recognized as standards for assessing the treatment requirements and overall survival in CLL patients. However, there is a need to seek newer prognostic markers to identify stable or progressive forms of CLL that will facilitate risk-adapted treatment strategies. Currently a molecular biomarker ZAP-70 has attracted interest as providing prognostic information in CLL patients. Objective: To determine the frequency of ZAP-70 positivity in B-CLL patients at disease presentation. Materials and Methods: From January 2011 to September 2014, 89 patients were diagnosed to have chronic lymphoid leukemia. Complete blood count was done on an automated analyzer (Cell Dyne, Abott Architect, USA), while immunophenotyping was conducted for each patient to establish the diagnosis of the disease. ZAP-70 expression was evaluated by flow cytometry. Data were compiled and analyzed by SPSS version 21. Results: Out of the total of 89 B-CLL patients, 62 (69.7%) were male and 27 (30.3%) were females with a male to female ratio of 2:1. The mean age was 57.5±12.1 years. The frequency of ZAP-70 positivity in our B-CLL patients was found to be 13.5%. ZAP-70 positivity was significantly correlated with stage III disease and high absolute lymphocytic count (P < 0.05). No correlation of ZAP-70 could be established with age and gender (p > 0.05). Conclusions: The frequency of ZAP-70 in our patients appears low. It is approximately half that in international data. We would recommend to screen all the newly diagnosed patients with CLL for ZAP-70 protein expression for risk stratification, family counseling and to predict overall survival.


Sultan S.,Liaquat National Hospital and Medical College | Irfan S.M.,Liaquat National Medical College
Asian Pacific Journal of Cancer Prevention | Year: 2016

Background: Primary myelodysplastic syndrome (MDS) is an acquired clonal disorder of myeloid progenitor cells, characterized by peripheral cytopenias in the presence of hypercellular marrow with dysplastic features. Our aim was to study the demographical and clinicopathological features of adult Pakistani patients with MDS at disease presentation. Materials and Methods: This single centre study was conducted at Liaquat National Hospital and Medical College, extending from January 2010 to December 2014. Data were retrieved from the patient archives. Results: Overall 45 patients were diagnosed at our institution with de novo MDS during the study period. There were 28 males and 17 females. Age ranged between 18 and 95 years with a mean age of 57.6±17.4 years and median of 64 years. The male to female ratio was 1.7:1. The main presenting complaints were generalized fatigue (60%), fever (33.3%), dyspnea (15.5%), bleeding (13.3%) and weight loss (11.1%). Examination was unremarkable in 42.2% of patients. Physical examination revealed pallor in 37.7%, followed by petechial and purpuric rashes in 20%. The commonest laboratory finding was anemia (hemoglobin < 10 g/dl in 41 (91.1%) patients. Out of these, 27 (60%) patients had normocytic anemia, followed by macrocytic (22.2%) and microcytic (8.8%). Conclusions: Primary MDS in Pakistani patients demonstrates a male preponderance. The proportion of anemic patients was high in our series with predominance of normocytic anemia. However, other clinico-hematological features appear comparable to published data.


Sultan S.,Liaquat National Hospital and Medical College | Irfan S.M.,Liaquat National Hospital and Medical College | Khan S.R.,Liaquat National Medical College
Asian Pacific Journal of Cancer Prevention | Year: 2016

Background: Polycythemia rubra vera (PV), being a primary polycythemia, is caused by neoplastic proliferation of erythroid, megakaryocytic and granulocytic lineages which result in panmyelosis. PV patients have a somatic acquired mutation in the Janus kinase (JAK2) pathway, rendering cell proliferation independent of the normal regulatory mechanisms that regulate erythropoiesis. The rational of this study was to determine the prevalence of the JAK-2 V617F mutation in Pakistani patients with PV. Materials and Methods: In this cross sectional study, 26 patients with PV were enrolled from January 2010 to December 2014. Patients were diagnosed based on WHO criteria for PV. All were screened for G-T point mutation (V617F) in the JAK2 gene on chromosome 9 by an allele specific PCR. Results: The mean age was 53.4±9.31 years (range 36-72) and the male to female ratio was 2:1. The frequency of JAK2 V617F positivity in our PV patients was found to be 92.3%. Overall 30.7% of patients were asymptomatic and remaining 69.3% presented with symptomatic disease. The mean hemoglobin was 18.1±1.9g/dl with the mean hematocrit of 55.6±8.3%. The mean total leukocyte count was 12.8±7.1x109/l and the platelet count was 511±341.9x109/l. A positive correlation of JAK2 V617F mutation was established with high TLC count (P=0.01). No correlation of JAK2 V617F could be established with age or gender (P > 0.05). Conclusions: The JAK2 V617F mutation frequency in our PV patients was similar to those reported internationally. Screening for the mutation in all suspected PV cases could be beneficial in differentiating patients with reactive and clonal erythrocytosis.


Sultan S.,Liaquat National Hospital and Medical College | Irfan S.M.,Liaquat National Hospital and Medical College | Jawed S.N.,Liaquat National Medical College
Asian Pacific Journal of Cancer Prevention | Year: 2016

Background: Myelodysplastic syndrome (MDS) is a clonal disorder of hemopoeitic stem cells, characterized by infective hematopoiesis, peripheral cytopenias along with hypercellularity of marrow and marked dysplastic features. Our aim was to study the spectrum of the WHO classification in adult Pakistani patients with MDS at disease presentation. Materials and Methods: This retrospective descriptive study was conducted at Liaquat National Hospital and Medical College, extending from January 2010 to December 2014. Patient data were retrieved from the maintained archives. Results: Overall, 45 patients were diagnosed at our institution with de novo MDS during the study period. There were 28 males and 17 females. Age ranged between 18 and 95 years with a mean of 57.6±17.4 years. The male to female ratio was 1.7:1. According to the WHO classification, 53.3% had refractory cytopenia with multilineage dysplasia, 22.2% had refractory cytopenia with unilineage dysplasia, 4.4% each had refractory anemia with excess of blasts-1 and II and 15.5% had MDS unclassified. The main presenting complaints were generalized fatigue (60%), fever (33.3%), dyspnea (15.5%), bleeding (13.3%) and weight loss (11.1%). Physical examination revealed pallor in 37.7%, followed by petechial and purpuric rashes in 20% of patients. Hemoglobin was < 10 g/dl in 41 (91.1%). Pancytopenia and bicytopenia were noted in 18 (40%) and 14 (31.1%) respectively. Conclusions: MDS in our patients presents at a relatively young age. Refractory c ytopenia with multilineage dysplasia was the dominant disease variant in our setting.


Qadir F.,Liaquat National Medical College | Zehra T.,Liaquat National Medical College | Khan I.,Jinnah Medical and Dental College
Journal of the College of Physicians and Surgeons Pakistan | Year: 2011

Objective: To assess whether students find concept mapping a useful learning methodology to conceptualize and organize topics studied in CNS module of Pharmacology; and to evaluate whether addition of concept mapping assignment could help to improve examination scores. Study Design: An analytical study. Place and Duration of Study: College of Dentistry, Jinnah Medical and Dental College, Karachi, Pakistan, from March to May 2009. Methodology: A class of 50 BDS students was recruited for the study. Two randomly selected groups of 12 students each, prepared concept maps in topics from CNS pharmacology which were displayed and discussed during tutorial sessions. The other two groups (n=25) following the traditional teaching methodology, served as controls. Scores from best choice questions and short essay questions were compared between the investigational and control groups using the student's t-test with significance at p < 0.05. Feedback obtained after completion of the study was evaluated as percent response. Results: One-best-choice test of the control group showed a mean grade of 57.1 ± 16.7 vs. test group mean of 58.8 ± 13. For the short essay questions, control group obtained a mean of 52.3 ± 18.8 vs. test group mean grade of 53.8 ± 22.5. Both results were not significantly different (p > 0.05). However, feedback about concept mapping showed that the technique helped the students to conceptualize difficult topics in CNS pharmacology (86.36%). Concept mapping was particularly beneficial in preparing for exams as it provided a quick overview of the entire subject (68.68%). Conclusion: Students found concept mapping as a useful pedagogical tool which could potentially be used to acquire meaningful learning in Pharmacology as a supplement to traditional teaching techniques. It was not found beneficial in improving examination grades probably because standard examinations and concept mapping measure different cognitive domains. © 2011. College of Physicians & Surgeons Pakistan.


Sultan S.,Liaquat National Hospital | Irfan S.M.,Liaquat National Hospital | Ahmed S.I.,Liaquat National Medical College
Advances in Hematology | Year: 2016

Objectives. Skeletal complications in β-homozygous thalassemic patients are uncommon but often debilitating, even amongst children and adolescent patients with well maintained transfusion and chelation therapy. The aim is to evaluate the biochemical markers of bone turnover in regularly transfused thalassemic patients and its possible correlations with demographic data and hematological and biochemical markers. Methods. In this prospective cross-sectional study, 36 β-thalassemia major patients were enrolled from March 2012 to March 2014. All patients underwent complete blood counts, LFTs, serum ferritin, serum calcium, phosphorus, serum albumin, alkaline phosphatase, 25-OH vitamin D, and parathormone (PTH) levels. Results. There were 17 males and 19 females with mean age of 12.56 ± 5.9 years. Hypocalcemia and hypophosphatemia were seen in 66.6% and 19.4%, respectively, while 25-OH vitamin D deficiency was present in 72.2% of thalassemic children and adolescents. Hypoparathyroidism was seen in 13.8% while hyperparathyroidism was detected in 8.3% of patients. There was direct correlation between serum phosphorus and ferritin levels (P<0.05). No correlation was found between indirect bilirubin and skeletal parameters, calcium and parathyroid hormone (P>0.05). Conclusions. Biochemical profile is significantly altered in patients with β-thalassemia major and bone associated biochemical abnormalities like hypocalcaemia, 25-OH vitamin D deficiency, and hypophosphatemia are not uncommon in Pakistani patients with thalassemia major. © 2016 Sadia Sultan et al.


PubMed | University of Sindh, Dow University of Health Sciences and Liaquat National Medical College
Type: Journal Article | Journal: JPMA. The Journal of the Pakistan Medical Association | Year: 2017

To observe the effects of ginkgo biloba extract on lead-induced morphometric changes in the kidneys of albino rats.This randomised controlled study was conducted at the Institute of Basic Medical Sciences, Dow University of Health Sciences, Karachi, from April 2009 to March 2010, and comprised male Wistar albino rats weighing between 150-180 gm who were randomly divided into three equal groups, A, B and C. These were further split into subgroups 1, 2, 3 and 4 according to the duration of the experiment (one, two, four and six weeks). Group A rats were given 1 ml normal saline intraperitoneally daily, group B rats were given lead acetate 8mg/kg intraperitoneally daily, while group C animals received 100mg/kg ginkgo biloba extract orally along with 8mg/kg lead acetate injection. The animals were sacrifised at the end of the prescribed period, and kidneys were retrieved, fixed, stained and examined under light microscope. SPSS 16 was used for data analysis.Of the 120 rats, there were 40(33.3%) in each group. Time-dependent deterioration was observed in the histological architecture of kidneys in group B animals compared to the group A animals, whereas less marked changes were observed in the protected group C animals. In group B animals, the diameter of proximal convoluted tubules increased, the number of proximal convoluted tubules and their nuclei decreased, whereas diameter of the nuclei decreased after an initial increase during the first and second weeks. These parameters remained largely undisturbed in group A animals, whereas changes in group C animals were comparable with those in the controlled group A animals.Ginkgo biloba extract had a protective effect on lead-induced morphometric changes in the kidneys of albino rats.


PubMed | University of Sindh, Liaquat National Medical College and Jinnah Medical & Dental College
Type: Journal Article | Journal: JPMA. The Journal of the Pakistan Medical Association | Year: 2017

To assess the environment of postgraduate fellowship training in teaching hospitals of an urban centre.The cross-sectional study was conducted at one public-sector and two private-sector teaching hospitals in Karachi from December 2014 to June 2015. Data was collected by using a modified version of Postgraduate Hospital Educational Environment Measure, a validated questionnaire, for which clinical residents were selected through convenience sampling. Data was analyzed using SPSS 16.Of the 302 participants, 168(55.6%) were males and 134(44.4%) were females. The overall mean age of the respondents was 28.463.03 years. The internal reliability of the questionnaire was good with a Cronbachs alpha of 0.92. The overall mean score of 93.9620.79suggested more positive than negative perception with room for improvement. After adjusting for all important socio-demographic and residency co-variates, residency in a private hospital was positively associated with Postgraduate Hospital Educational Environment Measure score (p<0.01) compared to residency in public hospitals.There is an urging need to standardise postgraduate training in terms of teaching, autonomy and social support in public and private hospitals of Karachi.

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