Shaheed Mohtarma Benazir Bhutto Medical University
Larkana, Pakistan
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Mujtaba G.,University of Malaya | Mujtaba G.,Sukkur Institute of Business Administration | Shuib L.,University of Malaya | Raj R.G.,University of Malaya | And 3 more authors.
PLoS ONE | Year: 2017

Objectives Widespread implementation of electronic databases has improved the accessibility of plaintext clinical information for supplementary use. Numerous machine learning techniques, such as supervised machine learning approaches or ontology-based approaches, have been employed to obtain useful information from plaintext clinical data. This study proposes an automatic multi-class classification system to predict accident-related causes of death from plaintext autopsy reports through expert-driven feature selection with supervised automatic text classification decision models. Methods Accident-related autopsy reports were obtained from one of the largest hospital in Kuala Lumpur. These reports belong to nine different accident-related causes of death. Master feature vector was prepared by extracting features from the collected autopsy reports by using unigram with lexical categorization. This master feature vector was used to detect cause of death [according to internal classification of disease version 10 (ICD-10) classification system] through five automated feature selection schemes, proposed expert-driven approach, five subset sizes of features, and five machine learning classifiers. Model performance was evaluated using precisionM, recallM, F-measureM, accuracy, and area under ROC curve. Four baselines were used to compare the results with the proposed system. Results Random forest and J48 decision models parameterized using expert-driven feature selection yielded the highest evaluation measure approaching (85% to 90%) for most metrics by using a feature subset size of 30. The proposed system also showed approximately 14% to 16% improvement in the overall accuracy compared with the existing techniques and four baselines. Conclusion The proposed system is feasible and practical to use for automatic classification of ICD-10-related cause of death from autopsy reports. The proposed system assists pathologists to accurately and rapidly determine underlying cause of death based on autopsy findings. Furthermore, the proposed expert-driven feature selection approach and the findings are generally applicable to other kinds of plaintext clinical reports. © 2017 Mujtaba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Tunio I.A.,Shaheed Mohtarma Benazir Bhutto Medical University | Memon M.Q.,Health Science University | Nahyoon W.A.,Health Science University
Medical Forum Monthly | Year: 2017

Objective: The present study was conducted to report the patterns of radiological imaging of physical injuries and its medicolegal implications presenting at a tertiary care hospital of Sindh. Study Design: Observational study Place and Duration of Study: This study was conducted at the Department of Radiology, Chandka Medical College Hospital Larkana from August 2014 to July 2016. Materials and Methods: Record of 5130 patients was screened of which only 987 fulfilled the inclusion criteria. Plain X-rays, CT scan, ultrasound and magnetic resonance imaging (MRI) records were checked for the findings of bony injury, body parts imagined, cause and nature of physical injury. Microsoft excels and Statistix 8.1 version (USA) was used for the data analysis (P-value ≤ 0.05). Results: Mean ± SD age was noted as 34 ± 15.9 years. Of 987, 880 (89.15%) were male and 107 (10.84%) were female (p=0.0001). Plain X-rays were performed in 99.81%, Sonography in (24.11%), CT scans in (33.43%) and MRI in (13.8%) (p=0.0001). Fractures of limb bones, skull, chest cage and pelvi bones were noted. Motor bicycle (44.07%) was most common cause of physical injury followed by motor vehicle 25.83%) and fire arm injuries (8.71%). Medicolegal patterns reveal 6% were accidental, 2% homicidal and remaining were non-medicolegal cases. Conclusion: Common cause of physical injures was the motor cycle use and radiological imaging was helpful in rapid diagnosis in particular of bony fractures for early medical therapy. CT scan and MRI are necessary for head injuries cases.

Kashif S.,Shaheed Mohtarma Benazir Bhutto Medical University | Kashif M.A.,Combine Military Hospital Cherat | Saeed A.,Frontier Medical College
Journal of the Pakistan Medical Association | Year: 2015

Objective: To determine the association of factor V Leiden mutation with recurrent pregnancy loss. Methods: The case-control study was conducted at the Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, fromJanuary to June 2012, and comprised women of 18 to 45 years of age who had a history of recurrent pregnancy loss, and controls with no history of pregnancy loss. All the subjects belonged to Punjabi ethnic group. Three ml blood was taken from cases and controls and deoxyribonucleic acid was extracted. In order to identify Factor V Leiden mutation, polymerase chain reaction method was utilised combined with the amplification refractory mutation system. Data was analysed using SPSS 17. Results: Of the 112 subjects, 56(50%) were in each of the two groups. The presence of factor V Leiden mutation among the cases was 3(5.4%) while it was absent among the controls. The mutation was significantly associated with recurrent pregnancy loss (p=0.017).Recurrent pregnancy loss was higher in cases than controls (p=0.001). Conclusion: Factor V Leiden mutation was significantly associated with recurrent pregnancy loss. It should be considered one of the causes of recurrent pregnancy loss. © 2015, Pakistan Medical Association. All rights reserved.

Ram N.,Shaheed Mohtarma Benazir Bhutto Medical University | Qadri H.,Shaheed Mohtarma Benazir Bhutto Medical University | Shah A.,Shaheed Mohtarma Benazir Bhutto Medical University | Shaikh A.S.,Civil Hospital
Medical Channel | Year: 2012

Introduction: Spontaneous bacterial peritonitis is a common and severe complication of liver cirrhosis. Hepatic encephalopathy is one of the presentation of SBP. Without early antibiotic treatment, this complication is associated with high mortality rate, so early diagnosis is needed for those presenting with encephalopathy. Objectives: To determine the frequency of SBP in Hepatic Encephalopathy patients and association of different grades of hepatic encephalopathy with SBP. Design: Descriptive study Place of Study: Department of medicine, Medical Unit-I Chandka Medical College Hospital, Shaheed Mohtarma Benazir Bhutto Medical University Larkana. Duration of Study: From February 2009 to February 2010. Patients and Method: Patients with any grade of hepatic encephalopathy who were admitted, meeting the inclusion criteria were entered in the study. Informed consent was taken. Paracentesis was performed for ascitic fluid analysis on patients with ascites. Proforma was filled by researcher after getting report of ascitic fluid DR. Results: Total 122 patients with hepatic encephalopathy were included in study. Mean age of patients was 43 ±16. Out of them 96(78.7%) were male and 26(21.3%) were female. SBP was present in 59 (48.46%) patients. SBP was found in 46 (78%) males and 13 (22%) in females. Among the SBP patients 23(39%) grade-I, 23(39%) grade-II, 9(15.3%) grade-III, 4(6.8%) grade-IV encephalopathy was present with P value 0.01. Conclusion: SBP was present in significant number of patients with hepatic encephalopathy. SBP is one of the precipitating and life threatening factor in hepatic encephalopathy patients, so every patient should be evaluated for SBP and treated promptly.

Shaikh S.,Shaheed Mohtarma Benazir Bhutto Medical University | Shaikh A.H.,Shaheed Mohtarma Benazir Bhutto Medical University | Akhter S.,Shaheed Mohtarma Benazir Bhutto Medical University | Isran B.,Shaheed Mohtarma Benazir Bhutto Medical University
Journal of the Pakistan Medical Association | Year: 2012

Objective: To determine the efficacy of transdermal Nitroglycerine patch in idiopathic pre-term labour and foeto-maternal outcome. Methods: This quasi-experimental study was conducted at the Obstetrics Unit-II of Shaikh Zayed Hospital for Women, Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, from Jan 1 to June 30, 2010. Sixtyfive pregnant women at 28-34 weeks of gestation were recruited after they met the selection criteria based on non-probability consecutive sampling. Initially, 73 patients were selected, but 65 of them completed the treatment, while 8 patients refused to continue. Patients diagnosed with pre-term labour were given glyceryl trinitrate (GTN) 5 mg/12 hours transdermal patch which was applied on the anterior abdominal wall. The second patch of same dose was given after 12 hours. Arrest of labour, prolongation of pregnancy in days or weeks along with side effects of the agent were monitored. Patients were followed till delivery to know the foeto- maternal outcome. Results: Dramatic effects were seen in around 60 (92.3%), of the total patients who had felt relief from premature labour pains within the first hour and only 5 (7.6%) patients could not go beyond 24 hours, as among them 3 (4.61%) had previous uterine scar and 2 (3.07%) developed ruptured membranes after 12 hours of admission and their babies also could not survive. Mean pregnancy prolongation was 15.35±9.45 days (min: 4 max: 35), so delivery was deferred up to 48 hours, 3 to 7 days and more than 7 days in 4 (6.15%), 6 (9.23%) and 50 (76.92%) respectively. Conclusion: Glyceryl trinitrate, trans dermal patch is effective and safe tocolytic in idiopathic preterm labour. By prolonging pregnancy it improves neonatal outcome.

Khatwani N.R.,Shaheed Mohtarma Benazir Bhutto Medical University
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2011

Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without an evident intra-abdominal surgically treatable source. Spontaneous bacterial peritonitis (SBP) is one of the severe complications in patients with cirrhosis and ascites. Without early antibiotic treatment, this complication is associated with high mortality rate, so early diagnosis and treatment of SBP is therefore necessary for survival. Leukocyte esterase dipstick test can rapidly diagnose the SBP. Objectives were to find out the diagnostic accuracy of leukocyte esterase dipstick test for the diagnosis of spontaneous bacterial peritonitis. This cross-sectional, validation study was conducted from January 2009 to June 2009 at Medical Unit-II, Chandka Medical College Hospital Larkana. All the Patients with cirrhosis and ascites of either gender were included in this study. Paracentesis were performed on admission. The ascitic fluid obtained at bedside was immediately tested with reagent strip Multistix 10 SG. Ascitic fluid was then analysed for PMN cell count. The result of reagent strip was compared with ascitic fluid PMN cell count for determination of sensitivity, specificity, PPV and NPV of the test, while taking ascitic fluid PMN count > or = 250/mm3 as standard for diagnosis of SBP. Leukocyte esterase dipstick read positive from +1 to +3 reaction while negative and trace reaction regarded as negative test result. Total ninety four patients were enrolled in this study. Ninety-four Ascitic fluid samples were obtained. SBP was diagnosed in 52 (55.3%) patients, 42 (44.7%) patients were negative for SBP by manual cell count. The sensitivity, specificity, PPV, NPV of leukocyte esterase dipstick test to diagnose SBP were 92%, 95%, 96%, 90% respectively. The leukocyte esterase dipstick test can be used as rapid test for diagnosis of SBP due to its high diagnostic validity.

Kucukkolbasi S.,Selcuk University | Temur O.,Agriculture and Rural Development Support Institution | Kara H.,Selcuk University | Khaskheli A.R.,Selcuk University | Khaskheli A.R.,Shaheed Mohtarma Benazir Bhutto Medical University
Food Analytical Methods | Year: 2014

In this study, a novel approach has been developed using differential pulse anodic stripping voltammetry (DPASV) for the simultaneous determination of Zn(II), Cd(II), Pb(II) and Cu(II) in edible oils at hanging mercury drop electrode. The microwave digestion of oil samples was carried out with concentrated HNO3 and H2O2. KNO3 was used as a supporting electrolyte. The experimental conditions optimized such as deposition time, stirring rate and size of mercury drop were 300 s, 600 rpm and 10 mm2, respectively. The method was applied to quantify Zn(II), Cd(II), Pb(II) and Cu(II) in crude and refined hazelnut, corn, sunflower and olive oils. During refining of different vegetable oils, the removal efficiencies of Zn(II), Cd(II), Pb(II) and Cu(II) were calculated as 98.20-99.91, 98.50-99.90, 95.26-99.76 and 95.93-99.92 %, respectively. The limits of detection for Zn(II), Cd(II), Pb(II) and Cu(II) were 2.1 × 10-8, 8.7 × 10-10, 7.1 × 10-9 and 3.4 × 10-9 and the limits of quantification were 6.8 × 10-8, 2.9 × 10-9, 2.3 × 10-8 and 1.1 × 10-8 M with linear regression coefficients (R 2) of 0.9930, 0.9928, 0.9893 and 0.9931, respectively. It was observed that the above metals in crude and refined vegetable oils could be determined simultaneously by the DPASV method. © 2013 Springer Science+Business Media New York.

Channa M.A.,Shaheed Mohtarma Benazir Bhutto Medical University
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2012

Administration of quinolone therapy is controversial during growing age as stated by earlier authors. The flouroquinolones are currently not indicated for young children because of arthropathy and adverse effect as new born shown by studies. However the effects of ciprofloxacin and ZnCl2 on prenatal conceptus have remained undocumented. The present study was designed to compare the effects on conceptus after maternal ingestion of ciprofloxacin and ZnCl2 using Wastar albino rats. Ciprofloxacin and ZnCl2 was administrated to pregnant female albino rats. Ciprofloxacin with a dose of 20 mg/Kg bodyweight and ZnCl2 120 microg/100 gm bodyweight two times therapeutic dose for 10 days (from day 8-18 of pregnancy). Each animal was weighted on day 1, day 8 and day 18 of pregnancy. Abortion resulted on day 18th of pregnancy. Each group of pregnant animals were sacrificed on day 18 of gestation by over dose of either anaesthesia, abdomen opened, uterus and both cornua containing conceptus identified, removed, there weight recorded, crown rump length was measured and was compared with similar value of control animals. The results were statistically analysed to find out the significance. The ciprofloxacin induces a mordanting effect as obviated by increased basophilia. Our study reveals that ciprofloxacin administered in maternal, decreased maternal body weight to 38.4 +/- 0.9 gm. However simultaneous ZnCl2 maintained the body weight to 41.4 +/- 0.7 gm, while ZnCl2 increased the body weight to 46.5 +/- 2.25 gm. The body weight and Crown Rump length (CR Length) in conceptus decreased by 4.52 +/- 0.10 gm and 3.06 +/- 0.09 Cm respectively. That ciprofloxacin and ZnCl2 administration maintained the body weight and CR length by 5.46 +/- 0.09 gm and 3.79 +/- 0.13 Cm respectively. That ZnCl2 administration increased the body weight and CR length by 6.71 +/- 0.05 gm and 4.15 +/- 0.08 Cm respectively. Prenatal administration of Ciprofloxacin caused reduction in growth rate and CR length, and ZnCl2 maintained body weight and CR length and growth of the rat conceptus.

PubMed | Shaheed Mohtarma Benazir Bhutto Medical University
Type: Journal Article | Journal: JPMA. The Journal of the Pakistan Medical Association | Year: 2016

To determine the frequency of perineal pain after childbirth after a single dose of diclofenac rectal suppository.This cross-sectional study was conducted at Shaikh Zayed Women Hospital, Larkana, Pakistan, from April to September 2014, and comprised patients who were admitted to the labour room for normal vaginal delivery. A single dose of rectal diclofenac suppository of 100mg was given to the patients delivered vaginally or by second-stage emergency Caesarean section. Post-partum pain was noted after 12 and 24 hours of the administration of analgesia. SPSS 16 was used for data analysis.Of the 169 subjects, 63(37.28%) were aged 20 years or less, 85(50.3%) between 21 and 30 years, and 21(12.43%) between 31 and 40 years. Frequency of perineal pain was predominantly mild in 95(56%) patients, moderate in 60(35.5%) and severe in 14(8.28%).The use of non-steroidal anti-inflammatory rectal suppositories was found to be a simple and highly effective modality of reducing the perineal pain.

PubMed | Shaheed Mohtarma Benazir Bhutto Medical University, Taibah University and Quaid-i-Azam University
Type: | Journal: Ophthalmic genetics | Year: 2017

Waardenburg anophthalmia syndrome (WAS), also known as ophthalmo-acromelic syndrome or anophthalmia-syndactyly, is a rare congenital disorder that segregates in an autosomal recessive pattern. Clinical features of the syndrome include malformation of the eyes and the skeleton. Mostly, WAS is caused by mutations in the SMOC-1 gene.The present report describes a large consanguineous family of Pakistani origin segregating Waardenburg anophthalmia syndrome in an autosomal recessive pattern. Genotyping followed by Sanger sequencing was performed to search for a candidate gene.SNP genotyping using AffymetrixGeneChip Human Mapping 250K Nsp array established a single homozygous region among affected members on chromosome 14q23.1-q24.3 harboring the SMOC1 gene. Sequencing of the gene revealed a novel homozygous missense mutation (c.812G>A; p.Cys271Tyr) in the family.This is the first report of Waardenburg anophthalmia syndrome caused by a SMOC1 variant in a Pakistani population. The mutation identified in the present investigation extends the body of evidence implicating the gene SMOC-1 in causing WAS.

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