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Biomedical subjects

I Siddiqui

Publications and source records attributed to I Siddiqui.

11 recordsLinked to original sources
PubMed2004

Q-probes study of replicate specimens at the clinical laboratory, the Aga Khan University Hospital, Karachi.

OBJECTIVE: The aim of this Q-probes study was to evaluate the precision of replicate specimens. METHODS: This Q-probes study done at the Clinical Laboratory, The Aga Khan University Hospital Karachi is about routine chemistry analytes because of their importance in critical care patients. The analytes data was collected for six months from April to September 2002. There were total 358 samples, which were given for reanalysis during this period under the constant working conditions. After analysis, results of both the runs on different days, were compared to determine the percent difference between the results. After calculating the percent difference, the results were either accepted or rejected on the basis of guidelines set by CLIA 88(Clinical Laboratories Improvement Amendment 1988). RESULTS: Among 358 results, 5 were rejected according to the criteria selected. All of these results were then subjected to statistical analysis for calculating statistical significance. As our Null hypothesis was that the prevalence of rejected results were more than 2% with an acceptable limit of less than or equal to 2%. We failed to accept the Null hypothesis that means that it did not exceed the acceptable limits (p-value = 0.962930) with the Confidence Interval range of 0.2 -2.6 where Upper Confidence Interval is still less than 5% for a p-value of 0.05. The rejection of null hypothesis favors high precision between the two sets of results in our studied population. CONCLUSION: It is concluded that Q-Probes study of replicate specimens at the Clinical Laboratory at The Aga Khan University Hospital is within the acceptable limits. These figures show that a high quality precision is maintained among the observed specimens. This is an ongoing exercise and studies like these should be a continuous process to maintain and enhance the quality of Laboratory results).

Chemistry, Clinical↗
PubMed2003

Determination of delay in turn around time (TAT) of stat tests and its causes: an AKUH experience.

OBJECTIVE: To evaluate the delay and reasons of delay of turn around time (TAT) of stat tests in the section of clinical chemistry of the clinical laboratory. SETTING: Clinical Laboratory, Aga Khan University Hospital, Karachi. PATIENTS AND METHODS: In our study turn around time (TAT) of stat tests were analyzed. Turn around time was specified as the time from receipt of the sample till the final verification of results (sample receipt time to result verification time). Delays were categorized into 15 minutes, 16-30 minutes, 31 to 60 minutes and > 60 minutes. It was also noted as to which time of the day was delay in reporting stat results occurred. Reasons for the delay were also looked into. RESULTS: Total 20079 stat samples were received from August 2001 till October 2001. Four hundred eight (2.03%) samples were reported after the acceptable turnaround time. Cumulative analysis of the excess TAT of stat tests showed that 0-15 minutes delay was noted in 68 (16.7%) samples, 16-30 minutes delay in 80(19.6%) samples, 31-60 minutes delay in 76 (18.6%) samples as and more than 60 minutes delay in 185 (45.3%) of samples. Most of the delay in reporting of stat test in three months time was surprisingly noted in the morning shift. Overall delay in reporting in morning shift was found to be of 242 (59.3%) samples. In the evening and night shift 83 (20.3%) and 82 (20.1%) samples respectively were found to be delayed. Reasons for delay in TAT were as follows: n = 163 (40%) due to machine breakdown, n = 147(36%) due to delay in the maintenance of analyzers, n = 73 (18%) due to overlook of the staff during shift change (e.g. night shift to morning shift) and n = 25 (6%) due to computer shutdown. CONCLUSION: We conclude that most of the delay in TAT of stat tests in our laboratory occurred for more than 60 minutes and was frequently seen in the morning shift. It was also noticed that machine breakdown was the most common reason for this delay. Regular audit of such data helps in the evaluation of the efficiency of the laboratory and hence corrective measures taken accordingly would be helpful in providing better service to the physicians and patients.

Clinical Laboratory Techniques↗
PubMed2002

CSF oligoclonal bands in multiple sclerosis.

OBJECTIVE: To study the significance of oligoclonal bands in neurological disorders, specifically in Multiple Sclerosis (MS). METHODS: The study was designed to assess the sensitivity and specificity of the test methodology of CSF electrophoresis by performing the retrospective analysis of CSF samples sent for oligoclonal bands (OCB). A total of 603 samples were received by the Clinical Laboratories, Department of Pathology of The Aga Khan University, during a period of 54 months (January 1993-June 1997). All of these samples were analyzed by performing CSF protein electrophoresis. One hundred thirty three out of 603 samples showed evidence of OCB. Out of these, 24 patients were registered with Section of Neurology, Department of Medicine, The Aga Khan University Hospital. These 24 patients were finally selected for analysis. Relevant clinical details such as age, sex and clinical presentations were recorded. RESULTS: Fifteen (62%) out of 24 patients with positive OCB were diagnosed as cases of MS. Four (17%) patients were diagnosed to have subacute sclerosing panencephalitis (SSPE). Five (21%) patients were having other inflammatory neurological disorders. CONCLUSION: The overall relative sensitivity and specificity for multiple sclerosis were found to be 100% and 62.5% respectively. Lack of specificity was attributed to the fact that OCB were positive in other neurological disorders as well.

Adolescent↗
PubMed2002

Tumor-induced hypercalcemia: predictors of early mortality.

OBJECTIVE: To delineate the demographics and predictors of early mortality associated with tumor-induced hypercalcemia (TIH) amongst cancer patients in Pakistan. SETTING: A tertiary care hospital in Pakistan. PATIENTS AND METHODS: Retrospective analysis of patients with cancers, presenting with TIH and admitted to the hospital between January 1988 and December 1997, was carried out. RESULTS: Eighty-four patients (56 males and 28 females) were diagnosed to have TIH. The mean age at the time of presentation was 55 +/- 14 years. Twenty-five percent of the patients each had multiple myeloma and hepatocellular carcinoma whereas 20% of the patients had underlying breast cancer. Other malignancies included lung cancer, gall bladder cancer and colorectal carcinomas. Univariate analysis revealed male sex (p < 0.04), underlying diagnosis other than multiple myeloma (p < 0.025) and a high TLC (p < 0.05) at presentation, as predictors of an early mortality. CONCLUSION: Multiple myeloma, hepatoma and breast carcinoma were common cancers causing TIH. One-third patients died within first few days. Male sex, a high white cell count and an underlying diagnosis other than multiple myeloma predicted early mortality.

Adolescent↗
PubMed2001

Voltammetric determination of vitamins in a pharmaceutical formulation.

Direct current polarography and differential pulse polarographic methods have been developed for the qualitative as well as quantitative analysis of vitamin B1, B2 and B6. Thiamin (vitamin B1) produced a well-defined wave in 0.1 M KCl at pH 5.2 with E(1/2)=-1.2 V and E(p)=-1.22 V versus saturated calomal electrode (SCE). Riboflavin (vitamin B2) gave two distinct waves in Britton Robinson buffer at pH 1.8 with E(1/2) values=-0.13 and -0.34 V versus SCE and at pH 6.5 with E(1/2)=-1.10 V and E(p)=-1.2 V versus SCE. Pyridoxin (vitamin B6) produced a well-defined wave in Britton Robinson buffer at pH 6.5 with E(1/2)=-1.7 V and E(p)=-1.68 V versus SCE. All the three vitamins under study are reversibly reduced at the electrode surface. The number of electrons involved in the electrode process for vitamin B1 and B6 is one in each case where as for the two waves of B2 it is one and two, respectively. This has been confirmed by the measurement of E(3/4)-E(1/4) values and also from the log plot slopes for the reduction waves. The wave height of polarogram was found to be proportional to the vitamin concentration. The developed methods have been standardised for the determination of these compounds in pharmaceutical formulation. The concentration of vitamin B1, B2 and B6 are found to be 9.96, 9.92 and 3.01 mg, respectively in 240 mg of capsule powder of a standard company (name has not been disclosed due to secrecy purpose). The results have been found to be in excellent agreement to that claimed by the manufacturer. The observed data has been subjected to statistical analysis, which revealed high reliability and precision.

Buffers↗
PubMed2000

Decline in breast feeding, who is to be blamed?!! A study of knowledge, attitude and practice of breast feeding amongst nurses.

OBJECTIVES: Breast-feeding is on the decline. Very often the first introduction to bottle-feeding is facilitated in the maternity units. This reduces the chances for the mother to breast feed successfully. The objective of the study was to evaluate the knowledge, attitude and practices of breast-feeding amongst the nurses working in the maternity units. SUBJECTS: Nurses working in the maternity units of North Nazimabad, Karachi. DESIGN/METHODOLOGY: A cross-sectional study was conducted in the maternity units of North Nazimabad, Karachi. The Nurses were interviewed through a structured questionnaire. RESULTS: Out of 110 nurses working in the units, interviews of 70 nurses were obtained. The survey reveals that out of 70 nurses only 16 were qualified. The result shows that the nurses know little about successful lactation management and their role in the promotion and support of breast-feeding. There was a significant difference (P < 0.00) between qualified and non-qualified nurses as regards management of different aspects of breast-feeding. CONCLUSION: There is a huge gap between what is desired and what is available. Intensive training programs should be organized to enhance nursing activities for the required services in order to promote and support breast-feeding.

Breast Feeding↗
PubMed2000

Central nervous system lymphomas: a histologic and immunophenotypic analysis.

OBJECTIVE: To observe the spectrum of non-Hodgkin's lymphomas involving the central nervous system including morphological subtypes and immunophenotypic status. SETTING: Retrospective analysis of eleven years (1986 to 1996) data from surgical pathology files of Department of Pathology. RESULTS: Forty-three cases of non-Hodgkin's lymphomas were diagnosed during the period of eleven years (from 1986 to 1996), all of which were diffuse types. A total of 1177 Central Nervous CNS biopsies were examined, out of which 937 cases were diagnosed as CNS neoplasms, the remaining were non-neoplastic in nature. Among 937 CNS neoplasms, 43 cases (4.6%) were reported as non-Hodgkin's lymphomas. As most of the cases were outside referrals, the primary or secondary nature of the lymphomatous process could not be assessed. Seventeen cases were intracranial, while 26 cases were spinal in location. Majority of the intracranial lymphomas were biopsied from the cerebrum (12 cases). Male to female ratio was 1:2. The median age for intracranial lymphomas was 50 years and for spinal lymphomas 29 years. There were 16 cases (37%) of diffuse large cell lymphomas; 7 cases (16%) of diffuse mixed small and large cell lymphomas; 3 cases (7%) of diffuse large cell immunoblastic lymphomas; 2 cases (4.6%) of lymphoblastic lymphomas and diffuse small non-cleaved cell lymphomas and one case of small lymphocytic lymphoma and diffuse small cleaved cell lymphoma. One case of T cell rich B cell lymphoma was also diagnosed in the thoracic spine as primary extranodal lymphoma. Eight cases were unclassifiable and in 2 cases the features were suggestive of lymphoma. Immunophenotypic analysis was performed in 20 cases, however, in 2 cases the results were inconclusive. Fifteen cases (83%) showed immunoreactivity for B cell markers and 3 cases showed T cell phenotype out of which one case was lymphoblastic lymphoma. CONCLUSION: CNS lymphomas were uncommon tumors and comprised 4.6% of the total CNS neoplasms in our study. Moreover, these CNS lymphomas accounted for 2.2% of the total non-Hodgkin's lymphomas, including both nodal and extranodal. There was a higher incidence of location of these lymphomas within the spinal cord than brain. Most of the lymphomas were of intermediate or high grade (75%) according to the working formulation. Immunophenotypical status revealed B-cell phenotype in 84% of the lymphomas, in which it was tested (JPMA 50:141, 2000).

Central Nervous System Neoplasms↗
PubMed1998

Physician compliance with national tuberculosis treatment guidelines: a university hospital study.

SETTING: The Aga Khan University Hospital, in Karachi, Pakistan, is a 650-bed university teaching hospital. OBJECTIVES: There is little data from Pakistan on the awareness and application of the World Health Organization (WHO)'s tuberculosis treatment guidelines among physicians. This study evaluates physician compliance with these guidelines. DESIGN: A questionnaire to measure physician compliance was developed, pilot tested and standardised. Case records of all patients hospitalized with tuberculosis were reviewed (January-December 1995, n = 229), and were classified into WHO Category 1 (n = 191), Category 2 (n = 9) and Category 3 (n = 29). RESULTS: A total of 53 (23%) patients had a diagnostic bacteriological sputum smear examination, of which 38% were smear positive and 47% culture positive. Of 25 cerebrospinal fluid cultures 12% were positive. No sputum smear tests were conducted during treatment. Of 58 patients in Category 1 who completed therapy 74% received a 2-month intensive phase consisting of HRZE (isoniazid, rifampicin, pyrazinamide, ethambutol) (n = 43), while 41% received a 6 month continuation phase with HE (n = 24). Over 70% patients were lost to follow up, more than half of these during the intensive phase. CONCLUSION: Our study reflects poor awareness of the WHO guidelines and low compliance among physicians, and a high loss to follow-up. Efforts are needed to create physician awareness about the WHO guidelines and their use. This study can be used to assess the effectiveness of any future physician education and to identify areas of weakness in health care.

Antitubercular Agents↗
PubMed1997

Suppression of spatial localization of a cutaneous stimulus following transcranial magnetic pulse stimulation of the sensorimotor cortex.

Transcranial magnetic pulse stimulation (TMS) over the region of the sensorimotor cortex impairs both perception and tactile localization of cutaneous stimuli delivered to the fingers of the contralateral hand. The region of the scalp over which TMS results in impaired cutaneous localization coincides with the region over which TMS suppresses simple perception. TMS has a more profound effect on tactile localization than on simple detection of cutaneous stimuli. TMS disrupts tactile localization for 400 ms after tactile perception has returned to normal.

Electric Stimulation↗