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Biomedical subjects

M Lakhani

Publications and source records attributed to M Lakhani.

14 recordsLinked to original sources
PubMed1997

In vitro effect of furosemide on the chemiluminescence of polymorphonuclear neutrophils in preterm infants.

We tested the hypothesis that the phagocytic activity of polymorphonuclear neutrophils (PMNs) of neonates is more sensitive to furosemide (FU) in vitro than that of adults. Phagocytosis was monitored by chemiluminescence of PMNs in cord blood of full-term (n = 10) and preterm (n = 8) neonates in the presence of 0, 6, 9, and 12 micrograms/ml of FU. Venous blood from adults (n = 10) was used for comparison. Random motility and chemotaxis were also determined in the three groups. The peak chemiluminescence of PMNs in preterm neonates was significantly decreased at a FU concentration of either 6, 9, or 12 micrograms/ml when compared to full-term infants. In contrast, no difference was observed between full-term infants and adults. Random motility and chemotaxis were comparable in all groups, regardless of the FU concentration. The results of this study suggest that preterm infants may be more sensitive to FU, as indicated by the adverse effect of this drug on chemiluminescence activity of their PMNs, in vitro.

Adult↗
PubMed1997

Effective audit in general practice: a method for systematically developing audit protocols containing evidence-based review criteria.

Though many general practitioners (GPs) now take part in audit, there is still concern about the extent to which participation in audit leads to improvements in practice. Improved methods are needed for the incorporation of research evidence into criteria for use in audit. In this paper, a six-stage systematic method is described for developing audit protocols containing prioritized evidence-based criteria. The stages are: selection of a topic, identification of key elements of care, focused literature reviews, prioritization of the criteria on the strength of the evidence and impact on outcome, preparation of full documentation, and peer review.

Clinical Protocols↗
PubMed1990

Ethical dilemmas of health care in the developing nations.

Limited resources, widespread poverty, and the absence of health insurance pose daily ethical problems for Third World physicians, who must balance their roles as individual patient advocates against a desire to provide health care to the greatest number of children. Pakistan has a per capita income of Rs. 7,220 (US$ 380) per year, or Rs. 800 (US$ 32) per month. The annual population growth of the country is 3.1%, and approximately 360,000 infants are born each year in Karachi, the largest city in the country. The Aga Khan University Hospital, a private teaching institution, is the only hospital in Karachi with a Level III Neonatal Intensive Care Unit (NICU). The financial and medical data of 200 infants admitted to the NICU in 1988 were reviewed retrospectively, and compared with those of two specific subgroups. (1) Among 15 infants who underwent surgical intervention, the average total cost of hospitalization was Rs. 36,040 (US$ 1,900) per patient, with an average daily cost of Rs. 923 (US$ 49). The longest hospital stay was 6 months, for a child who had total colonic aganglionosis associated with a short gut syndrome. There were two deaths in this group. (2) Of the 21 premature neonates admitted having Idiopathic Respiratory Distress Syndrome (IRDS) during this period, the total hospitalization cost per patient was Rs. 23,260 (US$ 788), with a daily cost of Rs. 1,050 (US$ 55). Eleven patients required ventilatory support. There were 16 survivors. Among both groups, 6% of all revenues generated in the NICU were used to help families pay for the bills under a welfare scheme.

Developing Countries↗
PubMed1989

Neonatal screening for congenital hypothyroidism in Pakistan.

Congenital hypothyroidism is a preventable cause of mental retardation. Since clinical signs of congenital hypothyroidism do not generally become obvious before three months of age, screening programmes have been introduced in North America and Europe, which consist of T4 or TSH screening on newborn infants on the third day of life. The screening for congenital hypothyroidism was initiated in Pakistan by the Aga Khan University Hospital (AKUH) in March 1987. By April 1988, 5000 neonates were screened and five cases of congenital hypothyroidism were diagnosed. The study revealed the incidence of hypothyroidism to be one case per 1000 newborns which is about 4 times more than that in the West.

Congenital Hypothyroidism↗
PubMed1987

A comparison of verapamil and digoxin in the treatment of atrial fibrillation.

Twelve patients (including 2 females) with chronic atrial fibrillation were entered into a randomized, double blind crossover study to compare the effects of digoxin and verapamil upon heart rate, exercise tolerance and symptom control. The dose of digoxin was adjusted so as to give serum concentrations within the range 1.3 to 2.6 nmol l-1 between four and six hours after dosing, and was continued for six weeks. The dose of verapamil was increased from 40 mg tds to 80 mg tds to 120 mg tds at fortnightly intervals. Three patients did not complete the study; two because of adverse effects attributable to verapamil. In the remaining nine patients, mean post exercise heart rates were significantly lower during treatment with verapamil 80 mgs tds (126.7 bpm) than with verapamil 40 mg tds (148.6 bpm) or digoxin (146.7 bpm). However, exercise tolerance was similar with both verapamil and digoxin and the superior control of exercise induced tachycardia achieved with higher doses of verapamil was not associated with improved exercise endurance. Visual analogue scale scores for constipation were significantly higher during treatment with verapamil; scores for other possible side effects and for overall wellbeing were similar. The results do not confirm the findings of others who have reported that verapamil is superior to digoxin in the treatment of atrial fibrillation.

Aged↗
PubMed1986

Survival after severe self poisoning with sodium valproate.

A 48 year old patient deliberately poisoned herself with 25 g of sodium valproate and survived with supportive measures only. This case contradicts the experience of those who advocate aggressive management of such severe overdoses.

Female↗
PubMed1986

Group B streptococcal meningitis in a diabetic adult.

A rare case of adult group B streptococcal meningitis is presented. The association with diabetes mellitus is emphasized and attention is drawn to microscopic and serological confusion that may arise in differentiating it from pneumococcal meningitis.

Diabetes Complications↗