7 results on '"Alina Ashraf"'
Search Results
2. Intussusception in an infant as a manifestation of COVID-19
- Author
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Zorays Moazzam, Areej Salim, Alina Ashraf, Fyezah Jehan, and Muhammad Arshad
- Subjects
COVID-19 ,Intussusception ,Pediatric ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
Gastrointestinal manifestations of COVID-19 are rare and have primarily been limited to diarrhea or vomiting. Intussusception is the most common cause of bowel obstruction in infants, with up to 30% of pediatric intussusception cases having a preceding viral illness. We present the rare case of intussusception in a SARS-CoV-2 positive infant. This is the first documented case of survival in a SARS-CoV-2 positive patient presenting with intussusception as the primary manifestation. As our knowledge of this disease evolves, surgeons need to remain suspicious for possible gastrointestinal manifestations of COVID-19.
- Published
- 2020
- Full Text
- View/download PDF
3. Granulomatosis with polyangiitis: a 17 year experience from a tertiary care hospital in Pakistan
- Author
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Omar Irfan, Haris Khan, Zarrar Khan, Alina Ashraf, Rimsha Ahmed, Javaid Ahmad Khan, and Ali Bin Sarwar Zubairi
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Granulomatosis with polyangiitis ,Vasculitis ,c-ANCA ,p-ANCA ,Medicine ,Biology (General) ,QH301-705.5 ,Science (General) ,Q1-390 - Abstract
Abstract Objective Granulomatosis with Polyangiitis (GPA) is an autoimmune, multi-system, small and medium vessel vasculitis with granulomatous inflammation. Aim of this study was to assess the clinical and radiological presentations of patients with GPA amongst the Pakistani population. It is a single centre retrospective single observation study. Results Study was conducted at the Aga Khan University Hospital, Karachi with records were reviewed from January 2000 to December 2017. Definitive diagnosis was made using a combination of serological anti-neutrophil cytoplasmic antibody (ANCA) testing along with the clinical and radiological presentation. A total of 51 patients met the diagnostic criteria in the time frame of the study. There were 23 males and 28 females with mean age of 44.0 ± 17.8 years on presentation. Arthritis was the most common symptom present in 41.2% of the cases followed by cough in 32.0%. Sixteen patients showed pulmonary infiltrates on chest X-ray. C-ANCA was positive in all of the patients compared with 21.6% p-ANCA positivity. A total of 13 biopsies were done. The median Birmingham Vasculitis Activity Score was 12. We report a 17.6% mortality rate with 5 deaths occurring due to respiratory failure. GPA is a diagnostic challenge leading to late diagnosis which can contribute to significant morbidity and mortality specially in the Third World.
- Published
- 2018
- Full Text
- View/download PDF
4. Vitamin C supplementation for prevention and treatment of pneumonia
- Author
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Hasana Bilal, Zulfiqar A Bhutta, Jai K Das, Zahra A Padhani, Rehana A Salam, Alina Ashraf, and Zorays Moazzam
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Adult ,medicine.medical_specialty ,Ascorbic Acid ,Placebo ,Drug Administration Schedule ,03 medical and health sciences ,0302 clinical medicine ,Lower respiratory tract infection ,Internal medicine ,Medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Adverse effect ,Child ,Aged ,Randomized Controlled Trials as Topic ,Aged, 80 and over ,Vitamin C ,business.industry ,Pneumonia ,Vitamins ,Middle Aged ,medicine.disease ,Confidence interval ,Treatment Outcome ,030228 respiratory system ,El Niño ,Relative risk ,Meta-analysis ,Child, Preschool ,Dietary Supplements ,business - Abstract
Background According to the Global Burden of Disease Study 2015, lower respiratory tract infection is the leading cause of infectious disease death, and the fifth most common cause of death overall. Vitamin C has a role in modulating resistance to infectious agents, therefore vitamin C supplementation may be important in preventing and treating pneumonia. Objectives To assess the impact of vitamin C supplementation to prevent and treat pneumonia in children and adults. Search methods We searched CENTRAL, MEDLINE, Embase, PubMed, CINAHL, LILACS, Web of Science, and two trials registers to 4 March 2020. We also checked references to identify additional studies. We did not apply any publication status or language filters. Selection criteria We included randomised controlled trials (RCTs) and quasi-RCTs (studies using allocation methods that are not random, e.g. date of birth, medical record number) assessing the role of vitamin C supplementation in the prevention and treatment of pneumonia in children and adults compared to control or placebo. Data collection and analysis We used standard methodological procedures expected by Cochrane. Main results We included seven studies in the review and identified two ongoing studies. The seven included studies involved a total of 2774 participants; five studies were RCTs and two were quasi-RCTs. The included studies were conducted in high-income countries (UK, USA and Chile) and lower-middle-income countries (Bangladesh and Pakistan). Four studies were conducted in hospital inpatient settings, two in schools, and one in a military training centre. Three studies included children under five years of age, two school-aged children, one adult participants, and one older participants aged 60 to 90 years. Two studies assessed the effect of vitamin C supplementation for pneumonia prevention; four studies assessed the effect of vitamin C supplementation as an adjunct to pneumonia treatment; and one study assessed the role of vitamin C for both prevention and treatment of pneumonia. For pneumonia prevention, the included studies provided supplementation in doses of 500 mg daily for 14 weeks, 2 g daily for 8 weeks, and 2 g daily for 12 weeks. For pneumonia treatment, the included studies provided vitamin C supplementation in doses of 125 mg daily (until discharge), 200 mg for 4 weeks, and 200 mg until discharge, as an adjunct to the pneumonia treatment. We assessed the included studies as at overall either high or unclear risk of bias for random sequence generation, allocation concealment, and blinding. We judged the quality of the evidence as very low. Three studies assessed the effect of vitamin C supplementation for pneumonia prevention; we judged the quality of the evidence as very low. We are uncertain about the effect of vitamin C supplementation on pneumonia incidence (risk ratio (RR) 0.46, 95% confidence interval (CI) 0.06 to 3.61; 2 studies, 736 participants; I² = 75%; very low-quality evidence) and adverse events (urticaria) (RR 3.11, 95% CI 0.13 to 76.03; 1 study, 674 participants; very low-quality evidence). No included studies reported our other primary outcomes (pneumonia prevalence and mortality) or any of our secondary outcomes. Five studies assessed the effect of vitamin C supplementation as an adjunct to pneumonia treatment; we judged the quality of the evidence as very low. One study reported a decrease in the duration of illness in the vitamin C supplementation group (3.4 days ± 2.54) compared to the control group (4.5 days ± 2.35), and one study reported a decrease in number of days required for improvement in oxygen saturation (1.03 days ± 0.16 versus 1.14 days ± 1.0) and respiratory rate (3.61 days ± 1.50 versus 4.04 days ± 1.62) in the vitamin C supplementation group compared to the control group. We are uncertain of the effect of vitamin C supplementation on mortality due to pneumonia (RR 0.21, 95% CI 0.03 to 1.66; 1 study, 57 participants; very low-quality evidence). One study reported that the mean duration of hospital stay was 6.75 days amongst children in the vitamin C supplementation group and 7.75 days in the control group; another study reported a lower mean duration of hospital stay in the vitamin C supplementation group compared to the control group (109.55 hours ± 27.89 versus 130.64 hours ± 41.76). Authors' conclusions Due to the small number of included studies and very low quality of the existing evidence, we are uncertain of the effect of vitamin C supplementation for the prevention and treatment of pneumonia. Further good-quality studies are required to assess the role of vitamin C supplementation in the prevention and treatment of pneumonia.
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- 2021
5. Congenital absence of the appendix in a child with malrotation
- Author
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Zorays Moazzam, Saqib Hamid Qazi, Alina Ashraf, Sohail Asghar Dogar, and Areej Salim
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Pediatric ,medicine.medical_specialty ,business.industry ,General surgery ,Malrotation ,lcsh:RJ1-570 ,lcsh:Surgery ,lcsh:Pediatrics ,lcsh:RD1-811 ,Surgical procedures ,Appendix ,digestive system ,digestive system diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,surgical procedures, operative ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,medicine ,030211 gastroenterology & hepatology ,Surgery ,Abnormality ,business - Abstract
Congenital absence of the appendix is an extremely rare condition. Often found incidentally during surgical procedures, it poses a surgical dilemma. Surgeons must be well versed in the congenital abnormalities and positional variations of the appendix and must know the steps required during surgery to diagnose this abnormality. In this case report, we discuss the first ever occurrence of congenital absence of appendix in association with malrotation.
- Published
- 2020
6. Intussusception in an infant as a manifestation of COVID-19
- Author
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Muhammad Arshad, Zorays Moazzam, Alina Ashraf, Fyezah Jehan, and Areej Salim
- Subjects
Pediatrics ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,lcsh:Surgery ,Disease ,Article ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Intussusception (medical disorder) ,medicine ,Pediatrics, Perinatology, and Child Health ,Pediatric ,business.industry ,lcsh:RJ1-570 ,COVID-19 ,lcsh:Pediatrics ,lcsh:RD1-811 ,medicine.disease ,Positive patient ,Bowel obstruction ,Diarrhea ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Vomiting ,Surgery ,medicine.symptom ,business ,Intussusception - Abstract
Gastrointestinal manifestations of COVID-19 are rare and have primarily been limited to diarrhea or vomiting. Intussusception is the most common cause of bowel obstruction in infants, with up to 30% of pediatric intussusception cases having a preceding viral illness. We present the rare case of intussusception in a SARS-CoV-2 positive infant. This is the first documented case of survival in a SARS-CoV-2 positive patient presenting with intussusception as the primary manifestation. As our knowledge of this disease evolves, surgeons need to remain suspicious for possible gastrointestinal manifestations of COVID-19.
- Published
- 2020
- Full Text
- View/download PDF
7. Applications and pitfalls of hemoglobin A1C and alternative methods of glycemic monitoring
- Author
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Michelle D. Lundholm, Alina Ashraf, Sarah Nadeem, and Mary Ann Emanuele
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Blood Glucose ,Glycation End Products, Advanced ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Cochrane Library ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,Diabetes mellitus ,Internal Medicine ,medicine ,Diabetes Mellitus ,Humans ,Glycated Serum Albumin ,Intensive care medicine ,Serum Albumin ,Glycemic ,Alternative methods ,Glycated Hemoglobin ,Continuous glucose monitoring ,business.industry ,Blood Glucose Self-Monitoring ,Skin autofluorescence ,medicine.disease ,Fructosamine ,chemistry ,Glucose monitors ,business - Abstract
Introduction Intensive glycemic control minimizes the risks of microvascular complications in diabetes. A1C is a convenient estimate of mean blood glucose, but is not the only marker available. The practical use and limitations of alternative markers and continuous glucose monitors are the focus of this review. Methods PubMed and the Cochrane Library were searched for studies concerning applications or limitations of A1C, fructosamine, glycated albumin, 1,5-anhydroglucitol, skin autofluorescence, and continuous glucose monitoring. Papers reporting on strengths, limitations, or comparisons of these methods were reviewed for inclusion. Results A1C reflects three months of glycemic control and is not an ideal marker in all patient populations. Fructosamine and glycated albumin reflect mean blood glucose over three weeks. 1,5-Anhydroglucitol can measure hyperglycemic excursions in days to weeks. Continuous glucose monitors provide immediate feedback for timely intervention to reduce glycemic excursions and can assess glycemic variability. Current barriers to continuous glucose monitor use include inexperience, cost, discomfort, and medication interference. Conclusions Many promising alternative glycemic markers exist. The main limitations for all alternative methods of glycemic monitoring are a lack of standardization for clinically useful cut-offs or guidelines, and a lack of long-term data on their association with complications, particularly in varied patient populations.
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- 2020
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