36 results on '"Mehmood Riaz"'
Search Results
2. Clinical spectrum of sarcoidosis in patients at a tertiary care hospital, Pakistan: 10-year follow-up study
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Ainan Arshad, Mehmood Riaz, Zehra Naseem, Fatima Qadri, Syed Mujtaba Baqir, Muhammad Talal Ibrahim, and Ahmed Ayaz
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Medicine - Abstract
Objectives: To identify the local patterns of manifestations, organ involvement other than lungs, diagnostic tools and treatment regimens related to patients of sarcoidosis. Method: The retrospective study was conducted from November 1, 2019, to February 28, 2020, at the Aga Khan University Hospital, Karachi, and comprised data of sarcoidosis patients who needed hospitalisation between 2009 and 2019. The entire clinical spectrum was noted based on organ involvement. Data was analysed using SPSS 21. Results: Of the 80 patients, 53(66.3%) were women. The overall mean age at diagnosis was 52.0+/-13.5 years. Pulmonary sarcoidosis was found in 60(75%) patients, while 13(16.3%) had extrapulmonary manifestations, and 6(8.8%) had both pulmonary and extrapulmonary involvement. None of the patient had hypercalcemia, while antinuclear antibodies was positive in 2 (18.2%) patients. In terms of treatment, 75(93.8%) patients received corticosteroids. Acute exacerbation of interstitial lung disease was the most common reason of hospitalisation 16(20%). Mortality was the outcome in 11(14.7%) cases. Conclusion: Sarcoidosis was found to be more prevalent in women aged 50 years and above. A quarter of patients had extrapulmonary manifestation, while interstitial lung disease was the most common complication. Key Words: Sarcoidosis, Pulmonary, Extrapulmonary, Clinical spectrum. more...
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- 2022
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3. Comparative analysis of connective tissue disease-associated interstitial lung disease and idiopathic pulmonary fibrosis from a tertiary care centre in Pakistan
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Ali Bin Sarwar Zubairi, Huzaifa Ahmad, Maryam Hassan, Faraz Siddiqui, Nousheen Iqbal, Mehmood Riaz, and Muhammad Irfan
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Medicine - Abstract
Objectives: The burden of interstitial lung disease (ILD) is rising globally. This study aimed to describe and compare characteristics of Connective Tissue Disease-associated ILD with Idiopathic Pulmonary Fibrosis, the two most commonly observed ILDs among outpatients at a tertiary care hospital in Karachi, Pakistan. Methods: A retrospective research study was conducted. Patients with ILD were identified through the outpatient data registry at the Aga Khan University Hospital (AKUH), Karachi from October 2016 to October 2017. We obtained data pertaining to demographics, clinical and radiologic features. A comparative analysis was done to compare the patient characteristics and key features between CTD-ILD and IPF patients. The analysis was done using STATA version 12.0. Results: We identified 184 patients with ILD, which included 52 (29.3%) with CTD-ILD and 62 (35%) with IPF. The most prevalent conditions among CTD-ILD patients included rheumatoid arthritis (42.3%) and scleroderma (25%). Usual interstitial pneumonitis was the common radiologic pattern in RA-ILD (63.6%) and scleroderma (61.5%) while non-specific interstitial pneumonitis was more common in MCTD (85.7%) and SLE (80%). Compared to patients with IPF, those with CTD-ILD were predominantly younger (p more...
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- 2021
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4. Massive fluid requirements and an unusual BUN/creatinine ratio for pre-renal failure in patients with cholera.
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Muhammad Tariq, Murtaza Memon, Asif Jafferani, Sana Shoukat, Saqib Ali Gowani, Rabeeya Nusrat, Mehmood Riaz, Junaid Patel, Bushra Jamil, and Raymond A Smego
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Medicine ,Science - Abstract
BACKGROUND:Cholera is an important infectious cause of secretory diarrhea. The primary symptom of infection is the sudden onset of watery diarrhea with subsequent volume depletion causing renal insufficiency. The objective of this research is to study the level of dehydration at presentation and subsequent fluid management in patients with cholera. METHODS:This study was conducted on 191 patients of Cholera admitted at a tertiary care hospital in Karachi, Pakistan during the period of 5 years. Medical charts were evaluated retrospectively for initial hydration status, baseline lab investigations on admission and discharge and fluid therapy given to all the patients while their stay in the hospital and the data was analyzed on SPSS 15.0. RESULTS:Out of the 191 patients, 83(43%) were males and 108 (57%) were females with mean age of 42.3 years (SD+/-18.34). The average duration of symptoms was 3.75 days (SD+/-2.04). Of 191 patients, 175 (92.1%) presented with dehydration, 80 (42.3%) were given Ringer's Lactate (R/L) + Normal Saline (N/S), 45 (24%) patients were given R/L + N/S + Oral Rehydration Therapy (ORS), 27 (14.3%) of the patients were kept on R/L only and remaining were given various combinations of R/L, N/S, ORS and Dextrose Saline (D/S). On admission mean Blood Urea Nitrogen (BUN) was 24.54 (SD+/-16.6), mean creatinine was 2.47 (SD+/-2.35) and mean BUN/Creatinine ratio was 11.63 (SD+/-5.7). CONCLUSION:Aggressive fluid rehydration remains the cornerstone of management of cholera. Instead of presenting with a classical BUN/Creatinine ratio of >20:1, patients with pre-renal failure in cholera may present with a BUN/Creatinine ratio of more...
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- 2009
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5. Comparison of five different disseminated intravascular coagulation criteria in predicting mortality in patients with sepsis.
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Amara Zafar, Filza Naeem, Muhammad Zain Khalid, Safia Awan, Muhammad Mehmood Riaz, and Saad Bin Zafar Mahmood
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Medicine ,Science - Abstract
ObjectiveEven though patients with sepsis and DIC have a higher mortality rate compared to those without DIC, screening for DIC is not currently part of sepsis management protocols. This may be due to a lack of literature on the frequency of DIC occurrence in sepsis patients, as well as the absence of evidence on the optimal DIC criteria to use for identifying DIC and predicting mortality among the five criteria available. To address this gap, this study investigates the predictive value of five different criteria for diagnosing DIC and its relationship to patient outcomes in our population of sepsis patients.MethodsIn the Medicine department of Aga Khan University Hospital, a retrospective observational study was conducted, enrolling all adult patients with International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) coding of sepsis and clinical suspicion of DIC between January 2018 and December 2020. To diagnose DIC, five different criteria were utilized, namely the International Society of Thrombosis and Hemostasis (ISTH), the Korean Society on Thrombosis and Hemostasis (KSTH), the Japanese Association for Acute Medicine (JAAM), the revised-JAAM (RJAAM), and the Japanese Ministry of Health and Welfare (JMHW). The study analyzed the sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of these five criteria, as well as the overall prediction of mortality.ResultsOf 222 septic patients included in this study with clinical suspicion of DIC, 94.6% of patient had DIC according to KSTH criteria, followed by JAAM (69.4%), ISTH (64.0%), JMHW (53.2%) and lastly R-JAAM (48.6%). KSTH had sensitivity of 95.4% in diagnosing DIC and predicting mortality with a positive predictive value of 70% but specificity of 7.3% only. JAAM had sensitivity of 75.9%, positive predictive value of 75.9% with a specificity of 45.5%. ISTH had sensitivity of 69.4%, positive predictive value 75.3% and specificity of 48.5%.ConclusionDIC can impose a significant burden on septic patients and its presence can lead to higher mortality rates. Early detection through screening for DIC in septic patients can potentially reduce mortality. However, it is necessary to identify the most appropriate diagnostic criteria for each population, as various criteria have demonstrated different performance in different populations. Establishing a gold standard for each population can aid in accurate diagnosis of DIC. more...
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- 2024
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6. Disease activity correlates and functionality in patients with rheumatoid arthritis – real-world experience from a South Asian country
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Noreen Nasir, Hafsa Majid, Ayesha Habib Khan, Safia Awan, and Mohammed Mehmood Riaz
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rheumatoid arthritis ,acute phase reactants ,disease activity score 28 ,modified health assessment questionnaire ,Medicine - Abstract
Introduction There is a lack of data assessing disease activity in patients with rheumatoid arthritis from Pakistan. We sought to determine the correlation between Disease Activity Score 28 (DAS28) and disease activity parameters and the modified Health Assessment Questionnaire (mHAQ). Secondarily, we evaluated the concordance of acute phase reactants with disease activity. Material and methods We prospectively studied 132 patients with rheumatoid arthritis (RA) as per the 2010 American College of Rheumatology/European League Against Rheumatism criteria, not in clinical remission. Based on the DAS28 score, the patients were divided into low, moderate, and high activity groups. The patients were also categorized according to the elevation of acute phase reactants to determine concordance and discordance with DAS28–ESR and DAS28–CRP. Descriptive statistics and Pearson’s correlation were computed. Results Complete demographics was available for 132 participants. The mean age was 46.2 ±12.8 years; there were 85.6% (n = 113) females. The mean disease duration was 5.7 ±6.4 years. The (Rephrase as mean ±SD) DAS28 and mHAQ scores were 3.4 ±1.8 and 0.77 ±0.68, respectively. A significant correlation was observed between DAS28 and tender and swollen joint count (r = 0.64; p more...
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- 2022
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7. GRADE-ADOLOPMENT of clinical practice guideline for postmenopausal osteoporosis management—a Pakistani context
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Sarah Nadeem, Alina Pervez, Muhammad Abbas Abid, Rehab Naeem Khalid, Nashia Ali Rizvi, Salima Saleem Aamdani, Bushra Ayub, Mohsin Ali Mustafa, Sibtain Ahmed, Mehmood Riaz, Khadija Irfan, Shahryar Noordin, Lena Jafri, Hafsa Majid, Masood Umer, Nawazish Zehra, Aisha Sheikh, Adil H. Haider, and Aysha Habib Khan more...
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Orthopedics and Sports Medicine - Published
- 2023
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8. A retrospective review of antiphospholipid syndrome from a South Asian country
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Saad Bin Zafar Mahmood, Tazein Amber, Mehmood Riaz, Muhammad Zain Mushtaq, Ahsan Syed, and Zaibunnisa Sattar
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Rheumatology - Abstract
Objectives: This study aims to investigate clinical presentations, antiphospholipid antibody patterns and their levels, therapeutic regimens, and outcomes in patients with antiphospholipid syndrome (APS) admitted to a tertiary care hospital of a South Asian country. Patients and methods: Between January 2009 and December 2019, a total of 216 patients with APS (8 males, 208 females; median age: 35.7±6.9 years; range, 20 to 76 years) who either fulfilled the modified Sydney criteria or those who satisfied only clinical criteria along with positive antiphospholipid antibody on at least one occasion (probable APS) were retrospectively analyzed. Results: The majority of the patients (n=183, 84.7%) had obstetric complications, followed by venous thrombosis in 23 (10.8%) patients. Recurrent early abortions in 126 (58.6%) and deep venous thrombosis in 16 (7.4%) patients were the most prevalent obstetrical and venous events, respectively, whereas limb gangrene in seven (3.3%) and ischemic stroke in seven (3.3%) were the most common arterial events. A total of 190 (88%) patients had primary APS, while 26 (12%) had secondary APS. Systemic lupus erythematosus was the frequent association with secondary APS found in 19 (73%) patients. Immunoglobulin M (IgM) anticardiolipin antibody was present in 173 (65.0%) patients, being the most commonly reported antibody. Probable catastrophic APS was found in four (1.9%) patients. Majority of the patients (n=190, 87.9%) were treated with a combination of acetylsalicylic acid and low-molecular-weight heparin. Single mortality was observed in our study population due to complications related to catastrophic APS. Conclusion: Antiphospholipid syndrome has a wide range of thrombotic and obstetrical manifestations with important variations in different regions of the world. There is a significant morbidity and mortality related to APS, despite treatment with anticoagulation and; therefore, describing prognostic markers and optimal therapeutic interventions is pivotal to prevent complications. more...
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- 2021
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9. Comparative analysis of connective tissue disease-associated interstitial lung disease and idiopathic pulmonary fibrosis from a tertiary care centre in Pakistan
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Mehmood Riaz, Huzaifa Ahmad, Faraz Siddiqui, Nousheen Iqbal, Muhammad Irfan, Ali Bin Sarwar Zubairi, and Maryam Hassan
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Pathology ,medicine.medical_specialty ,business.industry ,Interstitial lung disease ,General Medicine ,respiratory system ,medicine.disease ,behavioral disciplines and activities ,Tertiary care ,Connective tissue disease ,Idiopathic Pulmonary Fibrosis ,respiratory tract diseases ,Tertiary Care Centers ,body regions ,Idiopathic pulmonary fibrosis ,medicine ,Humans ,Female ,Pakistan ,Connective Tissue Diseases ,Lung Diseases, Interstitial ,business ,Retrospective Studies - Abstract
Objectives: The burden of interstitial lung disease (ILD) is rising globally. This study aimed to describe and compare characteristics of Connective Tissue Disease-associated ILD with Idiopathic Pulmonary Fibrosis, the two most commonly observed ILDs among outpatients at a tertiary care hospital in Karachi, Pakistan. Methods: A retrospective research study was conducted. Patients with ILD were identified through the outpatient data registry at the Aga Khan University Hospital (AKUH), Karachi from October 2016 to October 2017. We obtained data pertaining to demographics, clinical and radiologic features. A comparative analysis was done to compare the patient characteristics and key features between CTD-ILD and IPF patients. The analysis was done using STATA version 12.0. Results: We identified 184 patients with ILD, which included 52 (29.3%) with CTD-ILD and 62 (35%) with IPF. The most prevalent conditions among CTD-ILD patients included rheumatoid arthritis (42.3%) and scleroderma (25%). Usual interstitial pneumonitis was the common radiologic pattern in RA-ILD (63.6%) and scleroderma (61.5%) while non-specific interstitial pneumonitis was more common in MCTD (85.7%) and SLE (80%). Compared to patients with IPF, those with CTD-ILD were predominantly younger (p more...
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- 2021
- Full Text
- View/download PDF
10. Telemedicine for Rheumatology Patients in Covid-19 Pandemic: Perspectives of Patients
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Mehmood Riaz, Saad Bin Zafar Mahmood, and Muhammad Riaz
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Health (social science) ,Leadership and Management ,Health Policy - Abstract
Telemedicine use for patients with autoimmune rheumatic conditions during the pandemic mandates better characterization. We conducted a telephonic survey on patients who consulted rheumatologists remotely to determine their attitudes toward telemedicine. The study was conducted at Aga Khan University Hospital, a tertiary care hospital in Pakistan which is a lower-middle-income country. Descriptive analyses were performed. Fifty patients visited tele-rheumatology clinic, 35 (70.0%) were female with a mean (SD) age of 47.6 (18.1) years. Majority (27, 54.0%) learned about telemedicine from hospital website and outpatient clinic desk or helpline. Lack of examination was the biggest concern with teleconsultation (18, 22.2%). Most patients (38, 76.0%) agreed to continue teleconsultation beyond the pandemic. Telemedicine is preferable for providing rheumatology outpatient service during and after the pandemic. more...
- Published
- 2022
11. Clinical spectrum of sarcoidosis in patients at a tertiary care hospital, Pakistan: 10-year follow-up study
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null Ainan Arshad, null Mehmood Riaz, null Zehra Naseem, null Fatima Qadri, null Syed Mujtaba Baqir, null Muhammad Talal Ibrahim, and null Ahmed Ayaz
- Subjects
General Medicine - Abstract
Objectives: To identify the local patterns of manifestations, organ involvement other than lungs, diagnostic tools and treatment regimens related to patients of sarcoidosis. Method: The retrospective study was conducted from November 1, 2019, to February 28, 2020, at the Aga Khan University Hospital, Karachi, and comprised data of sarcoidosis patients who needed hospitalisation between 2009 and 2019. The entire clinical spectrum was noted based on organ involvement. Data was analysed using SPSS 21. Results: Of the 80 patients, 53(66.3%) were women. The overall mean age at diagnosis was 52.0+/-13.5 years. Pulmonary sarcoidosis was found in 60(75%) patients, while 13(16.3%) had extrapulmonary manifestations, and 6(8.8%) had both pulmonary and extrapulmonary involvement. None of the patient had hypercalcemia, while antinuclear antibodies was positive in 2 (18.2%) patients. In terms of treatment, 75(93.8%) patients received corticosteroids. Acute exacerbation of interstitial lung disease was the most common reason of hospitalisation 16(20%). Mortality was the outcome in 11(14.7%) cases. Conclusion: Sarcoidosis was found to be more prevalent in women aged 50 years and above. A quarter of patients had extrapulmonary manifestation, while interstitial lung disease was the most common complication. Key Words: Sarcoidosis, Pulmonary, Extrapulmonary, Clinical spectrum. more...
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- 2022
- Full Text
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12. Clinical Spectrum of Adult-Onset Still’s Disease in Patients Presenting At A Tertiary Care Hospital in Pakistan: A 16-Year Follow-Up Study
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Mehmood Riaz, Ainan Arshad, Ahmed Isra, and Syed Mujtaba Baqir
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Pediatrics ,medicine.medical_specialty ,Adult-onset Still's disease ,business.industry ,Follow up studies ,medicine ,In patient ,Tertiary care hospital ,business - Abstract
Objectives Adult-onset Still’s Disease (AOSD) is a rare systemic auto-inflammatory disorder with a low incidence rate and limited data. This study aims to lay down the clinical and laboratory spectrum, associated complications, and outcomes of patients who presented to a tertiary care center – in order to identify any regional variation in the presentation and enable physicians to develop a thought process in patients without characteristic features. Materials and Methods We reviewed the records of patients from January 2005 - February 2021 who presented with symptoms consistent with AOSD, using the Yamaguchi criteria. The patients’ clinical symptoms, laboratory values, therapeutic management, complications, and outcomes were analysed. Descriptive statistics were produced to illustrate the pattern of the disease. Results The mean age of patients was 37.7 years, with a male to female ratio of 1:1. Fever and arthralgia was seen in 90%, a salmon-coloured rash in 60%, and leukocytosis in 80%. 30% presented with a sore throat and recent lymphadenopathy, 40% with hepatomegaly and/or splenomegaly on imaging, 100% with abnormal liver function tests. Steroids were used as first-line treatment. Most patients did not present with common, previously reported, complications of AOSD. Conclusions The clinical aspects in this study are, to a large part, comparable to those seen in other parts of the world. Thus, a comprehensive analysis of AOSD would enable physicians to broaden their minds and keep it as a top differential in atypical presentations – enhancing patient care by preventing a delay in diagnosis and initiation of prompt management. more...
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- 2021
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13. Cutaneous Ulcers as Initial Presentation of Localized Granulomatosis with Polyangiitis: A Case Report and Review of the Literature
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Noreen Nasir, Syed Ahsan Ali, and Hafiz Mohammed Mehmood Riaz
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Diseases of the musculoskeletal system ,RC925-935 - Abstract
Background. Granulomatosis with polyangiitis (GPA) is an ANCA associated small vessel vasculitis characterized by necrotizing granulomatous inflammation involving the upper and the lower respiratory tract and the kidneys. The disease has a broad clinical spectrum that ranges from limited/localized involvement of a single organ system to a generalized systemic vasculitis that affects several organs with evidence of end organ damage. Atypical forms of the disease have been recognized with or without respiratory tract involvement with a long protracted course before manifesting as generalized disease. Case Presentation. We describe a 57-year-old woman who presented with recurrent fever and cutaneous ulcers on her legs who was diagnosed to have granulomatosis with polyangiitis (GPA) after an extensive evaluation which excluded infectious, other vasculitides, connective tissue disease and malignant etiologies. Conclusion. In the absence of typical manifestations, granulomatosis with polyangiitis (GPA) is indeed a diagnostic challenge to the physician. Atypical manifestations like unexplained recurrent fever and cutaneous ulcers nevertheless call for keeping a low threshold for the diagnosis of GPA as the disease can initially present in localized form before heralding into a generalized disease. more...
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- 2015
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14. 21st Asia Pacific League of Associations for Rheumatology Congress APLAR-ARA 2019 in conjunction with the Australian Rheumatology Association Impact of Comorbidities in patients with Rheumatoid arthritis: a study from a tertiary care center in Pakistan
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Nasir, Noreen and Mehmood Riaz
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- 2021
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15. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial
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Flavia K Borges, Mohit Bhandari, Ernesto Guerra-Farfan, Ameen Patel, Alben Sigamani, Masood Umer, Maria E Tiboni, Maria del Mar Villar-Casares, Vikas Tandon, Jordi Tomas-Hernandez, Jordi Teixidor-Serra, Victoria RA Avram, Mitchell Winemaker, Mmampapatla T Ramokgopa, Wojciech Szczeklik, Giovanni Landoni, Chew Yin Wang, Dilshad Begum, John D Neary, Anthony Adili, Parag K Sancheti, Abdel-Rahman Lawendy, Mariano Balaguer-Castro, Paweł Ślęczka, Richard J Jenkinson, Aamer Nabi Nur, Gavin CA Wood, Robert J Feibel, Stephen J McMahon, Alen Sigamani, Ekaterine Popova, Bruce M Biccard, Iain K Moppett, Patrice Forget, Paul Landais, Michael H McGillion, Jessica Vincent, Kumar Balasubramanian, Valerie Harvey, Yaiza Garcia-Sanchez, Shirley M Pettit, Leslie P Gauthier, Gordon H Guyatt, David Conen, Amit X Garg, Shrikant I Bangdiwala, Emilie P Belley-Cote, Maura Marcucci, Andre Lamy, Richard Whitlock, Yannick Le Manach, Dean A Fergusson, Salim Yusuf, PJ Devereaux, Laurent Veevaete, Bernard le Polain de Waroux, Patricia Lavand'homme, Olivier Cornu, Karim Tribak, Jean Cyr Yombi, Nassim Touil, Maike Reul, Jigme Tshering Bhutia, Carol Clinckaert, Dirk De Clippeleir, Justin de Beer, Diane L Simpson, Andrew Worster, Kim A Alvarado, Krysten K Gregus, Kelly H Lawrence, Darryl P Leong, Philip G Joseph, Patrick Magloire, Benjamin Deheshi, Stuart Bisland, Thomas J Wood, Daniel M Tushinski, David AJ Wilson, Clive Kearon, David D Cowan, Vickas Khanna, Amna Zaki, Janet C Farrell, Anne Marie MacDonald, Steven CW Wong, Arsha Karbassi, Douglas Steven Wright, Harsha Shanthanna, Ryan Coughlin, Moin Khan, Spencer Wikkerink, Faraaz A Quraishi, Waleed Kishta, Emil Schemitsch, Timothy Carey, Mark D Macleod, David W Sanders, Edward Vasarhelyi, Debra Bartley, George K Dresser, Christina Tieszer, Steven Shadowitz, Jacques S Lee, Stephen Choi, Hans J Kreder, Markku Nousiainen, Monica R Kunz, Ravianne Tuazon, Mopina Shrikumar, Bheeshma Ravi, David Wasserstein, David JG Stephen, Diane Nam, Patrick DG Henry, Stephen M Mann, Melanie T Jaeger, Marco LA Sivilotti, Christopher A Smith, Christopher C Frank, Heather Grant, Leone Ploeg, Jeff D Yach, Mark M Harrison, Aaron R Campbell, Ryan T Bicknell, Davide D Bardana, Katie McIlquham, Catherine Gallant, Samantha Halman, Venkatesh Thiruganasambandamoorth, Sara Ruggiero, William J Hadden, Brian P-J Chen, Stephanie A Coupal, Lisa M McLean, Hemant R Shirali, Syed Y Haider, Crystal A Smith, Evan Watts, David J Santone, Kevin Koo, Allan J Yee, Ademilola N Oyenubi, Aaron Nauth, Emil H Schemitsch, Timothy R Daniels, Sarah E Ward, Jeremy A Hall, Henry Ahn, Daniel B Whelan, Amit Atrey, Amir Khoshbin, David Puskas, Kurt Droll, Claude Cullinan, Jubin Payendeh, Tina Lefrancois, Lise Mozzon, Travis Marion, Michael J Jacka, James Greene, Matthew Menon, Robert Stiegelmahr, Derek Dillane, Marleen Irwin, Lauren Beaupre, Chad P Coles, Kelly Trask, Shelley MacDonald, J Andrew I Trenholm, William Oxner, C Glen Richardson, Niloofar Dehghan, Mehdi Sadoughi, Achal Sharma, Neil J White, Loretta Olivieri, Stephen B Hunt, Thomas R Turgeon, Eric R Bohm, Sarah Tran, Stephen M Giilck, Tom Hupel, Pierre Guy, Peter J O'Brien, Andrew W Duncan, Gordon A Crawford, Junlin Zhou, Yanrui Zhao, Yang Liu, Lei Shan, Anshi Wu, Juan Manuel Muñoz, Philippe Chaudier, Marion Douplat, Michel Henri Fessy, Vincent Piriou, Lucie Louboutin, Jean Stephane David, Arnaud Friggeri, Sebastien Beroud, Jean Marie Fayet, Frankie Ka Li Leung, Christian Xinshuo Fang, Dennis King Hang Yee, Parag Kantilal Sancheti, Chetan Vijay Pradhan, Atul Ashok Patil, Chetan Prabhakar Puram, Madhav Pandurang Borate, Kiran Bhalchandra Kudrimoti, Bharati Anil Adhye, Himanshu Vijaykumar Dongre, Bobby John, Valsamma Abraham, Ritesh Arvind Pandey, Arti Rajkumar, Preetha Elizabeth George, Manesh Stephen, Nitheesh Chandran, Mohammed Ashraf, AM Georgekutty, Ahamad Shaheel Sulthan, S Adinarayanan, Deep Sharma, Satish Prasad Barnawal, Srinivasan Swaminathan, Prasanna Udupi Bidkar, Sandeep Kumar Mishra, Jagdish Menon, Niranjan M, Varghese Zachariah K, Santosh Angad Hiremath, Madhusudhan NC, Abhijit Jawali, Kingsly Robert Gnanadurai, Carolin Elizabeth George, Tatarao Maddipati, Mary KP KP, Vijay Sharma, Kamran Farooque, Rajesh Malhotra, Samarth Mittal, Chavi Sawhney, Babita Gupta, Purva Mathur, Shivanand Gamangati, Vijaylaxmi Tripathy, Prem Haridas Menon, Mandeep S Dhillon, Devendra K Chouhan, Sharanu Patil, Ravi Narayan, Purushotham Lal, Prashanth Nabhirajappa Bilchod, Surya Udai Singh, Uttam Vaidya Gattu, Ravi Prabhakar Dashputra, Prashant Vitthal Rahate, Maurizio Turiel, Giuseppe De Blasio, Riccardo Accetta, Paolo Perazzo, Daniele Stella, Marika Bonadies, Chiara Colombo, Stefania Fozzato, Fabio Pino, Ilaria Morelli, Eleonora Colnaghi, Vincenzo Salini, Giuseppe Denaro, Luigi Beretta, Giacomo Placella, Giuseppe Giardina, Mirko Binda, Anna Marcato, Luca Guzzetti, Fabio Piccirillo, Maurizio Cecconi, HM Khor, Hou Yee Lai, CS Kumar, KH Chee, PS Loh, Kit Mun Tan, Simmrat Singh, Li Lian Foo, Komella Prakasam, Sook Hui Chaw, Meng-Li Lee, Joanne HL Ngim, Huck Wee Boon, Im Im Chin, Ydo V Kleinlugtenbelt, Ellie BM Landman, Elvira R Flikweert, Herbert W Roerdink, Roy B.G. Brokelman, Hannie F Elskamp-Meijerman, Maarten R Horst, Jan-Hein MG Cobben, Anila Anjum, Pervaiz Mehmood Hashmi, Tashfeen Ahmed, Haroon Ur Rashid, Mujahid Jamil Khattak, Rizwan Haroon Rashid, Riaz Hussain Lakdawala, Shahryar Noordin, Naveed Muhammed Juman, Robyna Irshad Khan, Muhammad Mehmood Riaz, Syedah Saira Bokhari, Ayesha Almas, Hussain Wahab, Arif Ali, Hammad Naqi Khan, Eraj Khurshid Khan, Kholood Abid Janjua, Sajjad Hassan Orakzai, Abdus Salam Khan, Khawaja Junaid Mustafa, Mian Amjad Sohail, Muhammad Umar, Siddra Ahmed Khan, Muhammad Ashraf, Muhammad Kashif Khan, Muhammad Shiraz, Ahmad Furgan, Piotr Dąbek, Adam Kumoń, Wojciech Satora, Wojciech Ambroży, Mariusz Święch, Jacek Rycombel, Adrian Grzelak, Jaroslaw Gucwa, Waldemar Machala, Mmampapatla Thomas Ramokgopa, Gregory Bodley Firth, Mwalimu Karera, Maria Fourtounas, Virsen Singh, Anna Biscardi, Muhammad Nasir Iqbal, Ryan Jonathan Campbell, Matimba Lenny Maluleke, Carien Moller, Lerato Nhlapo, Sithombo Maqungo, Margot Flint, Marcin B Nejthardt, Sean Chetty, Rubendren Naidoo, Miriam Garrido Clua, Vicente Molero-Garcia, Joan Minguell-Monyart, Jordi Selga Marsa, Juan A Porcel-Vazquez, Jose-Vicente Andres-Peiro, Marc Aguilar, Jaume Mestre-Torres, Maria J Colomina, Patricia Guilabert, M Luisa Paños Gozalo, Luis Abarca, Nuria Martin, Gemma Usua, Pedro Martinez-Ripol, MA Gonzalez Posada, Pilar Lalueza-Broto, Judith Sanchez-Raya, Jorge Nuñez Camarena, Antoni Fraguas-Castany, Pere Torner, Monsant Jornet-Gibert, Jorge Serrano-Sanz, Jaume Cámara-Cabrera, Mònica Salomó-Domènech, Christian Yela-Verdú, Anna Peig-Font, Laura Ricol, Anna Carreras-Castañer, Luis Martínez-Sañudo, Susana Herranz, Carlos Feijoo-Massó, Mònica Sianes-Gallén, Pablo Castillón, Martí Bernaus, Saioa Quintas, Olga Gómez, Jordi Salvador, Javiera Abarca, Cristina Estrada, Marga Novellas, Mercè Torra, Alfred Dealbert, Oscar Macho, Alexia Ivanov, Esther Valldosera, Marta Arroyo, Borja Pey, Antoni Yuste, Llorenç Mateo, Julio De Caso, Rafael Anaya, JL Higa-Sansone, Angelica Millan, Victoria Baños, Sergio Herrera-Mateo, Hector J Aguado, Gonzalo Martinez-Municio, Ricardo León, Silvia Santiago-Maniega, Ana Zabalza, Gregorio Labrador, Enrique Guerado, Encarnacion Cruz, Juan Ramon Cano, Jose Manuel Bogallo, Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Nachapan Pengrung, Theerawat Chalacheewa, Vanlapa Arnuntasupakul, Teerapat Yingchoncharoen, Bundit Naratreekoon, Miriam Adel Kadry, Surendini Thayaparan, Ihab Abdlaziz, Arash Aframian, Arjuna Imbuldeniya, Souad Bentoumi, Sherif Omran, Marcela Paola Vizcaychipi, Patricia Correia, Shashank Patil, Kevin Haire, Amy SE Mayor, Sally Dillingham, Laura Nicholson, Mohamed Elnaggar, Joby John, Shashi Kumar Nanjayan, Martyn J Parker, Susan O'Sullivan, Meir T Marmor, Amir Matityahu, Robert Trigg McClellan, Curt Comstock, Anthony Ding, Paul Toogood, Gerard Slobogean, Katherine Joseph, Robert O'Toole, Marcus Sciadini, Scott P Ryan, Molly E Clark, Charles Cassidy, Konstantin Balonov, Sergio D Bergese, Laura S Phieffer, Alicia A Gonzalez Zacarias, Andrew J Marcantonio, Sanela Dragic-Taylor, Chelsea Maxwell, Sarah Molnar, Jennifer R Wells, Sandra N Ofori, Stephen S Yang, Michael K Wang, Emmanuelle Duceppe, Jessica Spence, Javiera P Vasquez, Francesc Marcano-Fernández, Hyungjoo Ham, Carlos Prada, Terence CH Yung, Isidro Sanz Pérez, Michael J Bosch, Michael R Prystajecky, Chinmoy Chowdhury, James S Khan, Steffan F Stella, Behrouz Heidary, Allen Tran, Katarzyna Wawrzycka-Adamczyk, Yu Chiao Peter Chen, Aránzazu González-Osuna, Grzegorz Biedroń, Anna Wludarczyk, Marco Lefebvre, Jaclyn A Ernst, Bas Staffhorst, Jason D Woodfine, Emad M Alwafi, Marko Mrkobrada, Simon Parlow, Robin Roberts, Finlay McAlister, David Sackett, James Wright, (HIP ATTACK, Investigators), Landoni, G., Faculty of Medicine and Pharmacy, Orthopaedics - Traumatology, Supporting clinical sciences, Emergency Medicine, UCL - SSS/IONS - Institute of NeuroScience, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service d'anesthésiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and UCL - (SLuc) Service de médecine interne générale more...
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Postoperative Complications/epidemiology ,Male ,Internationality ,Femoral Neck Fractures/epidemiology ,Arthroplasty, Replacement, Hip ,Myocardial Ischemia ,Comorbidity ,Time-to-Treatment/statistics & numerical data ,030204 cardiovascular system & hematology ,law.invention ,Fracture Fixation, Internal ,Postoperative Complications ,0302 clinical medicine ,Randomized controlled trial ,Residence Characteristics ,law ,Activities of Daily Living ,Fracture fixation ,Risk of mortality ,Medicine and Health Sciences ,Fracture Fixation, Internal/methods ,Sepsis/epidemiology ,030212 general & internal medicine ,Cardiovascular Diseases/mortality ,Stroke ,Aged, 80 and over ,Hip fracture ,Residence Characteristics/statistics & numerical data ,Infections/epidemiology ,General Medicine ,Middle Aged ,Open Fracture Reduction ,Treatment Outcome ,Cardiovascular Diseases ,Diabetes Mellitus/epidemiology ,Female ,medicine.medical_specialty ,Hip Fractures/epidemiology ,Postoperative Hemorrhage ,Infections ,Early Medical Intervention/methods ,Time-to-Treatment ,03 medical and health sciences ,Arthroplasty, Replacement, Hip/methods ,Early Medical Intervention ,Sepsis ,Diabetes Mellitus ,medicine ,Humans ,Mortality ,Myocardial Ischemia/epidemiology ,Aged ,Proportional Hazards Models ,Postoperative Hemorrhage/epidemiology ,Hip Fractures ,Proportional hazards model ,business.industry ,Hemiarthroplasty/methods ,Dementia/epidemiology ,Delirium ,Delirium/epidemiology ,medicine.disease ,Femoral Neck Fractures ,Nursing Homes ,Surgery ,Open Fracture Reduction/methods ,Dementia ,Observational study ,Hemiarthroplasty ,business - Abstract
© 2020 Elsevier Ltd Background: Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. Methods: HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896). Findings: Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4–9) in the accelerated-surgery group and 24 h (10–42) in the standard-care group (p more...
- Published
- 2020
16. Health related quality of life over time in a multi-ethnic cohort of patients with systemic lupus erythematosus and correlation with disease activity and organ damage.
- Author
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Kandane-Rathnayake R., Lateef A., Mehmood Riaz M., Shen L., Teoh L.K., Kandane-Rathnayake R., Lateef A., Mehmood Riaz M., Shen L., and Teoh L.K.
- Abstract
Background/Purpose: Systemic lupus erythematosus (SLE) is a chronic disease affecting the physical, social, and psychological well-being of patients. Health related quality of life (HRQoL) measures add a new dimension to treatment response. However, their longitudinal correlation with clinical indicators such as disease activity and organ damage are not known. We aimed to determine HRQoL over time in a multi-ethnic Asian SLE cohort and to study its relationship with disease activity and damage. Method(s): Adult patients with SLE (ACR or SLICC criteria fulfilled) attending rheumatology clinics at our institution are recruited in a longitudinal observational study since 2013. Demographic and clinical data including SLEDAI-2K are collected at enrollment and every three months while organ damage (SLICC-ACR damage index [SDI]) is assessed annually. HRQoL is measured using SF-36 survey at enrollment and annually. Patients with 4 or more HRQoL measures from enrollment to December 2016 were included in the current analyses. Linear mixed effect model was used to compare the subsequent SF-36 scores with baseline, and among different races. Moreover, linear mixed effect model was used to evaluate the effect of disease activity(SLEDAI-2K) and damage (SDI) on the SF-36 scores, after adjustment for baseline scores, ethnicity, and time. Result(s): A total of 196 patients were studied; mean +/- SD age at enrollment was 47.05 +/- 12.54 years, 180 (90.9%) were women. 140 (70.7%), were Chinese; 28 (14.1%) Malays, 17 (8.6%) Indians, and 13(6.6%) were other races. Majority were non-smokers (91.9%) and 10.1% had a family history of SLE. Baseline mean +/- SD score of physical component summary (PCS) was 47.8 +/- 8.2, while mental component summary (MCS) score was 48.5 +/- 9.8 (Table 1). The mean PCS improved significantly in second (p<0.008) and third year (p<0.001) as compared to baseline scores while no significant change was noted in MCS scores in second (p<0.76) or third year (p<0.25) more...
- Published
- 2019
17. Women with pregnancy induced hypertension have a higher risk of developing essential hypertension - a case control study from a tertiary care center in Pakistan
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Amna, Qasim, Ahmad, Bashir, Sara, Sajid, Muhammad Mehmood, Riaz, and Aysha, Almas
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Adult ,Statistics as Topic ,Blood Pressure Determination ,Hypertension, Pregnancy-Induced ,Middle Aged ,Tertiary Care Centers ,Pregnancy ,Risk Factors ,Case-Control Studies ,Hypertension ,Humans ,Female ,Pakistan ,Essential Hypertension - Abstract
To determine the association of essential hypertension with pregnancy-induced hypertension in women.The case-control study was conducted at Aga Khan University Hospital, Karachi, from January 2012 to March 2013, and comprised on hypertensive female patients who visited the outpatient medicine clinics. The patients were aged 18-65 years and had been pregnant atleast once. Cases were women diagnosed as hypertensive or pre-hypertensive and the controls were normotensive women. The primary outcome was essential hypertension and the main exposure was pregnancy-induced hypertension.Of the 258 subjects, 175(49.7%) were cases and 177(50.3%) were controls. The overall mean age was 44.6±13.3 years. Odds Ratio (95% Confidence interval) for pregnancy-induced hypertension for the outcome of essential hypertension was 1.6 (0.88, 3.0). The odds ratio increased further to 2.5(1.2, 5.2) after adjustment for age, family history of hypertension and physical activity. The association remained after further adjusting for body mass index in the final model; 2.20 (1.06, 4.57).Women who develop hypertension in pregnancy are at higher risk of developing essential hypertension later in life. more...
- Published
- 2016
18. Cutaneous Ulcers as Initial Presentation of Localized Granulomatosis with Polyangiitis: A Case Report and Review of the Literature
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Syed Ahsan Ali, Noreen Nasir, and Hafiz Mohammed Mehmood Riaz
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Pathology ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,End organ damage ,business.industry ,Case Report ,General Medicine ,Disease ,medicine.disease ,Connective tissue disease ,medicine.anatomical_structure ,medicine ,Etiology ,lcsh:RC925-935 ,Presentation (obstetrics) ,Granulomatosis with polyangiitis ,business ,Respiratory tract ,Systemic vasculitis - Abstract
Background. Granulomatosis with polyangiitis (GPA) is an ANCA associated small vessel vasculitis characterized by necrotizing granulomatous inflammation involving the upper and the lower respiratory tract and the kidneys. The disease has a broad clinical spectrum that ranges from limited/localized involvement of a single organ system to a generalized systemic vasculitis that affects several organs with evidence of end organ damage. Atypical forms of the disease have been recognized with or without respiratory tract involvement with a long protracted course before manifesting as generalized disease.Case Presentation. We describe a 57-year-old woman who presented with recurrent fever and cutaneous ulcers on her legs who was diagnosed to have granulomatosis with polyangiitis (GPA) after an extensive evaluation which excluded infectious, other vasculitides, connective tissue disease and malignant etiologies.Conclusion. In the absence of typical manifestations, granulomatosis with polyangiitis (GPA) is indeed a diagnostic challenge to the physician. Atypical manifestations like unexplained recurrent fever and cutaneous ulcers nevertheless call for keeping a low threshold for the diagnosis of GPA as the disease can initially present in localized form before heralding into a generalized disease. more...
- Published
- 2015
19. Dengue Hemorrhagic Fever Complicated by Intercostal Artery Hemorrhage
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Syed Ahsan, Ali, Sara, Ahmed, and Mehmood, Riaz
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Dengue ,Male ,Hematoma ,Thoracic Arteries ,Treatment Outcome ,Rupture, Spontaneous ,Angiography ,Humans ,Hemorrhage ,Embolization, Therapeutic ,Aged - Abstract
Hemorrhagic manifestations are fairly common in Dengue hemorrhagic fever and are associated with increased mortality. During last few decades there have been increasing reports of Dengue infection with unusual manifestations. Here we present a case of dengue hemorrhagic fever complicated by spontaneous rupture of an intercostal artery leading to a large hematoma which was treated successfully with angio-embolization. To the authors' knowledge this is a first case of dengue hemorrhagic fever complicated by spontaneous intercostal artery hemorrhage. more...
- Published
- 2014
20. Does methotrexate increase the risk of varicella or herpes zoster infection in patients with rheumatoid arthritis? A systematic literature review
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Natalie, Zhang, Sarah, Wilkinson, Mehmood, Riaz, Andrew J K, Östör, and Muhammad K, Nisar
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Adult ,Arthritis, Rheumatoid ,Chickenpox ,Methotrexate ,Risk Factors ,Antirheumatic Agents ,Humans ,Middle Aged ,Herpes Zoster ,Risk Assessment ,Aged - Abstract
Methotrexate (MTX) has become the foundation disease-modifying anti-rheumatic drug (DMARD) for RA. However, concern exists regarding its possible association with infectious complications including varicella zoster virus (VZV) and herpes zoster (HZ). Furthermore, no consensus exists regarding pre-MTX VZV screening or the use of VZV vaccine.We undertook systematic literature review (SLR) investigating the relationship between the use of MTX in patients with RA and VZV and HZ infection. Additionally, the European Centre for Disease Prevention and Control, HPA, the CDC, Rheumatology societies and WHO web sites and publications were consulted.Thirty-five studies fulfilled the inclusion criteria comprising 29 observational studies and 6 case reports. The case reports and 13 observation studies considered the association between MTX and HZ. Three of the observational studies reported a positive association although in 5 cases, patients were concurrently treated with prednisolone. Five studies concluded that there was no association between HZ and MTX. Three studies comparing the infection rates of MTX with other RA therapies found that MTX did not result in higher HZ infection rates. Three studies examining the association between HZ and MTX treatment duration failed to show a link.No evidence exists to support an association between MTX and VZV infection in RA patients and the data regarding the role of MTX in HZ development is conflicting. The role of pre-MTX VZV screening is controversial and, as it may delay initiation of RA treatment, we suggest against VZV screening in this context. more...
- Published
- 2012
21. Efficacy and safety of quinine loading dose in patients with severe falciparum malaria at a tertiary care hospital in Pakistan
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Muhammad, Tariq, Taimur, Saleem, Hamid, Ullah, Vikram, Mehraj, Abdul Jawwad, Samdani, Syeda Hena, Kazmi, Syed Imran, Ayaz, Mehmood, Riaz, Mohammed Junaid, Patel, Jaweed, Akhtar, and Mohammed Asim, Beg more...
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Adult ,Male ,Adolescent ,Dose-Response Relationship, Drug ,Quinine ,Middle Aged ,Parasitemia ,Severity of Illness Index ,Parasite Load ,Antimalarials ,Young Adult ,Treatment Outcome ,Humans ,Female ,Pakistan ,Malaria, Falciparum ,Child ,Hospitals, Teaching ,Infusions, Intravenous ,Aged ,Retrospective Studies - Abstract
To compare the clinical outcomes of a loading dose regimen of quinine with a uniform dose regimen in patients with severe falciparum malaria.A retrospective chart review of 315 patients admitted with severe falciparum malaria and treated with quinine at a tertiary care teaching hospital of Karachi, Pakistan during 1999-2006 was conducted. Group A with 103 patients (32.7%) was given an initial loading dose of quinine while group B with 212 patients (67.3%) did not receive the loading dose. The two groups were compared in terms of reduction of parasite load, resolution of fever, recovery of consciousness and incidence of adverse effects. Outcome parameters were measured on the third day of therapy.More individuals in group A (62.1%) were afebrile as compared to group B (54.7%) at day 3 of therapy. Patients in group B showed greater reduction in parasitaemia (47.2% at baseline to 4.7% on day 3) as compared to group A (56.3 % at baseline to 9.7% on day 3). Following therapy, fewer patients in group B had altered consciousness (7.1% at baseline to 4.7% on day 3) as compared to patients in group A (7.8% at baseline to 5.8% on day 3). However, these associations were not statistically significant. The incidence of thrombocytopenia was higher in Group A (5.8%) as compared to Group B (0.9%).Although quinine loading dose may be more effective than uniform dose in rapid fever clearance; it also appears to be associated with higher toxicity. Uniform dose of quinine may be prescribed in severe falciparum malaria in view of its better safety profile. more...
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- 2012
22. Clinical characteristics and predictors of positive stool culture in adult patients with acute gastroenteritis
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Muhammad Mehmood, Riaz, Muhammad Junaid, Patel, Muhammad Shoaib, Khan, Muhammad Ali, Anwar, Muhammad, Tariq, Harith, Hilal, Safia, Awan, and Shahzad, Razi
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Adult ,Diarrhea ,Male ,Campylobacter ,Length of Stay ,Middle Aged ,Gastroenteritis ,Community-Acquired Infections ,Feces ,Young Adult ,Age Distribution ,Logistic Models ,Treatment Outcome ,Ciprofloxacin ,Predictive Value of Tests ,Salmonella ,Acute Disease ,Prevalence ,Fluid Therapy ,Humans ,Female ,Pakistan ,Shigella ,Vibrio cholerae - Abstract
To identify the presenting features and spectrum of pathogens in adult patients with acute diarrhoea and to determine the predictors of stool culture positivity.A descriptive study was conducted in a tertiary care hospital from April 1, 2005 to March 31, 2006. Medical records of all consecutive adult patients with history of acute diarrhoea were reviewed between June 2006 to December 2006 for clinical characteristics and laboratory investigations.A total of 454 patients were admitted from April 1, 2005 to March 31, 2006. Stool cultures were performed in 233 (50%) patients, 96 (42%) had positive results. Patients with positive stool culture compared to a negative Culture were found to have a younger mean age (43 vs. 53), greater number of unformed stools (16 vs. 11) and low serum bicarbonate level (16 vs. 20). Vibrio cholerae (86%) was found to be the most prevalent organism followed by Salmonella spp (6%), Campylobacter spp (5.2%), Shigella spp (2%). Ciprofloxacin was given to 97% patients along with fluid administration, and 78% were found to be resistant to quinolones. Most patients recovered before the finalized stool culture results.Careful selection of the patients based on their clinical presentation and initial laboratory work up can help to decide ordering of stool culture in adults with diarrhoea. Fluid resuscitation remains the main stay of treatment. more...
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- 2012
23. Copper sulphate toxicity in a young male complicated by methemoglobinemia, rhabdomyolysis and renal failure
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Sarah, Hassan, Mohammad Usman, Shaikh, Natasha, Ali, and Mehmood, Riaz
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Male ,Young Adult ,Copper Sulfate ,Poisoning ,Humans ,Dimercaprol ,Acute Kidney Injury ,Methemoglobinemia ,Rhabdomyolysis ,Chelating Agents - Abstract
Copper sulphate is a compound prepared by the action of sulphuric acid on copper II. Copper sulphate is widely used asfungicide, herbicide and for photography. In a human being, it can lead to anemia. Medical literature is lacking regarding accidental or suicidal poisoning cases of copper sulphate in Pakistan. We present a case of accidental ingestion of copper sulphate resulting in severe acute toxicity, which was successfully managed by intensive supportive measures and Dimercaprol (BAL). more...
- Published
- 2009
24. Massive fluid requirements and an unusual BUN/creatinine ratio for pre-renal failure in patients with cholera
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Saqib Ali Gowani, Raymond A. Smego, Mehmood Riaz, Rabeeya Nusrat, Bushra Jamil, Asif Jafferani, Sana Shoukat, Junaid Patel, Murtaza Memon, and Muhammad Usman Tariq
- Subjects
Adult ,Diarrhea ,Male ,Infectious Diseases/Gastrointestinal Infections ,medicine.medical_specialty ,medicine.medical_treatment ,Public Health and Epidemiology/Infectious Diseases ,lcsh:Medicine ,Gastroenterology ,Blood Urea Nitrogen ,chemistry.chemical_compound ,Cholera ,Internal medicine ,medicine ,Humans ,In patient ,Renal Insufficiency ,Oral rehydration therapy ,lcsh:Science ,Blood urea nitrogen ,Retrospective Studies ,Creatinine ,Multidisciplinary ,Dehydration ,business.industry ,lcsh:R ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Gastroenterology and Hepatology/Gastrointestinal Infections ,chemistry ,Fluid Therapy ,Female ,lcsh:Q ,medicine.symptom ,business ,Research Article ,Sudden onset - Abstract
BACKGROUND:Cholera is an important infectious cause of secretory diarrhea. The primary symptom of infection is the sudden onset of watery diarrhea with subsequent volume depletion causing renal insufficiency. The objective of this research is to study the level of dehydration at presentation and subsequent fluid management in patients with cholera. METHODS:This study was conducted on 191 patients of Cholera admitted at a tertiary care hospital in Karachi, Pakistan during the period of 5 years. Medical charts were evaluated retrospectively for initial hydration status, baseline lab investigations on admission and discharge and fluid therapy given to all the patients while their stay in the hospital and the data was analyzed on SPSS 15.0. RESULTS:Out of the 191 patients, 83(43%) were males and 108 (57%) were females with mean age of 42.3 years (SD+/-18.34). The average duration of symptoms was 3.75 days (SD+/-2.04). Of 191 patients, 175 (92.1%) presented with dehydration, 80 (42.3%) were given Ringer's Lactate (R/L) + Normal Saline (N/S), 45 (24%) patients were given R/L + N/S + Oral Rehydration Therapy (ORS), 27 (14.3%) of the patients were kept on R/L only and remaining were given various combinations of R/L, N/S, ORS and Dextrose Saline (D/S). On admission mean Blood Urea Nitrogen (BUN) was 24.54 (SD+/-16.6), mean creatinine was 2.47 (SD+/-2.35) and mean BUN/Creatinine ratio was 11.63 (SD+/-5.7). CONCLUSION:Aggressive fluid rehydration remains the cornerstone of management of cholera. Instead of presenting with a classical BUN/Creatinine ratio of >20:1, patients with pre-renal failure in cholera may present with a BUN/Creatinine ratio of more...
- Published
- 2009
25. Outbreak of dengue fever in Karachi 2006: a clinical perspective
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Muhammad Mehmood, Riaz, Khalid, Mumtaz, Muhammad Shoaib, Khan, Junaid, Patel, Muhammad, Tariq, Harith, Hilal, Shaheryar Ahmed, Siddiqui, and Farrukh, Shezad
- Subjects
Adult ,Male ,Cross-Sectional Studies ,Immunoglobulin M ,Seroepidemiologic Studies ,Humans ,Female ,Pakistan ,Health Care Costs ,Severe Dengue ,Dengue Virus ,Antibodies, Viral ,Disease Outbreaks - Abstract
This study reports clinical manifestations and spectrum of severity of dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) in adult patients admitted during 2006 outbreak in Karachi. A rough estimation of cost of care was also calculated.A cross-sectional study was done at a tertiary care hospital in Karachi from January to December 2006. Patients suspected of having DF with positive dengue IgM antibodies were included and records were reviewed. Patients were divided into DF, DHF and DSS as per WHO classification, and the severity of clinical manifestations was determined.A total of 278 (65.72%) of 423 patients admitted with suspected dengue illness had positive IgM titer. Mean age was 31 +/- 12.9 years, with 168 (60%) males and 110 (40%) females. Common presenting symptoms were fever (100%), vomiting (78%), epigastric pain (52%), bleeding tendencies (34%), and erythematous rash (33%). Thrombocytopenia (60%), Leucopenia (45%), elevated transaminases (ALT 71%; AST 88%), and deranged PT (22%) and aPTT (75%) were the predominant. Laboratory parameters: DF was diagnosed in 169 (61%) patients, 82 (29%) were classified as DHF, and 27 (10%) as DSS. Patients with DHF/DSS were younger30 years (n=60, 55%) and had longer hospital stay (p=0.001). Case fatality rate for DHF/DSS group was 4.6%.It was estimated that endemicity of DF is on the rise in Karachi and a significant proportion of patients had DHF and DSS. Younger patients develop DHF and DSS and have high case fatality rate. more...
- Published
- 2009
26. Dengue fever with hepatitis E and hepatitis A infection
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Javed, Yakoob, Wasim, Jafri, Shaheer, Siddiqui, and Mehmood, Riaz
- Subjects
Dengue ,Adolescent ,Immunoglobulin M ,Hepatitis E virus ,Humans ,Enzyme-Linked Immunosorbent Assay ,Female ,Dengue Virus ,Hepatitis A ,Hepatitis A Virus, Human ,Hepatitis E - Abstract
Infection with dengue viruses produces a spectrum of clinical illness ranging from a nonspecific viral syndrome to severe and fatal haemorrhagic disease. Important risk factors include the strain and serotype of the infecting virus, as well as the age, immune status, and genetic predisposition of the patient. The teaching point in this case study was Dengue fever which occurred concomitantly with Hepatitis A and Hepatitis E virus infection. more...
- Published
- 2009
27. Drug overdose: a wake up call! Experience at a tertiary care centre in Karachi, Pakistan
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Muhammad Junaid, Patel, Muhammad, Shahid, Mehmood, Riaz, Waqaruddin, Kashif, Syed Imran, Ayaz, Muhammad Shoaib, Khan, A Jawwad, Samdani, Ayesha L, Sorathia, and Muhammad, Furqan
- Subjects
Adult ,Male ,Middle Aged ,Analgesics, Opioid ,Benzodiazepines ,Accidents, Home ,Risk Factors ,Humans ,Anticonvulsants ,Female ,Pakistan ,Warfarin ,Drug Overdose ,Retrospective Studies - Abstract
To study the characteristics of patients admitted with drug overdose caused either by accidental overdose of the prescribed medications or as an act of deliberate self harm (DSH) at a tertiary care hospital in Karachi, Pakistan.A retrospective case series review was conducted at the Aga Khan University Hospital from January 2002 to October 2006. Three hundred and twenty four adult patients admitted with drug overdose were included in the study.Our sample group revealed mean age of 36.2 +/- 17.0 years, more females (59%), housewives (34%), and students (20%). Fifty six percent of patients committing DSH were married (p = 0.001), 81% needed in-patient psychiatric services (p = 0.016) of whom a significantly high number (38%) refused it. Domestic and social issues were rated highest among DSH group (p = 0.003), depression among females was common (p = 0.028) and Benzodiazepines (41%) was the most frequently used drug (p = 0.021). Sub-group analysis of accidental overdoses revealed mean age of 45.6 +/- 19.6 years, single (75.4%) and males (54.1%). Drugs used were mainly Benzodiazepines (18%) followed by Opioids (11%), Antiepileptics (10%) and Warfarin (10%).Our study showed that depressed housewives are at greater risk for DSH. Domestic and social issues were rated highest and Benzodiazepines were the most commonly used agents. Most of our patients refused inpatient psychiatric treatment leading us to believe that general awareness of psychiatric illnesses is imperative in our community. High number of accidental overdoses is alarming in older, single males convincing us to believe that existing pharmacy system needs further evaluation and modification. more...
- Published
- 2008
28. Knowledge about osteoporosis among healthy women attending a tertiary care hospital
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Mehmood, Riaz, Naushad, Abid, Junaid, Patel, Muhammad, Tariq, Muhammad Shoaib, Khan, and Lubna, Zuberi
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Adult ,Health Knowledge, Attitudes, Practice ,Cross-Sectional Studies ,Socioeconomic Factors ,Risk Factors ,Surveys and Questionnaires ,Age Factors ,Humans ,Osteoporosis ,Women's Health ,Female ,Pakistan ,Middle Aged - Abstract
To determinate the knowledge on osteoporosis-risk factors and disease in three age groups of Pakistani women.In this exploratory cross-sectional study, an osteoporosis knowledge assessment questionnaire (OKAT) was used to collect data and it was delivered through a face-to-face interview. Questions were asked about symptoms of osteoporosis, knowledge of risk factors, preventive factors and treatment. A convenience sample (n =320) comprising of three groups of healthy women aged 25-35 years, 36-45 years, and over 45 years was taken. The scoring range was 0 to 20. Among-group comparisions of means were analyzed by two-way ANOVA. To determine the overall influence of osteoporosis-risk factors, the multivariate analysis was used.The knowledge on osteoporosis in younger women was very poor compared to relatively older females. However, women belonging to higher socioeconomic status and better education had slightly more knowledge about osteoporosis compared to those with a low education level, regardless of age.The majority of women had modest knowledge on osteoporosis. Younger women were at increased risk for low bone mass and premature osteoporosis. more...
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- 2008
29. Preventive medicine practices by primary care providers in Karachi
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Muhammad Junaid, Patel, Nawal, Salahuddin, Waqar, Kashif, Mehmood, Riaz, Muhammad, Tariq, A Jawwad, Samdani, M Shoaib, Khan, Syed Imran, Ayaz, Ayesha, Sorathia, and Muhammad, Furqan
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Adult ,Male ,Attitude of Health Personnel ,Age Factors ,Physicians, Family ,Primary Prevention ,Sex Factors ,Surveys and Questionnaires ,Preventive Health Services ,Humans ,Female ,Pakistan ,Preventive Medicine ,Delivery of Health Care - Published
- 2007
30. Career goals of trainee physicians in internal medicine
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Muhammad Junaid, Patel, Mehmood, Riaz, Muhammad, Tariq, Sajjad, Jamil, Tayyaba, Ansari, M Shoaib, Khan, Abdul Jawwad, Samdani, Syed Imran, Ayaz, Ayesha, Sorathia, and Jaweed, Akhtar
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Male ,Career Choice ,Surveys and Questionnaires ,Decision Making ,Internal Medicine ,Humans ,Internship and Residency ,Female ,Pakistan - Abstract
To survey Internal Medicine trainees' future career choices and factors influencing their decision-making.Cross-sectional study.The Aga Khan University Hospital, Karachi, from November 2006 to January 2007.A standard questionnaire was administered to the residents and Interns working in the Department of Internal Medicine of The Aga Khan University Hospital. The questionnaire covered demographic details, specialty choice, work-time distribution and factors influencing career choice. Descriptive statistics were applied.A total of 49 doctors participated with 57% females; and 43% males, having 33% interns and 67% residents. A minority (22%) opted for internal medicine, while 78% selected sub-specialties with cardiology (20%) being the most sought- after sub-specialty. Majority (69%) wanted to spend more time in clinical activities compared to administration (18%) or research (13%). Majority (92%) wanted to work in an academic setting. Availability of a structured training program (61%), ability to practice broad area of medicine (41%) and prestige of the specialty (41%) highly influenced their career choices. Forty one (82%) wanted to proceed abroad for further training and 80% wanted to eventually practice in Pakistan.Most of the interviewed under-training physicians wanted to pursue sub-specialty. Clinical work was more attractive compared to research. A structured training program was detrimental in affecting their choices. Majority wanted further training abroad but eventual settlement in Pakistan. The study results can help us create the basis for reforming the current training programs. more...
- Published
- 2007
31. Parotid gland sarcoidosis with renal failure
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Muhammad Azhar, Uddin, Mehmood, Riaz, and Maqsood A, Bhatti
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Sarcoidosis ,Humans ,Female ,Parotid Diseases ,Renal Insufficiency - Abstract
Sarcoidosis is a multisystem granulomatous disorder of unknown etiology. Although any organ can be involved in sarcoidosis, significant renal involvement is rare, mostly due to nephrocalcinosis. Renal impairment in the absence of nephrocalcinosis is uncommon and is usually due to glomerulonephritis or granulomatous pathology in the interstitium. Bilateral parotid swelling with renal impairment, as a presenting feature of sarcoidosis, as in this case, has never been reported before. more...
- Published
- 2004
32. Cutaneous Ulcers as Initial Presentation of Localized Granulomatosis with Polyangiitis: A Case Report and Review of the Literature
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Nasir, Noreen, primary, Ali, Syed Ahsan, additional, and Mehmood Riaz, Hafiz Mohammed, additional
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- 2015
- Full Text
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33. Drift Line = à la dérive
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Lessard, Denis, Mehmood, Riaz, Olanick, Natalie, Stuart, Jasia, Frosst, Andrew, Charpentier, Elsa, Maclellan, Jenna Dawn, Chabauty, Marie-Claire, Fournier, Nicole, Delfolie-Noulin, Dider, Lessard, Denis, Mehmood, Riaz, Olanick, Natalie, Stuart, Jasia, Frosst, Andrew, Charpentier, Elsa, Maclellan, Jenna Dawn, Chabauty, Marie-Claire, Fournier, Nicole, and Delfolie-Noulin, Dider more...
- Published
- 2010
34. The learners' perspective on internal medicine ward rounds: a cross-sectional study
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Afaq Motiwala, Syed Umer Ali, Muhammad Usman Tariq, Safia Awan, Mehmood Riaz, and Jaweed Akhter
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Male ,medicine.medical_specialty ,Conference room ,Attitude of Health Personnel ,Cross-sectional study ,education ,MEDLINE ,lcsh:Medicine ,Education ,Physicians ,Surveys and Questionnaires ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Teaching Rounds ,Medicine(all) ,lcsh:LC8-6691 ,Medical education ,lcsh:Special aspects of education ,business.industry ,lcsh:R ,General Medicine ,Cross-Sectional Studies ,Education, Medical, Graduate ,Family medicine ,Female ,Communication skills ,Bedside teaching ,business ,Clinical skills ,Research Article - Abstract
Background Ward rounds form an integral part of Internal Medicine teaching. This study aimed to determine the trainees' opinions regarding various aspects of their ward rounds, including how well they cover their learning needs, how they would like the rounds to be conducted, and differences of opinion between medical students and postgraduates. Methods A cross-sectional study was conducted on a total of 134 trainees in Internal Medicine, comprising medical students, interns, residents and fellows, who were asked to fill in a structured, self-designed questionnaire. Most of the responses required a rating on a scale of 1-5 (1 being highly unsatisfactory and 5 being highly satisfactory). Results Teaching of clinical skills and bedside teaching received the lowest overall mean score (Mean ± SD 2.48 ± 1.02 and 2.49 ± 1.12 respectively). They were rated much lower by postgraduates as compared to students (p < 0.001). All respondents felt that management of patients was the aspect best covered by the current ward rounds (Mean ± SD 3.71 ± 0.72). For their desired ward rounds, management of patients received the highest score (Mean ± SD 4.64 ± 0.55), followed by bedside examinations (Mean ± SD 4.60 ± 0.61) and clinical skills teaching (Mean ± SD 4.50 ± 0.68). The postgraduates desired a lot more focus on communication skills, counselling and medical ethics as compared to students, whose primary focus was teaching of bedside examination and management. A majority of the respondents (87%) preferred bedside rounds over conference room rounds. Even though the duration of rounds was found to be adequate, a majority of the trainees (68%) felt there was a lack of individual attention during ward rounds. Conclusions This study highlights important areas where ward rounds need improvement in order to maximize their benefit to the learners. There is a need to modify the current state of ward rounds in order to address the needs and expectations of trainees. more...
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35. Telemedicine for Rheumatology Patients in Covid-19 Pandemic: Perspectives of Patients
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Muhammad Mehmood Riaz FCPS, Saad Bin Zafar Mahmood FCPS, and Noreen Nasir FCPS
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Medicine (General) ,R5-920 - Abstract
Telemedicine use for patients with autoimmune rheumatic conditions during the pandemic mandates better characterization. We conducted a telephonic survey on patients who consulted rheumatologists remotely to determine their attitudes toward telemedicine. The study was conducted at Aga Khan University Hospital, a tertiary care hospital in Pakistan which is a lower-middle-income country. Descriptive analyses were performed. Fifty patients visited tele-rheumatology clinic, 35 (70.0%) were female with a mean (SD) age of 47.6 (18.1) years. Majority (27, 54.0%) learned about telemedicine from hospital website and outpatient clinic desk or helpline. Lack of examination was the biggest concern with teleconsultation (18, 22.2%). Most patients (38, 76.0%) agreed to continue teleconsultation beyond the pandemic. Telemedicine is preferable for providing rheumatology outpatient service during and after the pandemic. more...
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- 2022
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36. Adult-onset chronic recurrent multifocal osteomyelitis: A case report of a rare entity.
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Jibril H, Riaz M, and Ali SA
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Background: Chronic recurrent multifocal osteomyelitis is a rare autoimmune disorder causing inflammatory joint lesions. It has an estimated prevalence of 1-2 per million while adult-onset disease constitutes only 6.3% of patients., Case Report: We present a case of a 44 years old male who presented to the rheumatology clinic with lower back pain for twelve years. Magnetic resonance imaging of the lumbosacral spine showed ovoid areas of abnormal signal intensities along superior and inferior endplates of multiple vertebrae of the dorsolumbar and sacral spine. Computed tomography guided biopsy of L4 vertebrae was done. Histopathology revealed linear cores of degenerating fibrocartilage focally exhibiting small spicules of mineralized bone and fibro-collagenous tissue. He initially did not respond to traditional therapy. His symptoms improved with the addition of a Janus Kinase inhibitor. To the best of our knowledge, this is the first case of chronic recurrent multifocal osteomyelitis to be reported from Pakistan., (Copyright: © Pakistan Journal of Medical Sciences.) more...
- Published
- 2024
- Full Text
- View/download PDF
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