- Department of Rehabilitation Medicine
PNS Shifa Hospital, DHA II, Karachi, Pakistan - 00923200400675
- Physical Medicine and Rehabilitation, Medical Education (in Education), Neurology, Medical Rehabilitation in Disasters, Cardiac/Stroke Rehabilitation, Spinal Cord Injury, and 7 moreParaplegia, Rehabilitation Medicine, Stroke rehabilitation, Epidemiology, Pakistan, Surgery, and Orthopedic Surgeryedit
Long COVID is a term used to describe the persistence of symptoms in people who have had COVID-19 for an extended period. It affects multiple systems including neurological (fatigue, brain fog, attention issues, memory issues),... more
Long COVID is a term used to describe the persistence of symptoms in people who have had COVID-19 for an extended period. It affects multiple systems including neurological (fatigue, brain fog, attention issues, memory issues), neuromuscular (sarcopenia, myositis, arthritis and myopathy), cardiovascular (myopericarditis, right ventricular dysfunction, vasculitis and aortic, arterial and venous thrombosis) and respiratory (pulmonary fibrosis, pleurisy, pulmonary embolism and pneumonitis). This results in functional impairments which adversely affect the quality of life of patients. The rehabilitation of persons who have experienced long COVID-19, also known as "long haulers," is a relatively new field of study. We have described potential rehabilitation interventions to improve functional capacity and quality of life in patients with long COVID. These rehabilitation interventions include but are not limited to, endurance, flexibility and strength training, pulmonary rehabil...
Research Interests:
Artificial intelligence (AI) is increasingly being used in the field of healthcare to improve the efficiency and accuracy of medical diagnoses, treatment plans, and decisionmaking.1 It has the potential to transform the way healthcare is... more
Artificial intelligence (AI) is increasingly being used in the field of healthcare to improve the efficiency and accuracy of medical diagnoses, treatment plans, and decisionmaking.1 It has the potential to transform the way healthcare is delivered and improve patient outcomes. There are many examples of the use of artificial intelligence (AI) in healthcare. One way that AI is being used in healthcare is by developing machine learning algorithms that can analyze vast amounts of patient data and identify patterns and trends that may not be immediately apparent to humans.2 This can be particularly useful in identifying early signs of diseases or conditions, allowing for earlier diagnosis, treatment, prognosis evaluation, and more. Another application of AI in healthcare is through the use of natural language processing (NLP). NLP systems can analyze electronic medical records (EMR) and extract important information, allowing healthcare providers to access and interpret patient data con...
Research Interests:
Physical medicine and rehabilitation (PMR) is evolving in low- to middle-income countries. Although established as a separate specialty in Bangladesh 40 years ago, there has been no formal documentation of the history and current state of... more
Physical medicine and rehabilitation (PMR) is evolving in low- to middle-income countries. Although established as a separate specialty in Bangladesh 40 years ago, there has been no formal documentation of the history and current state of PMR, or associated disability issues in Bangladesh. The aim of this review is to provide a brief overview of the health-care system in Bangladesh, to discuss the available disability statistics, legislation for persons with disability (PWD), and current system(s) of disability management in the country. The evolution of PMR is presented along with an exploration of future perspectives. Data sources included an online literature search (English language only; 1970–2018) with predefined keywords. Official government websites were examined for disability-related statistics, and informal interviews with Bangladeshi government officials and rehabilitation professionals provided further insights. The reported disability prevalence in Bangladesh varies widely from 5.6% to 16.2%. Currently, there are 130 physiatrists, and over 1400 physiotherapists, 190 occupational therapists, and 200 speech and language therapists. A developing economy, illiteracy, maldistributions of wealth, and a rising prevalence of chronic diseases add to the burden of the existing disability. Legislations have been passed with an aim to protect the rights and dignity of PWD, but there are major barriers in implementing the acts. Social stigmatization of PWD remains largely unaddressed, with low rates of community reintegration. PWD also face mobility barriers and accessibility issues. PMR and other rehabilitation services are improving, but disability management is largely considered a social issue rather than a medical problem. There is a need to involve all stakeholders in disability management to strengthen medical rehabilitation and improve service delivery, while advocating for the rights of PWD.
Research Interests:
Research Interests:
Research Interests:
To audit the number and type of published articles related to medical education in leading Pakistani biomedical journals. The audit covered the period from January 2001 to December 2013. Journals either indexed in Medline or having an... more
To audit the number and type of published articles related to medical education in leading Pakistani biomedical journals. The audit covered the period from January 2001 to December 2013. Journals either indexed in Medline or having an impact factor were selected. The audit was done in two phases. First, articles related to medical education were screened by reading the titles. Then abstracts were studied and articles were placed into several pre-defined categories based on article type and research topic. Data was analysed using SPSS 20. A total of 118 relevant articles were published. Of them, 60(51%) articles were published in the Journal of Pakistan Medical Association, 42(35.6%) in the Journal of College of Physicians and Surgeons Pakistan, 4(3.4%) in Pakistan Journal of Medical Sciences, and 12(10.2%) in the Journal of Ayub Medical College. Articles related to curriculum development were 33(28.0 %), teaching 28(23.7%), assessment 29(24.6%), faculty training 5(4.2%), continuous ...
Research Interests:
OBJECTIVES: To explore the general knowledge of Pakistani healthcare professionals about basic facts related to disability and its management. METHODS: A structured questionnaire consisting of four questions was devised. Questionnaires... more
OBJECTIVES: To explore the general knowledge of Pakistani healthcare professionals about basic facts related to disability and its management. METHODS: A structured questionnaire consisting of four questions was devised. Questionnaires were distributed among 550 healthcare professionals working in the leading health care institutes/centers in major cities of the country (Islamabad, Lahore, Karachi, Quetta and Peshawar). RESULTS: 477 forms (Response rate 86.7%) were returned and 96 were discarded (incomplete or ...
Objective: This study analyzed the published research on gout and hyperuricemia in the national biomedical journals with an aim to highlight the research gaps in the management of gout and hyperuricemia in Pakistan. Methods: An online... more
Objective: This study analyzed the published research on gout and hyperuricemia in the national biomedical journals with an aim to highlight the research gaps in the management of gout and hyperuricemia in Pakistan. Methods: An online literature survey on global databases (Medline and Google Scholar) and local Pakistani database Pak Medinet was conducted from January to March 2018. Different keywords on gout and hyperuricemia in Pakistan were combined using Boolean operators. We included all kinds of manuscripts reporting work specifically related to gout or hyperuricemia from Pakistan and having the corresponding author or at least one author with an affiliation from a Pakistani institution. We also considered manuscript published on this topic in Pakistani journals by authors affiliated with other countries. Results: Thirty-four manuscripts were selected for review and analysis. Thirty-one manuscripts were written by local authors affiliated with institutions located in different ...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Background: Few studies have explored the determinants of health-related quality of life (HRQoL) in the elderly during the COVID-19 pandemic. Identifying these factors may help implement appropriate policies to enhance HRQoL in the... more
Background: Few studies have explored the determinants of health-related quality of life (HRQoL) in the elderly during the COVID-19 pandemic. Identifying these factors may help implement appropriate policies to enhance HRQoL in the elderly. Therefore, we aimed to identify the predictors of physical and mental component summary (PCS and MCS) scores of HRQoL in selected six low- and middle-income Asian countries. Methods: We conducted an online survey of older people aged ≥55 years in six countries: Bangladesh, Iran, Iraq, Malaysia, Palestine, and Sri Lanka. The Stark QoL questionnaire was used to measure the PCS and MCS scores. Univariate and multiple variable analyses after adjusting for confounders were performed to identify the possible predictors of PCS and MCS. Results: A total of 1644 older people (69.1 ± 7.8 years, range 55–97 years, Female: 50.9%) responded to the survey. We documented age, country of residence, marital status, number of male children, current employment stat...
Research Interests:
Diabetes Mellitus (DM) is one of the most common metabolic disorders in the world. It can result in several neurological and musculoskeletal (MSK) conditions. These conditions adversely affect the mobility, community functioning and... more
Diabetes Mellitus (DM) is one of the most common metabolic disorders in the world. It can result in several neurological and musculoskeletal (MSK) conditions. These conditions adversely affect the mobility, community functioning and quality of life for the patient with DM. Rehabilitation Medicine Physicians (Physiatrists) can offer both diagnostic and therapeutic interventions for the accurate diagnosis and optimal management of neurological and MSK conditions associated with DM. These include diagnostic tests such as Nerve Conduction Studies and Electromyography, therapeutic interventions in form of pharmacological management of symptoms, prescription of appropriate physical therapy, occupational therapeutic exercise, injections, as well as psychosocial and cognitive interventions. A physiatrist can provide expert advice on musculoskeletal disorders in patients with DM, as they are formally trained in the evaluation, diagnosis, and management of MSK conditions. A multidisciplinary ...
Research Interests:
Research Interests:
Virtual reality (VR) uses computer-generated simulations to create a virtual environment for users which appears, sounds, and feels like real-life objects and events. The use of VR in rehabilitation is relatively new and has demonstrated... more
Virtual reality (VR) uses computer-generated simulations to create a virtual environment for users which appears, sounds, and feels like real-life objects and events. The use of VR in rehabilitation is relatively new and has demonstrated to be an effective tool in achieving desired clinical outcomes by active engagement of participants. Over the past few years, the use of VR in rehabilitation has rapidly increased because of its advantages over traditional rehabilitation techniques. These include better patient adherence to the rehabilitation protocols with high levels of engagement and motivation. This review summarisesthe available evidence on the role of VR in rehabilitation, its effects, and scope across different clinical conditions andoutcomes. We also describe the current status of VR utilization in rehabilitation settings across Pakistan and highlight the need for further research.Keywords: Virtual reality, exergaming, augmented reality, narrative review, neurorehabilitatio...
Research Interests:
The novel coronavirus (COVID-19) pandemic has spread globally to more than 200 countries with more than 5 million confirmed cases World Health Organization and other global public health organizations have issued guidelines to prevent the... more
The novel coronavirus (COVID-19) pandemic has spread globally to more than 200 countries with more than 5 million confirmed cases World Health Organization and other global public health organizations have issued guidelines to prevent the community spread of virus These include basic measures like repeated hand washing, social distancing, and cough etiquettes Advice regarding disinfection of surfaces have also bee circulated Due to the infodemic and misinformation public and even institutions particularly in the developing world have adopted certain unproven measure which have the potential to do more harm than good We describe one such measure being commonly used called Sanitization walk through gate or anti-viral gate We discuss how this tool is totally ineffective in protecting against the spread of COVID-I9 and only offers a false sense of security There are concerns that such measure may discourage public to forgo the established and recommended practices in favor of these stra...
Research Interests:
The prevalence of disability is substantiallyhigher in the low-incomecountries as compared to the high-incomecountries.1 An estimated 80% ofthe people with disabilities live in thelow-income countries, which is morethan one billion people... more
The prevalence of disability is substantiallyhigher in the low-incomecountries as compared to the high-incomecountries.1 An estimated 80% ofthe people with disabilities live in thelow-income countries, which is morethan one billion people with disabilitiesaccording to the world report ondisability.2 Among these persons withdisabilities (PWD), 110-190 million havesignificant disabilities including difficultyin mobility, self-care, communicationand participation in education or employment.Neurological disorders likestroke, spinal cord injuries, traumatic andnon-traumatic brain diseases and neurodegenerativediseases are an importantcause of disability worldwide. Most ofthem result in long-term disabilities andresidual weaknesses, which adverselyaffects the mobility and quality of thelife of the patients. In addition, long-termmanagement of these often-permanentdisabilities is “a huge unmeasured economicburden and psychological stresson families who take care of their functionallydepend...
Research Interests:
Research Interests:
Research Interests:
The Coronavirus disease due to SARS-CoV-2 emerged in Wuhan city, China in December 2019 and rapidly spread more than 200 countries as a global health pandemic. There are more 3 million confirmed cases and around 207,000 fatalities. The... more
The Coronavirus disease due to SARS-CoV-2 emerged in Wuhan city, China in December 2019 and rapidly spread more than 200 countries as a global health pandemic. There are more 3 million confirmed cases and around 207,000 fatalities. The primary manifestation is respiratory and cardiac but neurological manifestations are being reported in the literature as case reports and case series. The most common reported symptoms to include headache and dizziness followed by encephalopathy and delirium. Among the complications noted are Cerebrovascular accident, Guillian barre syndrome, acute transverse myelitis, and acute encephalitis. The most common peripheral manifestation was hyposmia. It is further noted that sometimes the neurological manifestations can precede the typical features like fever and cough and later on typical manifestations develop in these patients. Hence a high index of suspicion is required for timely diagnosis and isolation of cases to prevent the spread in neurology war...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Alkaptonuria is a rare inborn error of metabolism, which is classified as an orphan disease. It is due to the lack of an enzyme homogentisate 1,2-dioxygenase, which results in an accumulation of homogentisic acid in different areas of the... more
Alkaptonuria is a rare inborn error of metabolism, which is classified as an orphan disease. It is due to the lack of an enzyme homogentisate 1,2-dioxygenase, which results in an accumulation of homogentisic acid in different areas of the body, including sclera, skin, cardiac valves, articular cartilage of the large joints and intervertebral disks. We present two cases of alkaptonuria resulting in ochronotic arthropathy with advanced secondary generalized osteoarthritis, intervertebral disk calcifications, skin and scleral pigmentation. In these case reports, both patients had symptoms for >10 years before being diagnosed. Conservative management in the form of high-dose ascorbic acid, exercises, and gait aids was offered to both of them, which resulted in some symptomatic improvement in the first case, while the second case was lost to follow-up. Alkaptonuria is a rare disease, and although it does not clearly impact mortality, early diagnosis may improve the quality of life.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Neurogenic Thoracic Outlet Syndrome (TOS) is a set of signs and symptoms existing due to compression of brachial plexus in the cervical area. We performed the study to highlight the role of therapeutic exercises on patients with... more
Neurogenic Thoracic Outlet Syndrome (TOS) is a set of signs and symptoms existing due to compression of brachial plexus in the cervical area. We performed the study to highlight the role of therapeutic exercises on patients with neurogenic thoracic Outlet Syndrome. This quasi-experimental study was carried out at Armed Forces Institute of Rehabilitation Medicine (AFIRM), Rawalpindi. Fifty consecutive patients of neurogenic TOS of both genders and all ages were selected. Patients were diagnosed clinically and the diagnosis was confirmed by electrodiagnosis. These patients were asked to follow a therapeutic exercises program for 6 months. Outcome measures included Visual Analogue Scale (VAS) and Ulnar Nerve Conduction Velocity across neck. Results were compared by applying relevant tests of significance on follow up visits at 3 and 6 months. Mean age was 39.1 +/- 7.79 years. Thirty seven (74%) cases were females and thirteen (26%) were males. On each visit, statistical analysis showed...
Research Interests: Neurology, Rehabilitation, Pakistan, Exercise therapy, Medicine, and 15 morePeripheral Nerve Injury, Humans, Thoracic Outlet Syndrome, Entrapement Neropathy, Female, Male, Key words, Therapeutic Exercises, Middle Aged, Adult, Brachial Plexus, Electrodiagnosis, Neuralgia, Recovery of Function, and Entrapment syndromes
Research Interests:
Research Interests:
Research Interests:
UK PubMed Central (UKPMC) is an archive of life sciences journal literature.
Research Interests:
Background: Few studies have explored the determinants of health-related quality of life (HRQoL) in the elderly during the COVID-19 pandemic. Identifying these factors may help implement appropriate policies to enhance HRQoL in the... more
Background: Few studies have explored the determinants of health-related quality of life (HRQoL) in the elderly during the COVID-19 pandemic. Identifying these factors may help implement appropriate policies to enhance HRQoL in the elderly. Therefore, we aimed to identify the predictors of physical and mental component summary (PCS and MCS) scores of HRQoL in selected six low- and middle-income Asian countries. Methods: We conducted an online survey of older people aged ≥55 years in six countries: Bangladesh, Iran, Iraq, Malaysia, Palestine, and Sri Lanka. The Stark QoL questionnaire was used to measure the PCS and MCS scores. Univariate and multiple variable analyses after adjusting for confounders were performed to identify the possible predictors
of PCS and MCS. Results: A total of 1644 older people (69.1 ± 7.8 years, range 55–97 years, Female: 50.9%) responded to the survey. We documented age, country of residence, marital status, number of male children, current employment status, and health insurance, ability to pay household bills, frequency of family members visits and receiving support during COVID-19 pandemic predicted both PCS and MCS. However, gender, residence, and a number of female children were associated
with PCS only (all p < 0.05). Conclusion: Socio-demographic factors such as age, country of residence, marital status, number of male children, current employment status, health insurance, ability to pay household bills, frequency of family members visiting family members, and receiving support during the COVID-19 pandemic affecting both physical and mental quality of life. These results can guide the formulation of health care planning policies to enhance QoL during COVID-19 and future pandemics in the elderly.
of PCS and MCS. Results: A total of 1644 older people (69.1 ± 7.8 years, range 55–97 years, Female: 50.9%) responded to the survey. We documented age, country of residence, marital status, number of male children, current employment status, and health insurance, ability to pay household bills, frequency of family members visits and receiving support during COVID-19 pandemic predicted both PCS and MCS. However, gender, residence, and a number of female children were associated
with PCS only (all p < 0.05). Conclusion: Socio-demographic factors such as age, country of residence, marital status, number of male children, current employment status, health insurance, ability to pay household bills, frequency of family members visiting family members, and receiving support during the COVID-19 pandemic affecting both physical and mental quality of life. These results can guide the formulation of health care planning policies to enhance QoL during COVID-19 and future pandemics in the elderly.
Research Interests:
Objective:The objective of this survey was to explore the attitudes towards plagiarism of faculty members and medical students in Pakistan. Methods:The attitudes toward plagiarism questionnaire (ATPQ) was modified and distributed among... more
Objective:The objective of this survey was to explore the attitudes towards plagiarism of faculty members and medical students in Pakistan. Methods:The attitudes toward plagiarism questionnaire (ATPQ) was modified and distributed among 550 medical students and 130 faculty members in 7 medical colleges of Lahore and Rawalpindi. Data was entered in the SPSS v.20 and descriptive statistics were analyzed. The questionnaire was validated by principal axis factoring analysis. Results Conclusions: The general attitudes of Pakistani medical faculty members and medical students as assessed by ATPQ were positive. We propose training in medical writing and research ethics as part of the under and post graduate medical curriculum.
There are around 175,600 registered doctors in Pakistan, but limited data is available about Pakistani physicians pursuing medical careers abroad. Additionally, no data is reported about Pakistani physicians who leave the country to... more
There are around 175,600 registered doctors in Pakistan, but limited data is available about Pakistani physicians pursuing medical careers abroad. Additionally, no data is reported about Pakistani physicians who leave the country to pursue medical career overseas, but end up in non-medical professions. We identified two groups of physicians leaving the country: those going abroad for postgraduate training and residency; and those doing so for better career incentives and monetary benefits and to avoid the deteriorating law and order situation and rising hostilities towards doctors in the last few years. Other factors contributing towards physician's migration include poor service structure and career prospects, lack of research funding, increased workload and stressful work environment. Optimal measures need to be taken so that the locally trained doctors can deliver their services where they are needed the most, instead of seeking overseas opportunities. Similarly, volume of ex...
Research Interests:
The aim of this commentary is to discuss in a rehabilitation perspective the published Cochrane Review “Combination pharmacotherapy for the treatment of fibromyalgia in adults” by J Thorpe & B Shum, under the direct supervision of... more
The aim of this commentary is to discuss in a rehabilitation perspective the published Cochrane Review “Combination pharmacotherapy for the treatment of fibromyalgia in adults” by J Thorpe & B Shum, under the direct supervision of Cochrane Pain, Palliative and Supportive Care Group. This Cochrane Corner is produced in agreement with Journal of Musculoskeletal and Neuronal Interactions by Cochrane Rehabilitation.
Research Interests:
Research Interests:
Research Interests:
But a recent study has found that 'good' cholesterol may not be as good as previously thought.2 The study published in Lancet looked at the genes of about 170,000 individuals, looking for variations in DNA that earlier research... more
But a recent study has found that 'good' cholesterol may not be as good as previously thought.2 The study published in Lancet looked at the genes of about 170,000 individuals, looking for variations in DNA that earlier research shows naturally raise HDL levels in those who possess them. After looking for these 15 genetic variations — called single nucleotide polymorphisms — in the participants, the researchers discovered none of these variations actually reduced their risks for having a cardiac event, compared with people who didn't have the variations. Authors concluded that "Some genetic mechanisms that raise plasma HDL do not seem to lower risk of myocardial infarction. These data challenge the concept that raising of plasma HDL will uniformly translate into reductions in risk of myocardial infarction".