Background: Non adherence to inhaler medication is a common therapeutic problem in patients treat... more Background: Non adherence to inhaler medication is a common therapeutic problem in patients treated for Asthma and COPD. We aimed this study to determine the level of adherence to inhaler medications and to know the frequency of etiologic factors for non-adherence. Material and Methods: This was a descriptive study conducted at Pulmonology OPD, Khyber teaching hospital Peshawar from 1st Aug 2016 till 31st Jan 2017. All adult patients having Asthma or COPD who were already prescribed at least one regular inhaler for control of their disease were included. Patients with severe exacerbations, unwilling or seriously ill were excluded. After consent, adherence to inhaler medicines was assessed according to Morisky medication adherence scale. The following five reasons for inhaler non-adherence were asked i.e. economic problem, fear of dependence/social stigma, not knowing about un-interrupted use, non-efficacy of inhalers, and adverse effects. The information was collected in a structur...
Background: Arterial blood gases are necessary for management of respiratory failure in patients ... more Background: Arterial blood gases are necessary for management of respiratory failure in patients with acute exacerbation of COPD. Venous blood gas analysis may be a less invasive potential alternative. The objective of our study was to determine the accuracy of venous blood gases in the diagnosis of hypercapnic respiratory failure and to determine the correlation between arterial and venous PH, PCO and HCO . 2 3
Objective: Secondary polycythemia is an important complication of chronic obstructive pulmonary d... more Objective: Secondary polycythemia is an important complication of chronic obstructive pulmonary disease (COPD) but its frequency of occurrence is unknown in our setup. There are many potentially modifiable risk factors to prevent secondary polycythemia. This study was performed to know the frequency of secondary polycythemia in patients with COPD. Methods and Methodology: This was cross sectional study carried out in the Department of Pulmonology of Khyber Teaching Hospital Peshawar from October 2015 to October 2016. In this study Patients, diagnosed with COPD of aged 40 years and above were included in the study through consecutive, nonprobability sampling technique. World Health Organization (WHO) software was used to calculate sample size with the assumptions of6% proportions of secondary polycythemia in COPD patients, 95% confidence interval and 7% margin of error. Patients with asthma and diagnosed polycythemia were excluded fromthe study. Results: 241 patients with Chronic O...
OBJECTIVE: To determine the efficacy of BiPAP in patients with Hypercap-nic respiratory failure a... more OBJECTIVE: To determine the efficacy of BiPAP in patients with Hypercap-nic respiratory failure admitted at Pulmonology Unit Khyber Teaching Hospital (KTH), Peshawar. PATIENTS AND METHODS: This was a quasi experimental study conducted at Pulmonology Unit KTH, Peshawar from 11th August 2011 till 10th August 2013. All patients with the diagnosis of Hypercapnic Respiratory Failure (HRF) were included. Information regarding primary diagnosis, duration and outcome of Bi-PAP, respiratory rate and ABGs (pH, PCO2) before, at 1-2 hours and 4-6 hours after BiPAP were recorded in a structured proforma and then entered into SPSS 16. Frequencies/percentages were calculated for qualitative variables (age, sex, primary diagnosis and Outcome of BiPAP), Mean and SD for quantitative variables (duration of BiPAP) and paired samplèt' test was applied for comparison of means of changes in Respiratory rate, pH and PCO2. P value of less than 0.05 with 95% confidence interval was taken as significant. ...
Patients and Methods: A questionnaire was prepared in accordance with the objectives of the study... more Patients and Methods: A questionnaire was prepared in accordance with the objectives of the study. Questionnaire contained detailed history, general physical examination, and neurological examination. Association of risk factors with stroke was also studied. Results: Two hundreds and eleven patients with established diagnosis of stroke were selected. Sixty-six patients (31.27%) had more than one risk factors. The age range of patients was from 27 to 91 years with mean age of 59 years. Out of 211 patients 126(59.71%) were males and 85(40.28%) females. Risk factors distribution was: Hypertension (55.45%) diabetes (32.70%) hyperlipidemia (19.43%), smoking (10.90%), ischemic heart disease (9.00%), Atrial fibrillation (3.31%) and history of oral contraception use (0.94%). Conclusion: Hypertension, diabetes, hyperlipidemia and smoking are major modifiable risk factors of stroke, which require proper management and counseling of patients.
Human infection with avian infl uenza (H5N1) virus raises concern for the possibility of a pandem... more Human infection with avian infl uenza (H5N1) virus raises concern for the possibility of a pandemic. We report 20 cases, which ranged from asymptomatic to fatal, in Pakistan in 2007. These cases indicate human-to-humanto-human transmission of this virus, and the number of cases may be higher than realized. Evidence of human-to-human transmission of influenza A (H5N1) virus raises concern over a possible pandemic (1). Previous epidemiologic investigation of the outbreak of influenza (H5N1) among persons in the Northwest Frontier Province of Pakistan (Figure 1) in 2007 found 5 cases—3 confirmed, 1 asymptomatic, and 1 probable—as defined by the World Health Organization (WHO) (2). We report a larger set of 20 cases during this outbreak in Pakistan, supporting human-to-human-to-human transmission.
Background: Arterial blood gases are necessary for management of respiratory failure in patients ... more Background: Arterial blood gases are necessary for management of respiratory failure in patients with acute exacerbation of COPD. Venous blood gas analysis may be a less invasive potential alternative. The objective of our study was to determine the accuracy of venous blood gases in the diagnosis of hypercapnic respiratory failure and to determine the correlation between arterial and venous PH, PCO2 and HCO3. Methodology: All adult patients presenting to Pulmonology department between November 2018 and March 2019 with COPD exacerbation having SPO 45mm of Hg as cut off value to diagnose hypercapnia using ABGs as the gold standard. Correlation between arterial and venous PH, PCO2 and HCO3 were calculated via Pearson correlation. Results: We enrolled 87 patients, with mean age of 51yrs (+ 8.89 SD) and male to female ratio of 1: 2.2. The mean venous minus arterial PH (7.39-7.40) was -0.13. The mean venous minus arterial PCO (60-54) was 6mm of Hg. The 2 sensitivity of venous PCO in the ...
BACKGROUND: COPD is a heterogeneous disorder displaying variable clinical and pathophysiological ... more BACKGROUND: COPD is a heterogeneous disorder displaying variable clinical and pathophysiological features.Different phenotypes have been recognized that differ in respect to their biomarker profiles and response to treatment. Eosinophilic airway inflammation has been identified in significant number of COPD patients. OBJECTIVE : The objective of our study was to determine the frequency of blood eosinophilia in COPD patients admitted with acute exacerbation. METHODS: This was a cross-sectional study conducted at pulmonology unit KTH, Peshawar from 10-12-2016 to 10-06-2017.All the COPD patients admitted with acute exacerbation (diagnosed by spirometry i.e post bronchodilator FEV 1 /FVC less than 70) were enrolled in the study. Exclusion criteria were strictly followed to control confounding factors in our study. The age and gender of the patient was documented and blood eosinophil count was measured for each patient using a standardized method to eliminate bias. All the data was col...
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2009
OBJECTIVE To determine the frequency of common risk factors for multi-drug resistant tuberculosis... more OBJECTIVE To determine the frequency of common risk factors for multi-drug resistant tuberculosis in patients presented at a tertiary care hospital, Peshawar. STUDY DESIGN Cross-sectional, observational study. PLACE AND DURATION OF STUDY Pulmonology Department, Khyber Teaching Hospital, Peshawar, from December 2006 to October 2007. METHODOLOGY Patients with positive AFB culture and sensitivity results and found resistant to both rifampicin and isoniazid with or with resistance to other first line anti-tuberculosis drugs, were recruited from both Pulmonology Ward and Outpatient Department (OPD). Informed verbal consent was taken and a questionnaire administered to all participants of the study. Information regarding demographics, education status, occupation, monthly household income, AFB C/S, details of past history of tuberculosis and family history of TB or Multi-Drug Resistant (MDR-TB) was recorded. Data was analyzed on SPSS version 11. RESULTS A total of 30 patients of MDR-TB we...
Introduction Interstitial lung disease (ILD) is a heterogeneous group of over 200 parenchymal lun... more Introduction Interstitial lung disease (ILD) is a heterogeneous group of over 200 parenchymal lung diseases with a myriad of etiologies. Interstitial lung disease registries from around the world show varying prevalence and incidence of these diseases. The aim of this study was to determine the epidemiology and characteristics of ILD in Pakistan. Methods This web-based registry, which is the first multicenter registry of ILD from Pakistan, recruited patients from 10 centers of five major cities between January 2016 and March 2019. Results A total of 744 patients were enrolled in the registry. The five most frequent ILDs were idiopathic pulmonary fibrosis (IPF) 34.4%, hypersensitivity pneumonitis (HP) - 17.7%, idiopathic nonspecific interstitial pneumonitis (iNSIP) - 16.8%, connective tissue disease-associated ILD (CTD-ILD) - 16.3%, and sarcoidosis - 9.1%. Conclusion Idiopathic pulmonary fibrosis is the most prevalent ILD in Pakistan, followed by HP and iNSIP. An ongoing prospective ...
Background: Tuberculosis (TB) is a multi system disease and it involves many organs including hea... more Background: Tuberculosis (TB) is a multi system disease and it involves many organs including heart. Method and Material: The aim of this descriptive study was to determine treatment outcome of patients with pericardial effusion, presented to Cardiology and Pulmonology Units KTH from February 2004 to December 2006, who were treated according to the WHO guidelines with implementation of DOTS strategy. Results: Out of 67 patients, 36(54%) were male and 31(46%) were female with the mean age of 34 Years (age range: 17-63 Years). Fifty five (82%) patients were in age range of 10-40 years and 9 (13%) had a TB contact in the past. All 67 patients were started on Anti Tuberculous Treatment (ATT) according to the WHO guidelines and oral steroids were added in tapering dosage. All the patients were followed for 8 months with regular monthly follow up. Fifty four (82%) patients had completed the treatment, 3(4.4%) patients died, 7 (10.4%) patients were lost to follow up and 3 patients had deve...
Objective: To determine the frequency of cigarette smoking among students of Peshawar University ... more Objective: To determine the frequency of cigarette smoking among students of Peshawar University and compare it with the previous study conducted in year 2000. Design: A cross sectional study was conducted and data was collected on a self-administered questionnaire from the participants selected from the departments of Peshawar University. Place and duration of Study: The study was conducted among the students of Peshawar University from Sep2003 to March 2004 Subjects and Methods: A sample of 550 students was invited to participate in this study. After signing the consent, information on demographics, smoking habits, media influences and health histories were obtained using the standardized questionnaire. The data after auditing was analysed using SPSS version 12.1. Results: The results of 436 participants was analysed further and 114 questionnaires were found either blank or incomplete. Current smokers in the study were 119 (27%) and ex smokers were 69 (16%) There were 114 (34%) an...
Background: Ischemic heart disease (IHD) is the leading cause of morbidity and mortality in non-c... more Background: Ischemic heart disease (IHD) is the leading cause of morbidity and mortality in non-communicable group of diseases. By year 2030, Chronic Obstructive Pulmonary Disease (COPD) will be the third leading cause of death globally. IHD and COPD coexist in 18-50% of patients in different studies. Objective: Objective of the present study was to determine gender related differences in clinical presentation of ischemic heart disease patients with concomitant chronic obstructive pulmonary disease (COPD).
Objective: To determine the frequency of undiagnosed ischemic heart disease inpatients admitted w... more Objective: To determine the frequency of undiagnosed ischemic heart disease inpatients admitted with acute exacerbation of COPD (AECOPD). Methodology: This cross sectional study was done from 1 January to 31December 2015 at Pulmonolgy Department of Khyber Teaching HospitalPeshawar on patients admitted with acute exacerbation of COPD. Ischemicheart disease was diagnosed if a patient was found to have unstable angina,myocardial infarction or had echo findings suggestive of ischemiccardiomyopathy or regional wall abnormality. Data was gathered on a structuredproforma where demographics, history of common risk factors and presence ofischemic heart disease and it’s further type was documented. Data entered onSPSS version 19 and analyzed. Results: A total of 412 patients were admitted with the diagnosis of AECOPD.Mean age of the study sample was 61.6±12.5 years, with 41% males.Frequency of undiagnosed ischemic heart disease was found to be 18%. Amongthem 47% had unstable angina, 23% had m...
It was a randomized controlled trial, conducted from June 2014 to June 2015, in two centres: Khyb... more It was a randomized controlled trial, conducted from June 2014 to June 2015, in two centres: Khyber Teaching Hospital Peshawar and Emergency Satellite Hospital Nahaqi. Patients enrolled for anti-TB drugs were distributed in intervention and control groups; daily mobile SMS reminders (intervention) were sent to patients of intervention group during initial 2 months of treatment (on top of usual DOTS) Feasibility was assessed at the time of enrolment of patients and acceptability of SMS-reminders was assessed by semi-structured questionnaire based interview after 2 months of anti-TB treatment.
Background: Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease ch... more Background: Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease characterized by partially reversible airflow limitation. COPD has two clinico-pathological types including emphysema and chronic bronchitis. These two factors vary from person to person. If frequency of Gastroesophageal reflux disease (GERD) is found to be higher in COPD patients it will help in deciding whether to routinely assess COPD patients for the likelihood ofGERDor not and manage adequately. Objective: To know about the frequency of GERD in patients with COPD effect relationship between GERD and COPD regarding the clinical significance of GERD in patients with COPD as it has a prognostic value in patients admitted to PulmonologyWard KTH. Methodology: A Descriptive cross-sectional study conducted at ChestWard, Khyber Teaching Hospital (KTH), Peshawar from April 2017 till October 2017. In this study 217 patients were observed. Patients (aged 18-70 years) were worked up with detailed...
Background: Tuberculosis is a common disease and health education is essential for the patients a... more Background: Tuberculosis is a common disease and health education is essential for the patients and their relatives for effective treatment of the index case and prevention of infection spread among the relatives and others. Objective & Methods: We conducted this cross-sectional study in the catchment population of Emergency Satellite Hospital (ESH) Nahaqi,a TB diagnostic & treatment centre, to assess the impact of different DOTS treatment modalities on the knowledge about TB and attitude of the patients and their relatives. Results: Total of 133, 58 males and 75 females, patients and their attendants accepted the invitation to participate in the study. Fifty seven percent were currently taking TB treatment, 43 had taken treatment in the past whereas 33 had never suffered from TB. Out of 100 patients treated under DOTS program, 21, 25 and 54 had taken treatment under supervision of LHW, relative or self respectively. Ninety two percent of the TB patients had taken treatment regularl...
Journal of Ayub Medical College, Abbottabad : JAMC, 2020
Background COVID-19 is an ongoing public health issue across the world. Several risk factors asso... more Background COVID-19 is an ongoing public health issue across the world. Several risk factors associated with mortality in COVID-19 have been reported. The present study aims to describe clinical and epidemiological characteristics and predictors of mortality in hospitalized patients from Khyber Pakhtunkhwa, a province in Pakistan with highest COVID-19 associated case fatality rate. Methods This multicentre, retrospective study was conducted in hospitalized COVID-19 patients who died or discharged alive until 1st May 2020. Data about sociodemographic characteristics, clinical and laboratory findings, treatment and outcome were obtained from hospital records and compared between survivors and non-survivors. Statistical tests were applied to determine the risk factors associated with mortality in hospitalized patients. Results Of the total 179 patients from the 10 designated hospitals, 127 (70.9%) were discharged alive while 52 (29.1%) died in the hospital. Overall, 109 (60.9%) patient...
Background: Non adherence to inhaler medication is a common therapeutic problem in patients treat... more Background: Non adherence to inhaler medication is a common therapeutic problem in patients treated for Asthma and COPD. We aimed this study to determine the level of adherence to inhaler medications and to know the frequency of etiologic factors for non-adherence. Material and Methods: This was a descriptive study conducted at Pulmonology OPD, Khyber teaching hospital Peshawar from 1st Aug 2016 till 31st Jan 2017. All adult patients having Asthma or COPD who were already prescribed at least one regular inhaler for control of their disease were included. Patients with severe exacerbations, unwilling or seriously ill were excluded. After consent, adherence to inhaler medicines was assessed according to Morisky medication adherence scale. The following five reasons for inhaler non-adherence were asked i.e. economic problem, fear of dependence/social stigma, not knowing about un-interrupted use, non-efficacy of inhalers, and adverse effects. The information was collected in a structur...
Background: Arterial blood gases are necessary for management of respiratory failure in patients ... more Background: Arterial blood gases are necessary for management of respiratory failure in patients with acute exacerbation of COPD. Venous blood gas analysis may be a less invasive potential alternative. The objective of our study was to determine the accuracy of venous blood gases in the diagnosis of hypercapnic respiratory failure and to determine the correlation between arterial and venous PH, PCO and HCO . 2 3
Objective: Secondary polycythemia is an important complication of chronic obstructive pulmonary d... more Objective: Secondary polycythemia is an important complication of chronic obstructive pulmonary disease (COPD) but its frequency of occurrence is unknown in our setup. There are many potentially modifiable risk factors to prevent secondary polycythemia. This study was performed to know the frequency of secondary polycythemia in patients with COPD. Methods and Methodology: This was cross sectional study carried out in the Department of Pulmonology of Khyber Teaching Hospital Peshawar from October 2015 to October 2016. In this study Patients, diagnosed with COPD of aged 40 years and above were included in the study through consecutive, nonprobability sampling technique. World Health Organization (WHO) software was used to calculate sample size with the assumptions of6% proportions of secondary polycythemia in COPD patients, 95% confidence interval and 7% margin of error. Patients with asthma and diagnosed polycythemia were excluded fromthe study. Results: 241 patients with Chronic O...
OBJECTIVE: To determine the efficacy of BiPAP in patients with Hypercap-nic respiratory failure a... more OBJECTIVE: To determine the efficacy of BiPAP in patients with Hypercap-nic respiratory failure admitted at Pulmonology Unit Khyber Teaching Hospital (KTH), Peshawar. PATIENTS AND METHODS: This was a quasi experimental study conducted at Pulmonology Unit KTH, Peshawar from 11th August 2011 till 10th August 2013. All patients with the diagnosis of Hypercapnic Respiratory Failure (HRF) were included. Information regarding primary diagnosis, duration and outcome of Bi-PAP, respiratory rate and ABGs (pH, PCO2) before, at 1-2 hours and 4-6 hours after BiPAP were recorded in a structured proforma and then entered into SPSS 16. Frequencies/percentages were calculated for qualitative variables (age, sex, primary diagnosis and Outcome of BiPAP), Mean and SD for quantitative variables (duration of BiPAP) and paired samplèt' test was applied for comparison of means of changes in Respiratory rate, pH and PCO2. P value of less than 0.05 with 95% confidence interval was taken as significant. ...
Patients and Methods: A questionnaire was prepared in accordance with the objectives of the study... more Patients and Methods: A questionnaire was prepared in accordance with the objectives of the study. Questionnaire contained detailed history, general physical examination, and neurological examination. Association of risk factors with stroke was also studied. Results: Two hundreds and eleven patients with established diagnosis of stroke were selected. Sixty-six patients (31.27%) had more than one risk factors. The age range of patients was from 27 to 91 years with mean age of 59 years. Out of 211 patients 126(59.71%) were males and 85(40.28%) females. Risk factors distribution was: Hypertension (55.45%) diabetes (32.70%) hyperlipidemia (19.43%), smoking (10.90%), ischemic heart disease (9.00%), Atrial fibrillation (3.31%) and history of oral contraception use (0.94%). Conclusion: Hypertension, diabetes, hyperlipidemia and smoking are major modifiable risk factors of stroke, which require proper management and counseling of patients.
Human infection with avian infl uenza (H5N1) virus raises concern for the possibility of a pandem... more Human infection with avian infl uenza (H5N1) virus raises concern for the possibility of a pandemic. We report 20 cases, which ranged from asymptomatic to fatal, in Pakistan in 2007. These cases indicate human-to-humanto-human transmission of this virus, and the number of cases may be higher than realized. Evidence of human-to-human transmission of influenza A (H5N1) virus raises concern over a possible pandemic (1). Previous epidemiologic investigation of the outbreak of influenza (H5N1) among persons in the Northwest Frontier Province of Pakistan (Figure 1) in 2007 found 5 cases—3 confirmed, 1 asymptomatic, and 1 probable—as defined by the World Health Organization (WHO) (2). We report a larger set of 20 cases during this outbreak in Pakistan, supporting human-to-human-to-human transmission.
Background: Arterial blood gases are necessary for management of respiratory failure in patients ... more Background: Arterial blood gases are necessary for management of respiratory failure in patients with acute exacerbation of COPD. Venous blood gas analysis may be a less invasive potential alternative. The objective of our study was to determine the accuracy of venous blood gases in the diagnosis of hypercapnic respiratory failure and to determine the correlation between arterial and venous PH, PCO2 and HCO3. Methodology: All adult patients presenting to Pulmonology department between November 2018 and March 2019 with COPD exacerbation having SPO 45mm of Hg as cut off value to diagnose hypercapnia using ABGs as the gold standard. Correlation between arterial and venous PH, PCO2 and HCO3 were calculated via Pearson correlation. Results: We enrolled 87 patients, with mean age of 51yrs (+ 8.89 SD) and male to female ratio of 1: 2.2. The mean venous minus arterial PH (7.39-7.40) was -0.13. The mean venous minus arterial PCO (60-54) was 6mm of Hg. The 2 sensitivity of venous PCO in the ...
BACKGROUND: COPD is a heterogeneous disorder displaying variable clinical and pathophysiological ... more BACKGROUND: COPD is a heterogeneous disorder displaying variable clinical and pathophysiological features.Different phenotypes have been recognized that differ in respect to their biomarker profiles and response to treatment. Eosinophilic airway inflammation has been identified in significant number of COPD patients. OBJECTIVE : The objective of our study was to determine the frequency of blood eosinophilia in COPD patients admitted with acute exacerbation. METHODS: This was a cross-sectional study conducted at pulmonology unit KTH, Peshawar from 10-12-2016 to 10-06-2017.All the COPD patients admitted with acute exacerbation (diagnosed by spirometry i.e post bronchodilator FEV 1 /FVC less than 70) were enrolled in the study. Exclusion criteria were strictly followed to control confounding factors in our study. The age and gender of the patient was documented and blood eosinophil count was measured for each patient using a standardized method to eliminate bias. All the data was col...
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2009
OBJECTIVE To determine the frequency of common risk factors for multi-drug resistant tuberculosis... more OBJECTIVE To determine the frequency of common risk factors for multi-drug resistant tuberculosis in patients presented at a tertiary care hospital, Peshawar. STUDY DESIGN Cross-sectional, observational study. PLACE AND DURATION OF STUDY Pulmonology Department, Khyber Teaching Hospital, Peshawar, from December 2006 to October 2007. METHODOLOGY Patients with positive AFB culture and sensitivity results and found resistant to both rifampicin and isoniazid with or with resistance to other first line anti-tuberculosis drugs, were recruited from both Pulmonology Ward and Outpatient Department (OPD). Informed verbal consent was taken and a questionnaire administered to all participants of the study. Information regarding demographics, education status, occupation, monthly household income, AFB C/S, details of past history of tuberculosis and family history of TB or Multi-Drug Resistant (MDR-TB) was recorded. Data was analyzed on SPSS version 11. RESULTS A total of 30 patients of MDR-TB we...
Introduction Interstitial lung disease (ILD) is a heterogeneous group of over 200 parenchymal lun... more Introduction Interstitial lung disease (ILD) is a heterogeneous group of over 200 parenchymal lung diseases with a myriad of etiologies. Interstitial lung disease registries from around the world show varying prevalence and incidence of these diseases. The aim of this study was to determine the epidemiology and characteristics of ILD in Pakistan. Methods This web-based registry, which is the first multicenter registry of ILD from Pakistan, recruited patients from 10 centers of five major cities between January 2016 and March 2019. Results A total of 744 patients were enrolled in the registry. The five most frequent ILDs were idiopathic pulmonary fibrosis (IPF) 34.4%, hypersensitivity pneumonitis (HP) - 17.7%, idiopathic nonspecific interstitial pneumonitis (iNSIP) - 16.8%, connective tissue disease-associated ILD (CTD-ILD) - 16.3%, and sarcoidosis - 9.1%. Conclusion Idiopathic pulmonary fibrosis is the most prevalent ILD in Pakistan, followed by HP and iNSIP. An ongoing prospective ...
Background: Tuberculosis (TB) is a multi system disease and it involves many organs including hea... more Background: Tuberculosis (TB) is a multi system disease and it involves many organs including heart. Method and Material: The aim of this descriptive study was to determine treatment outcome of patients with pericardial effusion, presented to Cardiology and Pulmonology Units KTH from February 2004 to December 2006, who were treated according to the WHO guidelines with implementation of DOTS strategy. Results: Out of 67 patients, 36(54%) were male and 31(46%) were female with the mean age of 34 Years (age range: 17-63 Years). Fifty five (82%) patients were in age range of 10-40 years and 9 (13%) had a TB contact in the past. All 67 patients were started on Anti Tuberculous Treatment (ATT) according to the WHO guidelines and oral steroids were added in tapering dosage. All the patients were followed for 8 months with regular monthly follow up. Fifty four (82%) patients had completed the treatment, 3(4.4%) patients died, 7 (10.4%) patients were lost to follow up and 3 patients had deve...
Objective: To determine the frequency of cigarette smoking among students of Peshawar University ... more Objective: To determine the frequency of cigarette smoking among students of Peshawar University and compare it with the previous study conducted in year 2000. Design: A cross sectional study was conducted and data was collected on a self-administered questionnaire from the participants selected from the departments of Peshawar University. Place and duration of Study: The study was conducted among the students of Peshawar University from Sep2003 to March 2004 Subjects and Methods: A sample of 550 students was invited to participate in this study. After signing the consent, information on demographics, smoking habits, media influences and health histories were obtained using the standardized questionnaire. The data after auditing was analysed using SPSS version 12.1. Results: The results of 436 participants was analysed further and 114 questionnaires were found either blank or incomplete. Current smokers in the study were 119 (27%) and ex smokers were 69 (16%) There were 114 (34%) an...
Background: Ischemic heart disease (IHD) is the leading cause of morbidity and mortality in non-c... more Background: Ischemic heart disease (IHD) is the leading cause of morbidity and mortality in non-communicable group of diseases. By year 2030, Chronic Obstructive Pulmonary Disease (COPD) will be the third leading cause of death globally. IHD and COPD coexist in 18-50% of patients in different studies. Objective: Objective of the present study was to determine gender related differences in clinical presentation of ischemic heart disease patients with concomitant chronic obstructive pulmonary disease (COPD).
Objective: To determine the frequency of undiagnosed ischemic heart disease inpatients admitted w... more Objective: To determine the frequency of undiagnosed ischemic heart disease inpatients admitted with acute exacerbation of COPD (AECOPD). Methodology: This cross sectional study was done from 1 January to 31December 2015 at Pulmonolgy Department of Khyber Teaching HospitalPeshawar on patients admitted with acute exacerbation of COPD. Ischemicheart disease was diagnosed if a patient was found to have unstable angina,myocardial infarction or had echo findings suggestive of ischemiccardiomyopathy or regional wall abnormality. Data was gathered on a structuredproforma where demographics, history of common risk factors and presence ofischemic heart disease and it’s further type was documented. Data entered onSPSS version 19 and analyzed. Results: A total of 412 patients were admitted with the diagnosis of AECOPD.Mean age of the study sample was 61.6±12.5 years, with 41% males.Frequency of undiagnosed ischemic heart disease was found to be 18%. Amongthem 47% had unstable angina, 23% had m...
It was a randomized controlled trial, conducted from June 2014 to June 2015, in two centres: Khyb... more It was a randomized controlled trial, conducted from June 2014 to June 2015, in two centres: Khyber Teaching Hospital Peshawar and Emergency Satellite Hospital Nahaqi. Patients enrolled for anti-TB drugs were distributed in intervention and control groups; daily mobile SMS reminders (intervention) were sent to patients of intervention group during initial 2 months of treatment (on top of usual DOTS) Feasibility was assessed at the time of enrolment of patients and acceptability of SMS-reminders was assessed by semi-structured questionnaire based interview after 2 months of anti-TB treatment.
Background: Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease ch... more Background: Chronic obstructive pulmonary disease (COPD) is a type of obstructive lung disease characterized by partially reversible airflow limitation. COPD has two clinico-pathological types including emphysema and chronic bronchitis. These two factors vary from person to person. If frequency of Gastroesophageal reflux disease (GERD) is found to be higher in COPD patients it will help in deciding whether to routinely assess COPD patients for the likelihood ofGERDor not and manage adequately. Objective: To know about the frequency of GERD in patients with COPD effect relationship between GERD and COPD regarding the clinical significance of GERD in patients with COPD as it has a prognostic value in patients admitted to PulmonologyWard KTH. Methodology: A Descriptive cross-sectional study conducted at ChestWard, Khyber Teaching Hospital (KTH), Peshawar from April 2017 till October 2017. In this study 217 patients were observed. Patients (aged 18-70 years) were worked up with detailed...
Background: Tuberculosis is a common disease and health education is essential for the patients a... more Background: Tuberculosis is a common disease and health education is essential for the patients and their relatives for effective treatment of the index case and prevention of infection spread among the relatives and others. Objective & Methods: We conducted this cross-sectional study in the catchment population of Emergency Satellite Hospital (ESH) Nahaqi,a TB diagnostic & treatment centre, to assess the impact of different DOTS treatment modalities on the knowledge about TB and attitude of the patients and their relatives. Results: Total of 133, 58 males and 75 females, patients and their attendants accepted the invitation to participate in the study. Fifty seven percent were currently taking TB treatment, 43 had taken treatment in the past whereas 33 had never suffered from TB. Out of 100 patients treated under DOTS program, 21, 25 and 54 had taken treatment under supervision of LHW, relative or self respectively. Ninety two percent of the TB patients had taken treatment regularl...
Journal of Ayub Medical College, Abbottabad : JAMC, 2020
Background COVID-19 is an ongoing public health issue across the world. Several risk factors asso... more Background COVID-19 is an ongoing public health issue across the world. Several risk factors associated with mortality in COVID-19 have been reported. The present study aims to describe clinical and epidemiological characteristics and predictors of mortality in hospitalized patients from Khyber Pakhtunkhwa, a province in Pakistan with highest COVID-19 associated case fatality rate. Methods This multicentre, retrospective study was conducted in hospitalized COVID-19 patients who died or discharged alive until 1st May 2020. Data about sociodemographic characteristics, clinical and laboratory findings, treatment and outcome were obtained from hospital records and compared between survivors and non-survivors. Statistical tests were applied to determine the risk factors associated with mortality in hospitalized patients. Results Of the total 179 patients from the 10 designated hospitals, 127 (70.9%) were discharged alive while 52 (29.1%) died in the hospital. Overall, 109 (60.9%) patient...
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