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Hakim Ali Abro

Bio: Hakim Ali Abro is an academic researcher from Chandka Medical College. The author has contributed to research in topics: Hepatitis C & Case series. The author has an hindex of 4, co-authored 7 publications receiving 70 citations.

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Journal Article
TL;DR: Hepatic dysfunction in acute P.falciparum malaria ranged from mild elevation of liver enzymes to acute hepatitis (ALT>10 times of normal level), which indicates severe illness with high frequency of complication and mortality rates.
Abstract: UNLABELLED To evaluate the frequency and severity of jaundice with hepatic dysfunction in Plasmodium (P.) falciparum malaria in adult patients admitted in the hospital. STUDY DESIGN Descriptive study. PLACE AND DURATION OF STUDY The Infectious Diseases Unit and Medical Wards at Rashid Hospital, Dubai, United Arab Emirates, from January 2005 to December 2007. METHODOLOGY This study included 105 adult patients who fulfilled the inclusion criteria. The diagnosis of P.falciparum malaria was confirmed by examination of thin and thick film stained with Leishman's stain. Other laboratory investigations included full blood count, liver function tests, blood urea, electrolytes, serum creatinine, reticulocyte count, blood sugar, viral hepatitis serology and coagulation profile. Patient with significant clinical/biochemical hepatic dysfunction were also subjected to ultrasonic examination of abdomen. RESULTS On clinical examination, 23% patients were found to be jaundiced. Serum alanine amino transferase (ALT) level was above the reference range in 67.6%, but in only 11.4%, ALT was more than 3 times of normal level. Serum bilirubin was found to be higher than normal level in 81%, however, only in 23% of the patients, Serum bilirubin was >3mg/dl. Predominantly conjugated hyperbilirubinemia was observed in patients with high ALT. There was no significant change in serum albumin and prothrombin time. In comparison to normal bilirubin level, the patient with bilirubin >3mg/dl had high frequency of raised ALT 87.5% vs. 45% (p .05). Overall, 5 (4.7%) patients died and mortality rate was high among the patients with bilirubin level>3mg/dl than with normal bilirubin level 4 (16.6%) vs 1 (5%). CONCLUSION Hepatic dysfunction in acute P.falciparum malaria ranged from mild elevation of liver enzymes to acute hepatitis (ALT>10 times of normal level). It indicates severe illness with high frequency of complication and mortality rates.

44 citations

Journal Article
TL;DR: Immobility was the commonest risk factor for developing VTE, followed by advancing age and obesity, and very few hospitalized patients actually received thromboprophylaxis.
Abstract: Objective: To determine the number of hospitalized patients at risk for developing venous thromboembolism (VTE) / deep vein thrombosis (DVT), identifying the most common risk factor and to document the use of thromboprophylaxis. Study Design: Observational and cross-sectional study. Place and Duration of Study: Chandka Medical College Hospital, Larkana, from October to December 2011. Methodology: A total of 170 patients underwent this study and these included 51 (30%) from general medical, and 119 (70%) from surgical units. Inclusion and exclusion criteria were defined and data was collected on printed format. VTE risk assessment was done according to Caprini Model and criteria defined by the American College of Chest PhysiciansACCP. Results: Out of 170 patients, 91 were male and 79 female with mean age of 39 ± 16 years. According to ACCP criteria for VTE risk assessment, 20% (n=34) patients were identified to be at low risk, 20% (n=34) at moderate risk, 47.65% (n=81) at high risk and 12.35% (n=21) at very high risk of developing VTE. The commonest risk factor significantly identified was immobility (54.7%, p < 0.005), followed by advancing age (41.17%, p < 0.005) and obesity (18.23%). The most common risk factor in all types of surgical patients was anaesthesia for more than 45 minutes 82.35% (n=98/119) and in medical patients advancing age 45% (n=23/51). Only 6 (3.5%) patients received thromboprophylaxis, all were surgical patients of very high-risk category. Conclusion: Majority of studied hospitalized patients were at high risk of developing VTE. Immobility was the commonest risk factor for developing VTE, followed by advancing age and obesity. Very few hospitalized patients actually received thromboprophylaxis.

16 citations

Journal Article
TL;DR: History of therapeutic injections and use of barber services for shave were the most frequent risk factors in the study and a number of risk factors of HCV transmission were present in these cases.
Abstract: Background: Viral hepatitis is a major public health problem. Infection with Hepatitis C virus (HCV) leads to chronicity and there are about 170 million people infected with HCV. Up to 70% of chronically infected individuals develop active liver disease. The Objective of the study was to find out the frequency of Anti-HCV seropositivity and risk factors of Hepatitis C Virus (HCV) transmission in people of Larkana city. Method: The study was conducted at Larkana from April 2006 to April 2007. Camps were established in the main general practitioners’ clinics. A questionnaire about knowledge of HCV and risk factors of its transmission was administered to subjects. Descriptive statistics were done by SPSS-10. Result: Total 450 cases were enrolled into this study. They were divided into 3 age groups. Eighty-nine (19.8%) cases were in age group 40 years. There were 353 (78.4%) male and 97 (21.6%) female subjects, out of these 450 cases 30 (6.6%) were positive for Anti-HCV. A number of risk factors of HCV transmission were present in these cases. History of therapeutic injections was present in 72 cases and 35 cases used public barber services. Conclusion: History of therapeutic injections and use of barber services for shave were the most frequent risk factors in our study. Keywords: Risk factors, HCV, Sero-positivity, Hepatitis, Cirrhosis, Hepatocellular Carcinoma

9 citations

Journal Article
TL;DR: The leukocyte esterase dipstick test can be used as rapid test for diagnosis of spontaneous bacterial peritonitis due to its high diagnostic validity.
Abstract: Background : Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without an evident intra-abdominal surgically treatable source. Spontaneous bacterial peritonitis (SBP) is one of the severe complications in patients with cirrhosis and ascites. Without early antibiotic treatment, this complication is associated with high mortality rate, so early diagnosis and treatment of SBP is therefore necessary for survival. Leukocyte esterase dipstick test can rapidly diagnose the SBP. Objectives were to find out the diagnostic accuracy of leukocyte esterase dipstick test for the diagnosis of spontaneous bacterial peritonitis. Methods: This cross-sectional, validation study was conducted from January 2009 to June 2009 at Medical Unit-II, Chandka Medical College Hospital Larkana. All the Patients with cirrhosis and ascites of either gender were included in this study. Paracentesis were performed on admission. The ascitic fluid obtained at bedside was immediately tested with reagent strip Multistix ® 10 SG. Ascitic fluid was then analysed for PMN cell count. The result of reagent strip was compared with ascitic fluid PMN cell count for determination of sensitivity, specificity, PPV and NPV of the test, while taking ascitic fluid PMN count ≥250/mm 3 as standard for diagnosis of SBP. Leukocyte esterase dipstick read positive from +1 to +3 reaction while negative and trace reaction regarded as negative test result. Results : Total ninety four patients were enrolled in this study. Ninety-four Ascitic fluid samples were obtained. SBP was diagnosed in 52 (55.3%) patients, 42 (44.7%) patients were negative for SBP by manual cell count. The sensitivity, specificity, PPV, NPV of leukocyte esterase dipstick test to diagnose SBP were 92%, 95%, 96%, 90% respectively. Conclusion : The leukocyte esterase dipstick test can be used as rapid test for diagnosis of SBP due to its high diagnostic validity. Keywords : spontaneous bacterial peritonitis, ascites, cirrhosis, validity, leukocyte esterase.

7 citations

Journal ArticleDOI
TL;DR: It is revealed that HCV infection significantly increased the risk of stroke in patients with ischemic stroke at CMCH Larkana.
Abstract: .. Objectives: To determine the frequency of Hepatitis C infection in patients with ischemic Stroke at CMCH Larkana. Study Design: Cross-sectional study. Setting: Medical wards of Shaheed Mohtarma Benazir Bhutto Medical University Larkana. Period: From January 2018 to December 2018. Material & Methods: This study was conducted on 125 diagnosed ischemic stroke patient with age >18 years or both genders. Patients with sudden history of partial or complete weakness of half the body persisting for more than 24 hours and clinical examination supporting reduced power and presence of focal sign and CT brain showing hypodense area in respected blood supply. Patients were considered suffering from Hepatitis C who were reactive to anti HCV on second generation ELISA. Results: We surveyed 125 patients admitted with clinical diagnosis of ischemic stroke after exclusion criteria with mean age of 54.53 ± 10.994. In this study male were 51.2% and female were 48.8%. About 40 (32% patients were anti HCV reactive. Conclusion: It is revealed that HCV infection significantly increased the risk of stroke.

2 citations


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TL;DR: Evidence of high nosocomial transmission calls for immediate measures aimed at ensuring safe medical practices in Pakistan, with a 2.45% seroprevalence among blood donors demands immediate measures to curtail the risk of transfusion transmitted HCV.
Abstract: Hepatitis C virus (HCV) is endemic in Pakistan and its burden is expected to increase in coming decades owing mainly to widespread use of unsafe medical procedures. The prevalence of HCV in Pakistan has previously been reviewed. However, the literature search conducted here revealed that at least 86 relevant studies have been produced since the publication of these systematic reviews. A revised updated analysis was therefore needed in order to integrate the fresh data. A systematic review of data published between 2010 and 2015 showed that HCV seroprevalence among the general adult Pakistani population is 6.8%, while active HCV infection was found in approximately 6% of the population. Studies included in this review have also shown extremely high HCV prevalence in rural and underdeveloped peri-urban areas (up to 25%), highlighting the need for an increased focus on this previously neglected socioeconomic stratum of the population. While a 2.45% seroprevalence among blood donors demands immediate measures to curtail the risk of transfusion transmitted HCV, a very high prevalence in patients attending hospitals with various non-liver disease related complaints (up to 30%) suggests a rise in the incidence of nosocomial HCV spread. HCV genotype 3a continues to be the most prevalent subtype infecting people in Pakistan (61.3%). However, recent years have witnessed an increase in the frequency of subtype 2a in certain geographical sub-regions within Pakistan. In Khyber Pakhtunkhwa and Sindh provinces, 2a was the second most prevalent genotype (17.3% and 11.3% respectively). While the changing frequency distribution of various genotypes demands an increased emphasis on research for novel therapeutic regimens, evidence of high nosocomial transmission calls for immediate measures aimed at ensuring safe medical practices.

131 citations

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TL;DR: To characterize hepatitis C virus (HCV) epidemiology in Pakistan and estimate the pooled mean HCV antibody prevalence in different risk populations, all available records of HCV incidence and/or prevalence from 1989 to 2016 were systematically reviewed.
Abstract: To characterize hepatitis C virus (HCV) epidemiology in Pakistan and estimate the pooled mean HCV antibody prevalence in different risk populations, we systematically reviewed all available records of HCV incidence and/or prevalence from 1989 to 2016, as informed by the Cochrane Collaboration Handbook. This systematic review was reported following the PRISMA guidelines. Populations were classified into six categories based on the risk of exposure to HCV infection. Meta-analyses were performed using DerSimonian and Laird random-effects models with inverse variance weighting. The search identified one HCV incidence study and 341 prevalence measures/strata. Meta-analyses estimated the pooled mean HCV prevalence at 6.2% among the general population, 34.5% among high-risk clinical populations, 12.8% among populations at intermediate risk, 16.9% among special clinical populations, 55.9% among populations with liver-related conditions and 53.6% among people who inject drugs. Most reported risk factors in analytical epidemiologic studies related to healthcare procedures. Pakistan is enduring an HCV epidemic of historical proportions—one in every 20 Pakistanis is infected. HCV plays a major role in liver disease burden in this country, and HCV prevalence is high in all-risk populations. Most transmission appears to be driven by healthcare procedures. HCV treatment and prevention must become a national priority.

92 citations

Journal ArticleDOI
TL;DR: The Caprini risk assessment model was unable to identify a subset of medical patients who benefit from pharmacologic prophylaxis, and an extremely low incidence of venous thromboembolism events in non-intensive care unit medical patients was observed.

74 citations

Journal ArticleDOI
TL;DR: Hematological and liver dysfunctions measured parameters were seen associated with moderate and severe parasitaemia infection, and could be indicator of malaria in endemic regions.
Abstract: Plasmodium falciparum malaria is the most common infection in Yemen. The present study aims to investigate changes in hematological and hepatic function indices of P. falciparum infected individuals. This study included 67 suspected falciparum malarial patients attended in clinics and rural Abs Hospital (Tehama, Hajjah), Yemen, from October 2013 to April 2014. The diagnosis of malaria was confirmed by thick and thin film with Giemsa staining of malaria parasite. Hematological parameters and serum levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and bilirubin (total and direct) as test indicators of liver function were studied. Patients with parasitaemia tended to have significantly lower hemoglobin, hematocrit, white blood cell count, lymphocytes, and platelets, compared with healthy normal subjects. Neutrophils levels were significantly higher in cases of falciparum malaria in comparison to healthy normal subjects. Serums AST, ALT, ALP, and bilirubin (total and direct) in falciparum malaria patients were significantly higher () than those of falciparum malaria of free individuals. Hematological and liver dysfunctions measured parameters were seen associated with moderate and severe parasitaemia infection. This study concludes that hematological and hepatic dysfunction parameters could be indicator of malaria in endemic regions.

48 citations