elderly, againg

OBJECTIVE: To determine the correlation of functional and nutritional status of elderly patients (equal to and more than 60 years of age) visiting family medicine clinics of tertiary care hospital in Karachi. STUDY DESIGN: Cross-sectional, descriptive study. PLACE AND DURATION OF STUDY: Family medicine clinics of Aga Khan University Hospital, in Karachi, from August 2014 to February 2015. METHODOLOGY: A total of 200 participants (60 years and above), Family medicine outpatient clinics, were recruited via non-probability consecutive sampling...

OBJECTIVE: To find outcomes of emergency bowel surgery and review the processes involved in the care of these patients on the same template used in National Emergency Laparotomy Audit (NELA). STUDY DESIGN: An audit. PLACE AND DURATION OF STUDY: Surgery Department, The Aga Khan University Hospital, Karachi, from December 2013 to November 2014. METHODOLOGY: Patients undergone emergency bowel surgery during the review period were included...

BACKGROUND: Mini-craniotomy for chronic subdural hematoma (CSDH) is associated with lower rates of recurrence. However, the procedure is performed mostly with the patient under general anesthesia (GA) and therefore frequently requires an intensive care unit (ICU) facility, especially in the elderly population. Because of the unavailability of ICU beds, and to avoid GA, we started to perform this procedure with the patient under local anesthesia (LA). MATERIALS AND METHODS: This was a retrospective medical chart review conducted in the section of Neurosurgery at the Aga Khan Hospital in Karachi, Pakistan...

The occurrence of a genetic background in the etiology of polycystic ovarian syndrome (PCOS) represents the rational basis to postulate the existence of a male PCOS equivalent. Hormonal and metabolic abnormalities have been described in male relatives of women with PCOS. These males also have a higher prevalence of early onset (<35 years) androgenetic alopecia (AGA). Hence, this feature has been proposed as a clinical sign of the male PCOS equivalent. Clinical evidence has shown that men with early onset AGA have hormonal and metabolic abnormalities...

The use of rituximab has significantly improved outcomes in patients with haematological malignancies and autoimmune disease. There are reports of rituximab-associated ulcerative colitis; however, we report for the first time, two cases of rituximab-induced Crohn's disease in elderly patients treated for lymphoma. Both patients had evidence of inflammation, ulceration, and granulomas consistent with Crohn's disease, and responded well to immunosuppression. The association of rituximab and ileocolitis suggests a protective effect of CD20 + lymphocytes in the gut, and implicates their depletion to the development and exacerbation of inflammatory bowel disease...

OBJECTIVE: To explore peri-operative risk factors associated with prolonged stay in cardiac intensive care unit among patients undergoing isolated coronary artery bypass grafting. Methods: This retrospective case control study was conducted at the Aga Khan University Hospital, Karachi, comprised medical records of patients who had undergone cardiothoracic revascularisation surgery from January 2006 to December 2013. The patients were grouped into cases and controls at a ratio of 1:2 on the basis of length of stay at cardiac intensive care unit, i...

INTRODUCTION: Androgenetic alopecia (AGA) is characterized by miniaturization of the hair follicle, leading to vellus transformation of the terminal hair follicle. It is caused by interactions between androgens, several genes, and environmental factors with hair follicles. Benign prostatic hyperplasia (BPH) is highly prevalent among elderly men but infrequent in those younger than 40 years. Because both entities share a common pathogenesis and AGA manifests before the onset of BPH, there could be an association between AGA and BPH...

OBJECTIVE: To find out frequency of isolation of carbapenem-resistant enterobacteriaceae and the predominantly responsible metallo-beta-lactamasegene in a hospital setting. METHODS: The descriptive, cross-sectional study was conducted from May 2009 to June 2012 at the Aga Khan University Hospital, Karachi, and comprised non-duplicate clinical carbapenem-resistant enterobacteriaceae isolates obtained from different collection units across Pakistan. Kirby-Bauer disk diffusion screening of carbapenem-resistant enterobacteriaceae was confirmed by minimum inhibitory concentration using E-test...

Over the past decade, the prevalence of chronic kidney disease (CKD) has reached epidemic proportions. The search for novel pharmacological treatment for CKD has become an area of intensive clinical research. l-Carnitine, considered as the "gatekeeper" responsible for admitting long chain fatty acids into cell mitochondria. l-Carnitine synthesis and turnover are regulated mainly by the kidney and its levels inversely correlate with serum creatinine of normal subjects and CKD patients. Previous studies showed that l-carnitine administration to elderly people is improving and preserving cognitive function...

BACKGROUND: Alzheimer's disease (AD) is characterized with progressive memory loss and severe cognitive impairments, which affect everyday life and human health in the elderly. It is required that an effective and safe protective reagent against AD should be developed. It has been reported that humanin (HN) exerts neuroprotective effects against AD. In this study, we investigated the effect of a novel and more effective HN derivative, Colivelin (CLN) on AD. METHODS: PDAPP(V717I) transgenic AD model mice (derived from parental C57/BL6 mice) were used in our study as AD model...

OBJECTIVE: To evaluate early experience with helical hip system in osteoporotic elderly patients with per-trochanteric fractures. METHODS: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of patients having low-velocity pertrochanteric fractures who were fixed with spiral blade Dynamic Helical Hip Systemfrom July to December 2014 and were followed up for a minimum of 3 months. Demographic variables and clinical outcomes were noted from the medical records whereas operative details were recorded from the operative note...

BACKGROUND: Bone remodeling is a continuous and complex process which occurs throughout life. Radiomorphometric and radioangular indices on the orthopantomogram are the predictors of bone remodeling associated with mandible. Bone mineral density is the amount of calcified tissue in a certain volume of the bone. MATERIALS AND METHODS: Fifty normal healthy individuals within the age range of 25-55 years were included in the study. Linear measurements including mandibular cortical width (MCW) and panoramic mandibular index (PMI); and angular measurements including mandibular angle (MA) and antegonial angle (AGA) were recorded...

BACKGROUND: Adverse drug reactions (ADRs) present a challenging and expensive public health problem. Polypharmacy is defined according to the WHO criteria as the, "concurrent use of five or more different prescription medication". Elderly are more prone to adverse reactions due to comorbid conditions, longer lists of medications and sensitivity to drug effects. The aim of the study is to estimate the incidence and strength of association of ADRs due to polypharmacy among the geriatric cohort attending outpatient clinics at a tertiary care center...

OBJECTIVE: The authors sought to investigate the clinical features and characteristics of genetic mutation in patients with aspartylglucosaminuria. METHOD: Clinical data of two pediatric siblings in a family were analyzed retrospectively and relative literature was reviewed in order to study the clinical features, imaging and enzymatic characteristics and genetic mutations. RESULT: Case 1, the proband, male, he was hospitalized at 20 months of age because of fever and hepatosplenomegaly for nine days...

BACKGROUND: Pneumonia represents the leading cause of infection-related death and the fifth cause of overall mortality, in the elderly. With increasing age, the human immune system undergoes characteristic changes which lead to increased incidence and severity of infectious diseases and to insufficient protection following vaccination as antibody response of elderly vaccines are weaker and decline faster. OBJECTIVE: Knowledge and Attitude toward Pneumonia and its Vaccination in elderly patients...

The KhŌja Ismā'ĪlĪs, socially and geographically mobile NĪzarĪ ShĪ'Ītes who are followers of the Aga Khan, have migrated in recent years to many urban areas of North America from South and Central Asia and Africa. Numerous cultural, geographic, and socioeconomic factors are shaping the ways in which over 4,500 Ismā'ĪlĪ households come to grips with providing informal long-term care to aging parents. Case descriptions illustrate some immigrant KhŌja Ismā'ĪlĪ elder-care strategies, as well as the particular limiting and enabling considerations with which Ismā'ĪlĪ families must cope in coordinating, planning and delivering care to their elders...

BACKGROUND: Worldwide the proportion of elderly people in the population is increasing. Currently in Pakistan 7.3 million people (5.6% of total population) are more than 60 years old. This age shift has emerged as an important health issue and is associated with an increased utilization of emergency services by the elderly. We carried out this study to assess the pattern of elderly patients (>60 years) who visit emergency departments in comparison to young adults (18-60 years). METHODS: Data was collected retrospectively of patients aged 18 years or more who visited the Emergency Department (ED) of Aga Khan University Hospital, Karachi (AKUH) during September, 2009 to September, 2011...

OBJECTIVE: To compare the effect of induction position on block characteristics (sensory and motor nerves) and haemodynamic stability in elderly patients with isobaric bupivacaine. Patient comfort was also looked at. METHODS: The randomized single blinded study was conducted at the Aga Khan University Hospital, Karachi, from September 2007 to August 2008. A total of 70 patients aged >60 years of both genders were included. Spinal anaesthesia was performed either in sitting or lateral position according to random allocation...

BACKGROUND: Errors in consuming drugs are associated with significant morbidity and mortality, besides an impact on the already overburdened health-care system. Misunderstanding drug labels and prescriptions plays an important role in contributing to adverse drug events. OBJECTIVE: To evaluate abilities to understand prescriptions and drug labels among patients attending tertiary care hospital in Karachi. METHODS: A cross sectional study was conducted at the Aga Khan University Hospital (AKUH), from January to March 2009...

To determine prevalence and risk factors of trachoma in communities receiving intervention with the SAFE strategy (surgery, antibiotic, face washing, environmental hygiene), a cross-sectional trachoma survey was undertaken in 2006 in the Enemor district of southern Ethiopia where the SAFE program has been implemented for over five years. A sample of 374 household heads and 2,080 individuals were interviewed and examined for trachoma using an established trachoma grading system of the World Health Organization...