Aasim Ahmad | Frontier women university Pakisatn (original) (raw)
Papers by Aasim Ahmad
Journal of the College of Physicians and Surgeons Pakistan, 2019
Objective: To compare adequacy of dialysis between single-use and reused dialyzer in order to asc... more Objective: To compare adequacy of dialysis between single-use and reused dialyzer in order to ascertain whether reuse of dialyzers provides adequate dialysis and thereby enable provision of effective yet affordable renal replacement therapy in resource-limited countries.
Journal of the Pakistan Medical Association
Objective: Despite being an important predictor of morbidity and mortality, routine screening for... more Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64...
Journal of Ayub Medical College Abbottabad
Background: Restless leg syndrome (RLS) is one of the problem hemodialysis patients may encounter... more Background: Restless leg syndrome (RLS) is one of the problem hemodialysis patients may encounter. This study was done to find out the association of restless legs syndrome (RLS) in end stage renal disease patients with serum calcium, phosphorus and parathyroid hormone levels. Methods: This cross-sectional observational study was done at The Kidney Centre, postgraduate Training Institute Karachi, Pakistan from Jan to June 2020. One hundred and twelve patients on three per week hemodialysis for more than three months at our hemodialysis centre were face to face interviewed as per International Restless Legs Syndrome Study Group criteria (IRLSSG) for the presence of RLS symptoms. Their demographic data and laboratory values were recorded from history chart and computer records. The bone mineral profile in this study includes serum calcium (corrected for albumin), serum phosphate levels and serum intact Parathyroid hormone (iPTH) levels. Statistical analyses were done by using SPSS-21....
Journal of the Pakistan Medical Association
Objective: To evaluate the characteristics and outcomes of second wave of coronavirus disease-201... more Objective: To evaluate the characteristics and outcomes of second wave of coronavirus disease-2019 in haemodialysis patients. Method: The retrospective, observational cohort study was conducted at The Kidney Center Post-Graduate-Training-Institute, Karachi, Pakistan and comprised data of patients regardless of gender who contracted coronavirus disease-2019 during the second wave from November 3, 2020, till February 12, 2021. Epidemiological, clinical, laboratory, and radiological characteristics and outcomes the patients were reviewed. Data was analysed using SPSS 21. Results: Of 437 patients on haemodialysis, 46(10.5%) contracted coronavirus disease-2019; 29(63%) males and 17(37%) females. The overall median age was 61.5+/-13.02 years. Most patients developed mild disease 27(%). The most common symptom was fever 29(63%), and 6(13.1%) patients had patchy bilateral opacity on chest radiograph. Major complications were lymphocytopenia 29(63%), pneumonia 15(32.6%), thrombocytopenia 8(1...
Cureus, Dec 13, 2021
Objective: Our study aimed to evaluate the optimal and financially efficient numbers of blood cul... more Objective: Our study aimed to evaluate the optimal and financially efficient numbers of blood cultures (BC) required in our chronic kidney disease (CKD) patients with suspected bloodstream infections (BSI). Design: This is a prospective, cross-sectional study.
Paul Appelbaum and colleagues, in 1982, described the term “Therapeutic Misconception”. This term... more Paul Appelbaum and colleagues, in 1982, described the term “Therapeutic Misconception”. This term points to a misconception that exists among the participants of research studies, where they tend to believe that participating in a study is equivalent to getting treatment and the primary goal of the investigator is interpreted as a therapist, who is deemed to work in the individual patient’s best interests. Similar misconceptions are likely to exist among beneficiaries of philanthropy or humanitarian aid when these agencies conduct or sponsor research projects. The participants may start believing that the aim of such researchers is primarily human welfare and the best interests of individuals instead of research. We have termed this misconception “Philanthropic Misconception”. The primary aim of this article is to create awareness and sensitivity regarding this issue among researchers and sponsors of research when they belong to humanitarian aid awarding bodies. It is also our objec...
Journal of the College of Physicians and Surgeons Pakistan, 2021
Methodology: All participants were initially started on erythropoietin alpha and then converted t... more Methodology: All participants were initially started on erythropoietin alpha and then converted to erythropoietin beta after three months. The effectiveness of the erythropoietin alpha and erythropoietin beta was calculated on the basis of net change of mean hemoglobin and mean hematocrit level in the last four weeks on either erythropoietin therapy. Results: A total of 80 patients completed the study, in which 47 (58.8%) were males while 33 (41.3%) were females. The mean age was 59.7 ± 14.7 years. The net mean hemoglobin change during last 04 weeks was ̶ 0.19 ± 1.2 and ̶ 0.03 ± 1.0 for erythropoietin alpha and erythropoietin erythropoietin beta, respectively (p = 0.41). The net mean hematocrit change during the last four weeks was ̶ 0.45 ± 3.9 and ̶ 0.49 ± 3.7 for erythropoietin alpha and erythropoietin beta, respectively (p = 0.95). The mean weekly erythropoietin dosage per Kg body weight during the last four weeks was 177.6 ± 130.4 IU/Kg/week for erythropoietin alpha and 121.3 ± 69.6 IU/Kg/week for erythropoietin beta (p = <0.001). Conclusion: Erythropoietin alpha and erythropoietin beta have similar therapeutic efficacy in anemia management in chronic kidney disease patients. Reduced dosage of erythropoietin beta achieves and maintains the target hemoglobin level.
Iranian journal of kidney diseases, 2016
Month of Ramadan bring many changes in life style, especially the diet of Muslims all over the wo... more Month of Ramadan bring many changes in life style, especially the diet of Muslims all over the world among both fasting and nonfasting individuals. Hemodialysis patients are kept on restricted diet because of fluid and electrolytes imbalance. The aim of this study was to compare changes in the clinical and biochemical parameters in fasting and nonfasting hemodialysis patients during the Ramadan. In a longitudinal study, we recruited 282 patients who were on maintenance dialysis for more than 3 months. Measurements included body weight, blood pressure, serum potassium, serum albumin, and serum phosphorus at the beginning and during the last week of Ramadan. There were 252 patients who were not fasted while 34 patients were those who fasted during the Ramadan. In the nonfasting hemodialysis patients, serum albumin significantly increased at the end of Ramadan (P < .001), while serum phosphorus levels (P = .004) and diastolic blood pressure (P = .002) showed a decrease as compared w...
Journal of the Pakistan Medical Association
Renal pathologists, nephrologists and transplant surgeons held a meeting in 1991 at Banff, Canada... more Renal pathologists, nephrologists and transplant surgeons held a meeting in 1991 at Banff, Canada, and developed a classification scheme that standardised the international classification of renal allograft biopsies and called it the Banff Classification. Following the first meeting, 15 meetings were held, usually every two years, that revised the classification in the light of new evidence and techniques. The latest printed consensus was after the 2019 meeting in Pittsburgh in the United States of America. Several articles have been published in the last 30 years that have created ambiguities for nephrologists and have made things challenging for the expert pathologists. The current perspective review was planned to make it easy and clear for beginners and for practitioners how the Banff Classification has evolved since its inception. Key Words: Development, Banff classification, Renal allograft rejection.
Journal of the College of Physicians and Surgeons Pakistan, 2019
Objective: To study the clinical characteristics of patients on hemodialysis for more than ten ye... more Objective: To study the clinical characteristics of patients on hemodialysis for more than ten years in order to highlight the modifiable factors that may improve survival in low socioeconomic status.
The American Journal of Bioethics, 2020
During the Ebola virus disease outbreak in West Africa, an advisory panel to the World Health Org... more During the Ebola virus disease outbreak in West Africa, an advisory panel to the World Health Organization (WHO) argued that it can be ethically appropriate to offer individual patients experimenta...
Journal of Nephrology & Renal Diseases, 2018
Introduction: Diabetes mellitus (DM) and hypertension (HTN) are considered as the leading causes ... more Introduction: Diabetes mellitus (DM) and hypertension (HTN) are considered as the leading causes of CKD all around the world. But the causes of CKD differ from region to region. In developing countries the population is heterogeneous therefore regional causes of CKD need to be evaluated. Material and method: This cross sectional study included all adult CKD patients, who visited to nephrology service in two tertiary care hospitals in metropolitan city Karachi in Pakistan. The sociodemographic data was collected by interview through a structured questionnaire while laboratory data was collected from patients records. Results: Diabetic nephropathy (DNP) was the main cause of CKD (37.5%) followed by hypertensive nephropathy (17.1%) and obstructive nephropathy (ONP) (12.7%). ONP and hereditary disorders (HD) were more prevalent in males than females (70. 1% vs. 29.9%) and (75% vs. 25%) respectively, while urinary tract infection (UTI), drug induced kidney disease and tubulointerstitial nephritis (TIN) were more common in females than in males (87.5% vs. 12.5%), (75.8% vs.24.2%) and (64.7% vs. 35.3%) respectively. Gender, area of residence and socioeconomic status were the factors which affect the cause of CKD (p ≤ 0.05). Conclusion: DNP and hypertensive nephropathy were more prevalent in urban, educated males with high socioeconomic background. On the other hand CKD of unknown etiology and stone diseases were more common in rural, uneducated, males with low socioeconomic background.
Cureus
The aim of our study was to evaluate the incidence, causes, risk factors, outcomes, and cost of h... more The aim of our study was to evaluate the incidence, causes, risk factors, outcomes, and cost of hospital readmission after live related renal transplantation (LRRT). Methods We conducted a cross-sectional study and followed patients' re-admissions for six months whose LRRT was done in our center between September 2019 and June 2020. Results We recruited 53 patients, 40 (75.5%) were male. The mean age was 36.9 ± 11.9 years. Donor gender was similar, and their mean age was 31.6 ± 9.2 years. The mean length of hospital stay after LRRT was 14 ± 2.2 days. A total of 81.1% were readmitted after LRRT within the first six months, with a total of 113 readmissions. The median time of readmission after LRRT was 66 days. The median readmission hospital stay was four days. The causes of readmission were surgical in 11 (9.7%), medical in 89 (78.8%), and combined medical and surgical in 13 (11.5%). Infection was the most common medical cause, followed by rejection. Statistically significant difference between readmission and non-readmission groups was found in estimated glomerular filtration rate (eGFR) at six month 61.3 ± 25.9 vs. 84.3 ± 36.1 mL/min/1.73 m 2 respectively (p = 0.02). The median cost of readmission was PKR 40629, equivalent to USD 261. Conclusion Over three-fourths of the patients were readmitted after LRRT within the first six months. The most common causes were infection and rejection. Readmissions after LRRT are associated with lower graft function at six months and a significant cost burden on the health system.
Journal of the College of Physicians and Surgeons Pakistan, 2019
Objective: To compare adequacy of dialysis between single-use and reused dialyzer in order to asc... more Objective: To compare adequacy of dialysis between single-use and reused dialyzer in order to ascertain whether reuse of dialyzers provides adequate dialysis and thereby enable provision of effective yet affordable renal replacement therapy in resource-limited countries.
Journal of the Pakistan Medical Association
Objective: Despite being an important predictor of morbidity and mortality, routine screening for... more Objective: Despite being an important predictor of morbidity and mortality, routine screening for malnutrition in dialysis patients is not a common practice in Pakistan. Modified Subjective Global Assessment (SGA) is a convenient, inexpensive and practical method to assess nutritional status particularly in resource limited setup. Methods: This cross sectional study was conducted in The Kidney Center Post Graduate Training institute (TKC-PGTI). Patients on maintenance hemodialysis (MHD) were included through non-probability consecutive sampling. A one-time SGA score was calculated based on the history and physical examinations using modified SGA or Dialysis Malnutrition Score (DMS). Chi square test was applied to find association between variables, while to observe the amount of effect of factors on SGA score; binary logistic regression analysis was run. P value of ? 0.05 considered significant. Results: Mild-Moderately malnourished patients were the most frequent in our study 96(64...
Journal of Ayub Medical College Abbottabad
Background: Restless leg syndrome (RLS) is one of the problem hemodialysis patients may encounter... more Background: Restless leg syndrome (RLS) is one of the problem hemodialysis patients may encounter. This study was done to find out the association of restless legs syndrome (RLS) in end stage renal disease patients with serum calcium, phosphorus and parathyroid hormone levels. Methods: This cross-sectional observational study was done at The Kidney Centre, postgraduate Training Institute Karachi, Pakistan from Jan to June 2020. One hundred and twelve patients on three per week hemodialysis for more than three months at our hemodialysis centre were face to face interviewed as per International Restless Legs Syndrome Study Group criteria (IRLSSG) for the presence of RLS symptoms. Their demographic data and laboratory values were recorded from history chart and computer records. The bone mineral profile in this study includes serum calcium (corrected for albumin), serum phosphate levels and serum intact Parathyroid hormone (iPTH) levels. Statistical analyses were done by using SPSS-21....
Journal of the Pakistan Medical Association
Objective: To evaluate the characteristics and outcomes of second wave of coronavirus disease-201... more Objective: To evaluate the characteristics and outcomes of second wave of coronavirus disease-2019 in haemodialysis patients. Method: The retrospective, observational cohort study was conducted at The Kidney Center Post-Graduate-Training-Institute, Karachi, Pakistan and comprised data of patients regardless of gender who contracted coronavirus disease-2019 during the second wave from November 3, 2020, till February 12, 2021. Epidemiological, clinical, laboratory, and radiological characteristics and outcomes the patients were reviewed. Data was analysed using SPSS 21. Results: Of 437 patients on haemodialysis, 46(10.5%) contracted coronavirus disease-2019; 29(63%) males and 17(37%) females. The overall median age was 61.5+/-13.02 years. Most patients developed mild disease 27(%). The most common symptom was fever 29(63%), and 6(13.1%) patients had patchy bilateral opacity on chest radiograph. Major complications were lymphocytopenia 29(63%), pneumonia 15(32.6%), thrombocytopenia 8(1...
Cureus, Dec 13, 2021
Objective: Our study aimed to evaluate the optimal and financially efficient numbers of blood cul... more Objective: Our study aimed to evaluate the optimal and financially efficient numbers of blood cultures (BC) required in our chronic kidney disease (CKD) patients with suspected bloodstream infections (BSI). Design: This is a prospective, cross-sectional study.
Paul Appelbaum and colleagues, in 1982, described the term “Therapeutic Misconception”. This term... more Paul Appelbaum and colleagues, in 1982, described the term “Therapeutic Misconception”. This term points to a misconception that exists among the participants of research studies, where they tend to believe that participating in a study is equivalent to getting treatment and the primary goal of the investigator is interpreted as a therapist, who is deemed to work in the individual patient’s best interests. Similar misconceptions are likely to exist among beneficiaries of philanthropy or humanitarian aid when these agencies conduct or sponsor research projects. The participants may start believing that the aim of such researchers is primarily human welfare and the best interests of individuals instead of research. We have termed this misconception “Philanthropic Misconception”. The primary aim of this article is to create awareness and sensitivity regarding this issue among researchers and sponsors of research when they belong to humanitarian aid awarding bodies. It is also our objec...
Journal of the College of Physicians and Surgeons Pakistan, 2021
Methodology: All participants were initially started on erythropoietin alpha and then converted t... more Methodology: All participants were initially started on erythropoietin alpha and then converted to erythropoietin beta after three months. The effectiveness of the erythropoietin alpha and erythropoietin beta was calculated on the basis of net change of mean hemoglobin and mean hematocrit level in the last four weeks on either erythropoietin therapy. Results: A total of 80 patients completed the study, in which 47 (58.8%) were males while 33 (41.3%) were females. The mean age was 59.7 ± 14.7 years. The net mean hemoglobin change during last 04 weeks was ̶ 0.19 ± 1.2 and ̶ 0.03 ± 1.0 for erythropoietin alpha and erythropoietin erythropoietin beta, respectively (p = 0.41). The net mean hematocrit change during the last four weeks was ̶ 0.45 ± 3.9 and ̶ 0.49 ± 3.7 for erythropoietin alpha and erythropoietin beta, respectively (p = 0.95). The mean weekly erythropoietin dosage per Kg body weight during the last four weeks was 177.6 ± 130.4 IU/Kg/week for erythropoietin alpha and 121.3 ± 69.6 IU/Kg/week for erythropoietin beta (p = <0.001). Conclusion: Erythropoietin alpha and erythropoietin beta have similar therapeutic efficacy in anemia management in chronic kidney disease patients. Reduced dosage of erythropoietin beta achieves and maintains the target hemoglobin level.
Iranian journal of kidney diseases, 2016
Month of Ramadan bring many changes in life style, especially the diet of Muslims all over the wo... more Month of Ramadan bring many changes in life style, especially the diet of Muslims all over the world among both fasting and nonfasting individuals. Hemodialysis patients are kept on restricted diet because of fluid and electrolytes imbalance. The aim of this study was to compare changes in the clinical and biochemical parameters in fasting and nonfasting hemodialysis patients during the Ramadan. In a longitudinal study, we recruited 282 patients who were on maintenance dialysis for more than 3 months. Measurements included body weight, blood pressure, serum potassium, serum albumin, and serum phosphorus at the beginning and during the last week of Ramadan. There were 252 patients who were not fasted while 34 patients were those who fasted during the Ramadan. In the nonfasting hemodialysis patients, serum albumin significantly increased at the end of Ramadan (P < .001), while serum phosphorus levels (P = .004) and diastolic blood pressure (P = .002) showed a decrease as compared w...
Journal of the Pakistan Medical Association
Renal pathologists, nephrologists and transplant surgeons held a meeting in 1991 at Banff, Canada... more Renal pathologists, nephrologists and transplant surgeons held a meeting in 1991 at Banff, Canada, and developed a classification scheme that standardised the international classification of renal allograft biopsies and called it the Banff Classification. Following the first meeting, 15 meetings were held, usually every two years, that revised the classification in the light of new evidence and techniques. The latest printed consensus was after the 2019 meeting in Pittsburgh in the United States of America. Several articles have been published in the last 30 years that have created ambiguities for nephrologists and have made things challenging for the expert pathologists. The current perspective review was planned to make it easy and clear for beginners and for practitioners how the Banff Classification has evolved since its inception. Key Words: Development, Banff classification, Renal allograft rejection.
Journal of the College of Physicians and Surgeons Pakistan, 2019
Objective: To study the clinical characteristics of patients on hemodialysis for more than ten ye... more Objective: To study the clinical characteristics of patients on hemodialysis for more than ten years in order to highlight the modifiable factors that may improve survival in low socioeconomic status.
The American Journal of Bioethics, 2020
During the Ebola virus disease outbreak in West Africa, an advisory panel to the World Health Org... more During the Ebola virus disease outbreak in West Africa, an advisory panel to the World Health Organization (WHO) argued that it can be ethically appropriate to offer individual patients experimenta...
Journal of Nephrology & Renal Diseases, 2018
Introduction: Diabetes mellitus (DM) and hypertension (HTN) are considered as the leading causes ... more Introduction: Diabetes mellitus (DM) and hypertension (HTN) are considered as the leading causes of CKD all around the world. But the causes of CKD differ from region to region. In developing countries the population is heterogeneous therefore regional causes of CKD need to be evaluated. Material and method: This cross sectional study included all adult CKD patients, who visited to nephrology service in two tertiary care hospitals in metropolitan city Karachi in Pakistan. The sociodemographic data was collected by interview through a structured questionnaire while laboratory data was collected from patients records. Results: Diabetic nephropathy (DNP) was the main cause of CKD (37.5%) followed by hypertensive nephropathy (17.1%) and obstructive nephropathy (ONP) (12.7%). ONP and hereditary disorders (HD) were more prevalent in males than females (70. 1% vs. 29.9%) and (75% vs. 25%) respectively, while urinary tract infection (UTI), drug induced kidney disease and tubulointerstitial nephritis (TIN) were more common in females than in males (87.5% vs. 12.5%), (75.8% vs.24.2%) and (64.7% vs. 35.3%) respectively. Gender, area of residence and socioeconomic status were the factors which affect the cause of CKD (p ≤ 0.05). Conclusion: DNP and hypertensive nephropathy were more prevalent in urban, educated males with high socioeconomic background. On the other hand CKD of unknown etiology and stone diseases were more common in rural, uneducated, males with low socioeconomic background.
Cureus
The aim of our study was to evaluate the incidence, causes, risk factors, outcomes, and cost of h... more The aim of our study was to evaluate the incidence, causes, risk factors, outcomes, and cost of hospital readmission after live related renal transplantation (LRRT). Methods We conducted a cross-sectional study and followed patients' re-admissions for six months whose LRRT was done in our center between September 2019 and June 2020. Results We recruited 53 patients, 40 (75.5%) were male. The mean age was 36.9 ± 11.9 years. Donor gender was similar, and their mean age was 31.6 ± 9.2 years. The mean length of hospital stay after LRRT was 14 ± 2.2 days. A total of 81.1% were readmitted after LRRT within the first six months, with a total of 113 readmissions. The median time of readmission after LRRT was 66 days. The median readmission hospital stay was four days. The causes of readmission were surgical in 11 (9.7%), medical in 89 (78.8%), and combined medical and surgical in 13 (11.5%). Infection was the most common medical cause, followed by rejection. Statistically significant difference between readmission and non-readmission groups was found in estimated glomerular filtration rate (eGFR) at six month 61.3 ± 25.9 vs. 84.3 ± 36.1 mL/min/1.73 m 2 respectively (p = 0.02). The median cost of readmission was PKR 40629, equivalent to USD 261. Conclusion Over three-fourths of the patients were readmitted after LRRT within the first six months. The most common causes were infection and rejection. Readmissions after LRRT are associated with lower graft function at six months and a significant cost burden on the health system.