Asma mushtaq - Academia.edu (original) (raw)

Papers by Asma mushtaq

This paper delves into the evolution and enduring impact of Persian culture in Kashmir often refe... more This paper delves into the evolution and enduring impact of Persian culture in Kashmir often referred to as "Iran-e-Sageer" (little Iran), its historical trajectory, cultural prominence and eventual decline. From the fourteenth to the eighteenth centuries, Kashmir experienced a cultural renaissance under the influence of Persian literature introduced largely by Islamic missionaries. The arrival of Persians significantly shaped the region's artistic and intellectual landscape, as it became the court language during the sultanate period. Sultan Zain-ul-Abideen championed Persian's role in administration, literature, and the arts, solidifying its importance in Kashmiri society. The influence of Persian, however, precedes Islam, with historical ties dating back to the Achaemenid Empire, later reinforced by Sufi luminaries like Syed Bulbul Shah and Mir Sayyid Ali Hamadani. This study employs a historical-analytical methodology, drawing from Persian texts, Kashmiri records, and colonial archives to trace Persian's gradual decline during the nineteenth century, attributed to shifts under Afghan, Sikh, Dogra and British rule. These political transitions replaced Persian with Urdu and English in educational and administrative systems, exacerbating its erosion. Post-1947, Urdu as the official language further marginalised Persian, severing contemporary Kashmiris from much of their literary heritage. This study also highlights Persian's enduring legacy in Kashmiri art, architecture, and literature, as reflected in Persian poetry and mosque motifs. It argues that while Persian's institutional presence has waned, its cultural imprint remains intrinsic to Kashmiri identity, reflecting a unique intellectual heritage. The objective is to underscore the historical significance of Persian culture in Kashmir and its lasting influence while assessing the socio-political factors that led to its decline, ultimately fostering an understanding of Persian's contribution to Kashmir's cultural identity.

The verifiable account of Islam-west relations, beginning favourably from the hour of the prophet... more The verifiable account of Islam-west relations, beginning favourably from the hour of the prophet, turns towards strife after some time. Despite a generally negative understanding throughout history, seismic events, notably the US-led war on terrorism, led to many in the Muslim world feeling targeted. This, thus, powered islamophobia, exacerbated by bombings, the ascent of ISIS, and a stressed connection between Muslim nations and Europe. The expression "islamophobia" itself assigns trepidation and antagonism towards Muslims, driven by prejudice and coming about in exclusionary, biased, and savage activities against those apparent as Muslim. This prejudice is rooted in the notion that Islam is an inferior religion posing a threat to dominant societal values. Discusses encompassing the reasons for islamophobia, especially attached to the fallout of the September 11 assaults, have been unmistakable among analysts. While islamophobia earned boundless respect in the last part of the 1990s, verifiable antagonism towards Islam in the West follows back to medieval times. In multicultural social orders, ideas like islamophobia are utilized to make sense of acts against Muslim diasporas by non-Muslims. The expression of Islamophobia takes various forms, often aligning with traditional Western Christian views and the Occident versus Orient narrative. The period since the tragic events of September 11, 2001, and subsequent international developments has seen a considerable deterioration in relations between the so-called Muslim world and the West over the past three decades. This paper aims to explore the underlying realities shaping Islam-West relations and giving rise to Islamophobia. The increased focus on Islam, the Muslim world, and Muslims in Western Europe in scholarly and journalistic publications is spurred by key global events, including the Iranian revolution, the Rushdie affair, the Gulf War, and the growing political significance of Islam.

The development of neo-orientalism in the 21 st century investigates the advancing talk encompass... more The development of neo-orientalism in the 21 st century investigates the advancing talk encompassing Islam and the Muslim world. It digs into the authentic setting of Orientalism, accentuating Edward Said's persuasive study and its effect on the Western impression of the East. The conversation follows the advancement of neoorientalists, featuring its coherence with traditional orientalism while adjusting to contemporary intricates, particularly after the occasions of 9/11. The point of this paper is how neo-orientalism mirrors the moving elements between the West and the East, examining the interconnectedness of islamophobia, scholarly exploration and worldwide legislative issues. It then explores the intersection of secularism and religion in the context of Orientalism, emphasizing the influence of Western scholars on Muslim-majority nations. It also presents a comprehensive manifestation and its impact on cultural perceptions and academic discourse.

SSRN Electronic Journal, 2010

The major concern of this paper is the women prisoners in Pakistan however; various International... more The major concern of this paper is the women prisoners in Pakistan however; various International laws and laws in Pakistan related to the prisoners will also be focused. It is thoroughly examined that what is the condition of women prisoners in Pakistan and what are the constitutional measures granted to them. Types of prisons, ages and classification of prisoners are also considered.

Genes

Autosomal recessive congenital hereditary endothelial dystrophy (CHED2) may be misdiagnosed as pr... more Autosomal recessive congenital hereditary endothelial dystrophy (CHED2) may be misdiagnosed as primary congenital glaucoma (PCG) due to similar clinical phenotypes during early infancy. In this study, we identified a family with CHED2, which was previously misdiagnosed as having PCG, and followed up for 9 years. Linkage analysis was first completed in eight PCG-affected families, followed by whole-exome sequencing (WES) in family PKGM3. The following in silico tools were used to predict the pathogenic effects of identified variants: I-Mutant 2.0, SIFT, Polyphen-2, PROVEAN, mutation taster and PhD-SNP. After detecting an SLC4A11 variant in one family, detailed ophthalmic examinations were performed again to confirm the diagnosis. Six out of eight families had CYP1B1 gene variants responsible for PCG. However, in family PKGM3, no variants in the known PCG genes were identified. WES identified a homozygous missense variant c.2024A>C, p.(Glu675Ala) in SLC4A11. Based on the WES findin...

Cardiology in the Young

Objectives: We aim to describe the early and upto 16 months follow-up of post-coronavirus disease... more Objectives: We aim to describe the early and upto 16 months follow-up of post-coronavirus disease (COVID), multi-system inflammatory syndrome in children (MIS-C), with special reference to cardiac involvement. Study design: This cohort non-interventional descriptive study included patients <18 years admitted between May, 2020 and April, 2021. Based on underlying similarities, children were classified as post-COVID MIS-C with overlapping Kawasaki Disease, MIS-C with no overlapping Kawasaki Disease, and MIS-C with shock. Post-discharge, patients were followed at 1, 3, 6, 12, and 16 months. Results: Forty-one patients predominantly males (73%), at median age of 7 years (range 0.2–16 years) fulfilled the World Health Organisation criteria for MIS-C. Cardiac involvement was seen in 15 (36.5%); impaired left ventricle (LV) function in 5 (12.2%), coronary artery involvement in 10 (24.4%), pericardial effusion in 6 (14.6%) patients, and no arrhythmias. There were two hospital deaths (4.9...

Journal of Fatima Jinnah Medical University, 2022

Background: The aim of this study was to find out the effectiveness of trans-scleral cyclophotoco... more Background: The aim of this study was to find out the effectiveness of trans-scleral cyclophotocoagulation in lowering intraocular pressure in the paediatric population.Patients and methods: This quasi-experimental study was conducted between July 2020 and January 2021 in Department of Ophthalmology, The Children’s Hospital, Lahore. Total 45 eyes of 42 children of age 1-14 years, both genders, with glaucoma were enrolled in this study. Diode cyclophotocoagulation unit and probe of make Quantel Medical was used for cycloablation under general anesthesia. Postoperative intraocular pressure was noted by using handheld Perkins applanation tonometer Mk2 after every 3 weeks for 12 weeks. If an IOP of ≤21mmHg was achieved, then efficacy or success was labeled. Patients with an IOP of >21mmHg after 12 weeks were selected for repeat cycloablation treatment. Failure was labeled to an IOP of >21mmHg even after a repeat session. Data analysis was done using SPSS 24. Results: In this study...

Journal of Fatima Jinnah Medical University, 2021

Background: Culture from various infected body fluids is one of the commonly used investigations ... more Background: Culture from various infected body fluids is one of the commonly used investigations to establish the etiology of infections and helps clinicians to select appropriate antimicrobial therapy. This study is aimed to determine the culture and sensitivity patterns of bacteriological agents grown in children admitted to a tertiary care center. Patients and methods: This descriptive cross-sectional study was conducted at the Department of Pediatric Medicine, The Children’s Hospital and the Institute of Child Health, Lahore from April 2019 to December 2019. All admitted children of age £ 15 years who fulfilled the criteria of systemic inflammatory response syndrome and sepsis were enrolled in the study. Blood and other body fluids were cultured in appropriate medium as indicated. Profile of microorganisms grown and their sensitivity patterns were noted and recorded on a predesigned data sheet. Statistical analysis was performed by SPSS v.22. Results: A total of 500 patients wer...

Pakistan Journal of Ophthalmology, 2022

Purpose: To find out the causes of delayed presentation of Retinoblastoma in a tertiary care hos... more Purpose: To find out the causes of delayed presentation of Retinoblastoma in a tertiary care hospital. Study Design: Questionnaire based Survey. Place and Duration of Study: Pediatric ophthalmology department of The Children’s Hospital, Lahore, from January 2018 to December 2019. Methods: Mothers of patients who presented in the hospital were recruited for this survey. A questionnaire with details of the patient were noted. It included first symptom, time lapse since onset of first symptom, gender, age at presentation to first doctor (general practitioner), time lapse to presentation at tertiary care center (The Children’s Hospital & Institute of Child health), gender and laterality. General physical Examination was done by an oncologist and examination under anesthesia was done by a pediatric ophthalmologist. Data was analyzed using SPSS version 20. Pearson Chi Square test was used to find significance of each cause. Results: Seventy participants were included in the study. De...

The British Journal of Surgery, 2021

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...

The Professional Medical Journal, 2021

Objective: To determine the types, clinical spectrum and outcome of Extra-Pulmonary Tuberculosis ... more Objective: To determine the types, clinical spectrum and outcome of Extra-Pulmonary Tuberculosis (EPTB) in children admitted at a tertiary care hospital. Study Design: Cross Sectional study. Setting: The Children's Hospital and The Institute of Child Health, Lahore. Period: May to December 2019. Material & Methods: A total of 63 patients diagnosed with EPTB aged 1 month to 16 years were included. All patients with lung involvement were excluded from the study. Anti-tuberculous therapy (ATT) was started in all patients and outcome was monitored during the hospital stay. Results: In a total of 63 patients, mean age was 9.03+3.1 years. There were 35 (55.5%) male and 28 (44.4%) female. The mean duration of symptoms at the time of presentation was 5.93+2.4 months. The common sites of EPTB were meninges noted in 17(26.9%), pleural in 13 (20.6%), abdominal in 12 (19.04%), lymph nodes in 11 (17.4%), disseminated in 6 (9.52%) and bone and joints in 4 (6.34%) patients. The most common sys...

Background: Renal damage frequently complicates perinatal asphyxia. Renal vasoconstriction due to... more Background: Renal damage frequently complicates perinatal asphyxia. Renal vasoconstriction due to adenosine metabolite leads to a fall in glomerular filtration rate (GFR) and filtration fraction (FF). This might be inhibited by the nonspecific adenosine receptor antagonist, theophylline. Objective: To determine the efficacy of prophylactic theophylline in prevention of acute renal failure in term neonates exposed to perinatal asphyxia. Material and Methods: This descriptive case series was conducted at Department of Neonatology, The Children’s Hospital, Lahore for 6 months. Total 75 asphyxiated term infants were included through non-probability purposive sampling technique. Children received 5 mg/kg single dose of IV theophylline during first 24 hours of life. Fluid intake, urine output, serum creatinine was recorded on proforma. The data was analyzed using SPSS version 20. The efficacy of theophylline was calculated as frequency and percentage. Results: Mean age of presentation was...

Interval methods offer quite new research aspects regarding Digital Signal Processing. In scenari... more Interval methods offer quite new research aspects regarding Digital Signal Processing. In scenarios like finite numeric representation, limited precision sensors or the quantization process, signal processing has been practicing interval mathematics as quite a reliable gizmo for expressing the uncertainties. Some types of control systems like estimating or soft computing systems, the uncertainties are caused due to the presence of variable instability, variance of signal, or the rate of safety of some actuators. Since most DSPs are designed to work in real time environments, effective implementation of interval arithmetic for these processors asks for fast processing capabilities. Hence the aim is to develop an environment that facilitates interval arithmetic operations to be executed at the very same computational speed as is offered in many contemporary signal processors. So we are proposing the design and implementation of Interval Arithmetic multiplier that functions with IEEE 7...

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2013

OBJECTIVE To determine the spectrum of clinical presentation, laboratory parameters and drug ther... more OBJECTIVE To determine the spectrum of clinical presentation, laboratory parameters and drug therapy in patients with Juvenile Rheumatoid Arthritis (JRA). STUDY DESIGN Case series. PLACE AND DURATION OF STUDY The Children's Hospital and The Institute of Child Health, Lahore, from October 2008 to October 2011. METHODOLOGY All patients who fulfilled the American College of Rheumatology criteria for JRA were enrolled. Their clinical features, investigations done and treatment received for JRA were noted. Statistical analysis of data was done on SPSS version 16.0 for obtaining descriptive statistics. RESULTS Out of 185 patients, 50.3% (n = 93) were females; 54% (n = 100) were between 10 - 15 years of age. Polyarthritis was found in 71.9% (n = 133) followed by oligoarthritis (22.7%, n = 42) and systemic onset disease (5.4%, n = 10). Morning stiffness (78%) and fever (68%) were the most common clinical presentations. All patients with systemic onset disease had fever (n = 10) followed...

Pakistan Journal of Medical and Health Sciences, 2021

Aim: To analyze clinical manifestations, course and outcome of Langerhans Cell Histiocytosis in c... more Aim: To analyze clinical manifestations, course and outcome of Langerhans Cell Histiocytosis in children in resource limited settings lacking salvage therapy. Study design: Observational retrospective study Place and duration of study: Department of Haematology/Oncology, The Children’s Hospital, Lahore Pakistan from 1st January 2011 to 31st December 2018. Methodology: Sixty-five patients with age range from<1 to 8 years included analysing their age, gender, clinical classification, course of therapy and outcome. The major treatment was composed of either prednisolone and vinblastine or cytarabine pulses. Results: There were 59% males and 41% females. Forty-seven (72%) patients presented with multi system-LCH with 49% Risk Organ involvement. Most of them 42 (65%) had bone lesions while 15patients (23%) presented with central nervous system involvement. Forty patients (61%) have completed treatment, 11(17%) left against medical advice and 12(18%)patients expired due to progressive ...

Malaysian Journal of Paediatrics and Child Health, 2017

Background: Pneumonia is defined as the inflammation of parenchyma of the lung. It is a substanti... more Background: Pneumonia is defined as the inflammation of parenchyma of the lung. It is a substantial cause of morbidity and mortality in childhood throughout the world. The incidence of pneumonia in children under the age of five years is 0.29 episodes per child-year, which equates 151.8 million cases annually in developing countries. Objective: To determine the risk factors for complicated pneumonia. Material and Methods: This case-control study conducted in Medical Unit III, The Children’s Hospital & Institute of Child Health Lahore. Out of total of 180 cases of pneumonia, 100 were labeled as complicated pneumonia (case) and 80 were labeled as uncomplicated pneumonia (control). Complicated pneumonia included pneumonia with associated complications. Detail history was taken in both groups and recorded on predesigned proforma. Data was analyzed by SPSS 20. Quantitative risk factors like child age, maternal age and father age were analyzed by mean and standard deviation. However quali...

Natural Science, 2021

The government of Pakistan started vaccination campaign for the frontline healthcare providers, a... more The government of Pakistan started vaccination campaign for the frontline healthcare providers, as they are more likely to be exposed to COVID-19 patients. In the next step, it extended the free vaccination campaign to include people above 60 and 50 years of age respectively. The drive is now open to all citizens >18 years of age. There is a significant reluctance to get vaccinated even though the government has provided it free of cost. The project uses self-reporting method to assess reasons of vaccine hesitancy among Pakistanis and possible solutions to overcome this problem. Concern for serious side effects was the most common issue 154 (48.42%) reported among all groups of people, including the healthcare workers. The major sources of COVID-19 related information were television 117 (36.8%) and healthcare professionals 105 (33%). The participants reported that they can be convinced to get vaccinated if more published data related to vaccine efficacy and safety is available 118 (37.1%), they observe no side effect among vaccine recipients 90 (28.3%) or higher government officials get the same vaccine 39 (12.3%). Vigorous analysis and publication of data generated is paramount to increase the percentage of people being vaccinated. The healthcare professionals should share evidence-based knowledge related to vaccine efficacy and safety through television and social media to increase acceptance rates and hence, decrease mortality and morbidity from COVID-19 in Pakistan.

SSRN Electronic Journal, 2021

Background: There is very limited data on the follow-up of multisystem inflammatory syndrome in c... more Background: There is very limited data on the follow-up of multisystem inflammatory syndrome in children (MIS-C). We aim to describe the early and up-to 16 months follow-up of MIS-C, with special reference to cardiac involvement. Methods: This cohort non-interventional descriptive study included patients < 18years admitted between May 2020 and April 2021. Based on underlying similarities children were classified as post-COVID MIS-C with overlapping Kawasaki Disease, MISC with no overlapping Kawasaki Disease and MIS-C with shock. Post-discharge, patients were followed at 1, 3, 6, 12 and 16 months. Findings: Forty-one patients predominantly males (73%), at a median age of 7(0.2-16) years fulfilled the World Health Organisation criteria for MIS-C. Cardiac involvement was seen in 15 (36.5%) patients;impaired left ventricle (LV) function in 5 (12.2%), coronary artery involvement in 10 (24.4%), and pericardial effusion in 6 (14.6%) patients. No arrhythmia was noted in any case. There were 2 hospital deaths (4.9%), both in MIS-C shock subgroup (20%). At one-month there was persistent LV dysfunction in 2/5, coronary artery abnormalities in 7/10 and pericardial effusion resolved completely in all patients. By 6-months LV function returned to normal in all but coronary abnormalities persisted in 2 patients. At last follow-up [median 9.8 (interquartile range, 2-16) months], in 36/38 (94.7%) patients, coronary artery dilatation was persistent in 2 (20%) patients. Interpretations: Children with MIS-C have a good early outcome although MIS-C with shock, if diagnosed late, has a high mortality. On midterm follow-up, there is normalisation of LV function in all and recovery of coronary abnormalities in 80% of patients. Longer-term follow-up will define the extended natural history of coronary artery involvement in MIS-C.

The Professional Medical Journal, 2021

Objectives: To determine the etiology of Fever of Unknown Origin (FUO) in children. Study Design:... more Objectives: To determine the etiology of Fever of Unknown Origin (FUO) in children. Study Design: Prospective Observational study. Setting: Department of Pediatric Medicine, The Children's Hospital, Lahore. Period: August 2019 to January 2020. Material & Methods: A total of 45 children aged between 01 to 180 months (15 years), having FUO were included. FUO was defined as a temperature of greater than 100.4ºF documented by a health care provider, persisting over a period of three weeks and for which no cause could be identified after at least 8 days of evaluation. All the study information was analyzed by using standard software SPSS 20. The quantitative variables like age and duration of fever before hospital admission were presented as mean and standard deviation. Qualitative variables like sex, antibiotic therapy use before definitive diagnosis and various diagnoses made were presented as frequencies and percentages. Results: The patient’s age range was from 01 to 180 months w...

This paper delves into the evolution and enduring impact of Persian culture in Kashmir often refe... more This paper delves into the evolution and enduring impact of Persian culture in Kashmir often referred to as "Iran-e-Sageer" (little Iran), its historical trajectory, cultural prominence and eventual decline. From the fourteenth to the eighteenth centuries, Kashmir experienced a cultural renaissance under the influence of Persian literature introduced largely by Islamic missionaries. The arrival of Persians significantly shaped the region's artistic and intellectual landscape, as it became the court language during the sultanate period. Sultan Zain-ul-Abideen championed Persian's role in administration, literature, and the arts, solidifying its importance in Kashmiri society. The influence of Persian, however, precedes Islam, with historical ties dating back to the Achaemenid Empire, later reinforced by Sufi luminaries like Syed Bulbul Shah and Mir Sayyid Ali Hamadani. This study employs a historical-analytical methodology, drawing from Persian texts, Kashmiri records, and colonial archives to trace Persian's gradual decline during the nineteenth century, attributed to shifts under Afghan, Sikh, Dogra and British rule. These political transitions replaced Persian with Urdu and English in educational and administrative systems, exacerbating its erosion. Post-1947, Urdu as the official language further marginalised Persian, severing contemporary Kashmiris from much of their literary heritage. This study also highlights Persian's enduring legacy in Kashmiri art, architecture, and literature, as reflected in Persian poetry and mosque motifs. It argues that while Persian's institutional presence has waned, its cultural imprint remains intrinsic to Kashmiri identity, reflecting a unique intellectual heritage. The objective is to underscore the historical significance of Persian culture in Kashmir and its lasting influence while assessing the socio-political factors that led to its decline, ultimately fostering an understanding of Persian's contribution to Kashmir's cultural identity.

The verifiable account of Islam-west relations, beginning favourably from the hour of the prophet... more The verifiable account of Islam-west relations, beginning favourably from the hour of the prophet, turns towards strife after some time. Despite a generally negative understanding throughout history, seismic events, notably the US-led war on terrorism, led to many in the Muslim world feeling targeted. This, thus, powered islamophobia, exacerbated by bombings, the ascent of ISIS, and a stressed connection between Muslim nations and Europe. The expression "islamophobia" itself assigns trepidation and antagonism towards Muslims, driven by prejudice and coming about in exclusionary, biased, and savage activities against those apparent as Muslim. This prejudice is rooted in the notion that Islam is an inferior religion posing a threat to dominant societal values. Discusses encompassing the reasons for islamophobia, especially attached to the fallout of the September 11 assaults, have been unmistakable among analysts. While islamophobia earned boundless respect in the last part of the 1990s, verifiable antagonism towards Islam in the West follows back to medieval times. In multicultural social orders, ideas like islamophobia are utilized to make sense of acts against Muslim diasporas by non-Muslims. The expression of Islamophobia takes various forms, often aligning with traditional Western Christian views and the Occident versus Orient narrative. The period since the tragic events of September 11, 2001, and subsequent international developments has seen a considerable deterioration in relations between the so-called Muslim world and the West over the past three decades. This paper aims to explore the underlying realities shaping Islam-West relations and giving rise to Islamophobia. The increased focus on Islam, the Muslim world, and Muslims in Western Europe in scholarly and journalistic publications is spurred by key global events, including the Iranian revolution, the Rushdie affair, the Gulf War, and the growing political significance of Islam.

The development of neo-orientalism in the 21 st century investigates the advancing talk encompass... more The development of neo-orientalism in the 21 st century investigates the advancing talk encompassing Islam and the Muslim world. It digs into the authentic setting of Orientalism, accentuating Edward Said's persuasive study and its effect on the Western impression of the East. The conversation follows the advancement of neoorientalists, featuring its coherence with traditional orientalism while adjusting to contemporary intricates, particularly after the occasions of 9/11. The point of this paper is how neo-orientalism mirrors the moving elements between the West and the East, examining the interconnectedness of islamophobia, scholarly exploration and worldwide legislative issues. It then explores the intersection of secularism and religion in the context of Orientalism, emphasizing the influence of Western scholars on Muslim-majority nations. It also presents a comprehensive manifestation and its impact on cultural perceptions and academic discourse.

SSRN Electronic Journal, 2010

The major concern of this paper is the women prisoners in Pakistan however; various International... more The major concern of this paper is the women prisoners in Pakistan however; various International laws and laws in Pakistan related to the prisoners will also be focused. It is thoroughly examined that what is the condition of women prisoners in Pakistan and what are the constitutional measures granted to them. Types of prisons, ages and classification of prisoners are also considered.

Genes

Autosomal recessive congenital hereditary endothelial dystrophy (CHED2) may be misdiagnosed as pr... more Autosomal recessive congenital hereditary endothelial dystrophy (CHED2) may be misdiagnosed as primary congenital glaucoma (PCG) due to similar clinical phenotypes during early infancy. In this study, we identified a family with CHED2, which was previously misdiagnosed as having PCG, and followed up for 9 years. Linkage analysis was first completed in eight PCG-affected families, followed by whole-exome sequencing (WES) in family PKGM3. The following in silico tools were used to predict the pathogenic effects of identified variants: I-Mutant 2.0, SIFT, Polyphen-2, PROVEAN, mutation taster and PhD-SNP. After detecting an SLC4A11 variant in one family, detailed ophthalmic examinations were performed again to confirm the diagnosis. Six out of eight families had CYP1B1 gene variants responsible for PCG. However, in family PKGM3, no variants in the known PCG genes were identified. WES identified a homozygous missense variant c.2024A>C, p.(Glu675Ala) in SLC4A11. Based on the WES findin...

Cardiology in the Young

Objectives: We aim to describe the early and upto 16 months follow-up of post-coronavirus disease... more Objectives: We aim to describe the early and upto 16 months follow-up of post-coronavirus disease (COVID), multi-system inflammatory syndrome in children (MIS-C), with special reference to cardiac involvement. Study design: This cohort non-interventional descriptive study included patients <18 years admitted between May, 2020 and April, 2021. Based on underlying similarities, children were classified as post-COVID MIS-C with overlapping Kawasaki Disease, MIS-C with no overlapping Kawasaki Disease, and MIS-C with shock. Post-discharge, patients were followed at 1, 3, 6, 12, and 16 months. Results: Forty-one patients predominantly males (73%), at median age of 7 years (range 0.2–16 years) fulfilled the World Health Organisation criteria for MIS-C. Cardiac involvement was seen in 15 (36.5%); impaired left ventricle (LV) function in 5 (12.2%), coronary artery involvement in 10 (24.4%), pericardial effusion in 6 (14.6%) patients, and no arrhythmias. There were two hospital deaths (4.9...

Journal of Fatima Jinnah Medical University, 2022

Background: The aim of this study was to find out the effectiveness of trans-scleral cyclophotoco... more Background: The aim of this study was to find out the effectiveness of trans-scleral cyclophotocoagulation in lowering intraocular pressure in the paediatric population.Patients and methods: This quasi-experimental study was conducted between July 2020 and January 2021 in Department of Ophthalmology, The Children’s Hospital, Lahore. Total 45 eyes of 42 children of age 1-14 years, both genders, with glaucoma were enrolled in this study. Diode cyclophotocoagulation unit and probe of make Quantel Medical was used for cycloablation under general anesthesia. Postoperative intraocular pressure was noted by using handheld Perkins applanation tonometer Mk2 after every 3 weeks for 12 weeks. If an IOP of ≤21mmHg was achieved, then efficacy or success was labeled. Patients with an IOP of >21mmHg after 12 weeks were selected for repeat cycloablation treatment. Failure was labeled to an IOP of >21mmHg even after a repeat session. Data analysis was done using SPSS 24. Results: In this study...

Journal of Fatima Jinnah Medical University, 2021

Background: Culture from various infected body fluids is one of the commonly used investigations ... more Background: Culture from various infected body fluids is one of the commonly used investigations to establish the etiology of infections and helps clinicians to select appropriate antimicrobial therapy. This study is aimed to determine the culture and sensitivity patterns of bacteriological agents grown in children admitted to a tertiary care center. Patients and methods: This descriptive cross-sectional study was conducted at the Department of Pediatric Medicine, The Children’s Hospital and the Institute of Child Health, Lahore from April 2019 to December 2019. All admitted children of age £ 15 years who fulfilled the criteria of systemic inflammatory response syndrome and sepsis were enrolled in the study. Blood and other body fluids were cultured in appropriate medium as indicated. Profile of microorganisms grown and their sensitivity patterns were noted and recorded on a predesigned data sheet. Statistical analysis was performed by SPSS v.22. Results: A total of 500 patients wer...

Pakistan Journal of Ophthalmology, 2022

Purpose: To find out the causes of delayed presentation of Retinoblastoma in a tertiary care hos... more Purpose: To find out the causes of delayed presentation of Retinoblastoma in a tertiary care hospital. Study Design: Questionnaire based Survey. Place and Duration of Study: Pediatric ophthalmology department of The Children’s Hospital, Lahore, from January 2018 to December 2019. Methods: Mothers of patients who presented in the hospital were recruited for this survey. A questionnaire with details of the patient were noted. It included first symptom, time lapse since onset of first symptom, gender, age at presentation to first doctor (general practitioner), time lapse to presentation at tertiary care center (The Children’s Hospital & Institute of Child health), gender and laterality. General physical Examination was done by an oncologist and examination under anesthesia was done by a pediatric ophthalmologist. Data was analyzed using SPSS version 20. Pearson Chi Square test was used to find significance of each cause. Results: Seventy participants were included in the study. De...

The British Journal of Surgery, 2021

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...

The Professional Medical Journal, 2021

Objective: To determine the types, clinical spectrum and outcome of Extra-Pulmonary Tuberculosis ... more Objective: To determine the types, clinical spectrum and outcome of Extra-Pulmonary Tuberculosis (EPTB) in children admitted at a tertiary care hospital. Study Design: Cross Sectional study. Setting: The Children's Hospital and The Institute of Child Health, Lahore. Period: May to December 2019. Material & Methods: A total of 63 patients diagnosed with EPTB aged 1 month to 16 years were included. All patients with lung involvement were excluded from the study. Anti-tuberculous therapy (ATT) was started in all patients and outcome was monitored during the hospital stay. Results: In a total of 63 patients, mean age was 9.03+3.1 years. There were 35 (55.5%) male and 28 (44.4%) female. The mean duration of symptoms at the time of presentation was 5.93+2.4 months. The common sites of EPTB were meninges noted in 17(26.9%), pleural in 13 (20.6%), abdominal in 12 (19.04%), lymph nodes in 11 (17.4%), disseminated in 6 (9.52%) and bone and joints in 4 (6.34%) patients. The most common sys...

Background: Renal damage frequently complicates perinatal asphyxia. Renal vasoconstriction due to... more Background: Renal damage frequently complicates perinatal asphyxia. Renal vasoconstriction due to adenosine metabolite leads to a fall in glomerular filtration rate (GFR) and filtration fraction (FF). This might be inhibited by the nonspecific adenosine receptor antagonist, theophylline. Objective: To determine the efficacy of prophylactic theophylline in prevention of acute renal failure in term neonates exposed to perinatal asphyxia. Material and Methods: This descriptive case series was conducted at Department of Neonatology, The Children’s Hospital, Lahore for 6 months. Total 75 asphyxiated term infants were included through non-probability purposive sampling technique. Children received 5 mg/kg single dose of IV theophylline during first 24 hours of life. Fluid intake, urine output, serum creatinine was recorded on proforma. The data was analyzed using SPSS version 20. The efficacy of theophylline was calculated as frequency and percentage. Results: Mean age of presentation was...

Interval methods offer quite new research aspects regarding Digital Signal Processing. In scenari... more Interval methods offer quite new research aspects regarding Digital Signal Processing. In scenarios like finite numeric representation, limited precision sensors or the quantization process, signal processing has been practicing interval mathematics as quite a reliable gizmo for expressing the uncertainties. Some types of control systems like estimating or soft computing systems, the uncertainties are caused due to the presence of variable instability, variance of signal, or the rate of safety of some actuators. Since most DSPs are designed to work in real time environments, effective implementation of interval arithmetic for these processors asks for fast processing capabilities. Hence the aim is to develop an environment that facilitates interval arithmetic operations to be executed at the very same computational speed as is offered in many contemporary signal processors. So we are proposing the design and implementation of Interval Arithmetic multiplier that functions with IEEE 7...

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2013

OBJECTIVE To determine the spectrum of clinical presentation, laboratory parameters and drug ther... more OBJECTIVE To determine the spectrum of clinical presentation, laboratory parameters and drug therapy in patients with Juvenile Rheumatoid Arthritis (JRA). STUDY DESIGN Case series. PLACE AND DURATION OF STUDY The Children's Hospital and The Institute of Child Health, Lahore, from October 2008 to October 2011. METHODOLOGY All patients who fulfilled the American College of Rheumatology criteria for JRA were enrolled. Their clinical features, investigations done and treatment received for JRA were noted. Statistical analysis of data was done on SPSS version 16.0 for obtaining descriptive statistics. RESULTS Out of 185 patients, 50.3% (n = 93) were females; 54% (n = 100) were between 10 - 15 years of age. Polyarthritis was found in 71.9% (n = 133) followed by oligoarthritis (22.7%, n = 42) and systemic onset disease (5.4%, n = 10). Morning stiffness (78%) and fever (68%) were the most common clinical presentations. All patients with systemic onset disease had fever (n = 10) followed...

Pakistan Journal of Medical and Health Sciences, 2021

Aim: To analyze clinical manifestations, course and outcome of Langerhans Cell Histiocytosis in c... more Aim: To analyze clinical manifestations, course and outcome of Langerhans Cell Histiocytosis in children in resource limited settings lacking salvage therapy. Study design: Observational retrospective study Place and duration of study: Department of Haematology/Oncology, The Children’s Hospital, Lahore Pakistan from 1st January 2011 to 31st December 2018. Methodology: Sixty-five patients with age range from<1 to 8 years included analysing their age, gender, clinical classification, course of therapy and outcome. The major treatment was composed of either prednisolone and vinblastine or cytarabine pulses. Results: There were 59% males and 41% females. Forty-seven (72%) patients presented with multi system-LCH with 49% Risk Organ involvement. Most of them 42 (65%) had bone lesions while 15patients (23%) presented with central nervous system involvement. Forty patients (61%) have completed treatment, 11(17%) left against medical advice and 12(18%)patients expired due to progressive ...

Malaysian Journal of Paediatrics and Child Health, 2017

Background: Pneumonia is defined as the inflammation of parenchyma of the lung. It is a substanti... more Background: Pneumonia is defined as the inflammation of parenchyma of the lung. It is a substantial cause of morbidity and mortality in childhood throughout the world. The incidence of pneumonia in children under the age of five years is 0.29 episodes per child-year, which equates 151.8 million cases annually in developing countries. Objective: To determine the risk factors for complicated pneumonia. Material and Methods: This case-control study conducted in Medical Unit III, The Children’s Hospital & Institute of Child Health Lahore. Out of total of 180 cases of pneumonia, 100 were labeled as complicated pneumonia (case) and 80 were labeled as uncomplicated pneumonia (control). Complicated pneumonia included pneumonia with associated complications. Detail history was taken in both groups and recorded on predesigned proforma. Data was analyzed by SPSS 20. Quantitative risk factors like child age, maternal age and father age were analyzed by mean and standard deviation. However quali...

Natural Science, 2021

The government of Pakistan started vaccination campaign for the frontline healthcare providers, a... more The government of Pakistan started vaccination campaign for the frontline healthcare providers, as they are more likely to be exposed to COVID-19 patients. In the next step, it extended the free vaccination campaign to include people above 60 and 50 years of age respectively. The drive is now open to all citizens >18 years of age. There is a significant reluctance to get vaccinated even though the government has provided it free of cost. The project uses self-reporting method to assess reasons of vaccine hesitancy among Pakistanis and possible solutions to overcome this problem. Concern for serious side effects was the most common issue 154 (48.42%) reported among all groups of people, including the healthcare workers. The major sources of COVID-19 related information were television 117 (36.8%) and healthcare professionals 105 (33%). The participants reported that they can be convinced to get vaccinated if more published data related to vaccine efficacy and safety is available 118 (37.1%), they observe no side effect among vaccine recipients 90 (28.3%) or higher government officials get the same vaccine 39 (12.3%). Vigorous analysis and publication of data generated is paramount to increase the percentage of people being vaccinated. The healthcare professionals should share evidence-based knowledge related to vaccine efficacy and safety through television and social media to increase acceptance rates and hence, decrease mortality and morbidity from COVID-19 in Pakistan.

SSRN Electronic Journal, 2021

Background: There is very limited data on the follow-up of multisystem inflammatory syndrome in c... more Background: There is very limited data on the follow-up of multisystem inflammatory syndrome in children (MIS-C). We aim to describe the early and up-to 16 months follow-up of MIS-C, with special reference to cardiac involvement. Methods: This cohort non-interventional descriptive study included patients < 18years admitted between May 2020 and April 2021. Based on underlying similarities children were classified as post-COVID MIS-C with overlapping Kawasaki Disease, MISC with no overlapping Kawasaki Disease and MIS-C with shock. Post-discharge, patients were followed at 1, 3, 6, 12 and 16 months. Findings: Forty-one patients predominantly males (73%), at a median age of 7(0.2-16) years fulfilled the World Health Organisation criteria for MIS-C. Cardiac involvement was seen in 15 (36.5%) patients;impaired left ventricle (LV) function in 5 (12.2%), coronary artery involvement in 10 (24.4%), and pericardial effusion in 6 (14.6%) patients. No arrhythmia was noted in any case. There were 2 hospital deaths (4.9%), both in MIS-C shock subgroup (20%). At one-month there was persistent LV dysfunction in 2/5, coronary artery abnormalities in 7/10 and pericardial effusion resolved completely in all patients. By 6-months LV function returned to normal in all but coronary abnormalities persisted in 2 patients. At last follow-up [median 9.8 (interquartile range, 2-16) months], in 36/38 (94.7%) patients, coronary artery dilatation was persistent in 2 (20%) patients. Interpretations: Children with MIS-C have a good early outcome although MIS-C with shock, if diagnosed late, has a high mortality. On midterm follow-up, there is normalisation of LV function in all and recovery of coronary abnormalities in 80% of patients. Longer-term follow-up will define the extended natural history of coronary artery involvement in MIS-C.

The Professional Medical Journal, 2021

Objectives: To determine the etiology of Fever of Unknown Origin (FUO) in children. Study Design:... more Objectives: To determine the etiology of Fever of Unknown Origin (FUO) in children. Study Design: Prospective Observational study. Setting: Department of Pediatric Medicine, The Children's Hospital, Lahore. Period: August 2019 to January 2020. Material & Methods: A total of 45 children aged between 01 to 180 months (15 years), having FUO were included. FUO was defined as a temperature of greater than 100.4ºF documented by a health care provider, persisting over a period of three weeks and for which no cause could be identified after at least 8 days of evaluation. All the study information was analyzed by using standard software SPSS 20. The quantitative variables like age and duration of fever before hospital admission were presented as mean and standard deviation. Qualitative variables like sex, antibiotic therapy use before definitive diagnosis and various diagnoses made were presented as frequencies and percentages. Results: The patient’s age range was from 01 to 180 months w...