Nayab Afzal | Lahore College For Women University Lahore Pakistan (original) (raw)
Papers by Nayab Afzal
Journal of the Pakistan Medical Association, 2022
Hepatitis E virus (HEV) is an RNA virus that is transmitted faeco-orally. Due to unhygienic livin... more Hepatitis E virus (HEV) is an RNA virus that is transmitted faeco-orally. Due to unhygienic living conditions and unsatisfactory treatment of drinking water, it is a major cause of acute viral hepatitis in Pakistan. Hepatitis E infection in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency may cause prolonged jaundice resulting in serious complications like, severe haemolysis, acute renal failure, encephalopathy and even demise. Although both these diseases occur frequently in our country there is a dearth of literature on the effect of Hepatitis E infection in G6PD deficient patients, leading to higher rate of complications in such patients. We report a case of 37 years old male who was referred to our hospital with worsening jaundice. Patient had HEV infection with concomitant G6PD deficiency. This case had a different prospect, since it resulted in prolonged jaundice and severe haemolysis. However patient’s condition improved with conservative management.
National Journal of Health Sciences, 2021
Objective: This study aims to determine the trend of seropositivity of anti-SARS-CoV-2 antibodies... more Objective: This study aims to determine the trend of seropositivity of anti-SARS-CoV-2 antibodies (total including IgM, Ig G) in patients presenting at a private hospital in Karachi. Materials & Methods: A total of 2500 patientswere included in the study. Informed consent was obtained and a questionnaire including patient's age, gender, symptoms, history of traveling, contact with people who had travelled recently, contact with confirmed/suspected COVID-19 patient at home or work was filled. Samples were analyzed for anti-SARS-CoV-2 antibodies on Roche Cobase601. Results: The mean age of the patients was 41.045±20.48 years. 674(26.96%) were reactive, while 1826(73.04%) were non-reactive. Mostly patients were males 1388(55.52%).The seroprevalence was higher in males 29.75% while females showed 23.47% seroprevalence. Commonest symptoms were found to be fever(88.73%) and dry cough(57.20%).The frequency of seropositive patients revealed an increasing trend with 20.5%and 27.8 % in first andlast 15 days of June respectively, 30.7% and 31.4% in first andlast 15 days of July 2020 respectively.Only221(32.79%) reactive patients reported recent symptoms while 453(67.21%)patients were completely asymptomatic.Odds Ratio(OR) for participants with recent history of travelling, contact with people who had travelled recently,exposure with COVID-19 patients at home or work was 11.50, 3.28, 8.45 and 0.72 respectively. Conclusion: The seropositivity has shown a definite gradual upward trend over the study period and approximately two thirds of the patients being completely asymptomatic pointing towards the fact that many people are silently exposed to the disease and develop antibodies through their natural immune mechanism.
Multiple Sclerosis (MS) is a very common chronic demyelinating disorder of the central nervous sy... more Multiple Sclerosis (MS) is a very common chronic demyelinating disorder of the central nervous system particularly among adults. In this study we aim to determine the frequency of vitamin D deficiency in patients of multiple sclerosis identifying such patients and providing proper treatment if needed, would help reducing the morbidity associated with MS. We conducted this study from August 2018 to February 2109 at Department of Neurology, Jinnah Postgraduate Medical Center Karachi. A total of 114 previously diagnosed patients of Multiple sclerosis were included in this study. Blood was drawn and sent for measurement of 25(OH)D levels. Patients was labeled as having vitamin D deficiency if the level of total 25(OH)D level was < 20ng/ml. The average age of the patients was 37.74±10.73 years. Frequency of vitamin D deficiency in patients of multiple sclerosis was 36.44% (42/114). Out of 42 deficient cases, 34(80.9%) were mildly deficient and 8(19.1%) were moderately deficient in Vi...
Severe hypertriglyceridemia (SHTG) is defined as plasma triglycerides >1000 mg/dl. It is a rar... more Severe hypertriglyceridemia (SHTG) is defined as plasma triglycerides >1000 mg/dl. It is a rare and understudied condition in children and adolescents. SHTG in pediatric patients may occur as a result of certain genetic disorders of enzymes involved in triglyceride synthesis and metabolism, or it may be seen secondary to uncontrolled diabetes, obesity, metabolic syndrome, or certain medications. SHTG can cause recurrent abdominal pain and acute pancreatitis. Rapid lowering of triglycerides is needed in SHTG to prevent these complications. However, there are no specific guidelines for the treatment of severe hypertriglyceridemia in children and adolescents. Here we report a case of a 16-year-old boy, who was diagnosed with metabolic syndrome three years back. He had a family history of diabetes type 2 and dyslipidemia. In the current case presentation, the patient presented with SHTG-induced acute pancreatitis, who was successfully treated using plasmapheresis. To our knowledge, n...
Archives of Gynecology and Obstetrics, 2017
Background Though the same types of complication were found in both elective cesarean section (El... more Background Though the same types of complication were found in both elective cesarean section (ElCS) and emergence cesarean section (EmCS), the aim of this study is to compare the rates of maternal and fetal morbidity and mortality between ElCS and EmCS. Methods Full-text articles involved in the maternal and fetal complications and outcomes of ElCS and EmCS were searched in multiple database. Review Manager 5.0 was adopted for meta-analysis, sensitivity analysis, and bias analysis. Funnel plots and Egger's tests were also applied with STATA 10.0 software to assess possible publication bias. Results Totally nine articles were included in this study. Among these articles, seven, three, and four studies were involved in the maternal complication, fetal complication, and fetal outcomes, respectively. The combined analyses showed that both rates of maternal complication and fetal complication in EmCS were higher than those in ElCS. The rates of infection, fever, UTI (urinary tract infection), wound dehiscence, DIC (disseminated intravascular coagulation), and reoperation of postpartum women with EmCS were much higher than those with ElCS. Larger infant mortality rate of EmCS was also observed. Conclusion Emergency cesarean sections showed significantly more maternal and fetal complications and mortality than elective cesarean sections in this study. Certain plans should be worked out by obstetric practitioners to avoid the post-operative complications.
Questioning the development and expansion of the Covid-19 virus, we highlight in this contributio... more Questioning the development and expansion of the Covid-19 virus, we highlight in this contribution the disparity in the treatment of this phenomenon in France as is the case in other Western countries between the working classes and the bourgeois classes. It is for us to focus on the changes brought about by this pandemic which has crossed borders by demonstrating the political limits of each country. Several data can be presented in this direction, particularly with regard to the inequality in the face of death in Western countries between populations often immigrants who do not have access to first aid and unequal treatment according to social and ethnic origin. To understand the roots of this social disparity, it is necessary to review the history of migration in these countries. In the case of France, the constitution of poor neighborhoods is one of the overdetermining factors in the spread of the virus. Although not exhaustive, this article offers a pragmatic analysis of this phenomenon by clearly pointing out its historical roots. By attempting to answer the essential question, namely are we dealing with a socioeconomic construction of vulnerability or rather a genetic exposure, we propose the notion of pandemic anomie to describe this social imbalance existing before, during and even after the passage. of this health crisis. In this sense, the statistics and figures put forward in this work clearly explain the extent of this pandemic anomie.
Journal of the Pakistan Medical Association, 2022
Hepatitis E virus (HEV) is an RNA virus that is transmitted faeco-orally. Due to unhygienic livin... more Hepatitis E virus (HEV) is an RNA virus that is transmitted faeco-orally. Due to unhygienic living conditions and unsatisfactory treatment of drinking water, it is a major cause of acute viral hepatitis in Pakistan. Hepatitis E infection in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency may cause prolonged jaundice resulting in serious complications like, severe haemolysis, acute renal failure, encephalopathy and even demise. Although both these diseases occur frequently in our country there is a dearth of literature on the effect of Hepatitis E infection in G6PD deficient patients, leading to higher rate of complications in such patients. We report a case of 37 years old male who was referred to our hospital with worsening jaundice. Patient had HEV infection with concomitant G6PD deficiency. This case had a different prospect, since it resulted in prolonged jaundice and severe haemolysis. However patient’s condition improved with conservative management.
National Journal of Health Sciences, 2021
Objective: This study aims to determine the trend of seropositivity of anti-SARS-CoV-2 antibodies... more Objective: This study aims to determine the trend of seropositivity of anti-SARS-CoV-2 antibodies (total including IgM, Ig G) in patients presenting at a private hospital in Karachi. Materials & Methods: A total of 2500 patientswere included in the study. Informed consent was obtained and a questionnaire including patient's age, gender, symptoms, history of traveling, contact with people who had travelled recently, contact with confirmed/suspected COVID-19 patient at home or work was filled. Samples were analyzed for anti-SARS-CoV-2 antibodies on Roche Cobase601. Results: The mean age of the patients was 41.045±20.48 years. 674(26.96%) were reactive, while 1826(73.04%) were non-reactive. Mostly patients were males 1388(55.52%).The seroprevalence was higher in males 29.75% while females showed 23.47% seroprevalence. Commonest symptoms were found to be fever(88.73%) and dry cough(57.20%).The frequency of seropositive patients revealed an increasing trend with 20.5%and 27.8 % in first andlast 15 days of June respectively, 30.7% and 31.4% in first andlast 15 days of July 2020 respectively.Only221(32.79%) reactive patients reported recent symptoms while 453(67.21%)patients were completely asymptomatic.Odds Ratio(OR) for participants with recent history of travelling, contact with people who had travelled recently,exposure with COVID-19 patients at home or work was 11.50, 3.28, 8.45 and 0.72 respectively. Conclusion: The seropositivity has shown a definite gradual upward trend over the study period and approximately two thirds of the patients being completely asymptomatic pointing towards the fact that many people are silently exposed to the disease and develop antibodies through their natural immune mechanism.
Multiple Sclerosis (MS) is a very common chronic demyelinating disorder of the central nervous sy... more Multiple Sclerosis (MS) is a very common chronic demyelinating disorder of the central nervous system particularly among adults. In this study we aim to determine the frequency of vitamin D deficiency in patients of multiple sclerosis identifying such patients and providing proper treatment if needed, would help reducing the morbidity associated with MS. We conducted this study from August 2018 to February 2109 at Department of Neurology, Jinnah Postgraduate Medical Center Karachi. A total of 114 previously diagnosed patients of Multiple sclerosis were included in this study. Blood was drawn and sent for measurement of 25(OH)D levels. Patients was labeled as having vitamin D deficiency if the level of total 25(OH)D level was < 20ng/ml. The average age of the patients was 37.74±10.73 years. Frequency of vitamin D deficiency in patients of multiple sclerosis was 36.44% (42/114). Out of 42 deficient cases, 34(80.9%) were mildly deficient and 8(19.1%) were moderately deficient in Vi...
Severe hypertriglyceridemia (SHTG) is defined as plasma triglycerides >1000 mg/dl. It is a rar... more Severe hypertriglyceridemia (SHTG) is defined as plasma triglycerides >1000 mg/dl. It is a rare and understudied condition in children and adolescents. SHTG in pediatric patients may occur as a result of certain genetic disorders of enzymes involved in triglyceride synthesis and metabolism, or it may be seen secondary to uncontrolled diabetes, obesity, metabolic syndrome, or certain medications. SHTG can cause recurrent abdominal pain and acute pancreatitis. Rapid lowering of triglycerides is needed in SHTG to prevent these complications. However, there are no specific guidelines for the treatment of severe hypertriglyceridemia in children and adolescents. Here we report a case of a 16-year-old boy, who was diagnosed with metabolic syndrome three years back. He had a family history of diabetes type 2 and dyslipidemia. In the current case presentation, the patient presented with SHTG-induced acute pancreatitis, who was successfully treated using plasmapheresis. To our knowledge, n...
Archives of Gynecology and Obstetrics, 2017
Background Though the same types of complication were found in both elective cesarean section (El... more Background Though the same types of complication were found in both elective cesarean section (ElCS) and emergence cesarean section (EmCS), the aim of this study is to compare the rates of maternal and fetal morbidity and mortality between ElCS and EmCS. Methods Full-text articles involved in the maternal and fetal complications and outcomes of ElCS and EmCS were searched in multiple database. Review Manager 5.0 was adopted for meta-analysis, sensitivity analysis, and bias analysis. Funnel plots and Egger's tests were also applied with STATA 10.0 software to assess possible publication bias. Results Totally nine articles were included in this study. Among these articles, seven, three, and four studies were involved in the maternal complication, fetal complication, and fetal outcomes, respectively. The combined analyses showed that both rates of maternal complication and fetal complication in EmCS were higher than those in ElCS. The rates of infection, fever, UTI (urinary tract infection), wound dehiscence, DIC (disseminated intravascular coagulation), and reoperation of postpartum women with EmCS were much higher than those with ElCS. Larger infant mortality rate of EmCS was also observed. Conclusion Emergency cesarean sections showed significantly more maternal and fetal complications and mortality than elective cesarean sections in this study. Certain plans should be worked out by obstetric practitioners to avoid the post-operative complications.
Questioning the development and expansion of the Covid-19 virus, we highlight in this contributio... more Questioning the development and expansion of the Covid-19 virus, we highlight in this contribution the disparity in the treatment of this phenomenon in France as is the case in other Western countries between the working classes and the bourgeois classes. It is for us to focus on the changes brought about by this pandemic which has crossed borders by demonstrating the political limits of each country. Several data can be presented in this direction, particularly with regard to the inequality in the face of death in Western countries between populations often immigrants who do not have access to first aid and unequal treatment according to social and ethnic origin. To understand the roots of this social disparity, it is necessary to review the history of migration in these countries. In the case of France, the constitution of poor neighborhoods is one of the overdetermining factors in the spread of the virus. Although not exhaustive, this article offers a pragmatic analysis of this phenomenon by clearly pointing out its historical roots. By attempting to answer the essential question, namely are we dealing with a socioeconomic construction of vulnerability or rather a genetic exposure, we propose the notion of pandemic anomie to describe this social imbalance existing before, during and even after the passage. of this health crisis. In this sense, the statistics and figures put forward in this work clearly explain the extent of this pandemic anomie.