Browsing by Person "Rahman, Attiya Sabeen"

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End treatment response and sustained viral response in hepatitis C virus genotype 3 among Pakistani population
(2013-12) Amir, Muhammad; Rahman, Attiya Sabeen; Jamal, Qaiser; Siddiqui, Muhammad A.
BACKGROUND AND OBJECTIVES: This study aimed to determine the end treatment response (ETR) and sustained viral response (SVR) to interferon (IFN) and ribavirin in hepatitis C virus (HCV) genotype 3 in the Pakistani population. DESIGN AND SETTINGS: This is an interventional study conducted from January 2010 to December 2012 in Lyari General Hospital and Abbasi Shaheed Hospital, Karachi, outpatients department. METHODS: All patients with chronic hepatitis C genotype 3 infections were included. Patients with decom.pensated chronic liver disease, or having coexisting hepatitis B virus/human immunodeficiency virus were excluded. All patients received IFN alpha, 3 million international units (MIU), subcutaneously 3 times weekly and ribavirin >800 mg/d for a period of 6 months. Outcome parameters included ETR (negative polymerase chain reaction [PCR] at the end of therapy), SVR (negative PCR both at the end of treatment and 6 months later), and relapse (PCR negative at the end of treatment but positive 6 months later) were determined. RESULTS: A total of 1170 patients were included with a female to male ratio of 1.64:1 and a mean age of 31.6 (8.4) years. Among 1170 patients, 985 completed the therapy as per the protocol, 119 were defaulted (treatment abandoned before completion), and 66 had to stop treatment due to side effects. ETR was 74.1%, SVR was 98%, relapse rate was 1.5%, and 10.1% were nonresponders. SVR was seen only in patients who had achieved an ETR (n=867). SVR was achieved in 848 patients (out of 867) (98%), relapse was seen in 13 (1.5%), and 6 (0.7%) patients lost follow-up after stopping treatment. Patients achieving ETR and SVR had a mean serum alanine aminotransferase of 71.3 (57.1) and 71.0 (56.5), respectively, which is approximately twice the upper normal limit. CONCLUSION: The conventional IFN and ribavirin therapy in genotype 3 chronic HCV-infected patients gives an ETR and SVR of 74.1% and 98%, respectively.
Knowledge, Skills and Practices of Transient Ischemic Attack Intervention amongst General Practitioners in Karachi, Pakistan
(JPMS Publisher, 2014-10) Rahman, Attiya Sabeen; Jamal, Qaiser; Siddiqui, Muhammad A.; Riaz, Mehwish; Aatif, Sabeen; Suleman, Faisal
BACKGROUND: The role of a general practitioner (GP) in the early recognition, assessment and management of transient ischemic attack (TIA) is vital to prevent subsequent stroke. The aim of this study was to determine the GPs knowledge of TIA recognition, assessment, and management. METHODS: The study comprised a questionnaire survey of 228 GPs in all 19 towns of Karachi, Pakistan. The questionnaire consists of demographic details and case scenarios based questions which had three responses (yes, no, do not know). Case scenarios were based on the typical neurological cases seen in general practice. The sections covered risk stratification, investigations, and management of TIA. Questionnaire were provided and briefed to GPs by two-trained research assistants. Statistical analysis was performed using SPSS (IBM SPSS Statistics 20.0). Data were expressed in frequencies for all questionnaire responses and calculated for all variables in numbers and percentage. Cross tabulation was performed to determine, if there was a relationship between subgroups. Chi-square test was used for comparative analysis. RESULTS: All 228 GPs responded to the survey. Most of the GPs responded correctly to the stratification of risk of TIA, and early risk of subsequent stroke. Majority of the GPs correctly responded to the investigations and the management of TIA. Difficulty in accessing neurological consultation was not identified as a barrier (74%). CONCLUSION: This study concludes that, GPs can recognize TIA reasonably which is a major contribution to the assessment and management of TIA in the community. This is due to the continuous medical education and training in dealing with the specialized groups of patients.
Prevalence of unrecognized depression in patients admitted in medical and surgical departments of a tertiary care hospital: a comparative analysis, Karachi, Pakistan
(2015-04-06) Rahman, Attiya Sabeen; Aziz, Adnan; Jamal, Qaiser; Siddiqui, Muhammad A.
Objective The aim of this study was to assess the frequency of depression in medical and surgical department using PHQ-9 questionnaire and to compare the incidence of depression in acute and chronic medical and surgical patients. Material and Methods This cross-sectional comparative analysis was conducted from April 2013 to March 2014. All patients admitted in the medicine and surgical departments were enrolled in the study. Patients with known history of depression or any other psychiatric history or on anti-depressants or on anti-psychotics were excluded from the study. Patients presenting with self-poisoning or any other suicidal attempt were also excluded from the study. Two residents from each department were trained to interview the patients according to the PHQ-9 questionnaire. The prevalence of depression was then seen in surgical and medical patients. Depression and its severity was seen and compared between the acute and chronic disorders of surgical and medical patients. Depression was also seen in between both genders in medical and surgical patients. Statistical analysis was performed using SPSS (IBM SPSS Statistics 20.0). Results A total of 748 patients were enrolled in which 399 patients and 349 patients were enrolled from the medicine and surgery department respectively. The mean age was 46.14 + 15 years of medical patients and 40.23 + 15 years of surgical patients. Among the 399 medical patients 233 (58.4%) were males, 349 surgical patients 178 (58%) were males. Gender was not found to be significantly associated with depression in medical (p= 0.367) and in surgical patients (p=0.606). Minimal depression was found in 48 (12%) medical patients and 131 (37.5%) surgical patients. Moderately severe and severe depression was found in 33 (8.3%) and 37 (9.3%) in medical patients respectively. While in surgical patients moderately severe depression was seen in 42 (12%) and severe depression was seen in 9 (2.6%) patients. Depression was significantly associated with acute and chronic medical disorders with a p<0.001.Depression was not significantly associated with acute and chronic surgical disorders with a p=0.059. Conclusion Unrecognized depression is a major health burden in Pakistan, and depression was significantly associated with acute and chronic medical disorders.