Pashtoon Murtaza Kasi

Publications

• The role of fine-needle aspiration cytology in the diagnosis of Basal cell carcinoma.

  Masoom Kassi, Pashtoon Murtaza Kasi, Abaseen Khan Afghan, Shah Mohammad Marri, Mahwash Kassi, Iqbal Tareen

  ISRN dermatology. 01/2012; 2012:132196.

  Background/Aims. Basal cell carcinoma (BCC) is the most common malignant tumor of the skin in humans. The diagnosis of BCC is made clinically, which can then be confirmed microscopically. Biopsy or surgical excision of the lesion provides the specimen for histopathological examination, which is the ... [more] Background/Aims. Basal cell carcinoma (BCC) is the most common malignant tumor of the skin in humans. The diagnosis of BCC is made clinically, which can then be confirmed microscopically. Biopsy or surgical excision of the lesion provides the specimen for histopathological examination, which is the mainstay for diagnosis. Fine-needle aspiration cytology (FNAC) on the other hand is an even simpler procedure, which can provide accurate diagnosis to confirm or exclude the malignancy. Methods. Here, we present our experience on the role of FNAC in diagnosing BCC. We were able to recruit 37 patients, of which 35 had BCC. Both FNAC and biopsy were obtained and then interpreted independently of one another. Results. Cytology correlated with histopathology in all cases except for 2 in which the yield was deemed inadequate. The sensitivity and specificity of fine-needle aspiration cytology for basal cell carcinoma were 94.3% and 100%, respectively. Conclusions. We, therefore, recommend this technique for the initial evaluation of a patient with suspected BCC or in cases of recurrence. The technique is cheap, quick, less invasive, and highly accurate for the diagnosis of BCC. The limitation of the technique is low yield in some of the cases.

• Clinical manifestations and distribution of cutaneous leishmaniasis in pakistan.

  Abaseen Khan Afghan, Masoom Kassi, Pashtoon Murtaza Kasi, Adil Ayub, Niamatullah Kakar, Shah Muhammad Marri

  Journal of tropical medicine. 01/2011; 2011:359145.

  Cutaneous leishmaniasis (CL) is a rising epidemic in Pakistan. It is a major public health problem in the country especially alongside regions bordering the neighboring Afghanistan and cities that have had the maximum influx of refugees. The purpose of our paper is to highlight the diverse clinical ... [more] Cutaneous leishmaniasis (CL) is a rising epidemic in Pakistan. It is a major public health problem in the country especially alongside regions bordering the neighboring Afghanistan and cities that have had the maximum influx of refugees. The purpose of our paper is to highlight the diverse clinical manifestations of the disease seen along with the geographic areas affected, where the hosts are particularly susceptible. This would also be helpful in presenting the broad spectrum of the disease for training of health care workers and help in surveillance of CL in the region. The increased clinical diversity and the spectrum of phenotypic manifestations noted underscore the fact that the diagnosis of CL should be not only considered when dealing with common skin lesions, but also highly suspected by dermatologists and even primary care physicians even when encountering uncommon pathologies. Hence, we would strongly advocate that since most of these patients present to local health care centers and hospitals, primary care practitioners and even lady health workers (LHWs) should be trained in identification of at least the common presentations of CL.

• Incidence, management, and outcome of molar pregnancies at a tertiary care hospital in quetta, pakistan.

  Mahrukh Fatima, Pashtoon Murtaza Kasi, Shahnaz Naseer Baloch, Masoom Kassi, Shah Muhammad Marri, Mahwash Kassi

  ISRN obstetrics and gynecology. 01/2011; 2011:925316.

  Molar pregnancies represent a significant burden of disease on the spectrum of gestational trophoblastic diseases. The incidence appears to be higher in women from South Asia. The purpose of our prospective study was to determine the incidence, presentation, and outcomes of all molar pregnancies at ... [more] Molar pregnancies represent a significant burden of disease on the spectrum of gestational trophoblastic diseases. The incidence appears to be higher in women from South Asia. The purpose of our prospective study was to determine the incidence, presentation, and outcomes of all molar pregnancies at our institution. During the study period, there were a total of 16,625 patients admitted to our department; out of whom 85 patients were diagnosed with a molar pregnancy. Vaginal bleeding was the commonest symptom (94.2%); theca lutein cysts were noted in 39% of the cases. Suction, dilatation, and curettage were noted to be the preferred method in almost all cases; hysterectomy was done in 12 (14.1%) patients. Single-agent chemotherapy was employed in high-risk patients and was well tolerated. Mean followup for these patients was 5.7 months (range 1-24 months). None of these patients developed persistent trophoblastic disease, invasive mole, or choriocarcinoma during the follow-up period.

• Experience of emergency peripartum hysterectomies at a tertiary care hospital in quetta, pakistan.

  Mahrukh Fatima, Pashtoon Murtaza Kasi, Shahnaz Naseer Baloch, Abaseen Khan Afghan

  ISRN obstetrics and gynecology. 01/2011; 2011:854202.

  Emergency peripartum hysterectomy (EPH) is associated with significant morbidity and mortality worldwide. The purpose of our paper was to determine the incidence, morbidity, and mortality of EPH done at our institution; the largest tertiary care government hospital in the city of Quetta, Pakistan. D... [more] Emergency peripartum hysterectomy (EPH) is associated with significant morbidity and mortality worldwide. The purpose of our paper was to determine the incidence, morbidity, and mortality of EPH done at our institution; the largest tertiary care government hospital in the city of Quetta, Pakistan. During the study period there were 12,642 deliveries, out of which 46 women had undergone an EPH, translating into an incidence of ∼4 per 1,000 births. Disturbingly, 82.6% of these patients had received no antenatal care prior to their presentation. There were 4 (8.7%) maternal deaths and 31 (67.4%) perinatal deaths. The commonest indication noted was uterine rupture in 21 (45.7%) cases. Lack of antenatal care is indeed a modifiable factor that needs to be addressed to help reduce maternal and fetal morbidity/mortality not only from emergency hysterectomies but also from all other preventable causes.
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  Safe blood transfusion practices in blood banks of Karachi, Pakistan.

  M Kassi, A K Afghan, M R Khanani, I A Khan, S H Ali

  Transfusion medicine (Oxford, England). 10/2010; 21(1):57-62.

  Since 1997, legislations pertaining to safe blood transfusion (SBT) have evolved considerably in Pakistan. The objective of this study was to evaluate the SBT practices in the blood banks of Pakistan. Twenty-three blood banks were randomly selected from a list of registered 40 in Karachi, the larges... [more] Since 1997, legislations pertaining to safe blood transfusion (SBT) have evolved considerably in Pakistan. The objective of this study was to evaluate the SBT practices in the blood banks of Pakistan. Twenty-three blood banks were randomly selected from a list of registered 40 in Karachi, the largest city in Pakistan. To evaluate the SBT practices in the selected blood banks, a questionnaire and a checklist were administered during 2007-2008. Of the 23 blood banks surveyed, 4 (17%) were affiliated with government or a semi-government institution; 16 (70%) blood banks had a healthy donor recruitment program and 2 (9%) of the blood banks agreed that they recruited remunerated (paid) blood donors. Donors were screened for HIV, Hepatitis B, Hepatitis C and syphilis by all 23 blood banks, whereas malaria was screened by all blood banks but one. SBT practices in Karachi have improved since 1995; an active role by the government in policy-making has proven effective.

• Determining the risk factors and prevalence of osteoporosis using quantitative ultrasonography in Pakistani adult women.

  M Fatima, H Nawaz, M Kassi, R Rehman, P M Kasi, A K Afghan, S N Baloch

  Singapore medical journal. 02/2009; 50(1):20-8.

  INTRODUCTION: Osteoporosis-related bone fractures are a significant public health problem. The aim of this study was to determine the prevalence of osteoporosis among Pakistani women and identify modifiable risk factors. METHODS: A cross-sectional study was conducted in an obstetrics / gynaecology s... [more] INTRODUCTION: Osteoporosis-related bone fractures are a significant public health problem. The aim of this study was to determine the prevalence of osteoporosis among Pakistani women and identify modifiable risk factors. METHODS: A cross-sectional study was conducted in an obstetrics / gynaecology setting during March-April 2007 in Quetta, Pakistan. A total of 334 women older than 20 years of age underwent quantitative ultrasonography and were interviewed to find out the risk factors for osteoporosis. Bone mineral density was assessed by the speed of sound using a quantitative ultrasound device. The sociodemographic characteristics of normal, osteopenic and osteoporotic women were compared using the chi-square test for categorical variables and ANOVA for continuous variables. Binary logistic regression was used to determine the independent predictors of being osteopenic or osteoporotic. RESULTS: 146 (43.7 percent) women were reported to be normal, 145 (43.4 percent) were osteopenic and 43 (12.9 percent) were osteoporotic. The mean age and standard deviation of the participants were 36.7 years +/- 13.0 years, with a body mass index (BMI) of 25.81 (standard deviation 5.10) kg per square metre. In the univariate analysis, factors that were associated with osteoporosis / osteopenia included age, parity, BMI, smoking (pack years), consumption of calcium-rich food/week, personal and family history of osteoporosis, education and socioeconomic status (p-value is less than 0.05). Using binary logistic regression with osteoporosis / osteopenia as an outcome compared to normal individuals, BMI, smoking pack years, a family history of osteoporosis / fracture and house ownership were found to be independent predictors of the outcome. CONCLUSION: The prevalence of osteoporosis and osteopenia is high, especially among young Pakistani women, and is associated with modifiable risk factors.
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  Quintuplets born to a woman without fertility treatment in Pakistan.

  Mahrukh Fatima, Pashtoon Murtaza Kasi, Rabeea Rehman, Shahnaz Naseer Baloch

  Fertility and sterility. 10/2008;

  OBJECTIVE: To report a case of quintuplets born to a woman without fertility treatment along with a discussion on the incidence and management of related cases. DESIGN: Case report. SETTING: Bolan Medical College, Quetta, Pakistan. PATIENT(S): The quintuplets and their mother. INTERVENTION(S): Perin... [more] OBJECTIVE: To report a case of quintuplets born to a woman without fertility treatment along with a discussion on the incidence and management of related cases. DESIGN: Case report. SETTING: Bolan Medical College, Quetta, Pakistan. PATIENT(S): The quintuplets and their mother. INTERVENTION(S): Perinatal care. MAIN OUTCOME MEASURE(S): Perinatal morbidity and mortality in multiple gestation. RESULTS AND CONCLUSIONS: Quintuplets are a rare occurrence. This is even rarer if they are born to a woman without fertility treatment. The survival of the infants is even rarer. We here report a case of a woman who presented in her third trimester of gestation and gave birth to five babies through normal delivery; all of them are alive and doing well along with the mother of the babies. The learning points and issues for discussion in this case are fourfold. We present, first, an account of surviving quintuplets and their occurrence; second, the medical issues involved in the management and care of such cases; third, the psychologic and social consequences involved in these scenarios; and, finally, the plight and difficulties faced by a woman from a poor socioeconomic background along with the dilemma faced by a practicing clinician in a developing country.

• Vector control in cutaneous leishmaniasis of the old world: a review of literature.

  Masoom Kassi, Pashtoon Murtaza Kasi, Shah Muhammad Marri, Iqbal Tareen, Talha Khawar

  Dermatology online journal. 02/2008; 14(6):1.

  Cutaneous Leishmaniasis (CL), a disfiguring disease, is prevalent in many parts of Pakistan and neighboring Afghanistan. Leishmaniasis is second only to malaria in terms of the number of people affected; it is a major public health issue with significant social stigma. Although the different methods... [more] Cutaneous Leishmaniasis (CL), a disfiguring disease, is prevalent in many parts of Pakistan and neighboring Afghanistan. Leishmaniasis is second only to malaria in terms of the number of people affected; it is a major public health issue with significant social stigma. Although the different methods to diagnose and treat the disease are well discussed in the literature, the role of vector control in the prevention of CL has been underemphasized. Both Pubmed and Ovid search engines were used to obtain articles on prevention and control of cutaneous leishmaniasis. These materials were then screened for articles pertaining to vector control only. The World Health Organization's website along with the Cochrane database were also searched for relevant text. From this qualitative review, it can be seen that many effective interventions exist. Considering the multitude of factors involved in transmission of CL and the various effective control measures tried and tested by investigators, an interdisciplinary approach involving more than one of the above interventions would make sense. The interventions selected would then depend on the incidence of CL in that particular area, the population being targeted, the reservoir, the particular vector, the environment, the acceptability/popularity of the intervention, and the availability of funds.
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  Marring leishmaniasis: the stigmatization and the impact of cutaneous leishmaniasis in pakistan and afghanistan.

  Masoom Kassi, Mahwash Kassi, Abaseen Khan Afghan, Rabeea Rehman, Pashtoon Murtaza Kasi

  PLoS neglected tropical diseases. 02/2008; 2(10):e259.

• Outcome of triple procedure in older children with developmental dysplasia of hip (DDH).

  Masood Umer, Haq Nawaz, Pashtoon Murtaza Kasi, Mahmood Ahmed, Syed Sohail Ali

  JPMA. The Journal of the Pakistan Medical Association. 12/2007; 57(12):591-5.

  OBJECTIVE: To evaluate the radiographic and functional results of the triple procedure (open reduction, femoral shortening and Salter's Osteotomy) in the treatment of Developmental Dysplasia of the Hip (DDH) disease in older children. METHODS: This case-series comprising 23 patients (29 hips) un... [more] OBJECTIVE: To evaluate the radiographic and functional results of the triple procedure (open reduction, femoral shortening and Salter's Osteotomy) in the treatment of Developmental Dysplasia of the Hip (DDH) disease in older children. METHODS: This case-series comprising 23 patients (29 hips) underwent the triple procedure of open reduction, femoral shortening and Salter osteotomy, at Aga Khan University Hospital between June 1995 and June 2005. Patients were classified pre-operatively according to the Tonnis class. Postoperative functional evaluation was performed using Modified MacKay's scoring system and radiographic assessment using Severin's scoring method. RESULTS: The mean age of patients at presentation was 6.84 years and the average follow-up was 19.6 months. The MacKay score was 'Good' to 'Excellent' in 25 hips; we had a failure in 1 hip joint. The Severin's class was I in 15 (51.7%) hips at the time of final evaluation as compared to none at the time of presentation. Patients younger than 5.6 years of age had a better radiological and clinical outcome as compared to older patients (p-value < 0.05). CONCLUSIONS: The triple procedure of open reduction, femoral shortening and Salter osteotomy gives best results in younger children. Early diagnosis and intervention is therefore imperative in the successful treatment of patients suffering from DDH.
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  Excessive work hours of physicians in training: maladaptive coping strategies.

  Pashtoon Murtaza Kasi, Masoom Kassi, Talha Khawar

  PLoS medicine. 10/2007; 4(9):e279.

• Factors influencing medical student participation in an obstetrics and gynaecology clinic.

  Ferha Saeed, Mahwash Kassi, Samia Ayub, Rabeea Rehman, Pashtoon M Kasi, Javed H Rizvi

  JPMA. The Journal of the Pakistan Medical Association. 10/2007; 57(10):495-8.

  OBJECTIVE: To identify factors influencing medical student participation in an obstetrics and gynaecology (OBGYN) setting. METHODS: This was a cross sectional study carried out on patients admitted in OBGYN wards of Aga Khan University Hospital, Karachi, Pakistan. A total of 250 patients consented t... [more] OBJECTIVE: To identify factors influencing medical student participation in an obstetrics and gynaecology (OBGYN) setting. METHODS: This was a cross sectional study carried out on patients admitted in OBGYN wards of Aga Khan University Hospital, Karachi, Pakistan. A total of 250 patients consented to participate in this study. RESULTS: Eighty three percent of the people responded 'yes' to the question of being initially seen by a medical student. People who consented were 3.5 times more likely to know that their primary consultant was a teacher at a medical school i.e. they were initially aware that they were in a teaching hospital (p-value < 0.01). Additionally, people who did consent were 3.5 times more likely to have been admitted because of labour/delivery (p-value < 0.001) and 2.7 times more likely to have a monthly income of more than Rs. 20,000 (p-value < 0.05). CONCLUSIONS: A number of factors have been identified in our study along with proposed solutions. Identification of these potentially modifiable factors in the medical student-patient interaction is important to improve the involvement of medical students in the care of the patients.
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  Epilepsy: public knowledge and attitude in a slum area of Karachi, Pakistan.

  M Shafiq, M Tanwir, A Tariq, P M Kasi, M Zafar, A Saleem, R Rehman, S Z Zaidi, F Taj, A A Khuwaja, K S Shaikh, A K Khuwaja

  Seizure : the journal of the British Epilepsy Association. 07/2007; 16(4):330-7.

  BACKGROUND: Epilepsy is a common but widely misunderstood illness. Consequently, epileptics suffer from considerable stigmatization in society. Since no studies have detailed the misperceptions about epilepsy in our community, it is not possible to provide focused intervention aimed at eliminating t... [more] BACKGROUND: Epilepsy is a common but widely misunderstood illness. Consequently, epileptics suffer from considerable stigmatization in society. Since no studies have detailed the misperceptions about epilepsy in our community, it is not possible to provide focused intervention aimed at eliminating this prejudice. PURPOSE: To assess the knowledge and attitude regarding epilepsy in an adult population of a Karachi slum area. METHODS: A face-to-face interview was conducted on 487 consenting adult non-epileptics (305 males; 182 females) who were conveniently sampled. Chi-square test was employed to calculate the variability in knowledge and attitude with demographic and other variables. RESULTS: In all, 12.5% had never heard about epilepsy. Among the rest, 66.7% identified epilepsy as being non-infectious, while 28.2% were unaware of any treatment available for it. Among the other 71.8%, 62.7% were aware of the existence of anti-epileptic drugs. Religious/spiritual treatment was chosen as the most effective treatment by 33.1%. Males were more likely to identify epilepsy as being non-infectious (p=0.02). Nearly 18% of the respondents would not object to their child marrying an epileptic, 69.5% did not want to socially isolate the epileptics, 83.1% said epileptics could receive academic education, 85.6% said they could perform activities of daily life and 62.4% said they could become useful members of the society. Those who considered epilepsy to be infectious were more likely to carry negative attitudes towards epilepsy (p<0.01 with four attitudes). CONCLUSIONS: Considerable gaps exist in the community's knowledge about epilepsy. Some of these may explain the prevalence of negative attitudes towards this ailment.
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  Seroprevalences and co-infections of HIV, hepatitis C virus and hepatitis B virus in injecting drug users in Quetta, Pakistan.

  Malik Achakzai, Masoom Kassi, Pashtoon Murtaza Kasi

  Tropical doctor. 02/2007; 37(1):43-5.

  A questionnaire-based survey was administered to a sample of street-recruited injecting drug users. Written informed consent was obtained. Serological screening and further testing for the three blood-borne infections was performed. Fifty (76.9%) consented for serological testing. Seroprevalences of... [more] A questionnaire-based survey was administered to a sample of street-recruited injecting drug users. Written informed consent was obtained. Serological screening and further testing for the three blood-borne infections was performed. Fifty (76.9%) consented for serological testing. Seroprevalences of hepatitis C virus (HCV), HIV and hepatitis B antigen were 60%, 24% and 6%, respectively. Co-infections of HCV/HIV were particularly high (20%).
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  Using choriocarcinoma to cause remission of other tumors: a novel approach to kill tumors.

  Pashtoon Murtaza Kasi, K M Pal

  Medical hypotheses. 02/2007; 68(3):717.
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  Acute health effects of the Tasman Spirit oil spill on residents of Karachi, Pakistan.

  Naveed Zafar Janjua, Pashtoon Murtaza Kasi, Haq Nawaz, Sadia Zohra Farooqui, Urooj Bakht Khuwaja, Najam-ul-Hassan, Syed Nadim Jafri, Shahid Ali Lutfi, Muhammad Masood Kadir, Nalini Sathiakumar

  BMC public health. 02/2006; 6:84.

  BACKGROUND: On July 27 2003, a ship carrying crude oil ran aground near Karachi and after two weeks released 37,000 tons of its cargo into the sea. Oil on the coastal areas and fumes in air raised health concerns among people. We assessed the immediate health impact of oil spill from the tanker Tasm... [more] BACKGROUND: On July 27 2003, a ship carrying crude oil ran aground near Karachi and after two weeks released 37,000 tons of its cargo into the sea. Oil on the coastal areas and fumes in air raised health concerns among people. We assessed the immediate health impact of oil spill from the tanker Tasman Spirit on residents of the affected coastline in Karachi, Pakistan. METHODS: We conducted a study consisting of an exposed group including adults living in houses on the affected shoreline and two control groups (A and B) who lived at the distance of 2 km and 20 km away from the sea, respectively. We selected households through systematic sampling and interviewed an adult male and female in each household about symptoms relating to eyes, respiratory tract, skin and nervous system, smoking, allergies, beliefs about the effect on their health and anxiety about the health effects. We used logistic regression procedures to model each symptom as an outcome and the exposure status as an independent variable while adjusting for confounders. We also used linear regression procedure to assess the relationship exposure status with symptoms score; calculated by summation of all symptoms. RESULTS: Overall 400 subjects were interviewed (exposed, n = 216; group A, n = 83; and group B, n = 101). The exposed group reported a higher occurrence of one or more symptoms compared to either of the control groups (exposed, 96% vs. group A, 70%, group B 85%; P < 0.001). Mean summary symptom scores were higher among the exposed group (14.5) than control group A (4.5) and control group B (3.8, P < 0.001). Logistic regression models indicated that there were statistically significant, moderate-to-strong associations (Prevalence ORs (POR) ranging from 2.3 to 37.0) between the exposed group and the symptoms. There was a trend of decreasing symptom-specific PORs with increase in distance from the spill site. Multiple linear regression model revealed strong relationship of exposure status with the symptoms score (beta = 8.24, 95% CI: 6.37-10.12). CONCLUSION: Results suggest that the occurrence of increased symptoms among the exposed group is more likely to be due to exposure to the crude oil spill.
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  Psychiatric health laws in Pakistan: from lunacy to mental health.

  Ahmed Ijaz Gilani, Umer Ijaz Gilani, Pashtoon Murtaza Kasi, Murad Musa Khan

  PLoS medicine. 12/2005; 2(11):e317.
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  Diagnosis of cutaneous leishmaniasis by fine needle aspiration cytology: a report of 66 cases.

  Masoom Kassi, Pashtoon Murtaza Kasi

  Tropical doctor. 02/2005; 35(1):50-1.
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  Blinding trachoma: a disease of poverty.

  Pashtoon M Kasi, Ahmed I Gilani, Khabir Ahmad, Naveed Z Janjua

  PLoS medicine. 12/2004; 1(2):e44.
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  Trachoma still ignored in developing countries.

  Pashtoon Murtaza Kasi, Ahmed Ijaz Gilani

  Lancet. 06/2004; 363(9422):1736.