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The Population Structure of Vibrio cholerae from the Chandigarh Region of Northern India
Moataz Abd El Ghany ,Jagadish Chander,Ankur Mutreja,Mamoon Rashid,Grant A. Hill-Cawthorne,Shahjahan Ali,Raeece Naeem,Nicholas R. Thomson,Gordon Dougan,Arnab Pain
PLOS Neglected Tropical Diseases , 2014, DOI: 10.1371/journal.pntd.0002981
Abstract: Background Cholera infection continues to be a threat to global public health. The current cholera pandemic associated with Vibrio cholerae El Tor has now been ongoing for over half a century. Methodology/Principal Findings Thirty-eight V. cholerae El Tor isolates associated with a cholera outbreak in 2009 from the Chandigarh region of India were characterised by a combination of microbiology, molecular typing and whole-genome sequencing. The genomic analysis indicated that two clones of V. cholera circulated in the region and caused disease during this time. These clones fell into two distinct sub-clades that map independently onto wave 3 of the phylogenetic tree of seventh pandemic V. cholerae El Tor. Sequence analyses of the cholera toxin gene, the Vibrio seventh Pandemic Island II (VSPII) and SXT element correlated with this phylogenetic position of the two clades on the El Tor tree. The clade 2 isolates, characterized by a drug-resistant profile and the expression of a distinct cholera toxin, are closely related to the recent V. cholerae isolated elsewhere, including Haiti, but fell on a distinct branch of the tree, showing they were independent outbreaks. Multi-Locus Sequence Typing (MLST) distinguishes two sequence types among the 38 isolates, that did not correspond to the clades defined by whole-genome sequencing. Multi-Locus Variable-length tandem-nucleotide repeat Analysis (MLVA) identified 16 distinct clusters. Conclusions/Significance The use of whole-genome sequencing enabled the identification of two clones of V. cholerae that circulated during the 2009 Chandigarh outbreak. These clones harboured a similar structure of ICEVchHai1 but differed mainly in the structure of CTX phage and VSPII. The limited capacity of MLST and MLVA to discriminate between the clones that circulated in the 2009 Chandigarh outbreak highlights the value of whole-genome sequencing as a route to the identification of further genetic markers to subtype V. cholerae isolates.
Which Knowledge and Skills Do Participants Retain after Attending Medical Education Training Workshops?  [PDF]
Naghma Naeem
Creative Education (CE) , 2016, DOI: 10.4236/ce.2016.76091
Abstract: The Aga Khan University (AKU) renewed its undergraduate curriculum and incorporated Problem Based Learning (PBL) as one of the main teaching strategies in years one and two. PBL requires a huge pool of facilitators. Recent AKU graduates were recruited as Teaching Assistants (TAs) to support teaching. A faculty development program was conducted to prepare TAs for their teaching role. This study aimed to evaluate the effectiveness of a faculty development program (conducted in two parts) in increasing knowledge, skills and teaching performance of the participants and assess the long term retention of knowledge by participants. A longitudinal, mixed method, evaluation study was conducted at Aga Khan University from 2006-2008. The participants included all eleven TAs recruited by AKU. Workshop evaluation forms, pre, post and delayed post test and student evaluations of TAs teaching performance were used to gather data. Evaluation of the PBL workshop was much better than the one on broader aspects of medical education since the PBL workshop was in line with the participants’ goals. TAs reported perceived improvement in PBL facilitation skills. Student evaluations of TAs facilitation skills validated this perception. The workshop helped improve knowledge (p = 0.036), which increased on immediate post-test but decayed at the end of year on delayed post-test. Short training programs lead to increase in knowledge, skills and improved teaching performance. The participants retain knowledge and skills which are applied while those that are not applied regularly decay over time. Regular, periodic refreshers should be instituted to reinforce and retain knowledge and skills.
International Journal of Engineering Science and Technology , 2012,
Abstract: As continual research is being conducted in the area of computer vision, one of the most practical applications under vigorous development is in the construction of a robust face detection system. While the problem of detecting faces under various variations remains largely unsolved, a demonstration system as proof of concept that such systems are now becoming practical have been developed. A system capable of reliable detection, with reduced constraints in regards to the position and orientation of the face and the illumination and background of the image, has been implemented. Those face detection system is based upon “eigenfaces”, which has been separated into three major modules – pre-processing, construction of face space and face localization. A completely robust real-time face detectionsystem is still under heavy investigation and development, the implemented systems are still serving as an extendable foundation for future research.
Naeem Karnalkar
Hygeia : Journal for Drugs and Medicines , 2012,
Abstract: Most people who get hemorrhoidsdo not know how to handle them. They have not been properly informed. There isjust no way to have a good day when you are having a hemorrhoid flare up. This disease is related to anusor lower rectum. The term Hemorrhoids or Piles, refers to a condition in whichthe veins around the anus are abnormally swollen and inflamed. These can beinternal (inside the anus) or external (outside and around the anus). These canalso be bleeding or non-bleeding (blind). Piles are usually very painful andtroublesome but are not life-threatening. In some cases, chronic blindpiles do not remain painful but do give a feeling of uneasiness. The size ofpiles varies from individual to individual and can be from the size of a smallgrape to a bunch of grapes. No one description of hemorrhoids symptoms fits allcases, since each case may vary from one patient to another. Usually, a varietyof conditions present themselves on a case-by-case basis.
Psychiatric Training in Pakistan
F Naeem
Medical Education Online , 2004,
Abstract: High rates of mental illness, particularly depression have been reported in Pakistan. The health system is both under developed and poorly resourced. It is therefore not surprising that psychiatric training is at its very early stages, at both undergraduate and the postgraduate level. In order to look after the mentally ill patients radical changes need to be implemented in training of doctors. Medical curriculum needs to place more focus on psychiatry. This should not only help junior doctors in understanding the need for psychiatry, but will also prepare them for the challenges they will face as a General Practitioner or a Family Physician. Similarly, postgraduate training can be made more useful by placing more emphasis on community based and primary care psychiatry and psychotherapy; especially family interventions. The training needs to aim towards preparing psychiatrists who are not only clinicians, but can be agents of change in the society, through health education.
Naeem Akhtar
The Professional Medical Journal , 2000,
Abstract: From November 1993 to March 1996, a total of 1154 urine specimens of patients from in-patient and outpatientdepartments of Bahawal Victoria Hospital, Bahawalpur were cultured on McConkey and blood agarplates to determine the incidence of urinary tract infection, the prevalent aetiological microorganisms andtheir antimicrobial susceptibility. Among these 470 specimens (40.7%) showed significant bacteriuria (105or more cfu/ml). Out of 804 male patients 340 (42.2%) and out of 350 female patients 130 (37.2%) hadsignificant bacteriuria. The commonest organism isolated was Escherichia coli (5 8.9%), followed byPseudomonas aeruginosa (17.5 %), Klebsiella pneumoniae (12.4%), Staphylococcus aureus (5.7%), Proteussp. (5.1) and Citrobacter sp. (0.4%). The predominant organisms in males were Pseudomonas aeruginosaand Proteus sp., while in females Escherichia coli and Staphylococcus aureus were predominant. Thebacterial isolate showed greater resistance to ampicillin, sulphamethoxazole-trimethoprim and doxycycline.However, the organisms showed good sensitivity (62.4-81.3%) to gentamicin, tobramicin, pipemidic acid,norfloxacin. ciprofloxacin and enoxacin. The organisms were relatively less sensitive to cefoperzone,ceftazidime and ceftizoxime. Peudomonas aeruginosa showed good sensitivity to quinolones andaminoglycosides and decreased sensitivity to third generation cephalosporin. Amoxycillin-clavulanic acidand sulbactam-ampicillin had good activity against Staphylococcus aureus. Keeping in view theantimicrobial susceptibility patterns of the bacterial isolates, amoxycillin-clavulanic acid or pipemidic acidare suggested for empirical therapy for urinary tract infections before the bacterial culture and antibioticsensitivity result is received.
The Professional Medical Journal , 2006,
Abstract: Objective: To investigate the course of intraocular pressure after cataract surgery in patients havingpseudo exfoliation syndrome but without any evidence of glaucoma. Design: Prospective age-matched comparativetype. Place and Duration of Study: Department of Ophthalmology, Combined Military Hospital, Peshawar and MilitaryHospital, Rawalpindi. From 1 November 2003 to 30 April st th 2004. Patients and Methods: Ninety five patients havingcataract, were divided into two groups. Group I consisted of forty five patients with pseudo exfoliation syndrome andGroup II comprised control group of fifty patients not having pseudo exfoliation. All the patients underwent extracapsularcataract extraction with posterior chamber intraocular lens implantation. The intra- ocular pressure wasmeasured pre-operatively as well as on 7th post-operative day, 1st and 3rd post-operative months, in addition to otherpre- and post-operative evaluation. Results: Statistically, there was no significant difference in the pre-operativeintraocular pressure between the two study groups. At 7th post-operative day, the intraocular pressure was below 18mm of Hg in all the patients. First and 3rd month after the surgery, a decrease in intraocular pressure was observed.The inter-group differences in intraocular pressures at 1st and 3rd post-operative months were statistically not significant.Conclusion: Seven days after extra-capsular cataract extraction with posterior chamber intraocular lens implantation,no increase in intraocular pressure was observed in the eyes with pseudo exfoliation syndrome. Three months aftercataract surgery, intraocular pressure levels decreased in eyes with pseudo exfoliation syndrome similarly as in controlgroup.
The Professional Medical Journal , 2005,
The Professional Medical Journal , 2007,
Abstract: Laryngeal cancer remained the most common malignant tumourof the head and neck despite an increase in the tumours of the oral cavity and oropharynx in the past two decades.However, it is the malignancy which has a high cure rate if diagnosed early and treated correctly. Objective: Toanalyse the results of treatment offered to laryngeal cancer patients. Design: Prospective study. Setting: Departmentof ENT and Head & Neck Surgery Unit-II Allied Hospital Faisalabad. Study Period: Nov 2003 to Oct 2005. Materialand Methods: 50 cases of laryngeal cancer were selected at random who presented with hoarseness and /orrespiratory distress in the out patient department. Majority of these patients were smokers. All these 50 cases wereanalysed from treatment point of view. Results: Out of 50 cases of laryngeal cancer, 12 patients (24%) presented withsupra-glottic growth. Only one patient (02%) involved the sub-glottic region. The trans-glottic growth was noted in 16patients (32%). We had to perform emergency tracheostomy in 19 patients (38%). 16 patients (32%) underwent totallaryngectomy as the primary mode of treatment. 18 patients (36%) were referred to oncology department for primarytherapeutic radiotherapy. Salvage total laryngectomy after primary radiotherapy failure was offered to 7 patients (14%).It was noted that recurrence of the lesion was more in those patients who received primary radiotherapy, 9(18%)showed recurrence in case of primary radiotherapy while 5(10%) showed the recurrence after total laryngectomy.Conclusion: Early diagnosis of laryngeal cancer pays a lot of dividends and makes the difference between life anddeath. Therefore more emphasis should be made on early diagnosis.
The Professional Medical Journal , 2008,
Abstract: Dysphagia in children due to ingestion of foreign body is quite common.We report a case of dysphagia & vomiting in a 5 years old boy who presented in ENT OPD Allied Hospital Faisalabad.Our case is an unusual one with respect to the duration of symptoms which last for 3,1/2 years. The case wasmisdiagnosed as a case of stricture of oesophagus on a number of occasions. The foreign body seed was removedper orally with the help of rigid Oesophagoscope. Literature review has been done and discussed.
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