Afsheen Raza - Aga Khan University

Afsheen Raza

Aga Khan University

Pakistan

Afsheen Raza - Aga Khan University

Afsheen Raza

Introduction

Primary Affiliation: Aga Khan University - Pakistan

Education

Dec 2013
Aga Khan University
PhD

Experience

Oct 2016
Harvard Medical School
Training course in cancer biology
Aug 2016
Hamad Medical Corporation
Research Scientist
Nov 2015
Indus Hospital
Head of Molecular Lab
Dec 2014
Aga Khan Hospital
Senior Instructor and Coordinator fof InterBio Project

Publications

22Publications

315Reads

3Profile Views

36PubMed Central Citations

Immunotherapeutic strategies in patients with advanced head and neck squamous cell carcinoma.

Ann Transl Med 2019 Mar;7(Suppl 1):S22

National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.

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http://dx.doi.org/10.21037/atm.2019.01.72DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462621PMC
March 2019
3 Reads

Extracellular vesicles-mediated intercellular communication: roles in the tumor microenvironment and anti-cancer drug resistance.

Mol Cancer 2019 03 30;18(1):55. Epub 2019 Mar 30.

Division of Translational Medicine, Sidra Medicine, PO BOX 26999, Doha, Qatar.

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http://dx.doi.org/10.1186/s12943-019-0965-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441157PMC
March 2019
5 Reads
4.257 Impact Factor

Prognostic markers in HIV mono-and co-infected individuals: A study from Karachi-Pakistan.

J Infect Public Health 2018 Mar - Apr;11(2):250-254. Epub 2017 Aug 23.

Dadabhoy Institute of Higher Education, Karachi, Pakistan; Clinical Microbiology and Immunology-IIDRL And Rector, Dadabhoy Institute of Higher Education, Karachi, Pakistan. Electronic address:

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http://dx.doi.org/10.1016/j.jiph.2017.07.027DOI Listing
November 2018
8 Reads

Cytokines, endothelial activation and microvascular dysfunction in acute respiratory syndrome due to Plasmodium vivax

DOI: https://doi.org/10.1016/j.ijid.2018.04.4113

International Journal of Infectious diseases

Background: Plasmodium vivax, previously considered benign, is now recognized as capable of causing severe disease syndromes associated with fatal outcomes. Endothelial activation is associated with circulating parasites, and systemic inflammation may contribute to pathology in vivax malaria. Microvascular dysfunction likely contributes to impaired tissue perfusion. Severe vivax malaria due to acute lung injury/acute respiratory distress syndrome (ARDS) may be linked to microvascular dysfunction in that organ. We carried out a study of vivax malaria patients with uncomplicated infection or ARDS as cases and compared them to healthy controls. Methods & Materials: Fifty vivax malaria patients (microscopy confirmed) were classified as having uncomplicated infection (n = 25) or severe malaria due to ARDS (n = 25) applying the standard WHO definition of sever malaria. Healthy controls (n = 50) participated in this study voluntarily with no history of malaria. Concentrations of cytokines, TNF- α,IL-6, IL-10 and endothelial activation markers ICAM-1 (intracellular adhesion molecule-1),VCAM- 1(vascular adhesion molecule-1) and E-selectin were determined by enzyme-linked immunosorbant assay (ELISA).Correlation of cytokines and endothelial activation markers was done using Pearson two way correlation matrix. The significance of biomarkers as indicators of disease severity was examined by multi-variate analyses. Results: Cytokines levels in all vivax malaria cases were compared with healthy controls and found to be significantly elevated. Healthy Vs uncomplicated P.vivax malaria, Selectin (9809 vs. 41622 pg/ml, p = 0.0001), ICAM (1089 vs. 255 pg/ml, p = 0.03), TNF (181 vs. 137 pg/ml, p = 0.3), IL6 (369 vs. 90 pg/ml, p = 0.001), IL10 (65 vs. 1001 pg/ml, p = 0.003) compared to healthy controls. Biomarkers levels in uncomplicated vs Pv- ARDS; E-Selectin (4162 vs. 66043 pg/ml, p = 0.03), ICAM (1089vs. 1895 pg/ml, p = 0.03), TNF (181vs. 520 pg/ml, p = 0.001), IL10 (1001 vs. 4753 pg/ml, p = 0.003) levels were significantly higher in ARDS severe malaria case compare to uncomplicated case. Conclusion: Cytokine-mediated endothelial activation pathway is a possible mechanism of pathogenesis in severe P. vivax. Increase levels of IL-10 and TNF may be plausible biomarkers of ARDS in P. vivax infection. However, further studies are required to understand the relevance of cytokines in manifestations of ARDS in P. vivax malaria

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October 2018
3 Reads

Serum Triglycerides and Non-High Density Cholesterol: Important Indicators for Cardiovascular Risk Assessment

2330-4596 (Print) / 2330-460X

Journal of Cardiovascular Diseases

This cross sectional study was carried out from September 2007 to December 2012 at the Department of Clinical Biochemistry, The Indus Hospital, Karachi. Analysis of 2115 lipid profiles showed that 1389 (66%) patients had triglyceride levels above 1.7 mmol/l. Of these, 10.3% of the samples showed high non-HDL-C with normal LDL-C while 2.6% showed high LDL-C with normal non-HDL-C. Non- HDL cholesterol is an important lipid profile parameter that could serve as an additional screening tool along with LDL-C for complete cardiac vascular risk profile assessment particularly in high risk patients. This together with TG/HDL ratio, an indicator of small dense LDL, could help clinicians in rigorous patient management. Therefore, it is recommended that non-HDL cholesterol be added as part of lipid profile parameter and TG/HDL ratio be recognized as a possible important indicator of cardiovascular risk.

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November 2016
6 Reads

Thrombocytopenia as a manifestation of Hepatitis C in patients with positive anti-HCV

Int J of infection

Background: The hepatitis C virus (HCV) has been recognized as the cause of thrombocytopenia (defined as a platelet count of < 150,000 platelets/uL) occurring in patients with chronic hepatitis C. Thrombocytopenia occurs in 64% - 76% of patients with cirrhosis and/or fibrosis, compared with 6% of non-cirrhotic patients with chronic liver disease. Objectives: The aim was to study the prevalence of thrombocytopenia in HCV patients without cirrhosis and splenomegaly. Patients and Methods: A cross-sectional study was carried out in the gastrointestinal out patient department (G.I. OPD) of the Sindh institute of urology and transplantation (SIUT) from September-November 2013. 30 patients aged between 18 - 60 years with a positive anti-HCV result were included. Patients with enlarged spleen, liver cirrhosis on an ultrasound of the abdomen, and thrombocytopenia related to other causes were excluded from the study. Results: A total of 30 patients satisfying the inclusion criteria were selected for study. The mean age of the patients was 42.2 ± 11.4 (16 - 60), and they included 21 females and 7 males. The majority of patients had normal liver function tests with normal spleen size. On the CBC, 13 had platelets of less than 150,000/µL and 17 patients had a platelet count in the normal range, i.e., 150,000 - 400,000/µL. The prevalence of thrombocytopenia was found to be 43.3% among those with hepatitis C. Conclusions: The conducted study showed moderate frequency of hepatitis C-induced thrombocytopenia in patients without hepatic fibrosis and splenomegaly among the Pakistani population.

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June 2016
6 Reads

Diagnostic Plausibility of Line Probe Assays MTBDR plus and MTBDRsl for rapid drug susceptibility testing of Drug Resistant Mycobacterium tuberculosis strains in Pakistan

Int J of infection

Background: World health organization (WHO) recommends the use of line probe assays (LiPAs) for rapid drug susceptibility testing (DST). However, only a limited number of studies from Pakistan have documented the performance characteristics of line probe assays in testing multi-drug resistant (MDR) strains of Mycobacterium tuberculosis (MTB). Objectives: The objective of this work is to evaluate the diagnostic plausibility of the LiPA tests MTBDRplus and MTBDRsl on MDR MTB isolates from Pakistan. Patients and Methods: This was a cross-sectional study conducted at the Indus hospital, Karachi. LiPA testing was performed on 196 smear-positive samples using BACTEC MGIT 960 as a gold standard. Results: The sensitivity of MTBDRplus for isoniazid and rifampicin was found to be 88.8% and 90.2%, respectively, while sensitivity of MTBDRsl for fluoroquinolones, amikacin/capreomycin, and ethambutol was found to be 72.9%, 81.8%, and 56.6%, respectively. Conclusions: The MTBDRplus and MTBDRsl genotypic testing can serve as useful additional tools for DST in a high-burden country like Pakistan provided it is used in combination with phenotypic testing.

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June 2016
5 Reads

Hepatitis C diagnostic management gap in Pakistan—Clinicians’ knowledge impacting public health

24: 299. doi:10.1007/s10389-016-0725-8

Journal of Public Health

Hepatitis C virus (HCV) infects 10 million people in Pakistan with a prevalence rate of 4.9 %. Methods commonly used to diagnose HCV include anti-HCV and HCV RNA testing. However, HCV RNA is a molecular test that aims to identify active infection and is a test indicated for monitoring disease progression during therapy, while anti-HCV is a screening tool for detecting the presence of a virus in the body. Furthermore, liver function tests are part of routine testing in cases to assess the extent of liver damage. However, many clinicians in Pakistan are utilizing molecular tests to screen and diagnose HCV. Furthermore, elevated liver function test values are being justified for direct utilization of molecular tests instead of opting for anti-HCV tests. As HCV RNA tests detect only active infection and LFT values can be elevated or decreased because of other infections, using the HCV RNA test as a screening tool may have implications for patient management. Therefore, the main objective of this study was to evaluate clinicians’ perspectives for HCV test-based diagnostic management and identify the quality gap with respect to the utility of molecular tests. Subjects and Methods A retrospective, cross-sectional study was conducted analyzing medical records of patients coming to the gastroenterology outpatient department (OPD) of The Indus Hospital Laboratory, Karachi, Pakistan, during January 2014–2015. The study included patients in whom HCV RNA testing was performed. Both positive and negative HCV RNA groups were further analyzed to determine whether HCV antibody and liver function testing had been performed for the respective patients. The diagnostic management quality gap was identified on the basis of clinicians’ perspectives with respect to the International Centers for Disease Control and Prevention (CDC) diagnostic guidelines. Results A total of 1758 patients with HCV RNA testing were included in the study. Of these, 17.5 % of the patients had been tested for LFT only with direct testing for HCV RNA. In both the HCV RNA-positive (56 %) and -negative groups (44 %), the following discrepancies in diagnostic management were observed—the anti-HCV test was not performed in 51 and 62 % of the patients in the positive and negative HCV RNA group, respectively. Furthermore, 9.6 and 36 % of the HCV RNA-negative and -positive groups had not been evaluated for liver function tests and anti-HCV prior to molecular testing. Conclusion Diagnostic management of HCV in Pakistan is compromised as clinicians utilize molecular testing as a screening tool rather than using the international guideline for utilizing anti-HCV for the diagnosis of HCV. Furthermore, the results of the liver function tests are being used to justify the generation of molecular tests. This practice is an important parameter in the diagnostic and disease management of HCV in Pakistan and requires robust clinician awareness at the national level.

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April 2016
7 Reads

Vivax malaria and chloroquine resistance: a neglected disease as an emerging threat.

Malar J 2015 Apr 8;14:146. Epub 2015 Apr 8.

Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan.

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http://dx.doi.org/10.1186/s12936-015-0660-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392755PMC
April 2015
33 Reads
2 Citations
3.110 Impact Factor

Tumour necrosis factor, interleukin-6 and interleukin-10 are possibly involved in Plasmodium vivax-associated thrombocytopaenia in southern Pakistani population.

Malar J 2014 Aug 16;13:323. Epub 2014 Aug 16.

Department of Pathology and Microbiology, Aga Khan University, Stadium Road, PO Box 3500, Karachi 74800, Pakistan.

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http://dx.doi.org/10.1186/1475-2875-13-323DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141950PMC
August 2014
32 Reads
2 Citations
3.110 Impact Factor

Population genetics and drug resistance markers: an essential for malaria surveillance in Pakistan.

J Coll Physicians Surg Pak 2013 Dec;23(12):878-84

Department of Pathology and Microbiology, The Aga Khan University, Karachi.

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http://dx.doi.org/12.2013/JCPSP.878884DOI Listing
December 2013
7 Reads
0.320 Impact Factor

Prevalence of drug resistance associated mutations in Plasmodium vivax against sulphadoxine-pyrimethamine in southern Pakistan.

Malar J 2013 Jul 26;12:261. Epub 2013 Jul 26.

Department of Pathology and Microbiology, Aga Khan University, Stadium Road, Karachi, Pakistan.

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http://dx.doi.org/10.1186/1475-2875-12-261DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733603PMC
July 2013
21 Reads
6 Citations
3.110 Impact Factor

Genetic diversity of Plasmodium vivax clinical isolates from southern Pakistan using pvcsp and pvmsp1 genetic markers.

Malar J 2013 Jan 11;12:16. Epub 2013 Jan 11.

Department of Pathology and Microbiology, Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan.

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http://dx.doi.org/10.1186/1475-2875-12-16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601996PMC
January 2013
11 Reads
6 Citations
3.110 Impact Factor

Hyper-reactive malarial splenomegaly in the absence of raised IgM antibodies.

Trop Doct 2013 Jan 26;43(1):37-8. Epub 2013 Feb 26.

Ziauddin University, Karachi, Pakistan.

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http://dx.doi.org/10.1177/0049475512473602DOI Listing
January 2013
19 Reads
1 Citation
0.530 Impact Factor