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Clinical Characteristics, Management, And 5-Year Survival Compared Between No Standard Modifiable Risk Factor (Smurfless) And ≥ 1 Smurf Acs Cases: An Analysis Of 15,051 Cases From Pakistan, Sana Sheikh, Ghazal Peerwani, Bashir Hanif, Salim S. Virani Jun 2023

Clinical Characteristics, Management, And 5-Year Survival Compared Between No Standard Modifiable Risk Factor (Smurfless) And ≥ 1 Smurf Acs Cases: An Analysis Of 15,051 Cases From Pakistan, Sana Sheikh, Ghazal Peerwani, Bashir Hanif, Salim S. Virani

Section of Cardiology

Background: There has been an increase in Acute Coronary Syndrome (ACS) patients without standard modifiable risk factors i.e. hypertension, diabetes, dyslipidemia, and tobacco use (SMuRFless) compared to the patients with ≥ 1 SMuRF but this has not been studied in South Asia despite them being a high-risk population. We conducted a comparative analysis of first episodes of ACS cases admitted to a tertiary cardiac center in Pakistan between SMuRFless and ≥ 1 SMuRF patients for clinical presentation, management, in-hospital, and 5-year mortality.
Methods: We undertook a retrospective study and data of 15,051 patients admitted at Tabba Heart Institute (THI) with …


Social Contributors For The Rise Of Covid-19 Infections In South Asia: A Large Cross-Sectional Survey, Zouina Sarfraz, Azza Sarfraz, Muzna Sarfraz, Nishwa Azeem, Namrata Hange, Miguel Felix, Ivan Cherrez-Ojeda Aug 2022

Social Contributors For The Rise Of Covid-19 Infections In South Asia: A Large Cross-Sectional Survey, Zouina Sarfraz, Azza Sarfraz, Muzna Sarfraz, Nishwa Azeem, Namrata Hange, Miguel Felix, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: The ongoing global coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was first reported in South Asia on 30th January 2020 in India. Ever since, certain countries have witnessed multiple waves of COVID-19, requiring attention by public health experts and strategists in the region. The objectives of this study are to assess social contributors to the recurrent waves of COVID-19 in South Asia including first demographic traits, second household characteristics and social measures, third workplace trends and personal protective equipment use, and fourth satisfaction and attitudes concerning public health measures and vaccination status. …


Community-Based Asthma Assessment In Young Children: Adaptations For A Multicentre Longitudinal Study In South Asia, Mohammad Shahidul Islam, Samin Huq, Steven Cunningham, Jurgen Schwarze, Asmd Ashraful Islam, Mashal Amin, Farrukh Raza, Benazir Baloch, Muhammad Imran Nisar, Sajid Bashir Soofi Jul 2022

Community-Based Asthma Assessment In Young Children: Adaptations For A Multicentre Longitudinal Study In South Asia, Mohammad Shahidul Islam, Samin Huq, Steven Cunningham, Jurgen Schwarze, Asmd Ashraful Islam, Mashal Amin, Farrukh Raza, Benazir Baloch, Muhammad Imran Nisar, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Systematic assessment of childhood asthma is challenging in low- and middle-income country (LMIC) settings due to the lack of standardised and validated methodologies. We describe the contextual challenges and adaptation strategies in the implementation of a community-based asthma assessment in four resource-constrained settings in Bangladesh, India, and Pakistan.
Method: We followed a group of children of age 6-8 years for 12 months to record their respiratory health outcomes. The study participants were enrolled at four study sites of the 'Aetiology of Neonatal Infection in South Asia (ANISA)' study. We standardised the research methods for the sites, trained field staff …


Childhood Mortality During And After Acute Illness In Africa And South Asia: A Prospective Cohort Study, Childhood Acute Illness And Nutrition (Chain) Network, Abdoulaye Hama Diallo, Abu Sadat Mohammad Sayeem Bin Shahid, Ali Fazal Khan, Ali Faisal Saleem, Benson O. Singa, Blaise Siezanga Gnoumou, Caroline Tigoi, Syed Asad Ali, Zaubina Kazi May 2022

Childhood Mortality During And After Acute Illness In Africa And South Asia: A Prospective Cohort Study, Childhood Acute Illness And Nutrition (Chain) Network, Abdoulaye Hama Diallo, Abu Sadat Mohammad Sayeem Bin Shahid, Ali Fazal Khan, Ali Faisal Saleem, Benson O. Singa, Blaise Siezanga Gnoumou, Caroline Tigoi, Syed Asad Ali, Zaubina Kazi

Department of Paediatrics and Child Health

Background: Mortality among children with acute illness in low-income and middle-income settings remains unacceptably high and the importance of post-discharge mortality is increasingly recognised. We aimed to explore the epidemiology of deaths among young children with acute illness across sub-Saharan Africa and south Asia to inform the development of interventions and improved guidelines.
Methods: In this prospective cohort study, we enrolled children aged 2-23 months with acute illness, stratified by nutritional status defined by anthropometry (ie, no wasting, moderate wasting, or severe wasting or kwashiorkor), who were admitted to one of nine hospitals in six countries across sub-Saharan Africa and …


An Epidemiological, Strategic And Response Analysis Of The Covid-19 Pandemic In South Asia: A Population-Based Observational Study, Hafiz Muhammad Salman, Javaria Syed, Atif Riaz, Zouina Sarfraz, Azza Sarfraz, Syed Hashim Abbas Ali Bokhari, Ivan Cherrez Ojeda Mar 2022

An Epidemiological, Strategic And Response Analysis Of The Covid-19 Pandemic In South Asia: A Population-Based Observational Study, Hafiz Muhammad Salman, Javaria Syed, Atif Riaz, Zouina Sarfraz, Azza Sarfraz, Syed Hashim Abbas Ali Bokhari, Ivan Cherrez Ojeda

Department of Paediatrics and Child Health

Introduction: South Asia has had a dynamic response to the ongoing COVID-19 pandemic. The overall burden and response have remained comparable across highly-burdened countries within the South Asian Region.
Methodology: Using a population-based observational design, all eight South Asian countries were analyzed using a step-wise approach. Data were obtained from government websites and publicly-available repositories for population dynamics and key variables.
Results: South Asian countries have a younger average age of their population. Inequitable distribution of resources centered in urban metropolitan cities within South Asia is present. Certain densely populated regions in these countries have better testing and healthcare facilities …


Clinical Characteristics And Prognostic Factors Of Atrial Fibrillation At A Tertiary Center Of Pakistan – From A South-Asian Perspective – A Cross-Sectional Study, Intisar Ahmed, Aiysha Nasir, Pirbhat Shams, Hunaina Shahab, Muhammad Hassan, Faryal Subhani, Ghurfan Adnan, Awais Farhad, Aamir Hameed, Yawer Saeed Jan 2022

Clinical Characteristics And Prognostic Factors Of Atrial Fibrillation At A Tertiary Center Of Pakistan – From A South-Asian Perspective – A Cross-Sectional Study, Intisar Ahmed, Aiysha Nasir, Pirbhat Shams, Hunaina Shahab, Muhammad Hassan, Faryal Subhani, Ghurfan Adnan, Awais Farhad, Aamir Hameed, Yawer Saeed

Section of Cardiology

Background: There is lack of large data from South-Asian region on atrial fibrillation and it is imperative that clinical presentation, prognostic factors, management pursued, and outcomes are known for this part of the world. Once collective evidence for the region is known, region-specific guidelines can be laid forward.
Objectives: To evaluate clinical characteristics and prognostic factors of atrial fibrillation at a tertiary care center of Pakistan.
Methods: This was a retrospective study conducted at a tertiary care center of Pakistan. Period of study ranged from July-December 2018. All hospitalized patients who were admitted with atrial fibrillation as a primary or …


Conflict, Extremism, Resilience And Peace In South Asia; Can Covid-19 Provide A Bridge For Peace And Rapprochement?, Zulfiqar Ahmed Bhutta, Arun Mitra, Afsah Salman, Fawad Akbari, Suraya Dalil, Fyezah Jehan, Mushtaque Chowdhury, Saroj Jayasinghe, Purnima Menon, Samiran Nundy Nov 2021

Conflict, Extremism, Resilience And Peace In South Asia; Can Covid-19 Provide A Bridge For Peace And Rapprochement?, Zulfiqar Ahmed Bhutta, Arun Mitra, Afsah Salman, Fawad Akbari, Suraya Dalil, Fyezah Jehan, Mushtaque Chowdhury, Saroj Jayasinghe, Purnima Menon, Samiran Nundy

Institute for Global Health and Development

Abstract, issue, and pagination are not provided by the author/publisher


Direct Maternal Morbidity And The Risk Of Pregnancy-Related Deaths, Stillbirths, And Neonatal Deaths In South Asia And Sub-Saharan Africa: A Population-Based Prospective Cohort Study In 8 Countries, Imran Ahmed, Shabina Ariff, Zulfiqar Ahmed Bhutta, Muhammad Ilyas, Fyezah Jehan, Usma Mehmood, Karim Muhammad, Muhammad Imran Nisar, Sajid Bashir Soofi, Yaqub Wasan, Anita K. M. Zaidi Jun 2021

Direct Maternal Morbidity And The Risk Of Pregnancy-Related Deaths, Stillbirths, And Neonatal Deaths In South Asia And Sub-Saharan Africa: A Population-Based Prospective Cohort Study In 8 Countries, Imran Ahmed, Shabina Ariff, Zulfiqar Ahmed Bhutta, Muhammad Ilyas, Fyezah Jehan, Usma Mehmood, Karim Muhammad, Muhammad Imran Nisar, Sajid Bashir Soofi, Yaqub Wasan, Anita K. M. Zaidi

Woman and Child Health

Background: Maternal morbidity occurs several times more frequently than mortality, yet data on morbidity burden and its effect on maternal, foetal, and newborn outcomes are limited in low- and middle-income countries. We aimed to generate prospective, reliable population-based data on the burden of major direct maternal morbidities in the antenatal, intrapartum, and postnatal periods and its association with maternal, foetal, and neonatal death in South Asia and sub-Saharan Africa.
Methods and findings: This is a prospective cohort study, conducted in 9 research sites in 8 countries of South Asia and sub-Saharan Africa. We conducted population-based surveillance of women of reproductive …


Early Marriage And Early Childbearing In South Asia: Trends, Inequalities, And Drivers From 2005 To 2018, Samuel Scott, Phuong Hong Nguyen, Sumanta Neupane, Priyanjana Pramanik, Priya Nanda, Zulfiqar Ahmed Bhutta, Kaosar Afsana, Purnima Menon Dec 2020

Early Marriage And Early Childbearing In South Asia: Trends, Inequalities, And Drivers From 2005 To 2018, Samuel Scott, Phuong Hong Nguyen, Sumanta Neupane, Priyanjana Pramanik, Priya Nanda, Zulfiqar Ahmed Bhutta, Kaosar Afsana, Purnima Menon

Woman and Child Health

Early marriage (EM) and early childbearing (ECB) have far-reaching consequences. This study describes the prevalence, trends, inequalities, and drivers of EM and ECB in South Asia using eight rounds of Demographic and Health Survey data across 13 years. We report the percentage of ever-married women aged 20-24 years (n = 105,150) married before 18 years (EM) and with a live birth before 20 years (ECB). Relative trends were examined using average annual rate of reduction (AARR). Inequalities were examined by geography, marital household wealth, residence, and education. Sociodemographic drivers of changes for EM were assessed using regression decomposition analyses. We …


Utilization Of Blood Culture In South Asia For The Diagnosis And Treatment Of Febrile Illness, Caitlin Hemlock, Stephen P. Luby, Shampa Saha, Farah Naz Qamar, Jason R. Andrews, Samir K. Saha, Dipesh Tamrakar, Kashmira Date, Ashley T. Longley, Denise O. Garrett, Isaac I. Bogoch Dec 2020

Utilization Of Blood Culture In South Asia For The Diagnosis And Treatment Of Febrile Illness, Caitlin Hemlock, Stephen P. Luby, Shampa Saha, Farah Naz Qamar, Jason R. Andrews, Samir K. Saha, Dipesh Tamrakar, Kashmira Date, Ashley T. Longley, Denise O. Garrett, Isaac I. Bogoch

Department of Paediatrics and Child Health

Background: Blood culture is the current standard for diagnosing bacteremic illnesses, yet it is not clear how physicians in many low- and middle-income countries utilize blood culture for diagnostic purposes and to inform treatment decisions.
Methods: We screened suspected enteric fever cases from 6 hospitals in Bangladesh, Nepal, and Pakistan, and enrolled patients if blood culture was prescribed by the treating physician. We used generalized additive regression models to analyze the probability of receiving blood culture by age, and linear regression models to analyze changes by month to the proportion of febrile cases prescribed a blood culture compared with the …


Diagnostic Value Of Clinical Features To Distinguish Enteric Fever From Other Febrile Illnesses In Bangladesh, Nepal, And Pakistan, Kristen Aiemjoy, Dipesh Tamrakar, Shampa Saha, Shiva R. Naga, Alexander T. Yu, Ashley Longley, Kashmira Date, Caitlin Hemlock, Farah Naz Qamar, Samir K. Saha Dec 2020

Diagnostic Value Of Clinical Features To Distinguish Enteric Fever From Other Febrile Illnesses In Bangladesh, Nepal, And Pakistan, Kristen Aiemjoy, Dipesh Tamrakar, Shampa Saha, Shiva R. Naga, Alexander T. Yu, Ashley Longley, Kashmira Date, Caitlin Hemlock, Farah Naz Qamar, Samir K. Saha

Department of Paediatrics and Child Health

Background: Enteric fever, a bacterial infection caused by Salmonella enterica serotypes Typhi and Paratyphi A, frequently presents as a nonlocalizing febrile illness that is difficult to distinguish from other infectious causes of fever. Blood culture is not widely available in endemic settings and, even when available, results can take up to 5 days. We evaluated the diagnostic performance of clinical features, including both reported symptoms and clinical signs, of enteric fever among patients participating in the Surveillance for Enteric Fever in Asia Project (SEAP), a 3-year surveillance study in Bangladesh, Nepal, and Pakistan.
Methods: Outpatients presenting with ≥3 consecutive days …


Hemoglobin Concentrations And Adverse Birth Outcomes In South Asian Pregnant Women: Findings From A Prospective Maternal And Neonatal Health Registry, Sumera Aziz Ali, Shiyam Sunder Tikmani, Sarah Saleem, Archana B. Patel, Patricia L. Hibberd, Shivaprasad S. Goudar, Sangappa Dhaded, Richard J. Derman, Janet L. Moore, Elizabeth M. Mcclure, Robert L. Goldenberg Nov 2020

Hemoglobin Concentrations And Adverse Birth Outcomes In South Asian Pregnant Women: Findings From A Prospective Maternal And Neonatal Health Registry, Sumera Aziz Ali, Shiyam Sunder Tikmani, Sarah Saleem, Archana B. Patel, Patricia L. Hibberd, Shivaprasad S. Goudar, Sangappa Dhaded, Richard J. Derman, Janet L. Moore, Elizabeth M. Mcclure, Robert L. Goldenberg

Community Health Sciences

Background: While the relationship between hemoglobin (Hb) concentrations and pregnancy outcomes has been studied often, most reports have focused on a specific Hb cutoff used to define anemia. Fewer studies have evaluated pregnancy outcomes across the entire range of Hb values. Moreover, to date, most studies of the relationship of Hb concentrations to pregnancy outcomes have been done in high-income countries. Thus, we have sought to determine the relationship between the range of maternal Hb concentrations and adverse birth outcomes among South Asian pregnant women.
Methods: For this study, we used data collected from two South Asian countries (Pakistan - …


Preconception Nutrition Intervention Improved Birth Length And Reduced Stunting And Wasting In Newborns In South Asia: The Women First Randomized Controlled Trial., Sangappa M Dhaded, K. Michael Hambidge, Sumera Aziz Ali, Manjunath Somannavar, Sarah Saleem, Omrana Pasha, Umber Khan, Veena Herekar, Sunil Vernekar, S. Yogesh Kumar, Jamie E. Westcott, Vanessa R. Thorsten, Amaanti Sridhar, Abhik Das, Elizabeth Mcclure, Richard J. Derman, Robert L. Goldenberg, Marion Koso-Thomas, Shivaprasad S. Goudar, Nancy F. Krebs Jan 2020

Preconception Nutrition Intervention Improved Birth Length And Reduced Stunting And Wasting In Newborns In South Asia: The Women First Randomized Controlled Trial., Sangappa M Dhaded, K. Michael Hambidge, Sumera Aziz Ali, Manjunath Somannavar, Sarah Saleem, Omrana Pasha, Umber Khan, Veena Herekar, Sunil Vernekar, S. Yogesh Kumar, Jamie E. Westcott, Vanessa R. Thorsten, Amaanti Sridhar, Abhik Das, Elizabeth Mcclure, Richard J. Derman, Robert L. Goldenberg, Marion Koso-Thomas, Shivaprasad S. Goudar, Nancy F. Krebs

Global Health Articles

South Asia has >50% of the global burden of low birth weight (LBW). The objective was to determine the extent to which maternal nutrition interventions commenced before conception or in the 1st trimester improved fetal growth in this region. This was a secondary analysis of combined newborn anthropometric data for the South Asian sites (India and Pakistan) in the Women First Preconception Maternal Nutrition Trial. Participants were 972 newborn of mothers who were poor, rural, unselected on basis of nutritional status, and had been randomized to receive a daily lipid-based micronutrient supplement commencing ≥3 months prior to conception (Arm 1), …


Rethinking Community Based Strategies To Tackle Health Inequities In South Asia, Zulfiqar Ahmed Bhutta, Abhay Bang, Kaosar Afsana, Bishal Gyawali, Mohammed Shafiq Mirzazada, Renuka Jayatissa Nov 2019

Rethinking Community Based Strategies To Tackle Health Inequities In South Asia, Zulfiqar Ahmed Bhutta, Abhay Bang, Kaosar Afsana, Bishal Gyawali, Mohammed Shafiq Mirzazada, Renuka Jayatissa

Department of Paediatrics and Child Health

No abstract provided.


Regional Variation In Chronic Kidney Disease And Associated Factors In Hypertensive Individuals In Rural South Asia: Findings From Control Of Blood Pressure And Risk Attenuation-Bangladesh, Pakistan And Sri Lanka, Liang Feng, Hithanadura Asita De Silva, Imtiaz Jehan, Anuradhani Kasturiratne, Gulshan Himani, Mohammad Abul Hasnat, Tazeen Jafar, Cobra-Bps Study Group Oct 2019

Regional Variation In Chronic Kidney Disease And Associated Factors In Hypertensive Individuals In Rural South Asia: Findings From Control Of Blood Pressure And Risk Attenuation-Bangladesh, Pakistan And Sri Lanka, Liang Feng, Hithanadura Asita De Silva, Imtiaz Jehan, Anuradhani Kasturiratne, Gulshan Himani, Mohammad Abul Hasnat, Tazeen Jafar, Cobra-Bps Study Group

Community Health Sciences

Background: We aimed to determine the prevalence of chronic kidney disease (CKD) and its cross-country variation among hypertensive individuals in rural Bangladesh, Pakistan and Sri Lanka. We also explored the factors associated with CKD in these populations.
Method: We studied baseline data from the Control of Blood Pressure and Risk Attenuation-Bangladesh, Pakistan and Sri Lanka (COBRA-BPS) trial, an ongoing cluster randomized controlled trial on 2643 hypertensive adults ≥40 years of age from 30 randomly selected rural clusters, 10 in each of the three countries. CKD was defined as an estimated glomerular filtration rate (eGFR) /min/1.73 m2 or a urine albumin:creatinine …


Prevalence And Correlates Of Cardiometabolic Multimorbidity Among Hypertensive Individuals: A Cross-Sectional Study In Rural South Asia—Bangladesh, Pakistan And Sri Lanka, Liang Feng, Imtiaz Jehan, H Asita De Silva, Aliya Naheed, Hamida Farazdaq, Samina Hirani Samina Hirani, Anuradhani Kasturiratne, Channa D. Ranasinha, Md Tauhidul Islam, Ali Tanweer Siddiquee, Tazeen Jafar Sep 2019

Prevalence And Correlates Of Cardiometabolic Multimorbidity Among Hypertensive Individuals: A Cross-Sectional Study In Rural South Asia—Bangladesh, Pakistan And Sri Lanka, Liang Feng, Imtiaz Jehan, H Asita De Silva, Aliya Naheed, Hamida Farazdaq, Samina Hirani Samina Hirani, Anuradhani Kasturiratne, Channa D. Ranasinha, Md Tauhidul Islam, Ali Tanweer Siddiquee, Tazeen Jafar

Community Health Sciences

Objective: To determinate the prevalence and correlates of cardiometabolic multimorbidity (CMM), and their cross-country variation among individuals with hypertension residing in rural communities in South Asia.
Design: A cross-sectional study.
Setting: Rural communities in Bangladesh, Pakistan and Sri Lanka.
Participants: A total of 2288 individuals with hypertension aged ≥40 years from the ongoing Control of Blood Pressure and Risk Attenuation- Bangladesh, Pakistan and Sri Lanka clinical trial.
Main outcome measures: CMM was defined as the presence of ≥2 of the conditions: diabetes, chronic kidney disease, heart disease and stroke. Logistic regression was done to evaluate the correlates of CMM.
Results: …


Cardio-Metabolic Disease Risk Factors Among South Asian Labour Migrants To The Middle East: A Scoping Review And Policy Analysis, Shiva Raj Mishra, Saruna Ghimire, Chandni Joshi, Bishal Gyawali, Archana Shrestha, Dinesh Neupane, Sudesh Raj Sharma, Yashashwi Pokharel, Salim S. Virani May 2019

Cardio-Metabolic Disease Risk Factors Among South Asian Labour Migrants To The Middle East: A Scoping Review And Policy Analysis, Shiva Raj Mishra, Saruna Ghimire, Chandni Joshi, Bishal Gyawali, Archana Shrestha, Dinesh Neupane, Sudesh Raj Sharma, Yashashwi Pokharel, Salim S. Virani

Office of the Provost

This paper aims to explore the burgeoning burden of cardiovascular and metabolic disease (CMD) risk factors among South Asian labor migrants to the Middle East. We conducted a qualitative synthesis of literature using PubMed/Medline and grey literature searches, supplemented by a policy review of policies from the South Asian countries. We found a high burden of cardio-metabolic risk factors among the migrants as well as among the populations in the home and the host countries. For example, two studies reported the prevalence of diabetes mellitus (DM) ranging between 9 and 17% among South Asian migrants. Overweight and obesity were highly …


Rationale And Protocol For Estimating The Economic Value Of A Multicomponent Quality Improvement Strategy For Diabetes Care In South Asia, Kavita Singh, Mohammed K. Ali, Raji Devarajan, Roopa Shivashankar, Dimple Kondal, Vamadevan S. Ajay, V. Usha Menon, Premlata K. Varthakavi, Vijay Viswanathan, Qamar Masood Mar 2019

Rationale And Protocol For Estimating The Economic Value Of A Multicomponent Quality Improvement Strategy For Diabetes Care In South Asia, Kavita Singh, Mohammed K. Ali, Raji Devarajan, Roopa Shivashankar, Dimple Kondal, Vamadevan S. Ajay, V. Usha Menon, Premlata K. Varthakavi, Vijay Viswanathan, Qamar Masood

Section of Diabetes, Endocrinology and Metabolism

Background: Economic dimensions of implementing quality improvement for diabetes care are understudied worldwide. We describe the economic evaluation protocol within a randomised controlled trial that tested a multi-component quality improvement (QI) strategy for individuals with poorly-controlled type 2 diabetes in South Asia.

Methods/Design: This economic evaluation of the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) randomised trial involved 1146 people with poorly-controlled type 2 diabetes receiving care at 10 diverse diabetes clinics across India and Pakistan. The economic evaluation comprises both a within-trial cost-effectiveness analysis (mean 2.5 years follow up) and a microsimulation model-based cost-utility analysis (life-time horizon). …


Applying Quality Improvement Methods To Neglected Conditions: Development Of The South Asia Burn Registry (Sabr), Nukhba Zia Nukhba Zia, Asad Latif, Saidur Rahman Mashreky, Ehmer Al-Ibran, Madiha Hashmi, A. K. M. Fazlur Rahman, Sazzad Khondoker, Mohammed Saeed Quraishy, Adnan A. Hyder Jan 2019

Applying Quality Improvement Methods To Neglected Conditions: Development Of The South Asia Burn Registry (Sabr), Nukhba Zia Nukhba Zia, Asad Latif, Saidur Rahman Mashreky, Ehmer Al-Ibran, Madiha Hashmi, A. K. M. Fazlur Rahman, Sazzad Khondoker, Mohammed Saeed Quraishy, Adnan A. Hyder

Department of Anaesthesia

Objective: South Asia has the highest mortality rate from burns in the world. Application of quality improvement methods to burn care can help identify health system gaps. Our overall aim is to introduce a sustainable hospital-based burn registry for resource-constrained settings to assess health outcomes of burn injury patients presenting to dedicated burn injury centers in South Asia.
Results: The South Asia Burn Registry (SABR) is implemented through collaborative approach in selected burn centers in Bangladesh and Pakistan. Th registry collects data on burn injury events, the care provided, and the functional status of patients at discharge from burn centers. …


Phase I Of The Surveillance For Enteric Fever In Asia Project (Seap): An Overview And Lessons Learned, Caitlin Barkume, Kashmira Date, Samir K. Saha, Farah Qamar, Dipika Sur, Jason R. Andrews, Stephen P. Luby, M Imran Khan, Alex Freeman, Mohammad Tahir Yousafzai, Denise Garret Nov 2018

Phase I Of The Surveillance For Enteric Fever In Asia Project (Seap): An Overview And Lessons Learned, Caitlin Barkume, Kashmira Date, Samir K. Saha, Farah Qamar, Dipika Sur, Jason R. Andrews, Stephen P. Luby, M Imran Khan, Alex Freeman, Mohammad Tahir Yousafzai, Denise Garret

Department of Paediatrics and Child Health

Objective: The objective of Phase I of the Surveillance for Enteric Fever in Asia Project (SEAP), a multiphase surveillance study characterizing the burden of disease in South Asia, was to inform data collection for prospective surveillance and to capture clinical aspects of disease.
Methods: Through a retrospective record review conducted at hospitals in Bangladesh, India, Nepal, and Pakistan, we examined laboratory and clinical records to assess the culture positivity rate for Salmonella Typhi and Salmonella Paratyphi, age and sex distribution, and antimicrobial susceptability in each country.
Results: Of all blood cultures performed in Bangladesh, India, Nepal, and Pakistan, 1.5%, 0.43%, …


A Retrospective Study Of Laboratory-Based Enteric Fever Surveillance, Pakistan, 2012-2014, Farah Naz Qamar, Mohammad Tahir Yousafzai, Shazia Sultana, Attaullah Baig, Sadia Shakoor, Farzeen Hirani, Abdul Wassay, Sehrish Khushboo, Junaid Mehmood, Alexander Freeman Nov 2018

A Retrospective Study Of Laboratory-Based Enteric Fever Surveillance, Pakistan, 2012-2014, Farah Naz Qamar, Mohammad Tahir Yousafzai, Shazia Sultana, Attaullah Baig, Sadia Shakoor, Farzeen Hirani, Abdul Wassay, Sehrish Khushboo, Junaid Mehmood, Alexander Freeman

Department of Paediatrics and Child Health

Introduction: The Surveillance for Enteric Fever in Asia Project (SEAP) is a multisite surveillance study designed to capture morbidity and mortality burden of enteric fever (typhoid and paratyphoid) in Bangladesh, Nepal, and Pakistan. We aim to describe enteric fever disease burden, severity of illness, and antimicrobial resistance trends in Pakistan.
Methods: In this retrospective, cross-sectional study, laboratory records of hospitalized patients who received a blood culture in any of 3 Aga Khan University hospitals in Karachi and Hyderabad, Pakistan, from 2012 to 2014 were reviewed. A case was defined as having a positive blood culture for Salmonella Typhi (S. Typhi) …


Causes And Incidence Of Community-Acquired Serious Infections Among Young Children In South Asia (Anisa): An Observational Cohort Study., Samir K. Saha, Stephanie J. Schrag, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta, Sajid Bashir Soofi, Muhammad Imran Nisar, Benazir Baloch, Furqan Kabir, Sheraz Ahmed, Imran Ahmed Jul 2018

Causes And Incidence Of Community-Acquired Serious Infections Among Young Children In South Asia (Anisa): An Observational Cohort Study., Samir K. Saha, Stephanie J. Schrag, Anita K. M. Zaidi, Zulfiqar Ahmed Bhutta, Sajid Bashir Soofi, Muhammad Imran Nisar, Benazir Baloch, Furqan Kabir, Sheraz Ahmed, Imran Ahmed

Department of Paediatrics and Child Health

Background: More than 500 000 neonatal deaths per year result from possible serious bacterial infections (pSBIs), but the causes are largely unknown. We investigated the incidence of community-acquired infections caused by specific organisms among neonates in south Asia.
Methods: From 2011 to 2014, we identified babies through population-based pregnancy surveillance at five sites in Bangladesh, India, and Pakistan. Babies were visited at home by community health workers up to ten times from age 0 to 59 days. Illness meeting the WHO definition of pSBI and randomly selected healthy babies were referred to study physicians. The primary objective was to estimate …


Mabry Syndrome In A Child Of South Asian Descent, Amir Humza Sohail, Muhammad Younus Khan Durrani, Shahnaz Hamid Ibrahim, Khadija Nuzhat Humayun Jan 2018

Mabry Syndrome In A Child Of South Asian Descent, Amir Humza Sohail, Muhammad Younus Khan Durrani, Shahnaz Hamid Ibrahim, Khadija Nuzhat Humayun

Section of Paediatric Surgery

Mabry syndrome is the triad of seizures, hyperphosphatasia, and mental disability. It usually manifests in first year of life and has an autosomal recessive mode of inheritance. Besides the usual triad, other manifestations of Mabry syndrome include hypoplasia of distal phalanges, brachytelencepahly, gastrointestinal malformations and constipation, hypertelorism, short nose with a broad nasal bridge and dip, and thin upper lip with down turned corners of the mouth. More than 20 cases of Mabry syndrome have been reported in medical literature. Herein, we report the case of a six-month child with Mabry syndrome that presented with decreased neck holding, hypotonia and …


Mental Illness And Injuries: Emerging Health Challenges Of Urbanisation In South Asia, Devaki Nambiar, Junaid Razzak, Kaosar Afsana, Alayne M. Adams, Arif Hasan, Dinesh Mohan, Vikram Patel Apr 2017

Mental Illness And Injuries: Emerging Health Challenges Of Urbanisation In South Asia, Devaki Nambiar, Junaid Razzak, Kaosar Afsana, Alayne M. Adams, Arif Hasan, Dinesh Mohan, Vikram Patel

Department of Emergency Medicine

No abstract provided.


Unmet Need For Surgery In South Asia, Sanjay Nagral, Maharra Hussain, Sarder A. Nayeem, Ranjan Dias, Ather Enam, Samiran Nundy Apr 2017

Unmet Need For Surgery In South Asia, Sanjay Nagral, Maharra Hussain, Sarder A. Nayeem, Ranjan Dias, Ather Enam, Samiran Nundy

Section of Neurosurgery

No abstract provided.


Raising Taxes Key To Accelerate Tobacco Control In South Asia, Prabhat Jha, Javaid Khan, Sujata Mishra, Prakash Gupta Apr 2017

Raising Taxes Key To Accelerate Tobacco Control In South Asia, Prabhat Jha, Javaid Khan, Sujata Mishra, Prakash Gupta

Section of Pulmonary & Critical Care

No abstract provided.


Diabetes, Cardiovascular Disease, And Chronic Kidney Disease In South Asia: Current Status And Future Directions, Anoop Misra, Nikhil Tandon, Shah Ebrahim, Naveed Sattar, Dewan Alam, Usha Shrivastava, K M Venkat Narayan, Tazeen H. Jafar Apr 2017

Diabetes, Cardiovascular Disease, And Chronic Kidney Disease In South Asia: Current Status And Future Directions, Anoop Misra, Nikhil Tandon, Shah Ebrahim, Naveed Sattar, Dewan Alam, Usha Shrivastava, K M Venkat Narayan, Tazeen H. Jafar

Section of Pulmonary & Critical Care

No abstract provided.


Progress In Maternal And Child Health: How Has South Asia Fared?, Nadia Akseer, Mahdis Kamali, Shams E. Arifeen, Ashar Muhammad Malik, Zaid Ahmad Bhatti, Naveen Thacker, Mahesh Maksey, Harendra D’Silva, Inacio Cm Da Silva, Zulfiqar Ahmed Bhutta Apr 2017

Progress In Maternal And Child Health: How Has South Asia Fared?, Nadia Akseer, Mahdis Kamali, Shams E. Arifeen, Ashar Muhammad Malik, Zaid Ahmad Bhatti, Naveen Thacker, Mahesh Maksey, Harendra D’Silva, Inacio Cm Da Silva, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.


Effects Of Bidi Smoking On All-Cause Mortality And Cardiorespiratory Outcomes In Men From South Asia: An Observational Community-Based Substudy Of The Prospective Urban Rural Epidemiology Study (Pure), Mylinh Duong, Sumathy Rangarajan, Xiaohe Zhang, Kieran Killian, Prem Mony, Sumathi Swaminathan, Ankalmadagu Venkatsubbareddy Bharathi, Sanjeev Nair, Krishnapillai Vijayakumar, Indu Mohan, Romaina Iqbal, Khawar Kazmi Jan 2017

Effects Of Bidi Smoking On All-Cause Mortality And Cardiorespiratory Outcomes In Men From South Asia: An Observational Community-Based Substudy Of The Prospective Urban Rural Epidemiology Study (Pure), Mylinh Duong, Sumathy Rangarajan, Xiaohe Zhang, Kieran Killian, Prem Mony, Sumathi Swaminathan, Ankalmadagu Venkatsubbareddy Bharathi, Sanjeev Nair, Krishnapillai Vijayakumar, Indu Mohan, Romaina Iqbal, Khawar Kazmi

Community Health Sciences

Background: Bidis are minimally regulated, inexpensive, hand-rolled tobacco products smoked in south Asia. We examined the effects of bidi smoking on baseline respiratory impairment, and prospectively collected data for all-cause mortality and cardiorespiratory events in men from this region.
Methods: This substudy of the international, community-based Prospective Urban Rural Epidemiology (PURE) study was done in seven centres in India, Pakistan, and Bangladesh. Men aged 35–70 years completed spirometry testing and standardised questionnaires at baseline and were followed up yearly. We used multilevel regression to compare cross-sectional baseline cardiorespiratory symptoms, spirometry measurements, and follow-up events (all-cause mortality, cardiovascular events, respiratory events) …


Coronary Calcium Scoring: Are The Results Comparable To Computed Tomography Coronary Angiography For Screening Coronary Artery Disease In A South Asian Population?, Nizar Bhulan, Ali Khawaja, Asif Jafferan, Maryam Baqir, Ramin Ebrahimi, Zafar Sajjad Jul 2013

Coronary Calcium Scoring: Are The Results Comparable To Computed Tomography Coronary Angiography For Screening Coronary Artery Disease In A South Asian Population?, Nizar Bhulan, Ali Khawaja, Asif Jafferan, Maryam Baqir, Ramin Ebrahimi, Zafar Sajjad

Section of Nephrology

Background: The need of having feasible screening tools like Coronary Calcium Scoring (CCS) and CT Coronary Artery (CTCA) for Coronary Artery Disease (CAD) has become paramount. We aimed to evaluate the accuracy of CCS in determining the degree of stenosis of coronary vessels as compared to that determined by CTCA in a South Asian population.

Methods: A retrospective study was conducted at The Aga Khan University Hospital. A total of 539 patient records were reviewed who had undergone CCS and CTCA between 2008 and 2010. Patient records were reviewed by comparing their CCS and CTCA results.

Results: About 268 out …