Digital Commons Network^™

Seasonal Variation And Sex Distribution Inpatients With Guillain-Barre Syndrome, Mohsin Zaheer, Muhammad Naeem, Muhammad Nasrullah

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Factors Influencing In-Hospital Length Of Stay And Mortality In Cancer Patients Suffering From Febrile Neutropenia, Amar Lal, Yasmin Bhurgri, Nida Rizvi, Mohni Virwani, Rasheed Uddin Memon, Wajeeha Saeed, Muhammad Rizwan Sardar, Pawan Kumar, Asim Jamal Shaikh, Salman Adil, Nehal Masood, Mohammad Khurshid

Section of Haematology/Oncology

Introduction: Febrile neutropenia (FN) is a major complication of chemotherapy, costly in terms of morbidity, mortality and associated financial expenditure. The present study was conducted with the goal of highlighting FN as a serious problem in Pakistan, with the longer term objective of improved cancer survival, reduction in length of stay (LOS) in hospital, morbidity, mortality and costs in our existing developing country scenario. Methods: A cross-sectional descriptive study was conducted on Patients, > or =18 years, admitted with FN as a consequence of chemotherapy at a referral hospital in Karachi from 1st September 2006 to 30th April 2007. Results: A …

Tetanus And Rabies Eradication In Pakistan; A Mission Not Impossible, Mohammad Wasay, Ismail A. Khatri, Naseem Salahuddin

Department of Medicine

No abstract provided.

Cervical Cancer Vaccine In Pakistan: Let's Start Thinking, Ali Jawaid

Medical College Documents

No abstract provided.

Labrad : Vol 33, Issue 1 - January 2008, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Diagnosis of Malaria
• Imaging Feature of Synovial Sarcoma in Pediatrics Patients
• Fine Needle Aspiration Biopsy: The best test to differentiate benign from malignant thyroid nodules
• HLA-B27 and Disease Association
• Bacterial Contamination of Blood Components
• Pathology Quiz
• Biochemical Investigations
• Leishmaniasis
• Answers to Quiz
• CD55 and CD59 for the Diagnosis of PNH
• Meeting Report

Beta-Hemolytic Streptococcus Group A Endocarditis: A Rare Clinical Presentation, Aysha Almas, M. Tariq

Section of Internal Medicine

A case report of an elderly gentleman is reported herein, who presented with one week history of fever, drowsiness and left lower limb weakness. Examination revealed left lower limb weakness with power of grade 3/5. His workup showed evidence of infection and multiple cerebral infarcts on the right side. Blood culture grew Streptococcus pyogens. Echocardiogram showed two vegetations on the aortic valve. Fever was the main presenting feature in this case but it was the presentation of patient with multiple cerebral infarcts that lead to the diagnosis of infective endocarditis. The organism causing Infective Endocarditis (IE) in this patient was …

Developmental Dysplasia Of Hip--Where Do We Stand?, Masood Umer, Haq Nawaz

Department of Surgery Docs

No abstract provided.

Antibiotic Susceptibility Of Pathogens Isolated From Patients With Community-Acquired Respiratory Tract Infections In Pakistan--The Active Study, Afia Zafar, Zahid Hussain, Eale Lomama, Sophie Sibille, Seema Irfan, Erum Khan

Department of Pathology and Laboratory Medicine

BACKGROUND: Respiratory tract infections (RTIs) are amongst the most wide spread and serious infections, accounting for over 50 million deaths globally each year. In developing countries, infants under 4 years of age are at greatest risk of lower RTIs, whereas in developed countries the severity of infection and rate of mortality are greater in elderly. The objective of the survey was to determine the in vitro susceptibility of antibiotics commonly prescribed RTIs against Streptococcus pneumoniae (SP), Haemophilus influenzae (HI) and Streptococcus pyogenes, isolated from patients with community-acquired RTIs globally. This survey involved 9 countries. In this study we present the …

Willingness And Ability To Pay For Artemisinin-Based Combination Therapy In Rural Tanzania, E.C. Saulo, B.C. Forsberg, Zul Premji, S.M. Montgomery, A. Bjorkman

Pathology, East Africa

Background: The aim of this study was to analyse willingness to pay (WTP) and ability to pay (ATP) for ACT for children below five years of age in a rural setting in Tanzania before the introduction of artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated malaria. Socio-economic factors associated with WTP and expectations on anti-malaria drugs, including ACT, were also explored.

Methods: Structured interviews and focus group discussions were held with mothers, household heads, health-care workers and village leaders in Ishozi, Gera and Ishunju wards in north-west Tanzania in 2004. Contingent valuation method (CVM) was used with "take-it-or-leave- it" …

Hiv, Hepatitis B And Hepatitis C Coinfection In Kenya, Reena Shah, Jane Karuru, Mark Nelson, Justin Stebbing

Internal Medicine, East Africa

There are few data regarding hepatitis and HIV coinfection in Africa. In 378 HIV seropositive individuals in Nairobi, 23 (6%) were hepatitis B virus (HBV) and HIV coinfected, four (1%) were hepatitis C virus (HCV) and HIV coinfected and one patient was infected with all three viruses. Coinfected individuals were more likely to be men and older; a lack of HBV vaccination was a risk factor for HIV/HBV coinfection (PU0.001) and tenofovir containing regimens appeared most effective at reducing HBV viral load.

Conclusions And Recommendations Of A Who Expert Consultation Meeting On Iron Supplementation For Infants And Young Children In Malaria Endemic Areas [Conclusions Et Recommandations À L'Issue De La Consultation De L'Oms Sur La Lutte Contre La Carence Martiale Chez Le Nourrisson Et Le Jeune Enfant Dans Les Pays D'Endémie Palustre], L. Allen, R.E. Black, N. Brandes, G. Brittenham, G. Chazot, C Chunming, J. Crawley, B. De Benoist, N. Dalmiya, I. Darnton-Hill, K. Dewey, S. El-Arifeen, O. Fontaine, C. Geissler, H. Haberle, P. Harvey, J. Hasler, C. Hershko, R. Hurrell, M.A. Juma, B. Lonnerdal, B. Lozoff, S. Lynch, H. Martines Salgado, E. Mclean, J. Metz, S. Oppenheimer, Zul Premji, A. Prentice, M. Ramsan, C. Ratledge, R. Stoltzfus, J. Tielsch

Pathology, East Africa

This article presents the results of an expert consultation meeting aimed at evaluating the safety and public health implications of administering supplemental iron to infants and young children in malaria-endemic areas. Participants at this meeting that took place in Lyon, France on June 12-14, 2006 reached consensus on several important issues related to iron supplementation for infants and young children in malaria-endemic areas. The conclusions in this report apply specifically to regions where malaria is endemic.

Aku-Nama : Winter 2008, Volume 1, Issue 2, Aga Khan University Alumni Association

The Aga Khan University Newsletter and Magazine for Alumni (AKU-NAMA)

No abstract provided.

Longitudinal Tracking Of Cytokines After Acute Exposure To Tuberculosis: Association Of Distinct Cytokine Patterns With Protection And Disease Development, Rabia Hussain, Najeeha Talat, Firdaus Shahid, Ghaffar Dawood

Department of Pathology and Laboratory Medicine

Household contacts (HCs) of patients with tuberculosis (TB) are at higher risk of infection as well as the development of active disease. Longitudinal tracking of antigen-specific cytokines after acute exposure may significantly advance our understanding of the dynamic changes in cytokine patterns associated with disease establishment. To achieve this objective, we carried out a prospective cohort study with healthy HCs after exposure to TB. The patterns of cytokines (gamma interferon [IFN-gamma] and interleukin 10 [IL-10]) in response to mycobacterial antigens (culture filtrate [CF] proteins) and nonspecific mitogens (phytohemagglutinin [PHA] and lipopolysaccharide [LPS]) were assessed at 0, 6, 12, and 24 …

Marriage Patterns And Pediatric Neurologicdisease In Damascus, Syria, Muhammad Talal Al-Rifai, Robert C. Woody

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Poor Knowledge--Predictor Of Nonadherence To Universal Precautions For Blood Borne Pathogens At First Level Care Facilities In Pakistan, Naveed Z. Janjua, Mahreen Razaq, Subhash Chandir, Shafquat Rozi, Bushra Mahmood

Community Health Sciences

Background: We conducted an assessment of knowledge about blood borne pathogens (BBP) and use of universal precautions at first level care facilities (FLCF) in two districts of Pakistan.Methods: We conducted a cross-sectional survey and selected three different types of FLCFs ; public, general practitioners and unqualified practitioners through stratified random sampling technique. At each facility, we interviewed a prescriber, a dispenser, and a housekeeper for knowledge of BBPs transmission and preventive practices, risk perception, and use of universal precautions. We performed multiple linear regression to assess the effect of knowledge score (11 items) on the practice of universal precautions score …

Epilepsy In Pakistan, Hasan Aziz

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Craniocerebral Aspergillosis In Immunocompetent Hosts: Surgical Perspective, Muhammad Shahzad Shamim, Arshad A. Siddiqui, Ather Enam, Ahmed Ali Shah, Rashid Jooma, Saleha Anwar

Section of Neurosurgery

Craniocerebral aspergillosis is a rare but dangerous variety of central nervous system infections. Surgery is being widely recognized as the cornerstone of management. Due to the rarity of the disease, difficulty and delay in diagnosis and poor outcome, there is very little in the literature regarding the various surgical strategies that may be adopted in these patients. Early aggressive surgery followed by chemotherapy offers the best chances. Surgical planning would depend upon the type and location of the disease process as well as the condition of the patient. Perioperative care holds immense importance and knowledge of possible complications is essential. …

Thirty Years Of Alma Ata Pledges: Is Devolution In Pakistan An Opportunity For Rekindling Primary Health Care?, Babar T. Shaikh, Muhammad Masood Kadir, Gregory Pappas

Community Health Sciences

The 1978 Alma Ata Conference presented the manifesto to attain global health for the next century by providing basic health care aimed at the urban and rural poor of the developing world. While the goals of Alma Ata were noble, they were untenable. Today, developing countries face serious issues of equity in health care delivery and fairness in health care management with even a greater need to transform the management systems and practice. Primary health care remains a cornerstone of building the capacity of health systems. Devolution in health sector in Pakistan seems like a chance to re-exert Alma Ata …

Aku Newsletter : May 2007, Volume 8, Issue 1, Aga Khan University

The Aga Khan University Newsletters

No abstract provided.

Hiv/Aids In Pakistan: The Battle Begins, Mohammad A. Rai, Haider J. Warraich, Syed H. Ali, Vivek R. Nerurkar

Department of Biological & Biomedical Sciences

Pakistan, the second most populous Muslim nation in the world, has started to finally experience and confront the HIV/AIDS epidemic. The country had been relatively safe from any indigenous HIV cases for around two decades, with most of the infections being attributable to deported HIV positive migrants from the Gulf States. However, the virus finally seems to have found a home-base, as evidenced by the recent HIV outbreaks among the injection drug user community. Extremely high-risk behavior has also been documented among Hijras (sex workers) and long-distance truck drivers. The weak government response coupled with the extremely distressing social demographics …

Soils: A Contemporary Perspective, Cheryl Palm, Pedro Sanchez, Sonya Ahamed, Alex Awiti

East Africa Institute

Soils are viewed in the context of ecosystem services, soil processes and properties, and key attributes and constraints. The framework used is based on the premise that the natural capital of soils that underlies ecosystem services is primarily determined by three core soil properties: texture, mineralogy, and soil organic matter. Up-to-date descriptions and geographical distribution of soil orders as well as soil attributes and constraints are given, along with the relationships between soil orders, properties, and biomes. We then relate ecosystem services to specific soil processes, soil properties, and soil constraints and attributes. Soil degradation at present is not adequately …

Influence Of Consecutive-Day Blood Sampling On Polymerase Chain Reaction-Adjusted Parasitological Cure Rates In An Antimalarial-Drug Trial Conducted In Tanzania, Andreas Martensson, Johan Ursing, M. Isabel Veiga, Lisa Wiklund, Christopher Membi, Scott M. Montgomery, Zul Premji, Anna Farnert, Andres Bjorkman, Billy Ngasala

Pathology, East Africa

We assessed the influence that consecutive-day blood sampling, compared with single-day blood sampling, had on polymerase chain reaction (PCR)-adjusted parasitological cure after stepwise genotyping of merozoite surface proteins 2 (msp2) and 1 (msp1) in 106 children in Tanzania who had uncomplicated falciparum malaria treated with either sulfadoxine-pyrimethamine or artemether- lumefantrine; 78 of these children developed recurrent parasitemia during the 42-day follow-up period. Initial msp2 genotyping identified 27 and 33 recrudescences by use of single- and consecutive-day sampling, respectively; in subsequent msp1 genotyping, 17 and 21 of these episodes, respectively, were still classified as recrudescences; these results indicate a similar sensitivity …

Adults' Perceived Prevalence Of Enteric Fever Predicts Laboratory-Validated Incidence Of Typhoid Fever In Children, Xinguang Chen, Bonita Stanton, Al Pach, Andrew Nyamete, R. Leon Ochiai, Linda Kaljee, Baiqing Dong, Dipika Sur, S.K. Bhattacharya, Siti Sapardiyah Santoso, Magdarina Agtini, Zahid Memon, Zulfiqar Ahmed Bhutta, Canh Gia Do, Lorenz Von Seidlein, John Clemens

Centre of Excellence in Women and Child Health

This study was undertaken to develop a model to predict the incidence of typhoid in children based on adults’ perception of prevalence of enteric fever in the wider community. Typhoid cases among children, aged 5-15 years, from epidemic regions in five Asian countries were confirmed with a positive Salmonella Typhi culture of the blood sample. Estimates of the prevalence of enteric fever were obtained from random samples of adults in the same study sites. Regression models were used for establishing the prediction equation. The percentages of enteric fever reported by adults and cases of typhoid incidence per 100,000, detected through …

Knowledge And Beliefs Of Adolescents Regarding Sexually Transmitted Infections And Hiv/Aids In A Rural District In Pakistan, Hafsa Raheel, Franklin White, Muhammad Masood Kadir, Zafar Fatmi

Community Health Sciences

Objective:

To assess the knowledge and beliefs of adolescents (15-19 years girls and boys) regarding sexually transmitted infections (STIs) and HIV/AIDS.

Methods:

A community based cross-sectional survey was conducted in October 2002 in a rural district (Mirpurkhas) of Sindh province, Pakistan.

Results:

A total of 428 adolescent girls and boys were interviewed. Only 44% correctly named at least one STI, while 55% knew at least two modes of transmission for HIV/AIDS. Adolescents with education greater than or equal to secondary level, those who were able to read the newspaper, possessed electricity in their homes and were allowed to meet their …

Maternal Characteristics In Relation To Income In A Semi-Rural Community In Pakistan, A R. Siddiqui

Community Health Sciences

Women's health and socioeconomic status is fundamental to development. The aim of this study was to evaluate the relationship of monthly household income with demographic, nutritional and social characteristics in women living in a semi-rural location near Karachi. Thus 1111 mothers with at least 1 child under 5 years of age were interviewed. Self-reported monthly income was positively associated with gravidity, mid upper-arm circumference, cooking frequency per day and self and spousal literacy; it was negatively associated with number of occupants per room, wood used as cooking fuel, and spouse in a skilled occupation. Income is dependent on non-income factors …

Resource Allocation Within The National Aids Control Program Of Pakistan: A Qualitative Assessment Of Decision Maker's Opinions, Sara Husain, Masood Kadir, Zafar Fatmi

Community Health Sciences

Background:

Limited resources, whether public or private, demand prioritisation among competing needs to maximise productivity. With a substantial increase in the number of reported HIV cases, little work has been done to understand how resources have been distributed and what factors may have influenced allocation within the newly introduced Enhanced National AIDS Control Program of Pakistan. The objective of this study was to identify perceptions of decision makers about the process of resource allocation within Pakistan's Enhanced National AIDS Control Program.

Methods:

A qualitative study was undertaken and in-depth interviews of decision makers at provincial and federal levels responsible to …

Noncommunicable Diseases And Injuries: Action Needed In South Asia Too, Ali Khan Khuwaja, Riaz Qureshi, Zafar Fatmi

Community Health Sciences

No abstract provided.

Knowledge, Attitude And Practice Regarding Immunization Among Family Practice Patients, Waris Qidwai, Syed Sohail Ali, Semi Ayub, Salma Ayub

Department of Family Medicine

Objective: To determine the knowledge, attitude and practices about immunization among family practice patients.
Design: A questionnaire based survey.
Patients and Method: A questionnaire was developed in line with the study objectives. It was administered to patients visiting family physicians, after they were administered, informed consent and assurance with regards to confidentiality was provided. Epi-info and SPSS software was used for data management.
Results: A total of 97 patients were surveyed. The majority were men (59.8%) with a mean age of 29.69 years. Majority was unmarried (51.5%), with graduate and post-graduate education (73%), and in government and …

Impact Of Antibiotic Restriction On Broad Spectrum Antibiotic Usage In The Icu Of A Developing Country, Shahla Siddiqui, Kashif Hussein, Roshan Manasia, Aijaz Samad, Nawal Salahuddin, Afia Zafar, M. Qamarul Hoda

Department of Anaesthesia

Objective: To reduce rates of nosocomial pneumonia and cost of antibiotic therapy.
Methods: By means of a policy implementation the following broad spectrum antibiotics were restricted to usage in the ICU for 72 hours: Cefepime, Meropenem, Imipenem, Tazocin, Polymixin B and Vancomycin, after an institutional based pharmacy and therapeutic committee approval. The ICU pharmacist would alert the ICU residents or consultants after 48 hours of the computer based antibiotic entry that the order would expire within hours. Telephone approval was obtained followed by a formal consultation if deemed necessary by the ID specialist or primary team. Antibiotic usage was …

Variant Merozoite Protein Expression Is Associated With Erythrocyte Invasion Phenotypes In Plasmodium Falciparum Isolates From Tanzania, A.K. Bei, C.D. Membi, J.C. Rayner, M. Mubi, B. Ngasala, A.A. Sultan, Zul Premji, M.T. Duraisingh

Pathology, East Africa

[No abstract available]