Digital Commons Network^™

Epidemiology, Determinants And Dynamics Of Cholera In Pakistan: Gaps And Prospects For Future Research., Maliha Naseer, Tanzil Jamali

Community Health Sciences

Cholera is one of the notifiable endemic diseases in Pakistan, but the reporting of cholera cases is still unsatisfactory. Most of the diagnosed cases are never reported to the relevant authorities. In the year 1993 - 2005, the country did not report any single case of cholera to the WHO. The objectives of this review were to understand the epidemiology and to identify the possible determinants of cholera infection in Pakistan. Medscape, Medline, PakMedinet and PubMed, was searched, using key words, epidemiology and determinants of cholera infection in Pakistan during 1995 - 2010. Morbidity and mortality due to cholera infection …

Integration Of Non-Communicable Diseases Into Primary Health Care: A Snapshot From Eastern Mediterranean Region, Shehla Zaidi, Abdul Latif Khan, Aftab Ali Mukhi, Yousuf Memon, Slim Slama, Samer Jabbour

Community Health Sciences

No abstract provided.

Public Health Service Options For Affordable And Accessible Noncommunicable Disease And Related Chronic Disease Prevention And Management, Sharon Brownie, Andrew P. Hills, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Globally, nations are confronted with the challenge of providing affordable health services to populations with increasing levels of noncommunicable and chronic disease. Paradoxically, many nations can both celebrate increases in life expectancy and bemoan parallel increases in chronic disease prevalence. Simply put, despite living longer, not all of that time is spent in good health. Combined with factors such as rising levels of obesity and related noncommunicable disease, the demand for health services is requiring nations to consider new models of affordable health care. Given the level of disease burden, all staff, not just doctors, need to be part of …

Exploring Adolescent Reproductive Health Knowledge, Perceptions, And Behavior, Among Students Of Non-Government Secondary Schools Supported By Brac Mentoring Program In Rural Bangladesh, Bachera Aktar, Malabika Sarker, Andrew Jenkins

Journal of Asian Midwives (JAM)

Adolescence is the transition period from childhood to adulthood. Since Bangladesh is such a conservative society, reproductive health education for adolescents has not been widely introduced. Very small adolescent health components are included in the secondary and higher secondary school curricula. The BRAC Mentoring Program provides mentorship training to secondary school pupils to develop them as peer leaders. However, this program does not provide adolescent reproductive health education. Therefore, a study, supported by BRAC Education Program in rural Bangladesh, was conducted to explore the current status of reproductive health knowledge, perceptions and practice among the students of secondary schools. This …

The Government Of Kenya Cash Transfer For Orphaned And Vulnerable Children: Cross-Sectional Comparison Of Household And Individual Characteristics Of Those With And Without, Lukoye Atwoli, Lonnie Embleton, Julius Koech, Paula Braitstein, Allan Kamanda

Internal Medicine, East Africa

Background: The ‘Cash Transfer to Orphans and Vulnerable Children’ (CT-OVC) in Kenya is a government-supported program intended to provide regular and predictable cash transfers (CT) to poor households taking care of OVC. CT programs can be an effective means of alleviating poverty and facilitating the attainment of an adequate standard of living for people’s health and well-being and other international human rights. The objective of this analysis was to compare the household socioeconomic status, school enrolment, nutritional status, and future outlook of orphaned and separated children receiving the CT compared to those not receiving a CT.

Methods: This project analyzes …

Approaches To Improve Quality Of Care (Qoc) For Women And Newborns: Conclusions, Evidence Gaps And Research Priorities, Zulfiqar Ahmed Bhutta, Rehana A. Salam, Zohra S. Lassi, Anne Austin, Ana Langer

Department of Paediatrics and Child Health

Despite progress in recent years, an estimated 273,500 women died as a result of maternal causes in 2010. The burden of these deaths is disproportionately bourne by women who reside in low income countries or belong to the poorest sectors of the population of middle or high income ones, and it is particularly acute in regions where access to and utilization of facility-based services for childbirth and newborn care is lowest. Evidence has shown that poor quality of facility-based care for these women and newborns is one of the major contributing factors for their elevated rates of morbidity and mortality. …

Predictors Of Hospital Stay And Mortality In Dengue Virus Infection-Experience From Aga Khan University Hospital Pakistan, Muhammad Abdul Mabood Khalil, Jackson Tan, Muhammd Ashhad Ullah Khalil, Safia Awan, Manickam Rangasami

Section of Nephrology

Background: Dengue virus infection (DVI) is very common infection. There is scarcity of data on factor associated with increased hospitalstay and mortality in dengue virus infection (DVI). This study was done to know about factors associated with increased hospital stay and mortality in patients admitted with DVI.

Results: Out of 532 patients, two third (72.6%) had stay ≤3 days while one third (27.4%) had stay greater than 3 days. The mean length of hospital stay was 3.46 ± 3.45 days. Factors associated with increased hospital stay (>3 days) included AKI (acute kidney injury) (Odd ratio 2.98; 95% CI 1.66-5.34), …

Unmet Need For Contraception And Unintended Pregnancies Among Women Of Reproductive Age Group: A Situation Analysis, Sumera Aziz Ali, Savera Aziz Ali

School of Nursing & Midwifery

Each year approximately 210 million pregnancies occur worldwide and more than one-third (75 to 80 million) of these are unintended, more than half of these (46 million) unintended pregnancies undergo unsafe abortions. In Pakistan 16% of the births are reported to be unwanted and if the unwanted fertility is eliminated, total fertility in Pakistan would be 3.1 births per woman. Total demand for family planning in Pakistan is 55%, while the contraceptive prevalence rate is 35% and unmet need for family planning is 20%. Reasons for unmet need and unintended pregnancy include lack of permission, fear of side effects, poor …

Global Burden, Distribution, And Interventions For Infectious Diseases Of Poverty, Zulfiqar Ahmed Bhutta, Johannes Sommerfeld, Zohra S. Lassi,, Rehana A. Salam, Jai K Das

Department of Paediatrics and Child Health

Infectious diseases of poverty (IDoP) disproportionately affect the poorest population in the world and contribute to a cycle of poverty as a result of decreased productivity ensuing from long-term illness, disability, and social stigma. In 2010, the global deaths from HIV/AIDS have increased to 1.5 million and malaria mortality rose to 1.17 million. Mortality from neglected tropical diseases rose to 152,000, while tuberculosis killed 1.2 million people that same year. Substantial regional variations exist in the distribution of these diseases as they are primarily concentrated in rural areas of Sub-Saharan Africa, Asia, and Latin America, with geographic overlap and high …

Impact : Issue 4, Patients' Behbud Society

IMPACT – The Aga Khan University Hospital Archives

Content

- Chairman’s Message

- Distribution of Patients Assisted by PBS

- Where There is Life There is Hope : Shaukat Qasim Agaria

- Happenings

- Dean, Medical College Comes on Board

- Department of Oncology

- Advancement, innovation and quality : Interview with Mr Moin Fudda

Political Determinants Of Health: Lessons For Pakistan, Rashid Jooma, Guido Sabatinelli

Section of Neurosurgery

There is much concern about the capacity of the health system of Pakistan to meet its goals and obligations. Historically, the political thrust has been absent from the health policy formulation and this is reflected in the low and stagnant public allocations to health. Successive political leaderships have averred from considering healthcare is a common good rather than a market commodity and health has not been recognized as a constitutional right. Over 120 of world's nation states have accepted health as a constitutional right but the 1973 Constitution of Pakistan does not mandate health or education as a fundamental right …

Protracted Effects Of Juvenile Stressor Exposure Are Mitigated By Access To Palatable Food, Jennifer Christine Mackay, Jonathan Stewart James, Christian Cayer, Pamela Kent, Hymie Anisman, Zul Merali

Brain and Mind Institute

Stressor experiences during the juvenile period may increase vulnerability to anxiety and depressive-like symptoms in adulthood. Stressors may also promote palatable feeding, possibly reflecting a form of self-medication. The current study investigated the short- and long-term consequences of a stressor applied during the juvenile period on anxiety- and depressive-like behavior measured by the elevated plus maze (EPM), social interaction and forced swim test (FST). Furthermore, the effects of stress on caloric intake, preference for a palatable food and indices of metabolic syndrome and obesity were assessed. Male Wistar rats exposed to 3 consecutive days of variable stressors on postnatal days …

Translation, Cultural Adaptation And Field-Testing Of The Thinking Healthy Program For Vietnam, Jane Fisher, Hau Nguyen, Priya Mannava, Ha Tran, Thao Dam, Tran Huong, Thach Tran, Kelly Durrant, Atif Rahman, Stanley Luchters

Population Health, East Africa

Background: Depression and anxiety are prevalent among women in low- and lower-middle income countries who are pregnant or have recently given birth. There is promising evidence that culturally-adapted, evidence-informed, perinatal psycho-educational programs implemented in local communities are effective in reducing mental health problems. The Thinking Healthy Program (THP) has proved effective in Pakistan. The aims were to adapt the THP for rural Vietnam; establish the program’s comprehensibility, acceptability and salience for universal use, and investigate whether administration to small groups of women might be of equivalent effectiveness to administration in home visits to individual women.

Methods: The THP …

Refeeding Syndrome In A Young Girl With Anorexia Nervosa., Om Parkash, Adil Ayub, Shahab Abid

Department of Medicine

We report the case of a 20-year-old anorexic girl (BMI=12.9), who was misdiagnosed the first time and developed severe electrolyte imbalances due to lack of awareness about refeeding syndrome. Few cases of RS have been reported in literature and protocols have been suggested for prevention and management of this syndrome, including the awareness of circumstances in which it is most likely to develop, refeeding slowly and building-up micronutrient content over several days. Improved awareness and understanding of refeeding syndrome along with a well-coordinated plan are vital in delivering safe and effective nutritional rehabilitation. We suggest a slow and gradual increase …

Perinatal Distress In Women In Low- And Middle-Income Countries: Allostatic Load As A Framework To Examine The Effect Of Perinatal Distress On Preterm Birth And Infant Health, Shahirose Sadrudin Premji

School of Nursing & Midwifery

In low- and middle-income countries (LMIC), determinants of women's and children's health are complex and differential vulnerability may exist to risk factors of perinatal distress and preterm birth. We examined the contribution of maternal perinatal distress on preterm birth and infant health in terms of infant survival and mother-infant interaction. A critical narrative and interpretive literature review was conducted. Peer-reviewed electronic databases (MEDLINE, Embase, Global Health, CINHAL), grey literature, and reference lists were searched, followed by a consultation exercise. The literature was predominantly from high-income countries. We identify determinants of perinatal distress and explicate changes in the hypothalamic-pituitary-adrenal axis, sympathetic, …

Correlations Of Skin Fold Thickness And Validation Of Prediction Equations Using Dexa As The Gold Standard For Estimation Of Body Fat Composition In Pakistani Children., Zainab Hussain, Tazeen H. Jafar, Maseeh Uz Zaman, Riffat Parveen Hussain

Department of Radiology

OBJECTIVE:

To determine the correlation between dual energy X-ray absorptiometry (DEXA) and skin fold thickness (SKF) equations for estimation of body fat (BF) composition in secondary school children and validation of prediction equations by Slaughter, Goran and Dezenberg.

DESIGN:

Cross sectional analytical study.

SETTING:

Joint Commission for International Accredited (JCIA) tertiary care hospital of Karachi, Pakistan from January 2010 to May 2010.

PARTICIPANTS:

The study was approved by the Hospital's ethical review committee. Written and verbal consents were obtained from principals of two schools and parents of 99 children (mean age of 14±1.89 years; min-max 9-19 years; 54 men and …

Gender: Shaping Personality, Lives And Health Of Women In Pakistan, Narjis Rizvi, Kausar S. Khan, Babar T. Shaikh

Community Health Sciences

Background: Gender norms determine the status of Pakistani women that influence their life including health. In Pakistan, the relationship between gender norms and health of women is crucial yet complex demanding further analysis. This paper: determines the reasons for reiteration of gender roles; describes the societal processes and mechanisms that reproduce and reinforce them; and identifies their repercussions on women's personality, lives and health especially reproductive health.
Methods: As part of a six-country study titled 'Women's Empowerment in Muslim Contexts', semi-structured group discussions (n = 30) were conducted with women (n = 250) who were selected through snowballing from different …

Isoflavones And Alzheimer’S Disease: The Effects Of Soy In Diet, Sara Habib, Asad Ali Khan Afridi, Mohammad Wasay, Romaina Iqbal

Pakistan Journal of Neurological Sciences (PJNS)

Pathologically, Alzheimer’s disease is a result of aggregation of amyloid peptides and protein tau in the brain forming neurofibrillary tangles which are highly toxic to neuronal circuits in the brain. Recent evidences report that apart from aging, estrogen deficiency is one of the risk factors predisposing to the development of Alzheimer’s disease. Isoflavones, also known as phytoestrogens, are metabolized by the body forming compounds that are known to interfere with neurotoxic pathways and through their anti-fibrillization effects they play a role in reducing apoptosis of neurons and glial cells and promote axonal regeneration. Experimental studies on transgenic models with Alzheimer’s …

Validation Of A Food Frequency Questionnaire For Assessing Macronutrient And Calcium Intake In Adult Pakistani Population, Romaina Iqbal, Mohammad Ali Haroon, Farhan Javed Dar, Mujtaba Bilgirami, Gulshan Bano, Aysha Habib Khan

Community Health Sciences

Objective: To develop and validate a food frequency table (FFQ) for use in urban Pakistani population.
Study design: A validation study.
Place and duration of study: The Aga Khan University, Karachi, from June to November 2008.
Methodology: Healthy adult females, aged ³ 18 years who consented to be included in the study were inducted, while males, unhealthy females, aged below 18 years or who did not consent were excluded. The FFQ was administered once while 4, 24 hours recalls spread over a period of one year were administered as the reference method. Daily intakes for energy, protein, fat, and calcium …

Gender: Shaping Personality, Lives And Health Of Women In Pakistan, Narjis Rizvi, Kausar S. Khan, Babar T. Shaikh

Community Health Sciences

Background: Gender norms determine the status of Pakistani women that influence their life including health. In Pakistan, the relationship between gender norms and health of women is crucial yet complex demanding further analysis. This paper: determines the reasons for reiteration of gender roles; describes the societal processes and mechanisms that reproduce and reinforce them; and identifies their repercussions on women's personality, lives and health especially reproductive health.
Methods: As part of a six-country study titled 'Women's Empowerment in Muslim Contexts', semi-structured group discussions (n = 30) were conducted with women (n = 250) who were selected through snowballing from different …

Antibiotics To Promote Growth In Children?, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Community Health Revolving Fund: Equity Fund For Mccs, Muhammad Ashar Malik

Community Health Sciences

No abstract provided.

Pregnancy And Childbirth Outcomes Among Adolescent Mothers: A World Health Organization Multicountry Study, Togoobaatar Ganchimeg, E Ota, N Morisaki, M Laopaiboon, P Lumbiganon, J Zhang, B Yamdamsuren, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objective: To investigate the risk of adverse pregnancy outcomes among adolescents in 29 countries. Design: Secondary analysis using facility-based cross-sectional data of the World Health Organization Multicountry Survey on Maternal and Newborn Health.

Setting: Twenty-nine countries in Africa, Latin America, Asia and the Middle East.

Population: Women admitted for delivery in 359 health facilities during 2–4 months between 2010 and 2011.

Methods: Multilevel logistic regression models were used to estimate the association between young maternal age and adverse pregnancy outcomes.

Main outcome measures: Risk of adverse pregnancy outcomes among adolescent mothers.

Results: A …

Closing Remarks And Vote Of Thanks, Saima Sachwani

AKU Symposium

No abstract provided.

Perspective From Khyber Pakhtunkhwa, Dr Shabina Raza

AKU Symposium

No abstract provided.

Media And Ncds: The Role Of Media In Health Reform Advocacy, Ms Huma Baqai

AKU Symposium

No abstract provided.

Role Of Nutrition In Prevention And Treatment Of Diabetes, Dr Parvez Paracha

AKU Symposium

No abstract provided.

Childhood Obesity From High Mountains Of Pakistan To The Plains Of United Arab Emirate: Its Role In Ncds, Dr Mahboob Shah

AKU Symposium

No abstract provided.

Implications Of Metabolic Syndrome, Dr M Hamed Farooqi

AKU Symposium

No abstract provided.

Provincial Legislation For Ncd Control, Dr Rashid Jooma

AKU Symposium

No abstract provided.