Digital Commons Network^™

Self-Perceived Health Among School Going Adolescents In Pakistan: Influence Of Individual, Parental And Life Style Factors?, Asad Ali Khan Afridi, Komal Motwani, Saleem Khawaja, Adeel Khoja, Zafar Fatmi, Iqbal Azam Syed, Muhammad Masood Kadir

Department of Medicine

BACKGROUND: Adolescents are at substantial risk of acquiring behaviors which might influence their health status. This study was aimed to assess the proportion of school going adolescents (both males and females) with poor self-perceived health and its associated factors.

METHODOLOGY: A cross-sectional study was conducted in three major cities of Pakistan i.e. Karachi, Lahore and Quetta. From each city, six (6) secondary schools were randomly selected (3 public and 3 private). Pre-tested, self-administered questionnaire was distributed to students. Binary logistic regression analysis was conducted to determine independent factors associated with poor self-perceived health.

RESULTS: Approximately 29% adolescents (119/414) reported poor …

Association Of Body Iron Status With The Risk Of Premature Acute Myocardial Infarction In A Pakistani Population, Mohammadl Perwaiz Iqbal, Naseema Mehbooi Ali, Asal Khan Tareen, Mohsin Yakub, Saleeml Perwaizl Iqbal, Khalida Iqbal, Ghulam Haider

Department of Biological & Biomedical Sciences

Background

Coronary artery disease is very common in Pakistani population. Some of the studies carried out on Western populations have shown a relationship between body iron status as determined by the ratio of concentrations of serum soluble transferrin receptor (sTfR) to ferritin and the risk of acute myocardial infarction (AMI). In order to investigate whether increased body iron status has any relationship with the risk of premature AMI in Pakistani population, a case-control study was carried out.

Methodology/Principal findings

In this case-control study, 203 consecutive AMI patients [146 males and 57 females; age range 18–45 years] admitted to the National …

The Objectives, Design And Implementation Of The Intergrowth-21st Project, Villar J, Altman D. G, Purwar M, Noble J. A, Knight H. E, Ruyan P, Ismail L. Cheikh, Barros F. C, Lambert A, Papageorghiou A. T, Maria Carvalho, Jaffer Y. A, Bertino E, Gravett M. G, Bhutta Z. A, Kennedy S. H

Obstetrics and Gynaecology, East Africa

INTERGROWTH-21st is a multicentre, multiethnic, populationbased project, being conducted in eight geographical areas (Brazil, China, India, Italy, Kenya, Oman, UK and USA), with technical support from four global specialised units, to study growth, health and nutrition from early pregnancy to infancy. It aims to produce prescriptive growth standards, which conceptually extend the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) to cover fetal and newborn life. The new international standards will describe: (1) fetal growth assessed by clinical and ultrasound measures; (2) postnatal growth of term and preterm infants up to 2 years of age; and (3) the relationship …

Implementation Of The Intergrowth-21st Project In Kenya, Maria Carvalho, Sudhir Vinayak, Roseline Ochieng, V Choksey, N Musee, W Stones, H E. Knight, L Cheikh Ismail

Obstetrics and Gynaecology, East Africa

The African site in the INTERGROWTH-21(st) Project was Parklands, a wealthy suburb of Nairobi, Kenya, with a largely middle-to-high socio-economic status population. There are three hospitals with obstetric units in Parklands, with approximately 4300 births per year. The Newborn Cross-Sectional Study (NCSS) sample was drawn from all three hospitals, covering 100% of births in this target population. The Fetal Growth Longitudinal Study (FGLS) sample was recruited from antenatal clinics serving these hospitals, using the eligibility criteria in the INTERGROWTH-21(st) protocol. Special activities to raise awareness of the study included securing media coverage and distributing leaflets in antenatal clinic waiting rooms. …

General Practitioners' Knowledge And Approach To Chronic Kidney Disease In Karachi, Pakistan, S Yaqub, W Kashif, M Q. Raza, H Aaqil, A Shahab, M A. Chaudhary, S A. Hussain

Section of Nephrology

Due to lack of adequate number of formally trained nephrologists, many patients with chronic kidney disease (CKD) are seen by general practitioners (GPs). This study was designed to assess the knowledge of the GPs regarding identification of CKD and its risk factors, and evaluation and management of risk factors as well as complications of CKD. We conducted a cross-sectional survey of 232 randomly selected GPs from Karachi during 2011. Data were collected on a structured questionnaire based on the kidney disease outcomes and quality initiative recommendations on screening, diagnosis, and management of CKD. A total of 235 GPs were approached, …

B-Type Natriuretic Peptide Versus Amino Terminal Pro-B Type Natriuretic Peptide: Selecting The Optimal Heart Failure Marker In Patients With Impaired Kidney Function, Lena Jafri, Waqar Kashif, Javed Tai, Imran Siddiqui, Iqbal Azam, Hira Shahzad, Farooq Ghani

Department of Pathology and Laboratory Medicine

Background: The effect of impaired kidney function on B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) is vague. This study was performed to examine the effect of kidney dysfunction on the afore-mentioned markers and determine appropriate cutoffs for systolic heart failure (SHF).

Methods: In this cross sectional study adults with estimated glomerular filtration rate (eGFR)/min for ≥3 months were identified in consulting clinics from June 2009 to March 2010. SHF was defined as documented by a cardiologist with ejection fraction of < 40% and assessed by New York Heart Association classification (NYHA). Plasma was assayed for creatinine (Cr), BNP and NT-proBNP.

Results: A total of 190 subjects were enrolled in the study, 95 with and 95 without SHF. The mean …

Better Drug Therapy For The Children Of Africa: Current Impediments To Success And Potential Strategies For Improvement, Stuart M. Macleod, Janet K. Finch, William Macharia, Gabriel M. Anabwani

Paediatrics and Child Health, East Africa

A commentary is presented on the urgent need for a comprehensive effort to improve the practice of pediatric therapeutics in Africa. A call for action is addressed to a variety of practitioners internationally, many of whom possess skills that could be fruitfully applied to the improvement of health outcomes for African children. Successful engagement with the many challenges requires the complementary effort of researchers in basic and clinical pharmacology and toxicology, nurses, pharmacists, physicians, clinical pharmacologists, clinical pharmacists, and political leaders and civil servants. While a comprehensive or systematic review of the relevant literature has not been attempted, the authors …

Perceived Relative Factors Influencing Nurses’ Practice Of Health Promotion For Women In Calabar, Cross River State, Nigeria, E. Samson-Akpan, O. B. Edet, I. I. Akpabio, Ekaete Asuquo

School of Nursing & Midwifery, East Africa

Socio-cultural factors negate the health of women. Therefore, health promotion as a focus of nursing practice aimed at capitalizing on the inherent capacities of women to establish health priorities, goals and strategies to improve their health. A descriptive survey with the purpose of ascertaining the influence of culture, social and health policies on nurses’ practice of health promotion was undertaken. Three hypotheses were formulated to guide the study. A sample of one hundred and thirty six nurses participated in the study. A validated questionnaire with a test-retest reliability coefficient (r) of 0.79 was used for data collection. Correlation analysis was …

Fiber-Free White Flour With Fructose Offers A Better Model Of Metabolic Syndrome, Faridah Amin, Anwar Hassan Gilani

Department of Biological & Biomedical Sciences

BACKGROUND: The metabolic syndrome (MS) is a combination of metabolic abnormalities that lead to an increased risk of cardiovascular diseases. Due to its rising incidence and demanding life-long use of multiple drugs, there is a growing interest in testing and developing new allopathic, complementary and alternative therapies for controlling or curing disorders of MS. The discovery of new therapeutic modalities requires animal models of disease and currently available models have limitations. Developing an appropriate animal model for MS to achieve various therapeutic targets remains a challenge and this study aims to develop a rat model which closely depicts MS in …

Nitric Oxide And Its Metabolites In The Critical Phase Of Illness: Rapid Biomarkers In The Making, Asad Mian, Mayank Aranke, Nathan S. Bryan

Department of Emergency Medicine

The potential of nitric oxide (NO) as a rapid assay biomarker, one that could provide a quantum leap in acute care, remains largely untapped. NO plays a crucial role as bronchodilator, vasodilator and inflammatory mediator. The main objective of this review is to demonstrate how NO is a molecule of heavy interest in various acute disease states along the emergency department and critical care spectrum: respiratory infections, central nervous system infections, asthma, acute kidney injury, sepsis, septic shock, and myocardial ischemia, to name just a few. We discuss how NO and its oxidative metabolites, nitrite and nitrate, are readily detectable …

Role Of Garlic Usage In Cardiovascular Disease Prevention: An Evidence-Based Approach, Waris Qidwai, Tabinda Ashfaq

Department of Family Medicine

Introduction:.Rapidly growing prevalence of cardiovascular disease is a major threat for the developed as well as developing world warranting urgent need of intervention. Complementary and alternative medicines are gaining popularity among general population because of their safety profile and easy administration. Garlic, in particular, is considered to be one of the best disease-preventive foods because of its potent and widespread effects. This study was done to find out the role of garlic usage in cardiovascular disease prevention.

Methodology : .Major databases including Google, PubMed,MEDLINE, and Cochrane library view were used for the literature search. Clinical trials conducted on humans assessing …

Daily Contact With A Patient And Poor Housing Affordability As Determinants Of Pulmonary Tuberculosis In Urban Pakistan, Batool A. Haider, Saeed Akhtar, Juanita Hatcher

Community Health Sciences

Objective: This study aimed to evaluate the factors associated with pulmonary tuberculosis (TB) among individuals aged 15years or more in urban Karachi, Pakistan.DESIGN AND SETTING: A case-control design was implemented in three major tertiary-care hospitals to select cases (n=342) with active pulmonary TB (i.e. two sputum smears positive for Mycobacterium tuberculosis with clinical and radiographic evidence of current pulmonary TB and diagnosed between August 2002 and October 2003. Selected controls (n=342) were surgery patients from the same hospitals at time of recruitment of the cases, without clinical and radiographic evidence of pulmonary TB.Results: Multivariable logistic regression model showed that daily …

The Political Economy Of Undernutrition National Report: Pakistan, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Shandana Khan Mohmand, Andres Mejia Acosta

Community Health Sciences

No abstract provided.

Public Private Partnerships For Improving Maternal And Neonatal Health Service Delivery A Review Of The Evidence, Shehla Zaidi, Rehana Salam, Zulfiqar Ahmed Bhutta, Shahid Ansari, Syeda Subika Rizvi, Beenish Fatima Zehra, Amin Pethani

Community Health Sciences

No abstract provided.

Effectiveness Of A Community-Based Positive Prevention Intervention For People Living With Hiv Who Are Not Receiving Antiretroviral Treatment: A Prospective Cohort Study, Avina Sarna, Stanley Luchters, Eustasius Musenge, Jerry Okal, Matthew Chersich, Waimar Tun, Sabine Mall, Nzioki Kingola, Sam Kalibala

Population Health, East Africa

Background: We report effectiveness of an HIV-prevention intervention delivered by community health workers (CHWs) in Mombasa, Kenya, to PLHIV who have not initiated or who have discontinued ART-an often difficult-to-reach population because they fall outside the ambit of health care and prevention services.

Methods: A 2-arm cohort study assessed a structured risk-reduction intervention involving at least 4 one-to-one counseling sessions and personalized support. The control group received standard prevention services. CHWs recruited treatment-naïve people living with HIV (PLHIV) or those who had previously taken antiretroviral drugs. Data were analyzed using a Propensity Score Matched (PSM)-sample to control for baseline differences …

Prevalence Of Hypertension In Healthy School Children In Pakistan And Its Relationship With Body Mass Index, Proteinuria And Hematuria, Arshalooz Jamila Rahman, Farah Naz Qamar, Sohail Ashraf, Zubair Ali Khowaja, Shafaq Binte Tariq, Hira Naeem

Department of Paediatrics and Child Health

To determine the prevalence of high blood pressure (BP) in healthy school Pakistani children and its association with high body mass index (BMI), asymptomatic hematuria and proteinuria, we studied 661 public school children and measured their body weight, height and BP and urine dipstick for hematuria performed on a single occasion. Hypertension (BP >95 th centile) and pre-hypertension (BP >90 th centile) were defined based on the US normative BP tables. Over-weight and obesity were defined according to the World Health Organization (WHO) classification of BMI. The mean age of the children was 14 ± 1.3 years. The mean BMI …

Elevated Chemerin Levels In Pakistani Men: An Interrelation With Metabolic Syndrome Phenotypes, Syeda Sadia Fatima, Kiymet Bozaoglu, Rehana Rehman, Faiza Alam, Abdul Shakoor Memon

Department of Biological & Biomedical Sciences

Chemerin is a novel protein linked to adipocyte differentiation and the development of metabolic imbalances. We sought to examine the relationship of chemerin with metabolic syndrome disturbances including body fat percentage, serum lipid, glucose, insulin levels and body fat percentage in lean and obese volunteers. A cross-sectional study of 90 randomly selected healthy males from Pakistan were divided into three groups as per Body Mass Index (BMI) criteria for South Asian Population. Anthropometric measurements were taken for BMI, waist circumference, hip circumference and body fat percentage, while serum analyses were performed for fasting blood glucose, fasting insulin, fasting lipid profile …

Overview, Aeme Conference 2013 And 16th Aku Symposium

AKU Symposium

No abstract provided.

Prevalence And Factors Associated With Maternal Postpartum Haemorrhage In Khyber Agency, Pakistan, N Gani, Tazeen S. Ali

School of Nursing & Midwifery

Background: Postpartum haemorrhage (PPH) is one of the main causes of maternal mortality globally. The objective of this study was to estimate the prevalence of PPH and identify factors associated with PPH in Khyber Agency, Pakistan.
Methodology: A quantitative, cross-sectional study design was selected to estimate the prevalence and associated factors for PPH among married women aged 15–49 years, residing in the Khyber Agency, FATA, Pakistan. A pre-tested structured questionnaire was adapted with some modifications to interview 1,000 women.
Results: Prevalence of PPH was 21.3% in the study population. Factors associated with PPH were age, number of pregnancies, …

Risk Of Childhood Asthma In A Tropical African Urban Setting: A Case - Control Study At The Aga Khan Hospital, Dar-Es-Salaam, Tanzania, Lynda C. Koech

Master of Medicine in Family Medicine

Objective: To determine the modifiable and non-modifiable risk factors for childhood asthma in children aged between two and 15years in a tropical urban East-African setting. Methods: Hospital based case-control study matched for age + two months and sex. Data were obtained from parents of cases and controls using a structured interviewer-administered questionnaire. The study sample consisted of 226 cases of two to 15years old, with physician-confirmed asthma, who met a set of defined clinical criteria and 226 controls with no previous diagnosis or symptoms of asthma matched by sex and age (+two months). The Risk Factors included in this study …

Simplified Regimens For Management Of Neonates And Young Infants With Severe Infection When Hospital Admission Is Not Possible, Antoinette Tshef, Adrien Lokangaka, Cyril Engmann, Fabian Esamai, Peter Gisore, Adejumoke Idowu Ayede, Adegoke Gbadegesin Falade, Ebunoluwa A. Adejuyigbe, Chineme Henry Anyabolu, Robinson D. Wammanda, William N. Ogala, Lu Gram, Simon Cousens, Rajiv Bahl, Nigel Rollins, Sachiyo Yoshida, Shamim Ahmad Qazi

Paediatrics and Child Health, East Africa

Background: In resource-limited settings, most young infants with signs of severe infection do not receive the recommended inpatient treatment with intravenous broad spectrum antibiotics for 10 days or more because such treatment is not accessible, acceptable or affordable to families. This trial was initiated in the Democratic Republic of Congo, Kenya and Nigeria to assess the safety and efficacy of simplified treatment regimens for the young infants with signs of severe infection who cannot receive hospital care.

Methods: This is a randomized, open-label equivalence trial in which 3600 young infants with signs of clinical severe infection will be enrolled. The …

A Rare Case Of Aeromonas Hydrophila Catheter Related Sepsis In A Patient With Chronic Kidney Disease Receiving Steroids And Dialysis: A Case Report And Review Of Aeromonas Infections In Chronic Kidney Disease Patients, Muhammad Abdul Mabood Khalil, Abdur Rehman, Waqar Uddin Kashif, Manickam Rangasami, Jackson Tan

Section of Nephrology

Aeromonas hydrophila (AH) is an aquatic bacterium. We present a case of fifty-five-year-old gentleman with chronic kidney disease (CKD) due to crescentic IgA nephropathy who presented to us with fever. He was recently pulsed with methyl prednisolone followed by oral prednisolone and discharged on maintenance dialysis through a double lumen dialysis catheter. Blood culture from peripheral vein and double lumen dialysis catheter grew AH. We speculate low immunity due to steroids and uremia along with touch contamination of dialysis catheter by the patient or dialysis nurse could have led to this rare infection. Dialysis catheter related infection by AH is …

Nutrition Political Economy, Pakistan. Province Report: Punjab, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Akhtar Rashid, Gul Nawaz, Noorya Hayat, Shandara Khan Mohmand, Andres Mejia Acosta

Epidemiology and Biostatistics Section

No abstract provided.

The Political Economy Of Undernutrition National Report: Pakistan, Shehla Zaidi, Zulfiqar Ahmed Bhutta, Shandana Khan Mohmand, Andres Mejia Acosta

Epidemiology and Biostatistics Section

No abstract provided.

Intimate Partner Violence And Mental Health Effects: A Population-Based Study Among Married Women In Karachi, Pakistan, Tazeen S. Ali, Ingrid Mogren, Gunilla Krantz

School of Nursing & Midwifery

Background: Intimate partner violence (IPV) is recognized all over the world for its association with mental health problems in women. In Pakistan, such violence occurs commonly, but detailed information on mental health effects is scarce. The purpose of this study is to focused on married couples in urban Karachi to investigate mental health effects associated with physical, sexual and psychological violence perpetrated by husbands towards wives. Disclosure rates and health care-seeking behaviour were also investigated.
Method: This cross-sectional study involved 759 women between the ages of 25 and 60 years, selected using a multi-stage random sampling technique. The women …

Prevalence Of Perceived Heavy Postpartum Hemorrhage And Its Associated Factors Among Married Mothers In Squatter Settlements Of Karachi, Tazeen S. Ali, Fazal Ather

School of Nursing & Midwifery

Objectives; To estimate the prevalence of postpartum hemorrhage (PPH) and identify its associated factors among the married women of 15-49 years, residingin the Karachi, Pakistan. Methodology: This cross-sectional survey was carried out in five squatter settlements of Karachi during 2000-2001. Information was collected regarding age, gravida, education, antenatal, natal and postnatal care, with perceived puerperal morbidities from 525 mothers, who were in their 42nd to 56th post delivery day. Univariate and multivariate analyses were computed using multiple logistic regression method. Results: The estimated prevalence for perceived PPH was 7.24%. Three hundred and ninety six (75.4 %) women received ante-natal …

Pakistan: Target Revision In Education Policy, Sajid Ali

Book Chapters / Conference Papers

No abstract provided.

Weight Patterns And Perceptions Among Female University Students Of Karachi: A Cross Sectional Study, Zubaida Sirang, Hassaan Hasan Bashir, Bilal Jalil, Sarah Haroon Khan, Samia Altaf Hussain, Aneeqa Baig, Maryam Taufeeq, Kashif Samad, Muhammad Masood Kadir

Community Health Sciences

Background: Body weight and its perception play an important role in the physical and mental well-being of a person. Weight perception is found to be a better predictor of weight management behaviour as compared to actual weight. In Pakistan, studies have been done on the prevalence of weight status but weight perception is still unexplored. The study was done to examine relationships between body weight perception, actual weight status, and weight control behaviour among the female university students of Karachi.
Methods: A cross sectional study was carried out during Sep-Nov 2009 on female students in four universities of Karachi, Pakistan. …

Sleep Duration And Breast Cancer Phenotype, Ali Khawaja, Santosh Rao, Li Li, Cheryl L. Thompson

Medical College Documents

Emerging evidence suggests that short sleep is associated with an increased risk of cancer; however, little has been done to study the role of sleep on tumor characteristics. In this study, we evaluated the relationship between sleep duration and tumor phenotype in 972 breast cancer patients. Sleep duration was inversely associated with tumor grade (univariate P = 0.032), particularly in postmenopausal women (univariate P = 0.018). This association did not reach statistical significance after adjustments for age, race, body mass index, hormone replacement therapy use, alcohol consumption, smoking, and physical activity in the entire study sample (P = 0.052), but …

Foot Dimensions As A Tool For Gender Determination In Kenyan Adults, Maureen W. Waithaka

Master of Medicine in Anatomic Pathology

Introduction: Anthropometry has gained popularity over the years as a reliable method to determine gender. In forensic investigation, there are cases where gender cannot be readily determined using anatomy such as in mass casualty disasters with dismemberment and commingling of limbs. Kenyan descriptive data of foot dimensions is lacking as are formulae for estimating gender. Proven differences in foot dimensions across races prevent application of formula obtained using different populations necessitating generation of local data and formulae. Objectives: To describe the foot lengths, breaths and navicular heights of a representative adult Kenyan population, both male and female, and derive from …