Digital Commons Network^™

Knowledge Of Coronary Artery Disease (Cad) Risk Factors And Coronary Intervention Among University Students, Aysha Almas, Aamir Hameed, Fateh Ali Tipoo Sultan

Section of Cardiology

Objective: To elucidate knowledge of coronary artery disease (CAD) risks factors and coronary intervention in adult students of Karachi East. To calculate the mean knowledge score about CAD risk factors among them.
Methods: A multi center crossectional study was conducted in Universities and colleges of Karachi East from April-September 2005. Questionnaires were distributed to 200 adult students of different non-medical universities and colleges. The questionnaire contained assessment of knowledge of risk factors on CAD and awareness about coronary angiography. Those belonging to medical colleges and universities were excluded from the study. Knowledge was assessed as a continuous variable. Risk factors …

Awareness Of Cancer Risk Factors Among Patients And Attendants Presenting To A Tertiary Care Hospital In Karachi, Pakistan, Hadi Bhurgri, Saqib Ali Gowani, Ahmed Itrat, Saira Samani, Akbar Zuberi, Momin Saulat Siddique, Waris Qidwai Dr, Yasmin Bhurgri

Community Health Sciences

OBJECTIVE: To determine awareness of cancer risk factors in the patients and attendants of Out-patient Clinics at a University Hospital in Karachi, Pakistan.

METHODS: A cross-sectional survey was conducted on 315 respondents reporting to a tertiary care hospital in Karachi, Pakistan, to assess their level of awareness regarding risk factors of cancer.

RESULTS: The respondents belonged to an urban population with the mean time spent in Karachi of 29.1 years (SD +/- 13.94). There were 213 (67%) males and 102 (33%) females. All respondents had heard of the word 'cancer', while only 57.5% were aware of cancer risk factors. However, …

Knowledge Of Coronary Artery Disease (Cad) Risk Factors And Coronary Intervention Among University Students, Aysha Almas, Aamir Hameed, Fateh Ali Tipoo Sultan

Department of Medicine

Objective: To elucidate knowledge of coronary artery disease (CAD) risks factors and coronary intervention in adult students of Karachi East. To calculate the mean knowledge score about CAD risk factors among them.
Methods: A multi center crossectional study was conducted in Universities and colleges of Karachi East from April-September 2005. Questionnaires were distributed to 200 adult students of different non-medical universities and colleges. The questionnaire contained assessment of knowledge of risk factors on CAD and awareness about coronary angiography. Those belonging to medical colleges and universities were excluded from the study. Knowledge was assessed as a continuous variable. Risk factors …

Familial Chylomicronemia In A Nine Months Old Infant, Saira Waqar Lone, Aamer Imdad, Abdul Gaffar Billoo

Department of Paediatrics and Child Health

Familial chylomicronemia syndrome is a rare disorder of lipoprotein metabolism due to familial lipoprotein lipase or apolipoprotein C-II deficiency or the presence of inhibitors to lipoprotein lipase. It manifests as eruptive xanthomas, acute pancreatitis, and lipaemic plasma due to marked elevation of triglyceride and chylomicrons levels. We report a rare case of familial chylomicronemia in a 9-month-old infant, who was diagnosed after his plasma was incidentally found to be milky. Lipid profile showed familial chylomicronemia (Type 1 Hyperlipidemia). The infant was started on a low fat diet and advised a regular follow-up.

Alma-Ata: Rebirth And Revision 8 - Primary Health Care: Making Alma-Ata A Reality, John Walley, Joy E. Lawn, Anne Tinker, Andres De Francisco, Mickey Chopra, Igor Rudan, Zulfiqar Ahmed Bhutta, Robert E. Black

Department of Paediatrics and Child Health

The principles agreed at Alma-Ata 30 years ago apply just as much now as they did then. "Health for all" by the year 2000 was not achieved, and the Millennium Development Goals (MDGs) for 2015 will not be met in most low-income countries without substantial acceleration of primary health care. Factors have included insufficient political prioritisation of health, structural adjustment policies, poor governance, population growth, inadequate health systems, and scarce research and assessment on primary health care. We propose the following priorities for revitalising primary health care. Health-service infrastructure, including human resources and essential drugs, needs strengthening, and user fees …

Icpd To Mdgs: Missing Links And Common Grounds., Farina G Abrejo, Babar Shaikh, Sarah Saleem

Community Health Sciences

The ICPD agenda of reproductive health was declared as the most comprehensive one, which had actually broadened the spectrum of reproductive health and drove the states to embark upon initiatives to improve reproductive health status of their populations. However, like all other countries, Pakistan also seems to have shifted focus of its policies and programs towards achieving MDGs. As a result, concepts highlighted in the ICPD got dropped eventually. In spite of specific goals on maternal and child mortalities in MDGs and all the investment and policy shift, Pakistan has still one of the highest maternal mortality ratios among developing …

Vitamin D Deficiency In Ambulatory Patients, Lubna M Zuberi, Aysha Habib, Naeemul Haque, Abdul Jabbar

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVE: To determine the frequency of subclinical vitamin D deficiency in an ambulatory care setting.

METHODS: This was an observational study which measured 25 vitamin D levels in medical clinic patients. Patients with chronic renal failure, known osteomalacia and rickets were excluded. A total of 119 patients were evaluated. They were divided in three diagnostic categories based on their serum 25 vitamin D levels. Those with levels below 8 ng/ml were categorized to have severe deficiency, levels between 8 - 20 ng/ml as moderate deficiency and levels of 21-35 mg/ml as mild deficiency.

RESULTS: Of 119 patients, 92% had vitamin …

Labrad : Vol 33, Issue 3 - September 2008, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Vitamin D Deficiency: Are We Still Ignoring the Evidence?
• Collection and Transport of Urine for Culture
• Understanding and Interpreting Serum Protein Electrophoresis
• Cystic Fibrosis at a Glance
• What you need to know about Dengue Infection
• CT Colonoscopy: Introduction
• CT Enteroclysis: A New Technique to Evaluate Small Bowel
• CSF-DR: An Important Diagnostic Tool
• G6PD Quantification
• Quality Assurance
• Clinical Laboratory Continuing Medical Education (CME) Seminars
• Meeting Reports

Enterocutaneous Fistulae In Children - A Management Challenge, Ali Imran Amjad, Saqib Hamid Qazi, Zafar Nazir

Department of Biological & Biomedical Sciences

No abstract provided.

Assessing Emergency Medical Care In Low Income Countries: A Pilot Study From Pakistan., Junaid A. Razzak, Adnan A Hyder, Tasleem Akhtar, Mubashir Khan, Uzma R. Khan

Department of Medicine

Background: Emergency Medical Care is an important component of health care system. Unfortunately it is however, ignored in many low income countries. We assessed the availability and quality of facility-based emergency medical care in the government health care system at district level in a low income country - Pakistan. Methods: We did a quantitative pilot study of a convenience sample of 22 rural and 20 urban health facilities in 2 districts - Faisalabad and Peshawar - in Pakistan. The study consisted of three separate cross-sectional assessments of selected community leaders, health care providers, and health care facilities. Three data collection …

Akhuwat Issue No. 71, Aga Khan University

AKHUWAT Newsletters

• International Nurses Day Celebrated at AKU
• Occupational Health, Safety and Environment (OHSE) Award
• Visit by Damascus General Assembly Hospital, Damascus Syria
• Ms Carol Ariano Vice President, Human Resources
• Consular Corps of London visit AKU-ISMC
• AKU Programme, Afghanistan
• 3^rd Nursing Graduation Ceremony in Afghanistan
• Role of AKU at MoPH
• Mental Health Project Afghanistan
• AKU-SON Students’ Quality Initiatives at Patel Hospital
• The 27th Lamp Lighting Ceremony
• Farewell to Dr. Abdul Jabbar Shah
• Dr Shamshad Akhtar Visits PDCN, Gilgit
• Syrian Delegation visits AKU-IED and PDCN
• Delegation from the University of Morogoro visits AKU-IED
• The Federal Additional Secretary Education at AKU-IED
• Student Mini-Conference …

Stroke In Pakistan, Bhojo A Khealani, Bilal Hameed, Uzma U Mapari

Section of Neurology

Stroke is the most common cause of disability and a leading cause of mortality world wide. Though the incidence is falling in West but probably is rising in Asia. The burden of stroke risk factors in Pakistan is enormous e.g. by 2020 Pakistan will be 4th most populous country in terms of diabetic patients. Similarly every 3rd person above age of 45 years has hypertension. Ironically a great majority of these patients are unaware of their diagnosis. This is further complicated by the fact that most of diagnosed patients have uncontrolled hypertension, as a result of poor compliance on patients …

Aku Newsletter : July 2008, Volume 9, Issue 1, Aga Khan University

The Aga Khan University Newsletters

No abstract provided.

An All Time Low Budget For Healthcare In Pakistan, Jamil Ahmed, Babar T Shaikh

Community Health Sciences

No abstract provided.

Vitamin B12 Deficiency Common In Primary Hypothyroidism, Abdul Jabbar, Aasma Yawar, Sabiha Waseem, Najmul Islam, Naeem Ul Haque, Lubna Zuberi, Ataullah Khan, J. Akhter

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVE: To assess the prevalence and clinical features of B12 deficiency in hypothyroid patients and to evaluate clinical response in symptoms to B12 replacement therapy.

METHODS: One hundred and sixteen hypothyroid patients from our endocrine clinic were evaluated for signs and symptoms of vitamin B12 deficiency. Laboratory parameters including Haemoglobin (Hb), MCV, Vitamin B12 levels and presence of anti thyroid antibodies were analyzed. Patients with low B12 levels were treated with parenteral intramuscular vitamin B12 monthly, and monitored for improvement of symptoms.

RESULTS: A total of 116 patients (95 females and 21 males) were evaluated. Forty six (39.6%) hypothyroid patients …

Chylopericardium--A Rare Complication After Ventricular Septal Defect Repair, Saqib A Gowani, Ameer A Khowaja, Asmatullah Khan, Saulat H Fatimi

Section of Cardiothoracic Surgery

Chylopericardium is a rare complication of cardiac surgery. It may be caused by a lesion in the thoracic duct or its tributaries or by thrombosis in the confluence of the jugular and left subclavian veins, obstructing the drainage of the thoracic duct. The treatment may be conservative or surgical, depending on the duration and on the volume of the effusion. We report the case of a 1 1/2 year-old male, who, in the late postoperative period of VSD repair, was hospitalized with low-grade fever and breathlessness for one week due to the presence of chylopericardium. The clinical findings and treatment …

Prenatal Exposure To Wood Fuel Smoke And Low Birth Weight, Amna R. Siddiqui, Ellen B. Gold, Xiaowei Yang, Kiyoung Lee, Kenneth H. Brown, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Maternal exposure to wood fuel smoke may lead to impaired fetal growth due to hypoxia and or oxidative stress from smoke constituents such as carbon monoxide and particulate matter. Objectives: We studied the risk of low birth weight (LBW) and reduced mean birth weight in relation to reported use of wood for cooking during the prenatal period, compared with natural gas (NG).
Methods: We studied a historical cohort of women who had a singleton live birth in the years 2000-2002, from a semirural area of Pakistan. Infant's birth weight was obtained from records, and prenatal records had data for …

Diagnostic Tool For Glanzmann's Thrombasthenia Clinicopathologic Spectrum, Natasha Bahadur Ali, Bushra Moiz, Mohammad Usman Shaikh, Salman Adil, Bushra Rizvi, Yasmeen Rahman

Department of Pathology and Laboratory Medicine

Objective: To platelet aggregometry and describe the clinical spectrum of Glanzmann's thrombasthenia diagnosed by platelet aggregometry.
Study design: A case-series.
Place and duration of study: This study was carried out at the clinical laboratories at the Aga Khan University Hospital, Karachi from January 2003 to January 2006.
Patients and methods: All patients irrespective of age and gender presenting with bleeding symptoms and having normal platelet count were evaluated. Demographic details, relevant clinical history along with results of complete blood count, bleeding time and platelet aggregation studies were retrieved through computerized data base and evaluated for the diagnosis of Glanzmann's thrombasthenia. …

Managing Severe Pneumonia In Children In Developing Countries - Increasing Resistance To First Line Antibiotics Means Recommendations Need Changing, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Frequency Of Abnormal Pap Smears And Assessment Of Risk Factors For Cervical Cancer In An Out-Patient Clinic, Firdous Jahan, Naheed Nabi, Waris Qidwai, Iqbal Azam

Department of Family Medicine

No abstract provided.

Aga Khan University Tanzania Institute Of Higher Education (Aku-Tihe) Advanced Nursing Studies Programme, Tanzania Institute Of Higher Education

The Aga Khan School of Nursing and Midwifery Archives

A comprehensive academic and administrative guide for students enrolled in the Advanced Nursing Studies Programme at the Aga Khan University, Tanzania Institute of Higher Education (AKU-TIHE). It outlines the programme's goals, academic policies, clinical standards, registration procedures, and grievance mechanisms. It also includes the AKU vision and mission, resources available to students, and expectations for professional conduct. Designed to support both undergraduate and post-registration students, the handbook reflects AKU’s commitment to developing nursing leaders who deliver high-quality care in East Africa.

Aga Khan University, Report 2008, Aga Khan University

The Aga Khan University Reports Archives

• Chairman’s Message
• President’s Foreword
• Capitalising on Synergies
• University Overview
• Expanding the Frontiers of Knowledge
• A Bold Vision for the Future
• Alumni – Making a Difference
• Forging Meaningful Partnerships
• Investing in a Better Tomorrow
• University Update
• Major Partners and Institutional Collaborations
• University Governance
• University in Numbers
• Financial Information
• Addresses

Educators’ Perceptions About Resources Needed For Effective School Health In Government Schools In Pakistan, Parvez Pirzado

Institute for Educational Development, Karachi

No abstract provided.

The Content Of African Diets Is Adequate To Achieve Optimal Efficacy With Fixed-Dose Artemether-Lumefantrine: A Review Of The Evidence, Zul Premji, S. Abdulla, B. Ogutu, A. Ndong, C.O. Falade, I. Sagara, N. Mulure, O. Nwaiwu, G. Kokwaro

Pathology, East Africa

A fixed-dose combination of artemether-lumefantrine (AL, Coartem®) has shown high efficacy, good tolerability and cost-effectiveness in adults and children with uncomplicated malaria caused by Plasmodium falciparum. Lumefantrine bioavailability is enhanced by food, particularly fat. As the fat content of sub-Saharan African meals is approximately a third that of Western countries, it raises the question of whether fat consumption by African patients is sufficient for good efficacy. Data from healthy volunteers have indicated that drinking 36 mL soya milk (containing only 1.2 g of fat) results in 90% of the lumefantrine absorption obtained with 500 mL milk (16 g fat). African …

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.

Laryngeal Mask Airway Insertion Anaesthesia And Insertion Techniques, Abdul Monem, Fauzia A. Khan

Department of Anaesthesia

Laryngeal Mask Airway has gained wide acceptance for routine airway management, difficult airway and in emergency situations. The classical method of insertion was recommended by Dr Brain. Over the years various induction and insertion techniques have been described with variable results. Combination of induction agents with narcotics, with or without small dose muscle relaxants has been found to be very effective. There is less also lesser incidence of mucosal trauma with partially inflated cuff. Insertion with cuff facing laterally or backwards and rotating it forwards into position has also been described. A review of various options and their advantages and …

Perforated Appendicitis: Accuracy Of Ct Diagnosis And Correlation Of Ct Findings With The Length Of Hospital Stay, Asma Hina Siddiqui, Shaista Afzal

Department of Radiology

Objective: To determine the sensitivity and specificity of CT findings in the differentiation of perforated from nonperforated appendicitis and correlate CT diagnosis with the length of hospital stay.STUDY Design: An analytical study.PLACE AND DURATION OF STUDY: This study was conducted at Radiology Department of Aga Khan University Hospital, Karachi, from January 2004 to June 2005.PATIENTS AND Methods: The study included 70 patients who presented with right lower quadrant abdominal pain and underwent pre-operative CT scan followed by appendectomy. Patients were divided into two groups of having perforated and nonperforated appendicitis on the basis of CT scan findings. The surgical and …

High Prevalence Of Lack Of Knowledge Of Symptoms Of Acute Myocardial Infarction In Pakistan And Its Contribution To Delayed Presentation To The Hospital, Muhammad S. Khan, Fahim H. Jafary, Azhar M. Faruqui, Syed I. Rasool, Juanita Hatcher, Nish Chaturvedi, Tazeen Jafar

Community Health Sciences

Background: We conducted an observational study to determine the delay in presentation to hospital, and its associates among patients experiencing first Acute Myocardial Infarction (AMI) in Karachi, Pakistan.Methods: A hospital based cross-sectional study was conducted at National Institute of Cardiovascular Disease (NICVD) in Karachi. A structured questionnaire was used to collect data. The primary outcome was delay in presentation, defined as a time interval of six or more hours from the onset of symptoms to presentation to hospital. Logistic regression analysis was performed to determine the factors associated with prehospital delay.Results: A total of 720 subjects were interviewed; 22% were …

Umbilical Cord Prolapse--A Review Of Diagnosis To Delivery Interval On Perinatal And Maternal Outcome, Rozilla Sadia Khan, Tahira Naru, Faryal Nizami

Department of Obstetrics & Gynaecology

Objective: To determine the significance of the Diagnosis to Delivery Interval (DDI) on perinatal outcome and maternal complications in patients with umbilical cord prolapse.
Methods: This was a case series of 44 patients identified with "Umbilical cord prolapse" during a 10-year period at the Aga Khan University Hospital. Data was retrieved for gestational age, foetal presentation, DDI, incision to delivery time, delivery method, apgar score, birth weight and outcome, and maternal complications. The influence of DDI on perinatal mortality, apgar scores at 5 minutes, neonatal intensive care unit (NICU) admission and maternal complications resulting from mode of delivery with cord …

Factors Influencing Medical Student Participation In An Obstetrics And Gynaecology Clinic, Ferha Saeed, Mahwash Kassi, Samia Ayub, Rabeea Rehman, Pashtoon M. Kasi, Javed H. Rizvi

Department of Obstetrics & Gynaecology

Objective: To identify factors influencing medical student participation in an obstetrics and gynaecology (OBGYN) setting.
Methods:This was a cross sectional study carried out on patients admitted in OBGYN wards of Aga Khan University Hospital, Karachi, Pakistan. A total of 250 patients consented to participate in this study.
Results: Eighty three percent of the people responded 'yes' to the question of being initially seen by a medical student. People who consented were 3.5 times more likely to know that their primary consultant was a teacher at a medical school i.e. they were initially aware that they were in a teaching …