Digital Commons Network^™

Role Of A Probiotic (Saccharomyces Boulardii) In Management And Prevention Of Diarrhoea, A G. Billoo, M A. Memon, S A. Khaskheli, G Murtaza, Khalid Iqbal, M Saeed Shekhani, Ahson Q. Siddiqi

Department of Paediatrics and Child Health

AIM: To assess the efficacy and safety of Saccharomyces boulardii (S. boulardii) in acute watery diarrhoea and its role in reducing the frequency of episodes of diarrhoea in subsequent two months.
Methods: Children from 2 mo to 12 years of age, with acute diarrhoea were selected according to inclusion criteria and randomised in S. boulardii group (treated with ORS, nutritional support and S. boulardii, 250 mg bid) and in control group (treated with ORS and nutritional support only). Active treatment phase was 5 d and each child was followed for two months afterwards. Frequency and consistency of stools as well …

Current Concepts In The Diagnosis And Treatment Of Typhoid Fever, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Hyperhomocysteinemia And Coronary Artery Disease In Pakistan, M Perwaiz Iqbal

Department of Biological & Biomedical Sciences

The relative risk of developing coronary artery disease (CAD) in Pakistani men is highest in early ages. Majority of those suffering from CAD belong to the lower middle socioeconomic stratum of the society. Mild hyperhomocysteinemia (concentration of plasma homocysteine between 15-25 micromol/l) is very commonly seen in Pakistani patients with acute myocardial infarction (AMI) as well as in normal healthy subjects. There appears to be a lack of association between hyperhomocysteinemia and CAD in Pakistani population. There is also no evidence of association of methylenetetrahydrofolate reductase 677C>T mutation with CAD in this population. High prevalence of deficiency of folate …

Angiokeratoma Of Tongue:A Series Of 14 Cases, Nausheen Yaqoob, Aamir Ahsan, Zubair Ahmed, Akhter Husain, Rashid Ahmed, Naila Kayani, Shahid Pervez, Sheema Hassan

Department of Pathology and Laboratory Medicine

Angiokeratomas (AC) are vascular lesions which are defined histologically as one or more dilated blood vessels lying directly subepidermal and showing an epidermal proliferative reaction with ectatic capillaries in the papillary dermis. Only three other cases of isolated mucosal angiokeratoma have been reported in the indexed literature. We reviewed all cases of angiokeratoma located on the tongue, diagnosed in our department during a study period of 10 years (1995-2005). Histologically all 14 cases showed dilated and congested blood vessels in the upper papillary dermis. They lack deep dermal involvement. Hyperkeratosis and acanthosis were also seen in most of the cases. …

Hypertension And Kidney Disease In Asia, Tazeen H. Jafar

Section of Nephrology

PURPOSE OF REVIEW: Communicable diseases were traditionally the major cause of public health concern in Asian countries, most of which were less developed. With industrialization and associated lifestyle changes during the past few decades, however, noncommunicable diseases similar to those that affect Western societies have emerged in Asian countries. The purpose of the review was to examine recent evidence about the burden and factors associated with hypertension and chronic kidney disease (CKD) in Asian countries.RECENT FINDINGS: Hypertension has become one of the leading causes of mortality in Asia. Although its prevalence continues to rise, it remains under-diagnosed and under-treated. CKD …

Knowledge Of Modifiable Risk Factors Of Heart Disease Among Patients With Acute Myocardial Infarction In Karachi, Pakistan: A Cross Sectional Study, Muhammad S. Khan, Fahim H. Jafary, Tazeen H. Jafar, Azhar M. Faruqui, Syed I. Rasool, Juanita Hatcher, Nish Chaturvedi

Community Health Sciences

Background: Knowledge is an important pre-requisite for implementing both primary as well as secondary preventive strategies for cardiovascular disease (CVD). There are no estimates of the level of knowledge of risk factor of heart disease in patients with CVD. We estimated the level of knowledge of modifiable risk factors and determined the factors associated with good level of knowledge among patients presenting with their first acute myocardial infarction (AMI) in a tertiary care hospital in Karachi, Pakistan.Methods: A hospital based cross-sectional study was conducted at the National Institute of Cardiovascular Disease, a major tertiary care hospital in Karachi Pakistan. Patients …

The Diagnostic Yield Of Various Tests For Helicobacter Pylori Infection In Patients On Acid Reducing Drugs, Javed Yakoob, Wasim Jafri, Z Abbas, Shahab Abid, Muhammad Islam, Saeed Hamid, Syed H Shah

Section of Gastroenterology

No abstract provided.

Life Threatening Mediastinal Haematoma: A Complication Of Central Venous Catheterization, Omer Ashraf, Hasanat Sharif

Section of Cardiothoracic Surgery

Central venous catheterization (CVC) has established risks and benefits in its application as a vascular access source, particularly in situations involving temporary cannulation. We present a rare case of life-threatening mediastinal haematoma resulting from CVC usage. Even though aggressive intervention yielded survival, the patient was left with permanent vocal compromise owing to traumatic palsy of the right recurrent laryngeal nerve. One should be careful in selection of venous access and be aware of alternatives routes.

Pakistan - Country Profile Of Cancer And Cancer Control 1995-2004, Yasmin Bhurgri, Asif Bhurgri, Sania Nishter, Ashfaq Ahmed, Ahmed Usman, Shahid Pervez, Naila Kayani, Rashida Ahmed, Sheema H. Hassan, Ahmed Riaz, Hadi Bhurgri, Imtiaz Bashir

Department of Pathology and Laboratory Medicine

No abstract provided.

Defining Quality In Early Childhood Settings: Experiences From The Field, Atiya Hussain, Audrey Juma

Book Chapters / Conference Papers

“The successful education of the child during her/his years of schooling and the participation of that child in society as an adult, depends to a greater degree upon the foundation laid during the early years” (Evans, Myers and IIfled, 2000, p.7). Research indicates that learning is crucial to development whereby knowledge, skills, attitudes and values are developed. Research from disciplines such as physiology, nutrition, health, sociology, psychology and education provide evidence indicating that the early years are crucial in terms of developing intelligence, personality and social behaviour of children. If children are not provided opportunities to communicate, learn and develop …

Health Curriculum And School Quality: Aku-Ied’S, Shabnam Ahmed

Book Chapters / Conference Papers

This paper is based on the experiences of the Health Action Schools project at AKU-IED and looks at issues surrounding the definition, choice and implementation of planned content of health education for primary schools in Pakistan. The paper argues that health education is a vital component to achieving quality because it links home with school; ‘needs now’ with ‘needs later’. Yet it proves exceptionally difficult to plan and deliver such content effectively because curriculum planning bodies are geared to work with separate subjects rather than across the curriculum, with classroom content rather than wider learning experiences in and from school, …

The Million Death Study In India: Cam It Help In Monitoring The Millennium Development Goals?, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

No abstract provided.

Improved Land Management In The Lake Victoria Basin: Final Report On The Transvic Project, Alex Awiti

East Africa Institute

This report addresses the challenges of land management in the Lake Victoria basin of East Africa. In 1999 the World Agroforestry Centre launched a major effort to identify, diagnose and reverse degradation in the Lake Victoria basin, focusing primarily on the Kenyan part of the basin. Dubbed “TransVic,” this project was supported by a number of donor agencies and collaborators, with particularly strong support from the Swedish International Development Cooperation Agency (Sida). Field activities in the Kenyan part of the basin were undertaken with Kenya’s National Agriculture and Livestock Extension Programme. This report summarizes the major achievements of TransVic from …

Evaluation Of A Cancer Awareness Campaign: Experience With A Selected Population In Karachi, Tazeen S. Ali, Sanah Baig

School of Nursing & Midwifery

The incidence and prevalence of cancer is rapidly increasing in both developed and developing countries. The most common cancers reported in Pakistan are breast and cervical cancers in females, and lung and oral cancers in males. Public awareness of cancer can play a vital role in its prevention, early diagnosis and treatment. A pilot survey conducted by the Cancer Support Group (CSG) of Aga Khan University Hospital from 2001 till 2004 to gauge the public awareness of cancer in Pakistan revealed that people were afraid of cancer and had little knowledge about its prevention and early detection. The survey also …

Understanding Of Puberty And Related Health Problems Among Female Adolescents In Karachi, Pakistan, Tazeen S. Ali, Parveen Azam Ali, Humaira Waheed, Azam Ali Memon

School of Nursing & Midwifery

Objectives: To understand the level of knowledge, a community based study conducted with the objectives as follows: To estimate the proportion of common facilities available and accessible and frequency of utilizing of it. To estimate the proportion of female adolescent utilizing the availability of facilities. To assess the level of understanding related to puberty and related health problems among female adolescents.
Methods: This cross-sectional study was conducted to determine the understanding and level of knowledge related to puberty and related health problems among female adolescents of Karachi, Pakistan. Data was collected from 150 female adolescents between 10-19 years …

Frequency And Determinants Of Vaginal Infection In Postpartum Period: A Cross Sectional Survey From Low Socioeconomic Settlements, Karachi, Pakistan, Tazeen S. Ali, Fariyal F. Fikree, Mohammad H. Rahbar, Sadia Mahmud

School of Nursing & Midwifery

Objective: To determine the frequency and factors associated with perceived vaginal infections among married women in their postpartum period.
Methods: A cross-sectional study was conducted from July 2000 to October 2000 in five squatter settlements of Karachi, Pakistan. These squatter settlements were selected on the basis of an existing surveillance system run by female community health workers for maternal and child healthcare which identified women who had delivered 42-56 days prior to the date of interview. Vaginal infection was considered present when a mother perceived foul smelling vaginal discharge during the postpartum period. Mothers were interviewed to gain …

Critical Evaluation Of The Claims Made By Pharmaceutical Companies In Drug Promotional Material In Pakistan, Dileep Kumar Rohra, Anwarul Hassan Gilani, Ismail Kamal Memon, Ghazala Perven, Muhammad Talha Khan, Hina Zafar, Rakesh Kumar

Department of Biological & Biomedical Sciences

Background: In Pakistan, there is no mechanism to monitor the drug promotional campaign by pharmaceutical industry despite the fact that there is enough evidence that irrational pharmacotherapy is increasingly encountered even in the developed countries due to unethical practices of pharmaceutical promotion. Objectives. To audit the drug promotional claims made by the pharmaceutical companies in Pakistan.
Methods: Drug promotional pamphlets and brochures containing claims for the drugs, which were circulated by the pharmaceuticalrepresentatives were collected from 122 general practitioners (GPs) from Karachi and Larkana cities of the Sindh Province. The claims were critically analyzed and audited with the help of …

A Long-Term Investment In Pakistan: Early Childhood Education, Zohra Nisar Hunzai

Institute for Educational Development, Karachi

This article explores the importance of early childhood education in the context of child development and focuses on Pakistan initiatives in the area of early childhood for long-term investment as child development and human development.

Primary Repair Of An Esophageal Rupture Using Pleural Flap, Saulat H. Fatimi, Sadaf Sheikh, Asif Anwar Ali

Section of Cardiothoracic Surgery

Esophageal perforation remains an important thoracic emergency. Aggressive operative therapy remains the mainstay for treatment. A case of esophageal perforation, consequent upon impacted food bolus, is presented. An 80 years old female, with multiple comorbidities, presented with dysphagia and right sided chest pain, who had a distal esophageal tear, secondary to accidental meat ball ingestion. Rigid esophagoscopy showed complete occlusion of the distal esophagus with a meat ball. Right thoracotomy was performed, which showed perforated esophagus with large meat ball protruding from it. Endoscopic removal of the food particles was done, and the rupture was repaired using a pleural flap. …

Prevalence And Determinants Of Asthma In Adult Male Leather Tannery Workers In Karachi, Pakistan: A Cross Sectional Study, Khurram Shahzad, Saeed Akhtar, Sadia Mahmud

Community Health Sciences

Background: This study aimed to estimate the prevalence and to identify some risk factors of adult asthma in male leather tannery workers in Karachi, Pakistan.
Methods: A cross sectional study was conducted from August 2003 to March 2004 on leather tannery workers of Karachi, Pakistan. Data were collected from 641 workers engaged in 95 different tanneries in Korangi industrial area selected as sample of convenience. Face to face interviews were performed using a structured pre-tested questionnaire by trained data collectors.
Results: Prevalence of adult asthma was 10.8% (69/641) in this study population. The prevalence of perceived work-related asthma was 5.3% …

Pharmaceutical Research: Paradox, Challenge Or Dilemma?, Abdul Latif Sheikh

Community Health Sciences

A great deal of pharmaceutical research is nowadays carried out in developing countries such as Pakistan. Is it, however, beneficial for the country and the participants, often the poorly educated and illiterate? Pharmaceutical research in Pakistan can bring benefits to both patients and country. Promotion of good clinical practice and the development of national guidelines are advocated. Government and industry both have a role to play to maintain the right balance.

Acceptability And Outcomes Of The Percutaneous Endoscopic Gastrostomy (Peg) Tube Placement--Patients' And Care Givers' Perspectives, Muhammad K. Anis, Shahab Abid, Wasim Jafri, Zaigham Abbas, Hasnain A. Shah, Saeed Hamid, Rozina Wasaya

Section of Gastroenterology

Background: Percutaneous endoscopic gastrostomy tube has now become a preferred option for the long-term nutritional support device for patients with dysphagia. There is a considerable debate about the health issues related to the quality of life of these patients. Our aim of the study was to assess the outcome and perspectives of patients/care givers, about the acceptability of percutaneous endoscopic gastrostomy tube placement.

Methods: This descriptive analytic study conducted in patients, who have undergone percutaneous endoscopic gastrostomy tube placement during January 1998 till December 2004. Medical records of these patients were evaluated for their demographic characteristics, underlying diagnosis, indications …

Small Is Healthy: A Guide To Promoting Health In Small Schools, Pat Pridmore, Tashmin Kassam-Khamis

Books

No abstract provided.

Screening For Cystic Fibrosis: The Importance Of Using The Correct Tools, Uzma Shah, Tariq Moatter

Department of Pathology and Laboratory Medicine

Background: Cystic Fibrosis (CF) is a potentially lethal genetic disorder. The most frequent mutation worldwide in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene is designated as the Delta F508 mutation. This mutation was found in only 33% of Pakistani patients studied. Since the common Pakistani mutations remain to be identified, appropriate screening tools are required to identify disease. Sweat chloride determinations remain the gold standard for diagnosing CF. This study was done to emphasize the importance of using the correct tests.
Methods: The study was conducted at the Aga Khan University Hospital. The CFTR delta F508 mutation was tested …

Affecting Schools Through A Health Education Initiative, Tashmin Kassam-Khamis, Sadia Muzzafar Bhutta

Book Chapters / Conference Papers

No abstract provided.

Aga Khan University Tanzania Institute Of Higher Education Prospectus 2006, Tanzania Institute Of Higher Education

The Aga Khan University Prospectuses and Brochures

• Vision, Mission and Values of the University

• Advanced Nursing Studies (ANS) Programme

• Introduction
• Principal Aims of the AKU Nursing Initiative in Tanzania
• Strategic Objectives
• Programmes Offered

• Post–Registration BSc Nursing Degree Programme

• Structure of the Programme
• Admission and Academic Requirements
• Enrolled Nurse to Registered Nurse Conversion Diploma
• Postgraduate Medical Education Programme
• Family Medicine Training Programme
• Logo and Symbolism
• About the University
• List of Faculty

Cisplatin Nephrotoxicity And Hydration Protocols, Ahmed Usman, Heeranand Keswani, Suresh Nagdev,, Ghulam H, Tehseen Khursheed,, Anis Malik,, Kasif Jafferi

Department of Medicine

Objective : Ahmed Usman, Heeranand Keswani, Suresh Nagdev, Ghulam Haider, Tehseen Khursheed, Anis Malik, Kasif Jafferi To evaluate the nephrotoxicity of cisplatiri in cancer patients, using different protocols of hydration.

Study Design : Randomized controlled trial.

Patients & Methods : This study was conducted between 1st June to 30th November 2004. Ninetynine patients with normal renal function were enrolled in the study and randomly assigned into the 3 study groups, each group having 33patients. In group 1 hydration was done with saline (2 liter) alone, in group 2 with saline (2 liter) and furosemide (40mg) and in group 3 with …

Does Malaria During Pregnancy Affect The Newborn?, Mohammad Yawar Yakoob, Asma Zakaria, Saima Naheed Waqar, Samiah Zafar, Ali Saeed Wahla, Sarah Kulsoom Zaidi, Arif R. Sarwari, Rahat N. Qureshi, Amna Rehana Siddiqui

Community Health Sciences

Objective: To investigate the effect of malarial infection during pregnancy on the newborn.Methods: A retrospective cohort study was conducted at The Aga Khan University Hospital (AKUH), Karachi, using in-patient hospital records over an 11-year period from 1988 to 1999. The incidence of preterm delivery, low birth weight (LBW) and intrauterine growth retardation (IUGR) in 29 pregnant women with malaria, was compared with that in 66 selected pregnant women without malaria, who delivered at the AKUH during the same time period.Results: Pregnant women with malaria had a 3.1 times greater risk of preterm labor (p=0.14). They were more likely to be …

Exploring Ethical Considerations For The Use Of Biological And Physiological Markers In Population-Based Surveys In Less Developed Countries, Gregory Pappas, Adnan A. Hyder

Community Health Sciences

Background: The health information needs of developing countries increasingly include population-based estimates determined by biological and physiological measures. Collection of data on these biomarkers requires careful reassessment of ethical standards and procedures related to issues of safety, informed consent, reporting, and referral policies. This paper reviews the survey practices of health examination surveys that have been conducted in developed nations and discusses their application to similar types of surveys proposed for developing countries.DISCUSSION: The paper contends that a unitary set of ethical principles should be followed for surveys around the world that precludes the danger of creating double standards (and …

Dermatophyte Growth And Degradation Of Human Stratum Corneum In Vitro (Pathogenesis Of Dermatophytosis)., Azam J. Samdani

Department of Medicine

Background: This study was carried out to determine growth of dermatophytes using human stratum corneum in vitro and the degrading effect of Keratinases (Proteinases) on stratum corneum for a complete understanding of the host parasite relationship.

Method: Trichophyton rubrum isolates derived from patients with tinea cruris infections were obtained from the Department of Medical Microbiology, University Hospital of Wales, U.K. Human stratum corneum sterilized with ethylene oxide was used as a nitrogen source in agar culture medium plates.

Result: Fungal growth took place in plates which contained human stratum corneum particles while there was no growth in the plates without …