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Higher Il-10 Levels Are Associated With Less Effective Clearance Of Plasmodium Falciparum Parasites, E. Hugosson, S.M. Montgomery, Zul Premji, M. Troye-Blomberg, A. Bjorkman

Pathology, East Africa

The implications of high levels of the immune regulatory cytokine IL-10 in Plasmodium falciparum malaria are unclear. IL-10 may down-regulate pro-inflammatory responses and also exacerbate disease by inhibiting anti-parasitic immune functions. To study possible inhibiting effects on parasite clearance, IL-10 plasma levels were determined in 104 Tanzanian children, 1 to 4 years old, with acute uncomplicated P. falciparum malaria, and analysed for association with parasite densities during 3 days of anti-malarial treatment. Higher baseline IL-10 plasma levels were associated with statistically significantly higher parasite densities after 24, 48 and 72 h of treatment. These associations could not be explained by …

Aku Newsletter : January 2004, Volume 5, Issue 1, Aga Khan University

The Aga Khan University Newsletters

No abstract provided.

Blood Lead Levels During Pregnancy And Pregnancy Outcome In Karachi Women, A Rahman, A Hakeem

Department of Biological & Biomedical Sciences

objective: To evaluate association of blood lead levels with pregnancy outcome in the obstetrics and gynaecology unit.
Methods: Blood lead levels were measured in 73 pregnant women at the time of delivery and assessed its association with pregnancyoutcome.
Results: Mean maternal lead level was 9.91+/-4.44 mg/dL (range 2.28-36.35 mg/dL). Mothers of boys had significantly higher (p=0.013, one-tailed t test) blood lead levels (11.05+/-5.19) when compared to mothers of girls (8.74+/-3.18 mg/dL.
Conclusion: Maternal lead levels at the time of delivery showed no association with gestational age, birth weight, recumbent length, or head circumference.

Helicobacter Pylori Infection And Micronutrient Deficiencies., Javed Yakoob, Wasim Jafri, Shahab Abid

Section of Gastroenterology

It is known that deficiencies of micronutrients due to infections increase morbidity and mortality. This phenomenon depicts itself conspicuously in developing countries. Deficiencies of iron, vitamins A, E, C, B12, etc are widely prevalent among populations living in the third world countries. Helicobacter pylori (H pylori) infection has a high prevalence throughout the world. Deficiencies of several micronutrients due to H pylori infection may be concomitantly present and vary from subtle sub-clinical states to severe clinical disorders. These essential trace elements/micronutrients are involved in host defense mechanisms, maintaining epithelial cell integrity, glycoprotein synthesis, transport mechanisms, myocardial contractility, brain development, cholesterol …

Risk Factors For Cardiovascular Disease In School Children--A Pilot Study., A. K. Khuwaja, Zafar Fatmi, W. B. Soomro, N. K. Khuwaja

Community Health Sciences

OBJECTIVE:

To assess the frequencies of risk factors for cardiovascular disease in school children. The information may help in designing interventions aimed at modifying unhealthy lifestyle in children, which may reduce the later incidence of cardiovascular disease in adults.

METHODS:

A cross-sectional study was conducted on 206 students (ages 14-18 years), enrolled in higher secondary school. Students were interviewed about their lifestyles, family history of cardiovascular disease and its risk factors. Moreover, they were assessed for height, weight and blood pressure.

RESULTS:

Twenty nine percent of the children were physically inactive, 31% were taking unhealthy diet daily, 21% were overweight …

Aku Newsletter : July 2003, Volume 4, Issue 2, Aga Khan University

The Aga Khan University Newsletters

No abstract provided.

Pharmacy Newsletter : June 2003, Pharmacy Department

Department of Pharmacy Archives

Content:

• Drug Induced Liver Injury
• Drug Expiration Date Clarification

Association Of Iron Deficiency Anaemia In Children Of 1-2 Years Of Age With Low Birth Weight, Recurrent Diarrhoea Or Recurrent Respiratory Tract Infection - A Myth Or Fact?, Niloufer Sultan Ali, Rukhsana Wamiq Zuberi

Department for Educational Development

No abstract provided.

Injection Practices And Sharp Waste Disposal By General Practitioners Of Murree, Pakistan, N Z. Janjua

Community Health Sciences

Objective: To describe the injection and sharp waste disposal practices of general practitioners of Murree, Pakistan.METHODOLOGY: In-depth interviews of all general practitioners available between 10th to 20th July 2000 were conducted. Practitioners were interviewed about injection administration and disposal of waste due to injections and other sharp material.Results: Twenty general practitioners out of 25 were interviewed. All claimed using disposable syringes only once. None of them was disposing off syringes in sharp containers in the clinic. Of 20, 12 (60%) were throwing syringes at open places and 5 (25%) in municipal waste bins. Most of the injections by general practitioners …

Radiologic Feeding Gastrostomy Placement: Experience In 23 Patients, T U. Haq, S M F Mosharraf, B Ahmad, K Munir, J Yaqoob, U Usman

Department of Radiology

Objective: To evaluate the safety, efficacy and complications of percutaneous gastrostomy catheter placementunder flouro guidance for long-term enteral feeding.MATERIALS AND Methods: Between April 1998 to May 2002, 23 patients who had percutaneous gastrostomy catheter placement were retrospectively reviewed. Clinical indications for catheter placement included patients with neurologic disease, head and neck malignancy, and pulmonary disease patients. Placement of 12 - 14 Fr gastrostomy catheter was then accomplished with the Seldinger technique. The technical success, procedural complications were recorded.Results: Twenty seven procedures, including revisions, were performed. The success rate for catheter placement was 100%. Revision was necessary in 7 (30%) instances …

Factors Affecting Utilization Of Antenatal Care Among Reproductive Age Group Women (15-49 Years) In An Urban Squatter Settlement Of Karachi, N Nisar, F White

Community Health Sciences

Objectives: To describe the socio-demographic characteristics and utilization pattern of antenatal care of reproductive age group women (15-49 years) in an urban squatter settlement of Karachi and to assess and compare the knowledge on antenatal care between women who received and those who did not receive antenatal care.Methods: A community-based cross sectional survey was conducted and a sample of 323 women was taken through systematic sampling. Two hundred ninety five (295) women were interviewed and 28 were excluded, as they never experienced a pregnancy. Socio-demographic characteristics and knowledge about antenatal care were compared on the basis of having received and …

Age, Temperature, And Parasitaemia Predict Chloroquine Treatment Failure And Anaemia In Children With Uncomplicated Plasmodium Falciparum Malaria, D.H. Hamer, W.B. Macleod, E. Addo-Yobo, C.P Duggan, B. Estrella, W.W. Fawzi, J.K. Konde-Lule, V. Mwanakasale, Zul Premji, F. Sempertegui, F.P. Ssengooba, K. Yeboah-Antwi, J.L. Simon

Pathology, East Africa

The prevalence of chloroquine-resistant Plasmodium falciparum malaria has been increasing in sub-Saharan Africa and parts of South America over the last 2 decades, and has been associated with increased anaemia-associated morbidity and higher mortality rates. Prospectively collected clinical and parasitological data from a multicentre study of 788 children aged 6-59 months with uncomplicated P. falciparum malaria were analysed in order to identify risk factors for chloroquine treatment failure and to assess its impact on anaemia after therapy. The proportion of chloroquine treatment failures (combined early and late treatment failures) was higher in the central-eastern African countries (Tanzania, 53%; Uganda, 80%; …

Qualifications You Can Trust, Aga Khan University Examination Board

The Aga Khan University Examination Board Archives

• Vision and Mission
• Development of Syllabi & Learning Resources
• Examination Development & Conduct
• Teacher Development & Research
• Assessment: Quality, Relevance, Access
• Middle School Programme (MSP)
• Secondary School Certificate (SSC, Grades IX–X)
• Higher Secondary School Certificate (HSSC, Grades XI–XII)
• Teacher Training & Continuous Professional Development
• School Affiliation Process & Checklist
• Examination Sessions & Result Access
• Scholarships & University Exemptions

Women's Beliefs Regarding Food Restrictions During Common Childhood Illnesses: A Hospital Based Study, Niloufer Sultan Ali, Syed Iqbal Azam, Rahat Noor

Community Health Sciences

Background: Malnutrition continues to be a major problem in Pakistan. Inadequate nutrition contributes substantially to childhood death and disease. Restriction of diet during common childhood illnesses further compromises the nutritional status of the child. The present study aims to determine the beliefs and practices regarding food restrictions during common childhood illnesses.Methods: A cross-sectional survey was conducted at Community Health Centre (CHC), of The Aga Khan University Hospital, Karachi to understand the beliefs and practices regarding food restrictions in common childhood illnesses. Four hundred adult females were interviewed from July-September 2000. A self-administered questionnaire was filled by the respondent.Results: Major sources …

A Comparison Of 'Cough And Cold' And Pneumonia: Risk Factors For Pneumonia In Children Under 5 Years Revisited, Zafar Fatmi, Franklin White

Community Health Sciences

Objectives: The aim of this study was to identify and measure the risk factors differentiating upper respiratory infection from pneumonia.Methods: The World Health Organization's acute respiratory infection case management criteria were used. We studied 259 cases of pneumonia (cases) and 187 cases of 'cough and cold' (controls) among children under 5 years of age at a large tertiary-care hospital in Gilgit, Pakistan. While previous studies used healthy controls, in this study we used controls who had mild infection ('cough and cold').Results: In the multivariate logistic regression analysis, lack of immunization (adjusted odds ratio (AOR)=1.54, 95% CI 1.0, 2.3), previous history …

Aku Newsletter : October 2002, Volume 3, Issue 2, Aga Khan University

The Aga Khan University Newsletters

No abstract provided.

Comparative Study--Efficacy, Safety And Compliance Of Intravenous Iron Sucrose And Intramuscular Iron Sorbitol In Iron Deficiency Anemia Of Pregnancy, A Wali, A Mushtaq, Nilofer

Department of Obstetrics & Gynaecology

Objective: (1) To determine an alternative iron supplementation with better efficacy, compliance & safety in treatment of iron deficiency anemia during pregnancy, (2) to reduce blood transfusion during pregnancy, labor and puerperium.
Material and Method: A prospective comparative study. A total number of 60 pregnant women with the gestational age of 12 - 34 weeks were included in the study who were suffering from iron deficiency anemia. They were divided in 3 groups (A, B and C). Group A (n15) received intravenous iron sucrose according to recommended dose containing 500 mg of iron sucrose for storage, in group B (n=20) …

Capacity-Building For Health Research In Developing Countries: A Manager's Approach, Franklin White

Community Health Sciences

Research may be viewed as rigorous inquiry to advance knowledge and improve practices. An international commission has argued that strengthening research capacity is one of the most powerful, cost-effective, and sustainable means of advancing health and development. However, the global effort to promote research in developing countries has been mostly policy driven, and largely at the initiative of donor agencies based in developed countries. This policy approach, although essential, both contrasts with and is complementary to that of research managers, who must build capacity "from the ground up" in a variety of health service settings within countries and with differing …

Nutrition Education In The Undergraduate Medical Curriculum At The Aga Khan University, Karachi, Pakistan, S H. Badruddin, S N B Inam

Section of Internal Medicine

No abstract provided.

The Obesity Pandemic--Implications For Pakistan, D J. Nanan

Community Health Sciences

Background: Adverse health outcomes are associated with overweight and obesity. In February 2000, the WHO Regional Office for the Western Pacific, the International Association for the Study of Obesity and the International Obesity Task Force published provisional recommendations for adults for the Asia-Pacific region: overweight at Body Mass Index (BMI) > or = 23 and obesity at BMI > or = 25.Methods: Data from the National Health Survey of Pakistan, 1990-94 were reanalyzed using BMI cut-offs recommended for Asians to reassess prevalence of overweight and obesity in the adult Pakistani population.Results: Prevalence of obesity (BMI > or = 25) in 25-44 year olds …

Utility Of Participatory Rural Appraisal For Health Needs Assessment And Planning., M. A. Mahmood, Kausar S. Khan, Muhammad Masood Kadir, S. Ali, R. Tunio, N. Barney

Community Health Sciences

BACKGROUND:

While poverty and lack of life opportunities are root causes of a high burden of disease and infant and maternal mortality, inadequate health care contributes heavily. Often those who are left without care are those who need it most. Existing health services are managed without taking into account acceptance and need perspectives. This further reduces the effectiveness of and equity in health care. In order to guide the planning of reproductive health services by a national NGO, health needs were assessed in a district in Sindh using a combination of participatory rural appraisal (PRA) and qualitative and quantitative research …

Anorexic Behaviour And Attitudes Among Female Medical And Nursing Students At A Private University Hospital, N Babar, M Alam, S S. Ali, A Ansari, M Atiq, A Awais, F Amin, S M. Israr

Community Health Sciences

Objective: To study the anorexic behaviour and attitude among female medical and nursing students in a tertiary care hospital.SUBJECTS AND Methods: A cross-sectional survey to determine the proportion of anorexic behaviour among female medical and nursing students at The Aga Khan University Hospital Karachi was conducted. A multistaged sampling technique was utilized in which our study population was first divided according to field of enrollment (medical or nursing school) and then stratified by class. Within each stratum, we used convenience sampling due to time and availability constraints. We utilized a modified Eating Attitudes Test (EAT-26) to collect data. The Eating …

Teachers Resource Centre - Making A Difference - 16th Annual Report, Teachers Resource Centre

Institute for Educational Development Pakistan (IED-PK) Archives

TRC at a Glance, An Overview, Our Workshop Programme, The Early Childhood Education Programme (ECEP), The Primary Education Programme (PEP), Our Publications, Our Library, Visitors to TRC, Membership, Our Special Events, Institutional Strengthening, Finance, Challenges Ahead, Annex 1: Overall Workshop Participation, Annex 2: Workshop Data, Annex 2: Workshop Data, Annex 3: Visitors, Annex 4: Institutional Members, Annex 5: Associate Members, Annex 6: Statement of Sources and Applications (Consolidation), Annex 7: Statement of Sources and Applications (TRC), Annex 8: Statement of Sources and Application (SIDP)

Lead-Based Paint Is A Hazard To Young Children: Implications For Pakistani Children, S Hozharbi

Community Health Sciences

No abstract provided.

Health Sector Reform In South Asia: New Challenges And Constraints, Anwar Islam, M Zaffar Tahir

Community Health Sciences

In early 1990s, Jamison, Mosley and others concluded that a profound demographic and consequent epidemiological transition is taking place in developing countries. According to this classical model, by the year 2015, infectious diseases will account for only about 20% of deaths in developing countries as chronic diseases become more pronounced. These impending demographic and epidemiological transitions were to dominate the health sector reform agenda in developing countries. Following an analysis of fertility, mortality and other demographic and epidemiological data from South Asian and other developing countries, the paper argues that the classical model is in need of re-evaluation. A number …

Health Sector Reform In Pakistan: Future Directions, A Islam

Community Health Sciences

The health care system in Pakistan is beset with numerous problems--structural fragmentation, gender insensitivity, resource scarcity, inefficiency and lack of functional specificity and accessibility. Faced with a precarious economic situation characterized by heavy external debt and faltering productivity, Pakistan's room to maneuver with health sector reform is quite limited. Although the recently announced Devolution Plan provides a window of opportunity, it must go beyond and introduce far-reaching changes in the health and social sectors. Regionalization of health care services in an integrated manner with functional specificity for each level of care is an essential step. Integration of current vertical programs …

Health Sector Reform In Pakistan: Why Is It Needed?, A Islam

Community Health Sciences

Objective: The health care system in Pakistan is beset with numerous problems--structural fragmentation, gender insensitivity, resource scarcity, inefficiency and lack of accessibility and utilization. Moreover, Pakistan is faced with a precarious economic situation, burdened by heavy external debt and faltering productivity and growing poverty. These circumstances, on the one hand, underscore the need for innovative health sector reform and, on the other, indicate the complexity of the task involved. The recently announced Devolution Plan of the Government of Pakistan (GOP) that seeks to introduce elected district level local bodies, offers an opportunity to assess the existing publicly funded health care …

Early Surgical Results With Intent To Treat By Radical Retropubic Prostatectomy For Clinically Localized Prostate Cancer, Farhat Abbas, Kamran Siddiqui, Syed R. Biyabani, Jamsheer J. Talati, S. H. Hasan

Section of Urology

Aims: To evaluate the early cancer control rates, morbidity and mortality in men undergoing radical retropubic prostatectomy (RRP) for clinicallylocalized adenocarcinoma prostate.
Methods: Patient's characteristics, operative data, progressive-free survival rates, morbidity and mortality were analyzed for 23 men with clinical T1-2 prostate cancer who underwent surgery with an intent to treat by RRP between December 1997 to July 2001.
Results: Patient's mean age was 63 +/- 6.2 years (range 51 to 76 years) with American Society of Anesthesiology (ASA) status I in 4%, II in 65% and III in 31%. Two third of the patients had lower urinary tract obstructive …

Effect Of Zinc On The Treatment Of Plasmodium Falciparum Malaria In Children: A Randomized Controlled Trial, F. Sempertegui, B. Estrella, F.R. Toapanta, D.S. Torres, D.E. Calahorrano, K. Yeboah-Antwi, E. Addo-Yobo, P. Arthur, S. Newton, Zul Premji, M. Hubert, C.S. Makwaya, F. Ssengooba, J. Konde-Lule, E. Mukisa, D.H. Hamer, W. Macleod, C. Duggan, W. Fawzi, J. Simon, V. Mwanakasale, M. Mulenga, T. Sukwa, J. Tshiula

Pathology, East Africa

Background: Zinc supplementation in young children has been associated with reductions in the incidence and severity of diarrheal diseases, acute respiratory infections, and malaria.

Objective: The objective was to evaluate the potential role of zinc as an adjunct in the treatment of acute, uncomplicated falciparum malaria; a multicenter, double-blind, randomized placebo-controlled clinical trial was undertaken.

Design: Children (n = 1087) aged 6 mo to 5 y were enrolled at sites in Ecuador, Ghana, Tanzania, Uganda, and Zambia. Children with fever and ≥ 2000 asexual forms of Plasmodium falciparum/μL in a thick blood smear received chloroquine and were randomly assigned to …

Acute Myeloid Leukemia In Children In Pakistan: An Audit, S. Zaki, I. A. Burney, Mohammad Khurshid

Section of Haematology/Oncology

Objective: To see the clinical features and treatment of children with Acute Myeloid Leukemia (AML) in Pakistan. Setting: Tertiary referral at a specialist Hematology/Oncology center.
Methods: Retrospective, chart-based review of children (less than 14 years) admitted to the hospital with a diagnosis of AML between January 1987 and August 1997.
Results: A total of 23 patients were admitted. There were 18 males and 5 females. The mean age was 8 5 years. M3 was the commonest morphological subtype (43%). Twenty- two percent of the patients presented with hyperleucocytosis (TLC> 100 x i09 /L) and 95% with an elevated …