Digital Commons Network^™

Community Knowledge, Attitude And Practices Regarding Sexually Transmitted Infections In A Rural District Of Pakistan, H A. Afsar, M A. Mahmood, N Barney, S Ali, M M. Kadir, M Bilgrami

Community Health Sciences

Objective: To determine knowledge, attitude and practices regarding sexually transmitted infections in district Khairpur, Sindh, Pakistan.DESIGN AND METHODOLOGY: A needs assessment study employing a community based survey, key informant interviews and focus group discussions was conducted in all seven sub-districts of the district. This paper is based on the results of the key informant interviews and the focus group discussions. Thirty interviews and six group discussions were held with members of the community and with the health care providers.Results: There was little awareness regarding causes and prevention of sexually transmitted infections in the community. The situation was slightly better among …

Factors Associated With Elevated Blood Lead Concentrations In Children In Karachi, Pakistan, Mohammad Hossein Rahbar, Franklin White, Mubina Agboatwalla, Siroos Hozhabri, Stephen Luby

Community Health Sciences

Objectives: To confirm whether blood lead concentrations in Karachi were as high as reported in 1989 and to identify which types of exposure to lead contribute most to elevated blood lead concentrations in children in Karachi.
Methods: A total of 430 children aged 36-60 months were selected through a geographically stratified design from the city centre, two suburbs, a rural community and an island situated within the harbour at Karachi. Blood samples were collected from children and a pretested questionnaire was administered to assess the effect of various types of exposure. Cooked food, drinking-water and house dust samples were collected …

Complications Of In-Dwelling Venous Access Devices: A Single Institution Experience, I A. Burney, N Khurshaidi, M T. Akbar, F N. Bhatti, T Siddiqui, Z Sophie

Department of Medicine

Objective: To determine the complications of venous access devices (VADs) in cancer patients.SETTING: Retrospective study in a tertiary referral center with specialist hematology and oncology services.SUBJECTS: First one hundred consecutive patients who were implanted a VAD. All patients had an underlying cancer and the devices were inserted by the same surgeon. The duration of use of VADs and causes of their premature removal were noted.Results: One hundred VADs (55 port-a-caths and 45 Hickman's lines) were inserted in a total of 89 patients over a 7.5 year period. Majority of patients had acute myeloid leukemia (22) gastrointestinal malignancies (20) breast cancer …

Aku Newsletter : November 2001, Volume 1, Issue 7, Aga Khan University

The Aga Khan University Newsletters

No abstract provided.

Promoting Curiosity Through Students’ Questioning, Harcharan Pardhan, Sadia Muzaffar Bhutta

Institute for Educational Development, Karachi

Asking questions is central to intellectual effort; it is instrumental in bridging the gap between the known and the unknown. Questioning existed even before the time of Greek philosopher Socrates and still prevails in classrooms. Questioning is a major teaching and learning strategy for teachers in Pakistan. Unfortunately, teachers’ questioning overrules students’ questioning, leaving neither space nor time to create an interactive environment that promotes curiosity and meaningful learning. Using an innovative approach, we attempted to implement students’ questioning in an upper primary science classroom. The encouraging findings of our study and their implications are discussed in this article.

Percutaneous Transhepatic Biliary Stenting, T U. Haq, M Sanaullah, H Mohsin, M Y. Sheikh, B Ahmed

Department of Radiology

Objective: Bilary stenting with endoprosthesis is a palliative procedure to relieve malignant biliary obstruction. Percutaneous transhepatic technique has been employed whenever endoscopic technique was not possible or had failed.SETTING: Angiography/intervention suite, department of radiology, Aga Khan University hospital, Karachi.Methods: We present retrospective analysis of 17 patients with malignant jaundice who were treated with percutaneous techniques after the endoscopic route had failed.Results: The success rate was 94% with placement of single plastic stent in 14 patients, double stents in 3 patients and self-expandable stent in one patient. The overall complication rate was 41% including sepsis, liver abscess, biloma formation, biliary leakage …

Communication About End Of Life For Patients Living With Amyotrophic Lateral Sclerosis: A Scoping Review Of The Empirical Evidence, Shelagh K. Genuis, Westerly Luth, Sandra Campbell, Tania M. Bubela, Wendy S. Johnston

Office of the Provost

Background: Communication about end of life, including advance care planning, life-sustaining therapies, palliative care, and end-of-life options, is critical for the clinical management of amyotrophic lateral sclerosis patients. The empirical evidence base for this communication has not been systematically examined.
Objective: To support evidence-based communication guidance by (1) analyzing the scope and nature of research on health communication about end of life for amyotrophic lateral sclerosis; and (2) summarizing resultant recommendations.
Methods: A scoping review of empirical literature was conducted following recommended practices. Fifteen health-related and three legal databases were searched; 296 articles were screened for inclusion/exclusion criteria; and quantitative …

Induced Abortions In Low Socio-Economic Settlements Of Karachi, Pakistan: Rates And Women's Perspectives, S Saleem, F F. Fikree

Community Health Sciences

Objective: The aim of the study was to determine rates on induced abortions and to identify the perceived and actual reasons for terminating an unplanned pregnancy, health care providers sought, methods used and post-abortion complications.SETTING: Three squatter settlements of Karachi, Pakistan.SUBJECTS: Interviews were conducted on 1,214 ever-married women in the reproductive age group (15-49) with a reproductive history of at least one pregnancy, irrespective of outcome.Methods: A cross-sectional survey from June-August 1997 was conducted in three selected squatter settlements of Karachi.Results: The abortion rate for the past year was 25.5 per 1,000 women of reproductive age group. The post-abortion complication …

Standard Of Knowledge About Their Disease Among Patients With Diabetes In Karachi, Pakistan, A Jabbar, Z Contractor, M A. Ebrahim, K Mahmood

Section of Diabetes, Endocrinology and Metabolism

Objective: The aim of this study was to determine the standard of knowledge among people with diabetes.METHOD: Two hundred and thirty patients were randomly chosen from outpatient clinics and a 34-item multiple choice questionnaire administered to them. The questionnaire was structured to assess knowledge about the disease state, diagnostic tests, complications and management.Results: The average score of correct answers for the group was 40%. A significantly higher score correlated with younger age (16-30 years), educational status and regular follow-up with a diabetic clinic. There was no significant difference in the knowledge score between males and females or between those on …

Bronchodilator, Spasmolytic And Calcium Antagonist Activities Of Nigella Sativa Seeds (Kalonji): A Traditional Herbal Product With Multiple Medicinal Uses, A H. Gilani, N Aziz, I M. Khurram, K S. Chaudhary, A Iqbal

Department of Biological & Biomedical Sciences

Objective: The seeds of Nigella sativa locally known as "Kalonji" has been used in traditional medicine for the treatment of a variety of diseases including diarrhoea and asthma. The crude extract of N. sativa seeds (Ns.Cr) was studied in vitro for its possible spasmolytic and bronchodilator activities to rationalize the folkloric uses.
Methods: Isolated rabbit jejunum and guinea-pig tracheal preparations were set up in Tyrode's and Kreb's solutions respectively and aerated with 5% CO2 in oxygen. Isotonic and isometric responses were measured on Bioscience oscillograph and Grass polygraph respectively.Results: The Ns.Cr caused a dose-dependent (0.1-3.0 mg/ml) relaxation of spontaneous contractions …

The Proposition: An Insight Into Research, B I. Avan, F White

Community Health Sciences

Propositions form the basis for scientific research. The validity of a research study is, to a large extent, evaluated on the criteria of its propositions. For internal validity, study propositions provide information regarding precision of definitions, measurements, associations, confounding factors etc. that are considered in research. While for external validity, propositions form the premise for the deduction of inferences. The aim of this article is to help readers understand the propositions that are made in research. This article discusses those propositions, which are relevant to medical research.

An Analysis Of Anemia And Child Mortality, B.J. Brabin, Zul Premji, F. Verhoeff

Pathology, East Africa

The relationship of anemia as a risk factor for child mortality was analyzed by using cross-sectional, longitudinal and case-control studies, and randomized trials. Five methods of estimation were adopted: 1) the proportion of child deaths attributable to anemia; 2) the proportion of anemic children who die in hospital studies; 3) the population-attributable risk of child mortality due to anemia; 4) survival analyses of mortality in anemic children; and 5) cause-specific anemia-related child mortality. Most of the data available were hospital based. For children aged 0-5 y the percentage of deaths due to anemia was comparable for reports from highly malarious …

Aga Khan University Progress Report 2000-2001, Aga Khan University

The Aga Khan University Reports Archives

• Foreword
• Aga Khan University
• University Focus
• University in the Community
• Research and Development Highlights
• Seminar and Conference Highlights
• Major University Partners and Supporters
• New Facilities
• Financial Information
• University Overview
• University Governance and Board of Trustees

Anatomical Variations Of Internal Jugular Vein As Seen By "Site Rite Ii" Ultrasound Machine--An Initial Experience In Pakistani Population, Hameedullah, M. A. Rauf, Fazal Hameed Khan

Department of Anaesthesia

Objective: To determine the anatomical variations of the internal jugular vein (IJV) in Pakistani adult population with the help of Site Rite II ultrasound machine.
Material and Method: The right IJV relation to the carotid artery was visualized at four different landmarks (angle of the mandible, thyroid cartilage, cricoid cartilage, and the supraclavicular area). Size of IJV in comparison to carotid artery was also seen.
Results: In 49 cases the IJV was found in aberrant relation to carotid artery at the angle of the mandible (p value
Conclusion:Care should be taken while cannulating IJV at the angle of the …

Hemoglobin Concentration In Children In A Malaria Holoendemic Area Is Determined By Cumulated Plasmodium Falciparum Parasite Densities, H. Ekvall, Zul Premji, S. Bennett, A. Bjorkman

Pathology, East Africa

In malaria holoendemic areas children are anemic, but the exact influence of falciparum malaria on hemoglobin (Hb) concentration remains largely unsettled. Prospective data were therefore collected in children < 24 months of age during five months in a Tanzanian village. Children with mean asymptomatic parasitemia ≥ 400/μl had lower median Hb levels during the study than those with mean density < 400/μl. The difference was 9.7 g/L (95% confidence interval [CI] 2.8-17). In children with one or more clinical malaria episodes, the median Hb was 8.3 g/L (95% CI 0.9-16) lower than those without episode. If early treatment failure was recorded, the immediate effect on Hb was particularly important with a mean drop of 17 g/L. Interestingly, at study-end the Hb concentration represented a function of the area under the parasitemia curve (AUPC) during the previous five months, adjusting for age. In conclusion, stepwise deterioration in median Hb levels was found by asymptomatic parasitemia, clinical malaria episode, and most significantly, treatment failure.

Out-Of-Pocket Expenses Borne By The Users Of Obstetric Services At Government Hospitals In Karachi, Pakistan, M M. Kadir, A Khan, S Sadruddin, S P. Luby

Community Health Sciences

Objective: Financing health services is a challenge for health policy makers world over, especially in developing countries. Alternate mechanisms such as user fees are being proposed. However, there is a feeling that in developing countries, users of government hospitals spend appreciable personal income to obtain "free services" at these facilities.Methods: This study aimed to measure the extent and the factors associated with of out-of-pocket expenses borne by the users of obstetric care at government hospitals. It also aimed to determine willingness of consumers to bear out of pocket expenses. It was conducted in three government hospitals in Karachi.Results: Seven hundred …

Health Care Utilization During Terminal Child Illness In Squatter Settlements Of Karachi, I J. Hasan, A Khanum

Community Health Sciences

Objective: Information on health seeking behavior and health care utilization has important policy implications in health systems development. The paper presents some of the issues related to health care utilization and health seeking behavior in case of terminal child illness in seven squatter settlements of Karachi.Methods: From seven squatter settlements of Karachi, with a population of 100,000 approximately, we collected information, using pretested structured questionnaire, from the mothers on health care utilization during the final illness of under five children dying during 1995-1996. These deaths were identified from an earlier baseline health and demographic survey in these areas.Results: Interviews were …

Risk Factors For Stunting And Wasting At Age Six, Twelve And Twenty-Four Months For Squatter Children Of Karachi, Pakistan, F F. Fikree, M H. Rahbar, H W. Berendes

Community Health Sciences

Objective: A high proportion of stunting and wasting in children under-five has been reported from developing countries. This paper presents the nutritional status of a two year cohort of urban squatter children in Karachi, Pakistan and assesses risk factors for wasting and stunting at the reference ages of six, twelve and twenty-four months.Methods: A birth cohort of 738 children were visited at specific intervals by trained nurses to collect information on anthropometric measurements, feeding practices and intercurrent illnesses. Socioeconomic and demographic information included water and sanitation facilities, availability of electricity, type of house construction material and average monthly income. Information …

Why Has So Little Changed In Maternal And Child Health In South Asia?, Z A. Bhutta

Department of Paediatrics and Child Health

No abstract provided.

The Minds Of Mothers: Maternal Mental Health In An Urban Squatter Settlement Of Karachi., Fauziah Rabbani, Furqan Farooq Raja

Community Health Sciences

BACKGROUND:

Community-based information on maternal mental health in developing countries is meager and nearly non-existent in Pakistan.

OBJECTIVE:

To determine the proportion of probable cases of women with mental disorders and examine the associated conditions and risk factors which contribute to maternal mental ill-health.

METHODS:

With convenient sampling 260 mothers in an urban squatter settlement of Karachi were interviewed. The tools consisted of a household questionnaire collecting information on basic demographic and other characteristics and the Aga Khan University Anxiety and Depression Scale (AKUADS), an instrument to assess psychiatric morbidity.

RESULTS:

The proportion of probable cases of mental disorder was …

Effectiveness Of Health Education In Promoting The Use Of Iodized Salt In Lotkoh, Tehsil Chitral, Pakistan, S Khoja, S Luby, Z Ahmed, A Akber

Community Health Sciences

Introduction: We evaluated the effect of health education on the use of iodized salt in a remote region.Methods: We randomly selected 31 villages in teh Lotkoh tehsil of district Chitral in the North West Frontier Province of Pakistan. We then randomly selected 7 households from each village and inteviewed the eldest women of the family. We also tested samples of salt for iodine concentration at the user's level.Results: Eighty-five percent of families (184/217) used iodized salt exclusively. Among the samples population, the Aga Khan Health Services (AKHS) informed 67% about the importance of iodized salt. Shopkeepers and neighbors informed 25%. …

Genitourinary Tuberculosis: A Profile Of 55 In-Patients, N P. Buchholz, S Salahuddin, R Haque

Section of Urology

Objective: To outline the pattern and trends in major cases of genito-urinary tuberculosis (GUTB) which require hospital treatment.
Method: We retrospectively reviewed 55 patients with proven GUTB who were treated as in-patients in a major referral hospital in Pakistan.
Results: The male/female ratio was 3:1. Prevailing symptoms were lower urinary tract symptoms, flank pain, gross hematuria and fever. A urine culture was positive for tuberculosis (TB) in 57%, bladder biopsies in 54%. For renal TB, intravenous urogram (IVU) and ultrasound were suggestive in about 50% of cases. Ultrasound was very helpful in the diagnosis of testicular TB. Patients underwent surgery …

Incidence And Pattern Of Thrombocy To Penia In Cardiac Surgery Patients, S Bashir, S M. Shah, I Babar

Department of Anaesthesia

No abstract provided.

Aku Newsletter : April 2000, Volume 1, Issue 2, Aga Khan University

The Aga Khan University Newsletters

No abstract provided.

Frequency Of Consumption And Nutrient Composition Of Composite Dishes Commonly Consumed In The Uk By South Asian Muslims Originating From Bangladesh, Pakistan And East Africa (Ismailis), Tashmin Khamis, P. A. Judd, J. E. Thomas

Faculty of Health Sciences, East Africa

Introduction: This paper presents information on the nutrient composition of commonly consumed traditional dishes eaten by the three major South Asian Muslim groups residing in Britain, namely Bangladeshi, Pakistani and East African Ismaili Muslims.

Methods: Information regarding the most common dishes consumed by South Asian Muslims originating from Bangladesh, Pakistan and East Africa (Ismailis) and living in London was obtained from 7-day menu records over two seasons. For each common dish, weighed recipes were collected in triplicate and the composition (energy and selected nutrients) was calculated from the ingredients and cooked weight of the dish.

Results: The three Muslim …

Micronutrient And Iron Supplementation And Effective Anti-Malarial Treatment Synergistically Improve Childhood Anaemia, H. Ekvall, Zul Premji, A. Bjorkman

Pathology, East Africa

The control of childhood anaemia in malaria holoendemic areas is a major public health challenge for which an optimal strategy remains to be determined. Malaria prevention may compromise the development of partial immunity. Regular micronutrient supplementation has been suggested as an alternative but its effectiveness remains unsettled. We therefore conducted a randomised placebo-controlled intervention trial with 207 Tanzanian children aged 5 months to 3 years on the efficacy of supervised supplementation of low-dose micronutrients including iron (Poly Vi-Sol with iron) three times per week, with an average attendance of ≥ 90%. The mean haemoglobin (Hb) level increased by 8 g/l …

Annual Report 2000, Aga Khan University

The Aga Khan University Reports Archives

No abstract provided.

Aku Newsletter : January 2000, Volume 1, Issue 1, Aga Khan University

The Aga Khan University Newsletters

No abstract provided.

Self-Reported Feeding Advice By Physicians For Common Childhood Illnesses, S Q. Nizami, Z A. Bhutta

Department of Paediatrics and Child Health

Background: A nutritious diet is important for recovery during illnesses. Dietary advice by physicians and consumption of food by the patients are often based upon their hot and cold concepts and beliefs about various foods rather than on scientific basis.
Objectives: To look at the food-advising behaviour of physicians during illnesses and to know the maternal concepts about various foods being hot or cold.
Methods: A questionnaire was served to the physicians participating in a continuous medical education session held at the Aga Khan University and Hospital, asking them to write the foods they advise or restrict during different illnesses …

Postprandial Glucose Response To Mango, Banana And Sapota, Z Contractor, F Hussain, A Jabbar

Section of Pulmonary & Critical Care

Objective: Mango and Sapota are two fruits indigenous to Indian subcontinent. The objective of this study was to evaluate postprandial blood glucose response to mango and sapota in comparison to banana in patients with diabetes mellitus Type 2.METHOD: The plasma glucose response to mango, sapota and banana were determined in ten diabetic patients. Blood was tested at 0, 30, 60, 120 and 180 minutes following the ingestion of test meal.Results: The results showed that the blood glucose response to these three fruits was not different in terms of area under the curve and postprandial change in blood glucose from baseline.CONCLUSION: …