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The Aga Khan Health Services - International Newsletter No. 58, Aga Khan University

The Aga Khan Health Services Archives

Prime Minister Commends AKU’s Role in National Development

• AKU Tenth Anniversary Special Issue

• A Mela with a Difference

• AKUH Declared “Baby Friendly Hospital”

• NICU Graduates Reunion at AKUH Newborn Health - A Neglected Sector in Pakistan

• Dr. Camer W. Vellani

• MRI to Enhance Diagnostic Capabilites at AKUH

• Foundation Stone of Rufaida Building Laid

• Cardiac Services Inaugurated at AKUH

• Cardiac Services at AKUH

• Donors and Volunteers’ Reception

• Memorable Moments from AKU’,

• Convocation 1994

• Convocation '94

• A Mela with a Difference

• Grand Seminar 1994

• AKU Alumni …

The Aga Khan Health Services - International Newsletter No. 57, Aga Khan University

The Aga Khan Health Services Archives

• Aga Khan University Centre President Honoured by McMaster University
• Changing Roles at Kisumu Primary Health Care Project
• AKHSP Contributes Towards National Polio Day
• lodine Deficiency
• Japan Labour Welfare Corporation Signs Agreement with AKUH
• Dr. Hasanali H. Ladhani Working towards Community Sustainability in India
• A Farmer's Ordeal
• The Theory of Islamic Medicine
• Changing Roles in Kisumu
• International Nurses Day
• School of Nursing
• Pharmacist - Base of the Health Triangle

Bias And Confounding, M A. Lobo, F Fikree, A F. Qureshi

Community Health Sciences

No abstract provided.

The Aga Khan Health Services - International Newsletter No. 56, Aga Khan University

The Aga Khan Health Services Archives

• Priorities of Infant and Maternal Mortality
• Towards Total Quality Management in Health Care
• Appointments at AKU
• Paponditi Women's Group
• Islamic Medicine: The Role of Private Practitioners
• AKHSP Students Secure Top Positions
• Nurdin Ajania Community Empowerment through Awareness
• Nurdin Ajania
• AKU Faculty Honoured
• New Shoes for Nina
• Scourge of AIDS costing $ 90 Billion Annually
• Moments of Inspiration
• Health care at its very best

Risk Factors For Intrauterine Growth Retardation: Results Of A Community-Based Study From Karachi, F F. Fikree, H W. Berendes, F Midhet, R M. D'Souza, R Hussain

Community Health Sciences

There is a serious lack of community-based information on low birthweight or intrauterine growth retardation from Pakistan. A community based prospective study was conducted in four squatter settlements of Karachi, to examine the prevalence and risk factors for adverse pregnancy outcome. This paper reports on the prevalence and risk factors for intrauterine growth retardation (age) among 755 singleton births. The incidence of intrauterine growth retardation was 25.4% (192 intrauterine growth retarded and 563 appropriate for gestational age). Major socioeconomic risk factors identified were low maternal education (RR = 1.4, 95% CI = 1.0,2.1) and poor housing material (RR = 1.7, …

The Aga Khan Health Services - International Newsletter No. 55, Aga Khan University

The Aga Khan Health Services Archives

• AKU Graduates Gaining Increasing International Recognition
• Canadian Health Professionals Visit Pakistan
• Volunteer Appreciation Evening at Aga Khan University
• New Paediatrics Wing at Aga Khan Hospital, Mombasa
• Islamic Medicine: Medical Teaching Institutions
• Dr. Afroze Sherali Creating Health Care Sustainability in Rural Areas
• Dr. Afroze Sherali
• AKU to Serve as Resource for Nursing in Pakistan
• Life-Style and Health AKHSP's Mass Awareness Drive
• Arif Returns to School
• A Gift of Love From a Ten Year Old
• Kisumu Workshop Discusses Transfer of PHC Responsibilities to Community
• Battle Against Disease in Urban Slums
• Battling Hepatitis-B

Anaemia In Pregnancy - Its Cause In The Underprivileged Class Of Karachi, Saadiya Aziz Karim, Mohammad Khurshid, A.M. Memon, Sadiqua N. Jafarey

Section of Haematology/Oncology

A prospective study of the frequency and type of anaemia amongst poor urban parturients of Karachi was done. It was performed at 2 large teaching hospitals over the time span January to September, 1990. Out of 318 women studied, 104(32.7%) were anaemic (Hb levels <10gm/dl). The type of anaemia was assessed. Iron deficiency predominated and was seen amongst 63.5% of the anaemic population. There was an even distribution of other kinds of anaemia amongst the remainder of the population

Cardiovascular Risk Factors In School Children From Low Middle Income Families In Karachi, Pakistan, Salma H. Badruddin, A. Molla, Mohammad Khurshid, S. Vaz, S. Hassanali

Section of Haematology/Oncology

Serum levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and trigly cerides (TG) were determined on 239 school children aged 5-19 years belonging to lower middle class families. The mean TC, LDL-C, HDL-C and TG ranged from 3.70-4.37 mmol/L, 2.17- 2.70 mmol/L, 0.94-1.14 mmol/L, 1.07-1.26 mmol/L respectively. In general, girls had higher TC, LDL-C and HDL-C levels. There was no significant difference in the TG levels between boys and girls. Thirty-three percent of the girls and 22% of the boys had TC level _4.4 mmol/L, the level at which dietary intervention is recommended …

Risk Factors For Term Intrauterine Growth Retardation: A Community-Based Study In Karachi, F F. Fikree, H W. Berendes

Community Health Sciences

Reported are the results of a community-based prospective study in four urban squatter settlements in Karachi that was carried out to assess the incidence of and risk factors for intrauterine growth retardation. The incidence of term intrauterine growth retardation was 24.4% among 738 singleton births. The socioeconomic and biological risk factors that were found to be statistically significant in a bivariate analysis were included in a logistic regression model to assess their independent effects. The major risk factors were low level of maternal education, paternal unemployment, consanguinity, short birth-to-conception intervals, short maternal stature, and low maternal weight. The population risk …

The Impact Of Nutritional Counselling On Serum Lipids, Dietary And Physical Activity Patterns Of School Children, S H. Badruddin, A Molla, M Khursheed, S Vaz

Section of Internal Medicine

Eighty-eight school children and their parents who had been counselled regarding appropriate dietary and activity patterns aimed at reducing serum cholesterol were followed-up 21 months later to determine changes in dietary and activity patterns and in serum lipid levels. The decline in serum total cholesterol ranged from 8 to 14% in the different age and sex groups (P < 0.05 to P < 0.001). Serum triglycerides did not change significantly. Cholesterol intake decreased 36% and 54% in 10-14 year old boys and girls respectively (P > 0.001). The activity level increased significantly in both the 5-9 year and 10-14 year olds (P < 0.05 to P < 0.005). These results show that nutrition education can bring about a change in dietary and activity patterns, resulting in a decline in serum cholesterol levels.

Disease Pattern, Health Services Utilization And Cost Of Treatment In Pakistan, M S. Karim

Community Health Sciences

Population based data on disease patterns, health services utilization and cost incurred on treatment in Pakistan were collected through a nation-wide sample survey in 1982-83. The survey for the first time revealed, the burden of disease on the society. The analysis done here suggest, that about one-sixth of the population suffered from an illness during the past one month period. As expected, illness was more prevalent among children, women in reproductive ages and the elderly. Over two-thirds of those who fell ill, suffered from malaria and fever and one-fifth from diarrhoea and dysenteries. There was heavy reliance on private physicians …

The Value Of Intermittent Growth Monitoring In Primary Health Care Programmes, I H. Thaver, F Midhet, R Hussain

Community Health Sciences

The objective of growth monitoring is to detect early growth faltering before the child becomes severely malnourished. It has been found in many large projects in the private sector and in Government run Primary Health Care (PHC) programmes that monthly weighing is not feasible which makes it impossible to develop a functional outreach programme on a sustainable basis. This study is an attempt to propose an intermittent growth monitoring which is operationally feasible for large scale PHC programmes in the public sector. A historical prospective study was conducted to find out the correlation of weights of children at different ages …

Nutritional Aspects Of Mammary Carcinogenesis: A Case-Control Study, I A. Malik, S Sharif, F Malik, A Hakimali, W A. Khan, S H. Badruddin

Section of Internal Medicine

Dietary factors are believed to play an important role in mammary carcinogenesis. International correlations, case-control and cohort studies have associated the incidence and mortality from breast cancer with high fat consumption in the form of meat, gravy and dairy products. Most of these studies have been conducted in the developed countries. Due to paucity of data from developing countries, we conducted a case-control study to evaluate the role of nutritional factors in mammary carcinogenesis. This prospective study was conducted in the oncology clinic at a university hospital. On a detailed questionnaire, information was collected from 80 patients with histologically proven …

The Aga Khan Health Services - International Newsletter No. 51, Aga Khan University

The Aga Khan Health Services Archives

• Convocation 92, Chief Justice of Pakistan Lauds Pioneering Role of Aga Khan University
• Prince & Princess of Japan Visit AKUMC
• Towards Sustainability In Rural India
• Workshop on Leadership
• The Role of Information Systems in Quality Health Care
• Enabling the Community to Manage its Disabled
• Garden Maternity Home Celebrates 25th Anniversary
• Al-Zahrawi's Tenth-Century Surgical Treatise
• Al-Zahrawi
• Sonam —Too Young to Die
• Dr. Mwanzia Reviews Health Activities in Pakistan
• Government of Pakistan Funds Women's Development at AKUMC
• Govt attitude towards nursing deplored
• Zullah Advocates end to 'Policy of Isolation in Scholarship’

Aga Khan University, Report 1993, Aga Khan University

The Aga Khan University Reports Archives

• Chancellor's Statement
• Message from the Borad of Trustees
• The Aga Khan University
• The Aga Khan University Hospital
• Finance and Funding

Childhood Acute Respiratory Infection In Pakistan, D R. Marsh, Inam-Ul-Haq, A F. Qureshi, Q Noorani, R Noorali

Community Health Sciences

No abstract provided.

Malabsorption Of Nutrients In Children With Diarrhoea Due To Unknown Aetiologies, Ayesha Molla, Mohammad Khurshid, Abdul Majid Molla, Makhduma Khatun

Department of Pathology and Laboratory Medicine

Intake and coefficient of absorption of nutrients wefe measured in 72 children dufing acute diarrhoea and 2 weeks after fecovery. No diarrhooeal pathogens could be identified in 18 (25%) childfen (group I). Aetiology of diafrhoea was identified in fest of the 54 children (group II). Absofption of oalofie, fat and cafbohydrate during the recovery stage were similaf in all 72 children, In group I, absorption of nutrients improved from acute stage to recovery stage as follows: fat from 62 to 85%, calofies from 68 to 86% and carbohydrate from 81 to 91%. Absorption of nitrogen during the acute stage was …

Cloning And Expression Of A Novel Na(+)-Dependent Neutral Amino Acid Transporter Structurally Related To Mammalian Na+/Glutamate Cotransporters, Saad Shafqat, Balaji Tamarappoo, Michael S Kilberg, Ram S Puranam, James O. Mcnamara, Ana Guadaño -Ferraz, R.T. Fremeau

Section of Neurology

A cDNA has been isolated from human hippocampus that appears to encode a novel Na(+)-dependent, Cl(-)-independent, neutral amino acid transporter. The putative protein, designated SATT, is 529 amino acids long and exhibits significant amino acid sequence identity (39-44%) with mammalian L-glutamate transporters. Expression of SATT cDNA in HeLa cells induced stereospecific uptake of L-serine, L-alanine, and L-threonine that was not inhibited by excess (3 mM) 2-(methylamino)-isobutyric acid, a specific substrate for the System A amino acid transporter. SATT expression in HeLa cells did not induce the transport of radiolabeled L-cysteine, L-glutamate, or related dicarboxylates. Northern blot hybridization revealed high levels …

The Aga Khan Health Services - International Newsletter No. 50, Aga Khan University

The Aga Khan Health Services Archives

• Medical Students Make "Family Ties" a Success
• Workshop in Nairobi Examines Ethics in PHC
• Value of Epidemiological Data
• Sadiq Gets a New Lease on Life
• PHC Workers Start Women's Education Programme
• AKUMC Contributes to Flood Relief
• AKUSON—A National Resource
• Dr. Paula Herberg
• Community Health and Katchi Abadis
• Evaluating Ar-Razi's Book on Gout
• Ar-Razi's Book
• Drug Abuse on Rise in Kenya
• The Switch in Baby Farida's Life
• Success Story of a Volunteer Service

Yoghurt (Dahi): A Probiotic And Therapeutic View, Z Abbas, W Jafri

Section of Gastroenterology

No abstract provided.

The Aga Khan Health Services - International Newsletter No. 49, Aga Khan University

The Aga Khan Health Services Archives

• Bangladesh Delegation studies AKU's Urban PHC Modules
• RNP Meeting in Mombasa a Big Success
• Elective Programmes at AKU Attract International Students
• Cluster Programme Provides Health Care to Remote Areas of Sindh
• Two New MCH Centres in Sindh
• Nurse-Physician Relationship
• Interview with Mrs. Shain Khoja Visiting Physiotherapist at AKUH
• Evaluating Ar-Razi's Book on Gout
• World Health Day Celebrated with Fervour in Kenya
• Setting Standards
• AKUH Wins Energy Conservation Award

The Aga Khan Health Services - International Newsletter No. 48, Aga Khan University

The Aga Khan Health Services Archives

• Aga Khan Foundation Reelected to the NGO World Bank Committee
• Medical Librarians from Iran train at Aga Khan University
• Aga Khan University’s Commitment to Research
• Interview with Dr. Meher Elavia Administrator of PAKH
• Self Help Project in Mombasa Ensures Availability of Medicine
• 53 Volunteers Recognised at AKUMC's Volunteers Appreciation Day
• Physiotherapy Brings Relief to Mountain Folk
• Chemical Therapy in Tenth Century Islamic Medicine
• Got Nyabondo Self Help Fund Raiser
• The Private Sector In Higher Education

Necrotizing Enterocolitis In Infants Weighing Less Than 2000 G, P Mufti, Z A. Bhutta

Department of Paediatrics and Child Health

Over a 4 year period, nine of 180 (5%) infants weighing less than 2000 G, admitted to the Aga Khan University Hospital (AKUH) developed necrotizing enterocolitis (NEC). An outbreak of NEC occurred in 1989, during which six infants developed the clinical illness. Overall incidence was 1.1%. Thirty-one birth weight and gestation matched controls were selected for comparison. Risk factors usually considered as predisposing factors, i.e., low 5 min Apgar score, rate of maternal complications, respiratory distress syndrome, mechanical ventilation, umbilical catheterisation, patient ductus arteriosus, use of antibiotics and feeding practices were found with equal frequency in both cases and controls. …

Prevalence Of Iron Deficiency Anaemia In Children Of The Urban Slums Of Karachi, Ayesha Molla, Mohammad Khurshid, A. Majid Molla

Department of Pathology and Laboratory Medicine

A preliminary baseline survey was conducted to estimate the prevalence of anaemia in a group of 391 children aged 6-60 months, randomly selected from three urban slums of Karachi. Haemoglobin and the red cell indices including haematocrit, MCV, MCH, MCHC, ABC and red cell distribution width (RDW) were estimated for each of the selected children. Ferritin estimation was done on 354 (9 1%) children to assess the iron storage status. According to WHO criteria, the accepted cut-off point for anaemia screening in children is set at 11 gm/dl, 70 fI and 20 pg for haemoglobin, MCV and MCH respectively. Following …

The Aga Khan Health Services - International Newsletter No. 47, Aga Khan University

The Aga Khan Health Services Archives

• Prime Minister Lauds Academic Excellence
• Convocation Seminar Explores Health Transition in Developing Countries
• Visitors at The Aga Khan University Medical Centre
• Women Train for Frontline Assignments.
• Dr. Wasim Afzal — First Winner of AKU’s Gold Medal
• Workshop in Northern Pakistan Helps Change Attitudes Towards Health Care
• Clinics Emphasise Disease Prevention in Tanzania
• AWARDS for AKU Faculty
• New DG at AKUH
• Joseph de Mora — New challenges in East Africa
• Chemical Therapy in Tenth Century Islamic Medicine

Congenital Pyloric Atresia And Epidermolysis Bullosa, Zafar Nazir, Zeba Batool Attar, Farhat Moazam

Section of Paediatric Surgery

Congenital pyloric atresia with epidermolysis bul­losa is recognized as a rare but distinct entity which is uniformly fatal^1,2. Until 1990 only 20 cases have been reported in the English literature^3,4. We present an additional case managed at the Aga Khan University Hospital to demonstrate the difficulties encountered in the management of such infants.

Clinical Features And Management Of Malignant Ascites, I Malik, S Abubakar, I Rizwana, F Alam, J Rizvi, A Khan

Section of Cardiology

Retrospective analysis of 45 patients (33 females, 12 males) with cytologically-proven malignant ascites is presented. Abdominal pain was the most frequent symptom (69%). Fiftythree percent cases had low serum albumin. Ascitic fluid was haemorrhagic or serosanguinous in 48% cases, in the rest it was clear or straw-coloured. Peritoneal effusion was exudative in 84% cases. Mean glucose content of ascitic fluid was 95 mg/dl and the mean white cell count of 919 cells/cmm. Vast majority (82%) of the cases had metastatic adenocarcinomas. Primary malignancy was mostly ovarian (47%) followed by non-Hodgkin's lymphoma (11%) and gall bladder carcinoma (9%). Primary site could …

The Aga Khan Health Services - International Newsletter No. 44, Aga Khan University

The Aga Khan Health Services Archives

• First Graduates of Nursing Degree Programme
• Seminar on Women in Health and Development
• Research on Diarrhoeal Disease in Gilgit Valley in Pakistan
• The Story of Little Malika and Her Grandmother
• First Residency Programme Completed
• Surgical Instruments in Islamic Medical Manuscripts
• Community Launches Health Programme in Aga Khan Baug in India
• Community Health Workers Bring Hope of Improved Health to Mountain Dewellers in Hunza
• Sneha Rema —A Graduate of Nursing Degree Programme
• Health Minister Inaugurates New Casualty Department
• Dream Come True
• Drug, Poison Information Centre Set-Up

Quality Concepts And Experiences, Nadeem Mustafa Khan

Nadeem Mustafa Khan Archives

• Quality Improvement
• Total Quality Management
• Strategic Quality Planning
• Executive Leadership
• Quality Council
• Customer Focus
• Quality Improvement Teams
• Project Team Organization
• Training and Education
• Cost of Poor Quality

The Aga Khan Health Services - International Newsletter No. 43, Aga Khan University

The Aga Khan Health Services Archives

• Health Network's Five Year Plan Announced
• Afghan Refugees Benefit from AKU-IRC Collaboration
• Hospital and Nursing Administrators Develop Network Nursing Strategy in Mombasa
• Paediatric Conference in Quetta
• Kabir Mitha—A Multisectorial Approach to Improving Quality of Life in Rural India
• Junagadh Primary Health Care Project
• AKU Faculty and Students Participate in International Health Project in Indonesia
• Cardiologist from America Volunteers Service at AKUMC
• AKU Faculty News
• Alumnus Award
• Islamic Miniature Paintings in Medical Manuscripts
• Plugged-in Healthcare— Computers to Safeguard Your Health