Medicine and Health Sciences Commons^™

Bilateral Retractile Testis: A Possible Risk Factor For Male Infertility, Syed Intesar Burni, Shazia R. Khan, Fareena Khalil Ahmed, Sameera Ali Rizvi, Tazeen Saeed Ali

School of Nursing & Midwifery

Healthy youth is an asset and strength for economic and social growth of any society. Developmental changes during puberty of youngsters need proper guidance to avoid future physical, physiological and psychological ailments. Bilateral Retractile Testis (BRT) is a health problem if remains unnoticed till adolescence can lead to tribulations. BRT may affect testicular parenchyma and spermatogenesis. Cremasteric muscles (muscles attached with testes) pull the testes up into groin so it randomly moves up and down and do not reside in its natural pouch always. It has been a controversial issue in male infertility as retraction may affect infertility.
Objective: To …

Is Covid-19 Impacting Cancer Screening In Pakistan? An Observational Study Of Cancer Screening Test Requests During The Pandemic, Sibtain Ahmed, Muhammad Abbas Abid, Noureen Niaz Ali, Junaid Ahmed, Imran Siddiqui

Department of Pathology and Laboratory Medicine

Background: The purpose of this study is to assess how the COVID-19 pandemic affected cancer screening at a large tertiary care setting in the city of Karachi, the third largest city in the world, and to identify if there has been any decrease in cancer screening during the ongoing pandemic.
Methods: A retrospective observational study was conducted at the clinical chemistry laboratory at the Department of Pathology & Laboratory Medicine, Aga Khan University Hospital (AKUH), Karachi Pakistan. Data for test volumes was extracted from the Integrated Laboratory Management System (ILMS) for the following tumor markers: CA19 Carbohydrate Antigen 19-9 (CA …

A Retrospective Review On Antibiotic Use In Acute Watery Diarrhea In Children In A Tertiary Care Hospital Of Karachi, Pakistan, Sonia Qureshi, Shahzadi Resham, Mariam Hashmi, Abdullah B. Naveed, Zoya Haq, Syed Asad Ali

Department of Paediatrics and Child Health

Introduction: Responsible for at least one in nine pediatric deaths, diarrheal diseases are the leading, global cause of death. Further abetted by improper antibiotic use in a hospital setting, children with acute watery diarrhea can see prolonged hospital stays, and unwanted adverse effects such as antibiotic resistance. Hence, this study is aimed to identify the association between antibiotic usage for the treatment of acute watery diarrhea in children, and the impact this line of management has on the duration of their hospital stay.
Methods: A retrospective review was conducted at the department of Pediatric of Aga Khan University Hospital (AKUH) …

Perception Of Non-Alcoholic Fatty Liver Disease: Real-Life Experience From Pakistan, Nazish Butt, Muhammad Ali Khan, Lajpat Rai, Riaz Hussain Channa, Hanisha Khemani, Amanullah Abbasi

Section of Gastroenterology

Introduction: Non-alcoholic fatty liver disease (NALFD) has become one of the most pervasive causes of hepatic pathology. Because of its marked association with metabolic syndrome, type II diabetes and cardiovascular disease, NAFLD has gained substantial focus recently. Its prevalence and incidence are on the rise in Pakistan. However, due to its indolent and mostly asymptomatic course, NAFLD is often overlooked. This reckless behavior towards a potentially deadly disease is influenced most notably by disinformation or flawed perception, although there are a number of other complex socioeconomic components to this as well. With respect to NAFLD, the gap between disease understanding …

Determinants Of Infant And Young Complementary Feeding Practices Among Children 6-23 Months Of Age In Urban Pakistan: A Multicenter Longitudinal Study, Shabina Ariff, Kamran Sadiq, Javairia Khalid, Laila Sikanderali, Batha Tariq, Fariha Shaheen, Gul Nawaz Khan, Atif Habib, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Suboptimal feeding practices have a negative impact on children's health and growth in the first 2 years of life and increase their risk of undernutrition, morbidity, and mortality. The aim of the study was to assess the factors that influence infant and young child feeding practices among urban mothers in a hospital setting at Karachi, Pakistan.
Methods: A longitudinal multi-center cohort study was conducted in four countries, MULTICENTER BODY COMPOSITION REFERENCE STUDY (MBCRS) to produce normal body composition reference data in healthy infants from 3 months to 24 months of age. Repeated anthropometric (weight, length and head circumference) and …

Polio Eradication And Health Systems In Karachi: Vaccine Refusals In Context, Svea Closser, Rashid Jooma, Emma Varley, Naina Qayyum, Sonia Rodrigues, Akasha Sarwar, Patricia Omidian

Section of Neurosurgery

Community and health worker engagement will be key to polio eradication in Karachi, Pakistan. In this study, the authors conducted participant observation, interviews, and a document review in SITE Town, Karachi, an area that in recent years has harbored poliovirus. SITE’s diverse population includes large numbers of internally displaced persons who are disproportionately affected by polio and are more likely than other populations to refuse the polio vaccine. Vaccine acceptance and worker motivation in SITE Town were shaped by the discrepancy in funding and attention for polio eradication campaigns as compared with routine services. Parental vaccine refusals stemmed from a …

Situation Analysis Of Child Labour In Karachi, Pakistan: A Qualitative Study, Asaad Ahmed Nafees, Kausar S. Khan, Zafar Fatmi, Mubashir Aslam

Community Health Sciences

In Karachi, large employment opportunities, burgeoning population and the availability of cheap labour might be the contributing factors for the increasing prevalence of child labour. A literature review was conducted in 2007 that included published and unpublished literature since 2000. Various organizations working in the field were also covered, while the perception of the child labourers was covered through three focus group discussions. Common health issues among the child labourers in Karachi included respiratory illnesses, fever and generalised pains, as well as drug and sexual abuse. Organisations working for child labour could be broadly categorised into those working for legal …

Self-Glucose Monitoring And Glycaemic Control At A Tertiary Care University Hospital, Karachi, Pakistan, Khurshid Khowaja, Humaira Waheed

Section of Diabetes, Endocrinology and Metabolism

OBJECTIVE: To explore the association between Self Monitoring of Blood Glucose (SMBG) levels and improved glycemic control (HbA1c level) among type 2 diabetic patients, receiving oral hypoglycaemic agents and insulin, and to ascertain the factors influencing SMBG.

METHOD: Using Comparative cross sectional study design five hundred Type 2 diabetes patients through convenient sampling between 30-70 years were interviewed through a structured questionnaire in year 2006 and 2007 at AKUH Ambulatory setting. These 500 subjects were divided as 250 in case (doing SMBG) and 250 in control (not doing SMBG) groups.

RESULTS: We identified that HbA1c value was maintained at good …

Treatment Outcome Of Multi-Drug Resistant Tuberculosis In A Tertiary Care Hospital In Karachi, Nisar Ahmed Rao, Zeeshan Mahfooz, Muhammad Irfan

Section of Pulmonary & Critical Care

Objective: To assess the outcomes of pulmonary multidrug-resistant tuberculosis (MDR-TB) patients treated at Ojha Institute of Chest Diseases (OICD), a reference hospital for TB in Karachi, Pakistan. Methods: Clinical study for the period 1996-2006, with follow-up until June 2007 was performed. All the culture and sensitivity proven cases of MDR pulmonary TB were initially admitted for 3-6 months till the sputum converted negative. Treatment regimen was decided on individual basis, and included 4-6 drugs. Supervised treatment was given to all patients during the hospitalization. After discharge from the hospital, patients were followed at monthly interval at the outpatient department of …

Assessment Of Asthma Control Using The Asthma Control Test At A Tertiary Care Centre In Karachi, Pakistan, Sana Shoukat, Saqib Ali Gowani, Ameer Ali Khowaja, Javaid Khan

Section of Pulmonary & Critical Care

The aim of our study was to assess asthma control among asthmatics at a tertiary care setting in Karachi using ACT questionnaire. The ACT questionnaire was filled by known asthmatics in January 2007. A total of 150 questionnaires were filled of which, 61 (40%) were males and 89 (60%) females. Mean ACT score was 17.71 +/- 4.41. Association between sex and asthma control was not statistically significant. Significant association was seen with asthma control and Ipratropium bromide inhaler. Asthma control among patients at a tertiary care centre is moderate. ACT can be used to follow patients in the hospital.

Primary Drug Resistance Against Mycobacterium Tuberculosis In Karachi, Nisar Ahmed Rao, Muhammad Irfan, Shahid Javed Hussain

Section of Pulmonary & Critical Care

OBJECTIVE: To evaluate the primary drug resistance of new culture positive cases of pulmonary tuberculosis in Karachi.

METHODS: All new suspected pulmonary tuberculosis patients were recruited initially. They were instructed to produce three-sputum samples for smear examination and on one of the specimen's culture was applied. Bronchoscopy and bronchial wash was done in patients who were not expectorating. Bronchial wash was then applied for both smear and culture for Mycobacterium tuberculosis.

RESULTS: Out of 79 cases recruited initially, 52 were able to produce sputum while bronchoscopy was performed in the remaining. AFB direct smear was positive in 32/52 sputum and …

Socio-Demographic Correlates Of Exhaled Breath Carbon Monoxide In Karachi's Adult Population, Majid Shafiq, Sumera Khan, M. Rizwanulhaq Khawaja, Suleman Haque, Javaid Khan

Section of Pulmonary & Critical Care

OBJECTIVE: To examine the relationship between CO levels and putative factors including smoking status among residents of Karachi, an urban center with very high levels of air pollution.

METHODS: Two hundred and eighteen volunteering subjects were asked to maximally exhale into a Smokerlyzer breath CO analyzer. Each of the volunteers was also asked to reply to a questionnaire-based interview seeking demographic information as well as details of exposure to tobacco, traffic fumes and other air pollutants.

RESULTS: Out of the 218 participating subjects, 75% were males and 27% were current or ex-smokers. The mean CO level was 2.92 parts per …

Hepatitis B And C: Prevalence And Risk Factors Associated With Seropositivity Among Children In Karachi, Pakistan, Wasim Jafri, Nadim Jafri, Javed Yakoob, Muhammad Islam, Syed Farhan Ali Tirmizi, Tazeen Jafar, Saeed Akhtar, Saeed Hamid, Hasnain Ali Shah, Sheikh Qamaruddin Nizami

Section of Gastroenterology

Background

Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) can lead to chronic liver disease and hepato-cellular carcinoma (HCC). This cross-sectional study estimated the prevalence and identified risk factors associated with Hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV) sero-positivity among children 1 to 15 years of age.

Methods

The study targeted the low to middle socioeconomic population that comprises 80% to 85% of the population. Consent was obtained from parents of the eligible children before administering questionnaire and collected a blood sample for anti-HCV and HBsAg serology.

Results

3533 children were screened for HBsAg and …

Knowledge, Attitude And Misconceptions Regarding Tuberculosis In Pakistani Patients, Javaid Ahmed Khan, Muhammad Irfan, Amna Zaki, Madiha Beg, Syed Fayyaz Hussain, Nadeem Rizvi

Section of Pulmonary & Critical Care

Objective:

To assess knowledge of patients with tuberculosis; about their disease and misconceptions regarding TB.

Methods:

A cross sectional study was conducted at Out-patient clinics of two teaching hospitals (private and public) in Karachi, Pakistan. A questionnaire was filled for the purpose.

Results:

A total of 170 patients were interviewed, 112 from private and 58 from a public sector hospital. Cough, fever, bloody sputum and chest pain were recognized as the common symptoms of TB. Eleven (7%) patients thought TB was not an infectious disease and 18 (10.6%) did not consider it a preventable disease. Contaminated food was considered the …

Socio-Demographic Correlates Of Betel, Areca And Smokeless Tobacco Use As A High Risk Behavior For Head And Neck Cancers In A Squatter Settlement Of Karachi, Pakistan, Samia Mazahir, Rabia Malik, Maria Maqsood, Kanwal Aliraza Merchant, Farida Malik, Atif Majeed, Zafar Fatmi, Muhammad Rizwanulhaq Khawaja, Shehzad Ghaffar

Community Health Sciences

Background

Head and neck cancers are a major cancer burden in Pakistan. They share a common risk factor profile including regular consumption of products of betel, areca and tobacco. Use of paan, chaalia, gutka, niswar and tumbaku is acceptable in Pakistan and is considered a normal cultural practice. This cross-sectional study was carried out to understand the relation of socio-demographic factors for the consumption of paan, chaalia, gutka, niswar and tumbaku in Pakistani population. Through systematic sampling, 425 subjects from a squatter settlement in Karachi were interviewed using a structured questionnaire. High risk behavior was defined as Daily use of …