Medicine and Health Sciences Commons^™

Parallel Ngo Networks For Hiv Control: Risks And Opportunities For Ngo Contracting., Shehla Zaidi, Xaher Gul, Noureen Aleem Nishtar

Community Health Sciences

Policy measures for preventive and promotive services are increasingly reliant on contracting of NGOs. Contracting is a neo-liberal response relying on open market competition for service delivery tenders. In contracting of health services a common assumption is a monolithic NGO market. A case study of HIV control in Pakistan shows that in reality the NGO market comprises of parallel NGO networks having widely different service packages, approaches and agendas. These parallel networks had evolved over time due to vertical policy agendas. Contracting of NGOs for provision of HIV services was faced with uneven capacities and turf rivalries across both NGO …

Household Food Access And Child Malnutrition: Results From The Eight-Country Mal-Ed Study, Zulfiqar Ahmed Bhutta, Maled Network Investigators, Anita K. M. Zaidi, Sajid Bashir Soofi, Ali Turab, Didar Alam, Shahida Qureshi, Aisha Khizar Yousafzai, Syed Asad Ali, Imran Ahmed, Sajad Memon, Muneera Rasheed

Woman and Child Health

Background: Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites.
Methods: We administered a socioeconomic survey to 800 households in research sites in eight countries, including a …

Fluoroquinolone And Macrolide Co-Resistance In Clinical Isolates Of Campylobacter Species: A 15-Year Study In Karachi, Pakistan, Seema Irfan, A Ahmad, D Guhar, E Khan, Fasial Malik, Syed Mahmood, Afia Zafar

Department of Pathology and Laboratory Medicine

Fluoroquinolone and macrolide antibiotics are generally considered as first-line drugs for the treatment of severe campylobacteriosis. This study was conducted to analyse the trend of erythromycin and ofloxacin resistance among Campylobacter spp. isolated from stool specimens over a period of 15 years (1992-2007) at The Aga Khan University clinical laboratory in Karachi, Pakistan. A total of 83 396 stool specimens were processed, with a 14% isolation rate for enteric pathogens. The isolation rate of Campylobacter spp. was low during 1992-93 (6%-13%), peaked in 1996 (46%), then ranged from 20% to 40%. We report a rising trend in ofloxacin resistance, re-emergence …

3t Or Not To 3t? Making Sense Of Magnetic Field Strengths In Mr Scanners, Zafar Sajjad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Survey Of Knowledge, Attitude And Practice Of Epilepsy Among 221 School Teachers In Karachi, Syed Wasim Akhtar, Zarin Mogal, Shaukat Ali, Munawar Ali, Abdul Latif Sonija, Husainuddin Afridi, Hasan Aziz

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Frequency Of Carpal Tunnel Syndrome In Patients Of Diabetic Peripheral Neuropathy, Ahmad Furqan Dr., Naeem Kasuri, Athar Javed, Javed Iqbal, Haroon Khan, Mohsin Zaheer

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Asymtomatic Arachnoid Cyst Presenting With Subdural Hygroma After Cyst Rupture: A Rare Complication, Pari Gul, Bushra Rehan, Saleha Anwar, Ayub Mansoor

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Leukemia With Ptosis, Saira Saad, Mazhar Badshah, Muhammad Tariq, Muhammad Irshad Awan, Sohail Rao, Mansoor Iqbal, Haris Majid Rajput, Zakir Jan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

A Clinical Approach To Myopathy, Sara Khan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Prevelacne Of Pressure Ulcers In Patients With Spinal Cord Injury; A Retrospective Study, Aatik Arsh, Haider Darain, Syed Muhammad Ilyas, Amir Zeb

Pakistan Journal of Neurological Sciences (PJNS)

Pressure ulcers in patients with spinal cord injury (SCI) are associated with incredible financial cost and human sufferings. The aim of this retrospective study was to determine prevalence of pressure ulcers amongst patients with different levels of SCI.

Labrad : Vol 38, Issue 2 - December 2012, Aga Khan University Hospital, Karachi

LABRAD

• Automation in Microbiology Specimen Processing and Inoculation
• Use of Automated Urine Analyzer for Urinanalysis
• Automation in Blood Culture
• Vitek 2 System: An Automated System for Antimicrobial Susceptibility Testing
• TB Diagnosis-A New Horizon
• Serological and Molecular Diagnosis of Malaria
• Diagnosis of Leishmaniasis
• Rapid Detection of Dengue NS1 Antigen by ELISA in Suspected Dengue Patients
• Saline Infusion Hysterosonography to Evaluate Abnormal Uterine Bleeding
• Workshop on “Diagnosis of Fungal Infections in Clinical Laboratory”

Omphalocoele, Ten Years Experience At A Tertiary Care Hospital, Anila Haroon, Akhtar Amin Memon, Rehan Ali

Department of Paediatrics and Child Health

Omphalocoele is a rare congenital anterior abdominal wall defect. We present 12 cases of Omphalocoele seen in our hospital. Further, we have discussed the clinical presentation, antenatal diagnosis, associated abnormalities and final outcome of the cases.

Correlation Of Respiratory Symptoms And Spirometric Lung Patterns In A Rural Community Setting, Sindh, Pakistan: A Cross Sectional Survey, Imran Naeem Abbasi, Adeel Ahsan, Asaad Ahmed Nafees

Community Health Sciences

Background: Symptom-based questionnaires can be a cost effective tool enabling identification and diagnosis of patients with respiratory illnesses in resource limited setting. This study aimed to determine the correlation of respiratory symptoms and spirometric lung patterns and validity of ATS respiratory questionnaire in a rural community setting.
Methods: This cross sectional survey was conducted between January - March 2009 on a sample of 200 adults selected from two villages of district Khairpur, Sindh, Pakistan. A modified version of the American thoracic society division of lung disease questionnaire was used to record the presence of respiratory symptoms. Predicted lung volumes i.e. …

Can Telemedicine Improve Stroke Outcomes?, Quratulain Shaikh, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Uchunguzi (Journal Watch/Montre De Journal) December 2012, Benjamin Wachira

Family Medicine, East Africa

Uchunguzi means investigation in Swahili and provides a summary of some of the most recent international literature as presented in other leading journals, but with an emphasis on what is relevant to our continent.

Limiting The Caesarean Section Rate In Low Risk Pregnancies Is Key To Lowering The Trend Of Increased Abdominal Deliveries: An Observational Study, Ilse Delbaere, Hendrik Cammu, Evelyne Martens, Inge Tency, Guy Martens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: As the rate of Caesarean sections (CS) continues to rise in Western countries, it is important to analyze the reasons for this trend and to unravel the underlying motives to perform CS. This research aims to assess the incidence and trend of CS in a population-based birth register in order to identify patient groups with an increasing risk for CS.

Methods: Data from the Flemish birth register ‘Study Centre for Perinatal Epidemiology’ (SPE) were used for this historic control comparison. Caesarean sections (CS) from the year 2000 (N = 10540) were compared with those from the year 2008 (N …

Antiseptics And Disinfectants For The Treatment Of Bacterial Vaginosis: A Systematic Review, Hans Verstraelen Verstraelen, Rita Verhelst, Kristien Roelens, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: The study objective was to assess the available data on efficacy and tolerability of antiseptics and disinfectants in treating bacterial vaginosis (BV).

Methods: A systematic search was conducted by consulting PubMed (1966-2010), CINAHL (1982-2010), IPA (1970-2010), and the Cochrane CENTRAL databases. Clinical trials were searched for by the generic names of all antiseptics and disinfectants listed in the Anatomical Therapeutic Chemical (ATC) Classification System under the code D08A. Clinical trials were considered eligible if the efficacy of antiseptics and disinfectants in the treatment of BV was assessed in comparison to placebo or standard antibiotic treatment with metronidazole or clindamycin …

Radiation Exposure In Interventional Procedures, G. K. Korir, B. O. Ochieng, J. S. Wambani, I. K. Korir, C. Y. Jowi

Imaging & Diagnostic Radiology, East Africa

The aim of this study was to estimate radiation doses patients and staff are exposed to during interventional procedures (IPs), compare them with the international diagnostic reference levels and to develop initial National Diagnostic Reference Levels. The IP survey was undertaken as the initial task of which, retrospective data were collected from the only four Kenyan hospitals carrying out interventional radiology and cardiology procedures at the time of the study. Real-time measurement of radiation dose to patients and staff during these procedures was done. To the patients, kerma-area product (KAP) and fluoroscopy time measurements were done using an in-built KAP …

Fiberoptic Intubation In A Paediatric Patient With Severe Temporomandibular Joint (Tmj) Ankylosis, Ali Asghar, Faisal Shamim, Asiyah Aman

Department of Anaesthesia

Craniofacial abnormalities are associated with mandibular hypoplasia, reduced mandibular space with overcrowding of soft tissues and maxillary hypoplasia. Decreased mouth opening and limitation in jaw protrusion are independent predictors of difficult airway in such patients. The relative difficult problem becomes even graver in the paediatric age group because of their small mouth opening and un-cooperativeness. A child with severe temporomandibular joint (TMJ) ankylosis presented with negligible mouth opening and required surgical correction under general anaesthesia. Successful intubation was performed with endotracheal tube size 5.5 mm using an adult 4.3 mm fiberoptic bronchoscope under inhalational as well as topical anaesthesia.

What Method Of Contact Works Best For Recruiting Participants In A Study: Lessons For Health Care Researchers?, Romania Iqbal, Ali Haroon, Abdul Jabbar, Neelofar Babar, Rahat Qureshi

Section of Internal Medicine

Objectives: To assess the various recruitment strategies used by medical researchers and their response rates.

Methods: The observational study, part of a larger retrospective cohort, was done at the Aga Khan University Hospital, Karachi, Pakistan, from May 2008-December 2010, covering a period from 1999 to 2005. We used a multi-mode contact approach for including participants in the study. This comprised an invitational letter that described the study sent along with a mail-back, postage-paid envelope and multiple phone calls for recruitment of participants. The response to each mode was noted and described as frequency and percentage.

Results: There …

Allogeneic Stem Cell Transplantation In Acute Myeloid Leukemia, Natasha Bahadur Ali, Salman Adil, Mohammad Usman Shaikh, Nehal Masood

Department of Pathology and Laboratory Medicine

We report a case series of 12 patients with acute myeloid leukemia who underwent allogeneic stem cell transplant with a matched related donor. Male to female ratio was 1:1. The main complication post-transplant was graft-versus-host disease (n=7 patients). Transplant-related mortality involved one patient; cause of death was multi-organ failure. After a median follow up of 36.0±11.3 months, overall survival was 16%.

Maternal Tetanus Toxoid Vaccination And Neonatal Mortality In Rural North India, A. Singh, S. Pallikadavath, R. Ogollah, W. Stones

Obstetrics and Gynaecology, East Africa

Objectives: Preventable neonatal mortality due to tetanus infection remains common. We aimed to examine antenatal vaccination impact in a context of continuing high neonatal mortality in rural northern India.

Methods and Findings: Using the third round of the Indian National Family Health Survey (NFHS) 2005-06, mortality of most recent singleton births was analysed in discrete-time logistic model with maternal tetanus vaccination, together with antenatal care utilisation and supplementation with iron and folic acid. 59% of mothers reported receiving antenatal care, 48% reported receiving iron and folic acid supplementation and 68% reported receiving two or more doses of tetanus toxoid (TT) …

Foleys Protection Caps: Inexpensive Alternative In Ilizarov Fixation, K Abbas, H Rashid

Section of General Surgery

No abstract provided.

Comparison Of Need And Supply Of Syringes For Therapeutic Injections In Pakistan, Adnan Ahmad Khan, Momina Saleem, Huma Qureshi, Rashid Jooma, Ayesha Khan

Section of Neurosurgery

Objectives: To determine the extent of shortfall in syringes by measuring the need from nationally validated sources and comparing it with position on the supply side. This was done in order to contribute to the ongoing national discussions that have focused on increasing syringe supply to curtail syringe reuse.
Methods: Using 'Injections received' data from the Pakistan Demographic Health Survey 2006-7 (N: 5429) and the National Hepatitis Survey (N: 47,043), the study estimated the number of injections received in Pakistan. We matched these against the local syringe production figures from the syringe manufacturers' association and import figures from the Federal …

Association Between Tumour Volume And Recurrence Of Squamous Cell Carcinoma Of The Head And Neck, Faraz Nasim Kazmi, Amina Adil, Shehzad Ghaffar, Farhan Ahmed

Section of Otolaryngology, Head & Neck Surgery

Objective: To evaluate the prognostic significance of computerized tomography derived tumour volume for squamous cell cancers of the head and neck, treated primarily by surgery.Methods: The retrospective review study comprised 72 patients with head and neck malignancies who were treated primarily by surgery at Aga Khan University Hospital, Karachi, with/without adjuvant. It was done from May 2007 to November 2008. Each patient was followed up for a minimum of one year to check for recurrence. For statistical analysis SPSS 17 was used. Frequencies, cross-tabulations with chi square tests to find associations, binary logistic regression analysis, Cox regression analysis and receiver …

Respiratory Symptoms And Illnesses Among Brick Kiln Workers: A Cross Sectional Study From Rural Districts Of Pakistan, Shiraz Shaikh, Asaad Ahmed Nafees, Vikash Khetpal, Abid Ali Jamali, Abdul Manan Arain, Akram Yousuf

Community Health Sciences

Background: Occupational risk factors are one of the major causes of respiratory illnesses and symptoms, and account for 13% of chronic obstructive pulmonary disease and 11% of asthma worldwide. Majority of brick kilns in Pakistan use wood and coal for baking the bricks which makes the brick kiln workers susceptible to high exposure of air pollution. This study was designed to describe frequency of chronic respiratory symptoms and illnesses and study the association between these symptoms and different types of work.
Methods: This was a questionnaire based cross sectional survey conducted among the brick kiln workers in Larkana and Dadu …

Improved Quality Of Management Of Eclampsia Patients Through Criteria Based Audit At Muhimbili National Hospital, Dar Es Salaam, Tanzania. Bridging The Quality Gap, Hussein Kidanto, Peter Wangwe, Charles D. Kilewo, Lennarth Nystrom, Gunnila Lindmark

Faculty of Health Sciences, East Africa

Background Criteria-based audits (CBA) have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the use of a CBA to improve quality of care among eclampsia patients admitted at a University teaching hospital in Dar es Salaam Tanzania.

Objective The prevalence of eclampsia in MNH is high (≈6%) with the majority of cases arriving after start of convulsions. In 2004–2005 the case-fatality rate in eclampsia was 5.1% of all pregnant women admitted for delivery (MNH obstetric data base). A criteria-based audit (CBA) was used to evaluate the …

Knowledge Of Patients' Visual Experience During Cataract Surgery: A Survey Of Eye Doctors In Karachi, Pakistan, Mohammad Zain Tauqir, Tanveer Anjum Chaudhry, Sehreen Mumtaz, Khabir Ahmad

Department of Surgery

Abstract

BACKGROUND:

Several recent studies have recommended that ophthalmologists must be aware of the visual sensations (and their associated anxiety/fear) experienced by patients undergoing cataract surgery. We assessed the knowledge of a group of eye doctors in Pakistan regarding these phenomena.

METHODS:

This was a cross-sectional survey. Eye doctors (ophthalmologists, residents and medical officers) attending the Ophthalmological Society of Pakistan Annual Conference 2011, in Karachi were invited to participate in the study. A self-administered structured questionnaire was used to examine their knowledge of visual sensations and their associated anxiety/fear experienced by patients during cataract surgery. Simple frequencies and proportions were …

Knowledge Attitude And Practices Among Urban Women Of Karachi, Pakistan, Regarding Breast Cancer, Zain-Ul-Abedeen Sobani, Zeb Saeed, Hafiza Noor-Ul-Ain Baloch, Amina Majeed, Sana Chaudry, Adil Sheikh, Jalal Umar, Hira Waseem, Murtaza Mirza, Irfan Qadir

Department of Surgery

Objective: To determine the knowledge,attitudes and practices of urban women regarding breast cancer and its available screening modalities.Methods: The cross-sectional, questionnaire-based, descriptive study was conducted in the urban population of Karachi in November 2010. Female attendants (n=373) visiting a tertiary care centre and four of its urban outreach centres during the study period were administered a questionnaire. The answers were then scored with regard to their knowledge. Frequencies and percentages were computed through SPSS 17, and analysis of variance was used to confirm significance.Results: Of the 373 participants with a mean age of 32.4+/-10.9 years, 293 (78.6%) were married, and …

Anaesthetic Management Of A Young Patient With Homocystinuria, Ali Asghar, Faiza Mazhar Ali

Department of Anaesthesia

Homocystinuria is a rare autosomal recessive genetic disease. It is caused by a deficiency in cystathionine-b-synthase leading to a defect in methionine metabolism. High levels of plasma homocysteine are associated with vascular injury via mechanisms of oxidative damage, vascular smooth muscle proliferation, promotion of platelet activation and aggregation,and disruption of normal procoagulant-anticoagulant balance favouring thrombosis. This is a case of 8 years old boy, a known case of homocystinuria, who was scheduled for bilateral lensectomy and intraocular lens placement. The major anaesthetic considerations include the development of thromboembolism, need to avoid nitrous oxide in balanced anaesthesia regimen and hypoglycaemia.