Medicine and Health Sciences Commons^™

Biorisk Management, Laboratory Acquired Infections And Clinical Containment, Kashif Ali, Furqan Kabir, Esmeralda Meyer

Department of Paediatrics and Child Health

No abstract provided.

Impact Of Enteropathogens On Faltering Growth In A Resource-Limited Setting, Furqan Kabir, Junaid Iqbal, Zehra Jamil, Najeeha Talat Iqbal, Fatima Aziz, Adil Kalam, Sahrish Muneer, Aneeta Hotwani, Sheraz Ahmed, Fayyaz Umrani, Sana Syed, Kamran Sadiq, Syed Asad Ali

Department of Paediatrics and Child Health

Introduction: Environmental enteropathy is an important contributor to childhood malnutrition in the developing world. Chronic exposure to fecal pathogens leads to alteration in intestinal structure and function, resulting in impaired gut immune function, malabsorption, and growth faltering leading to environmental enteropathy.
Methods: A community-based intervention study was carried out on children till 24 months of age in Matiari district, Pakistan. Blood and fecal specimens were collected from the enrolled children aged 3-6 and 9 months. A real-time PCR-based TaqMan array card (TAC) was used to detect enteropathogens.
Results: Giardia, Campylobacter spp., enteroaggregative Escherichia coli (EAEC), Enteropathogenic Escherichia coli (EPEC), …

Relationship Of Abdominal Circumference And Trunk Length With Spinal Anesthesia Block Height In Geriatric Patients Undergoing Transurethral Resection Of Prostate, Muhammad Yahya, Aliya Ahmed, Iayla Fatima, Muhammad Nasir

Department of Anaesthesia

Introduction: Spinal anesthesia is commonly used for various surgical procedures. Prediction of spinal anesthesia block height is always a challenging task for anesthetists. Higher than desired levels of spinal anesthesia blocks are associated with serious side effects, while inadequate block height does not provide satisfactory surgical anesthesia. In this study, we observed the relationship between the ratio of trunk length (TL) and square of the abdominal circumference (AC²) and spinal anesthesia sensory block height in geriatric patients undergoing transurethral resection of the prostate (TURP).
Material & Methods: This is a cross-sectional study conducted at the Aga Khan University …

Family Income And Cardiovascular Disease Risk In American Adults, Abdul Mannan Khan Minhas, Vardhmaan Jain, Monica Li, Robert W. Ariss, Marat Fudim, Erin D. Michos, Salim S. Virani, Laurence Sperling, Anurag Mehta

Office of the Provost

Socioeconomic status is an overlooked risk factor for cardiovascular disease (CVD). Low family income is a measure of socioeconomic status and may portend greater CVD risk. Therefore, we assessed the association of family income with cardiovascular risk factor and disease burden in American adults. This retrospective analysis included data from participants aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) cycles between 2005 and 2018. Family income to poverty ratio (PIR) was calculated by dividing family (or individual) income by poverty guidelines specific to the survey year and used as a measure of socioeconomic status. The …

Testicular Choriocarcinoma With Small Bowel Metastasis And Active Gastrointestinal Bleeding, Asad Saulat Fatimi, Khizer Masroor Anns, Faheemullah Khan, Wasim Ahmed Memon, Junaid Iqbal, Muhammad Aman, Izaz Ahmad, Sahar Fatima

Medical College Documents

Testicular choriocarcinomas make up less than 1% of all germ-cell tumors and are highly malignant, attributable to hematogenous spread. While the most common sites of metastasis are the lungs and liver, metastatic spread to the gastrointestinal tract is rare wherein patients may present with GI distress or even an upper GI bleed. In this report, we present a case of known testicular choriocarcinoma in a 40-year-old male who presented to the emergency room with severe anemia and a suspected upper GI bleed.

Urbanization And Physical Activity In The Global Prospective Urban And Rural Epidemiology Study, Kwadwo Boakye, Marit Bovbjerg, John Schuna Jr, Adam Branscum, Ravi Prasad Varma, Rosnah Ismail, Olga Barbarash, Juan Dominguez, Yuksel Altuntas, Romaina Iqbal

Community Health Sciences

Urbanization may influence physical activity (PA) levels, although little evidence is available for low- and middle- income countries where urbanization is occurring fastest. We evaluated associations between urbanization and total PA, as well as work-, leisure-, home-, and transport-specific PA, for 138,206 adults living in 698 communities across 22 countries within the Prospective Urban and Rural Epidemiology (PURE) study. The 1-week long-form International PA Questionnaire was administered at baseline (2003-2015). We used satellite-derived population density and impervious surface area estimates to quantify baseline urbanization levels for study communities, as well as change measures for 5- and 10-years prior to PA …

Metabolomics Of A Neonatal Cohort From The Alliance For Maternal And Newborn Health Improvement Biorepository: Effect Of Preanalytical Variables On Reference Intervals, Lena Jafri, Aysha Habib Khan, Muhammad Ilyas, Muhammad Imran Nisar, Javairia Khalid, Hafsa Majid, Aneeta Hotwani, Fyezah Jehan

Department of Pathology and Laboratory Medicine

Background: The study was conducted to determine reference interval (RI) and evaluate the effect of preanalytical variables on Dried blood spot (DBS)-amino acids, acylcarnitines and succinylacetone of neonates.
Methodology: DBS samples were collected within 48-72 hours of life. Samples were analyzed for biochemical markers on tandem mass spectrometer at the University of Iowa. Comparison of RI across various categorical variables were performed.
Results: A total of 610 reference samples were selected based on exclusion criteria; 53.2% being females. Mean gestational age (GA) of mothers at the time of delivery was 38.7±1.6 weeks; 24.5% neonates were of low birth weight and …

Concept Of Health-Related Quality Of Life Among People With Heart Failure In Karachi, Pakistan, Anny Ashiq Ali

MBE 2023

Background: Non-communicable diseases (NCDs), including cardiovascular diseases, are a leading cause of global mortality. The mortality rate for cardiovascular diseases is on the rise, with 80 % to 86 % of fatalities, particularly in low- and middle-income countries, including Pakistan. Among NCDs, heart failure (HF) is a condition for which there is no cure, and patients rely on supportive treatments to maintain their quality of life. HF not only affects physical well-being but also has far-reaching consequences on the emotional, social, and cognitive aspects of life. In the context of Pakistan, where unique healthcare, sociocultural, and economic factors prevail, the …

What Do People Affected By Amyotrophic Lateral Sclerosis Want From Health Communications? Evidence From The Als Talk Project, Shelagh K. Genuis, Westerly Luth, Tania M. Bubela, Wendy S. Johnston

Office of the Provost

Introduction/aims: Health communication is central to effective, supportive amyotrophic lateral sclerosis (ALS) clinical care. Guidance for ALS communication is limited, focuses on diagnosis disclosure, and frequently relies on expert consensus and/or reviews. Patient-based evidence is needed to guide ALS health communication. We investigated how the experiences of ALS patients and family caregivers can inform effective communication practices from diagnosis to end-of-life.
Methods: Data were drawn from the ALS Talk Project, an asynchronous, online focus group study. Seven focus groups and five interviews (105 participants) were conducted. Data were qualitatively analyzed using directed content analysis and the constant-comparative approach.
Results: We …

Determinants Of Progression Of Gestational Hypertension To Severe Preeclampsia And Eclampsia Among Postnatal Women At Machakos County Referral Hospital, Eunice Mwikali Muia

MSc in Advanced Practice Nursing

Worldwide, maternal morbidity and mortality among pregnant women pose a major challenge which is mainly brought by hypertensive disorders in pregnancy. Progression of gestational hypertension to severe preeclampsia contribute a lot in adverse birth outcomes hence posing a great challenge especially in developing countries. The study seeks to determine the factors leading to progression of gestational hypertension to severe preeclampsia by checking the sociodemographic factors, maternal obstetrical factors, medical factors and adverse birth outcomes. The study used descriptive cross-sectional design, including all mothers who had a diagnosis of gestational hypertension, pre-eclampsia and eclampsia and delivered in Machakos level 5 hospital. …

Trends Of Intra-Facility Births Outcomes Before And During Covid-19 Era In Dar Es Salaam, Tanzania, Willbroad Kyejo

Master of Medicine in Family Medicine

Background While substantial progress had been made in reducing maternal deaths, there was a risk that the COVID-19 pandemic might have reversed the progress made in maternal and newborn health in the last two decades. As such, maternal and newborn outcomes had been a topic of interest during the pandemic. Objectives This study aimed to compare the number of childbirths as an indicator of maternal health service utilization and to assess maternal and newborn outcomes before COVID-19 (2011-2019) and during the COVID-19 pandemic (2020/2021) in 22 health facilities in Dar es Salaam. Methodology A retrospective cohort study was conducted at …

Risk Factors And Outcomes Of Acute Kidney Injury Among Covid-19 Patients At A Tertiary Hospital In Kenya, Susan Cheruiyot

Master of Medicine in Family Medicine

Background: Corona Virus Disease 2019 (COVID-19), a novel infection caused by the SARS-Cov-2 virus, was declared a global pandemic on March 11, 2020. Three years later, 350,000 Kenyans had gotten the infection, with approximately 5,700 reported related deaths. Despite emerging research on the new virus, studies from the African continent on the impact of COVID-19 on the kidneys have been few. Early studies suggest that up to 75% of patients with COVID-19 have a derangement in their kidney function as evidenced by new onset proteinuria and hematuria. That said, the prevalence of acute kidney injury has varied greatly across populations, …

Factors Associated With Clinically Significant Hyperbilirubinemia Among Abo-Incompatible Newborns At A Tertiary Care Hospital In Kenya., Wandera Ivy Mwenesi

Master of Medicine in Paediatrics and Child Health

Background: ABO incompatibility is one of the most common causes of immune-mediated neonatal jaundice. It occurs in approximately 20-25% of all pregnancies. Literature shows that 60- 80% of newborns will develop physiological jaundice within the first week of life. Globally, the incidence ranges from 10-41%. Early detection of newborns with ABO incompatibility-related jaundice can prevent the incidence of bilirubin-induced neurological dysfunction. Whereas there have been extensive published data on rhesus isoimmunization, very few studies have examined ABO incompatibility and isoimmunization. From the published literature, there has been no known study that has assessed risk factors for developing clinically significant jaundice …

Health-Related Quality Of Life Of Children With Gastro-Oesophageal Reflux Disease After Nissen Fundoplication And Gastrostomy Tube Insertion, Felix Musibi, Stanley Mugambi, Pauline Samia, Waceke Nganga

Paediatrics and Child Health, East Africa

Introduction: Severe gastro‑oesophageal reflux disease (GERD) is associated with a poor health‑related quality of life (HRQoL). Nissen fundoplication is the most common surgical procedure for patients with GERD. A feeding gastrostomy tube may be inserted at the same time in selected patients where there are unsafe swallowing and/or feeding difficulties. The goals of surgery are to eliminate symptoms, prevent reflux complications and ultimately improve the quality of life. The main objective of this study was to assess the HRQoL of children with GERD after Nissen fundoplication and gastrostomy tube insertion.

Materials and Methods: This was an observational retrospective cohort study …

Why Inhumane? An Ethical Issue On Medical Negligence From Health Professionals, Zahira Amir Ali

School of Nursing & Midwifery

Medical negligence in healthcare settings is an infidelity to the profession, and a sin towards human lives. Often used as a matter of excuse, blame game, irrational mistake, and frustration with stressful environments, it is overlooked and swept under the carpet. However, acknowledging the ethical values of the profession, sensitizing healthcare professionals to implement best practices, and reporting events to prevent harm in future, is certainly imperative. This paper shares an overview of medical negligence under an analysis of different biomedical ethical theories and shares relatable recommendations for future implications in healthcare practice.

Recognizing Early Warning Signs (Ews) In Patients Is Critically Important, Shamsa Samani, Salma Amin Rattani

School of Nursing & Midwifery

Introduction: Monitoring vital signs is a basic indicator of a patient’s health status and allows prompt detection of delayed recovery or adverse effects and early intervention. Patients with adverse events during hospitalization often display clinical decline for several hours before the event is observed. Non-critical care Nurses’ inconsistent recognition and response to patient deterioration lead to an increase in the length of hospital stay, unexpected admissions to the ICU, and increased morbidity and mortality.
Aim: The study aimed to assess the factors that facilitate or impede the detection of early warning signs among adult patients hospitalized in tertiary care settings. …

Progression Of Dyad Mentorship To Work Driven Model: Is This A Value Addition?, Rehana Rehman, Tazeen Saeed Ali, Rahila Ali

Department of Biological & Biomedical Sciences

No abstract provided.

Current Status And Priorities Of Paediatric Oncology Nursing In Africa: A Synthesis Of Perspectives From Siop Africa Nurses, Glenn M. Afungchwi, Elianeth Kiteni, Mariam Ndagire, Biemba Maliti, Julia M. Challinor, Rachel Hollis

School of Nursing & Midwifery, East Africa

Introduction. As African countries adopt the global goal of improving childhood cancer survival to 60% by 2030, intentional actions are required to improve nursing. This report aims to describe the current status of paediatric oncology nursing in Africa.

Methods. We report on nursing-related aspects of a survey to map paediatric oncology services in Africa (2018–2019), document perceived nursing strengths and weaknesses (2017) and share nurses’ research priorities (2019). Additionally, we report on a survey to identify topics for a foundation course (2019) and the expressed perspective of African nurses about the status of paediatric oncology nursing across the continent (2022). …

Impact Of Climate Events, Pollution, And Green Spaces On Mental Health: An Umbrella Review Of Meta-Analyses, Pim Cuijpers, Clara Miguel, Marketa Ciharova, Manasi Kumar, Luke Brander, Pushpam Kumar, Eirini Karyotaki

Brain and Mind Institute

Climate change may affect mental health. We conducted an umbrella review of meta-analyses examining the association between mental health and climate events related to climate change, pollution and green spaces. We searched major bibliographic databases and included meta-analyses with at least five primary studies. Results were summarized narratively. We included 24 meta-analyses on mental health and climate events (n = 13), pollution (n = 11), and green spaces (n = 2) (two meta-analyses provided data on two categories). The quality was suboptimal. According to AMSTAR-2, the overall confidence in the results was high for none of the studies, for three …

Views And Opinions Of Mass Media Key Informants On Coverage Of Issues Related To Maternal, Newborn And Child Health In Lake Zone, Tanzania, Violeth A. Mbuni, Nyagwegwe Wango, Elias C. Nyanza

Institute for Educational Development, East Africa

In Tanzania, the mass media is a primary means of communicating health information to urban and rural populations. While unsafe abortion is the leading cause of maternal deaths and complications in Tanzania, this has increased the high unintended pregnancy rate. Journalists, editors, program managers and producers play a significant role in determining the health-related issues reported. In the present study, the views, and opinions of mass media key informants on coverage of issues related to maternal, newborn and child health in Lake Zone were investigated. This qualitative study was conducted with key informants from 24 mass media outlets that covered …

Skin Protection From Solar Ultraviolet Radiation Using Natural Compounds: A Review, Ankit Ankit Verma, Alessandra Zanoletti, Kola Yusuff Kareem, Bashir Adelodun, Pankaj Kumar, Fidelis Odedishemi Ajibade, Luis F. O. Silva, Ankur J. Phillips, Thangathurai Kartheeswaran, Elza Bontempi

Arusha Climate and Environmental Research Centre

Skin exposure to solar ultraviolet radiation and pollutants causes several skin disorders, calling for protection methods such as sunscreen application. However, common sunscreen contains chemicals that have displayed toxicity when exposed to ultraviolet radiation. Therefore, alternatives approaches have been recently developed, such as the use of natural phytochemicals as active ingredients in photoprotection preparations. Here, we review skin protection with focus on the physics of ultraviolet radiation and photoprotection by ultraviolet filters. We present sensors for measuring ultraviolet radiation and ultraviolet radiation in ecosystems. We discuss the phototoxicity of drugs, preservatives, personal care products, and pollutants. Photocarcinogenesis, photoallergy, photostability, and …

Relationship Between Crown Like Structures And Body Mass Index In Breast Cancer, Sophie Wanjiru Irungu

Master of Medicine in Anatomic Pathology

Introduction: Breast cancer (BC) is the most common malignancy in women worldwide, including Kenya. Globally, increasing incidences of BC have paralleled those of obesity. The mechanism by which obesity contributes to BC is still an active area of research but white adipose tissue inflammation characterized by crown-like structures (CLS), which are macrophages surrounding dying adipocytes, is considered an important contributor. Objectives: The primary objective was to determine the association between CLS and body mass index (BMI) in BC patients. The secondary objectives were to determine the association of CLS with BC risk factors specifically, age, menopausal status, subtypes of BC, …

A Rare Case Report Of Tuberculosis Endometritis In A Private Hospital Dar Es Salaam, Tanzania, Willbroad Kyejo, Brenda Moshi, Daudi Gidion, Muzdalfat Abeid, Samina Somji, Munawar Kaguta, Miriam Mgonja

Faculty of Health Sciences, East Africa

Tuberculosis endometritis is a pathological diagnosis and has been always over shadowed by pelvic tuberculosis. It is usually asymptomatic, but patients could complain of menstrual irregularity and per vaginal discharge. We report a case of a 37-year-old female who presented with per vaginal discharge for 2 years. Histopathology showed numerous caseating and non-caseating granulomas with plasma cells, Ziehl–Neelsen stain for acid fast bacillus is positive, and she was initiated on anti-tuberculosis treatment. On subsequent follow-up visits, patient was doing well with complete resolution of symptoms. Genital tuberculosis is usually caused by reactivation of organism from systemic distribution during primary infection. …

An Iceberg I Can’T Handle: A Qualitative Inquiry On Perceptions Towards Paediatric Rheumatology Among Healthcare Workers In Kenya, Angela Migowa, Sasha Bernatsky, Anthony Ngugi, Helen E. Foster, Peter Muriuki, Adelaide Lusambili, Stanley Luchters

Paediatrics and Child Health, East Africa

Background: Delay in diagnosis and access to specialist care is a major problem for many children and young people with rheumatic disease in sub-Saharan Africa. Most children with symptoms of rheumatic disease present to nonspecialists for care. There is an urgent need to understand and scale-up paediatric rheumatology knowledge and skills amongst non-specialist healthcare workers to promote early diagnosis, prompt referral, and management.

Purpose: We evaluated the knowledge, attitudes and practices towards diagnosis and care of paediatric rheumatology patients among health care workers in Kenya.

Methods: We conducted 12 focus group discussions with clinical officers (third-tier community health …

Knowledge Attitudes And Priorities Regarding Antimicrobial Resistance And Antimicrobial Stewardship Among Clinic Administrators And Clinicians In Outpatient Medical Centres In Kenya: A Qualitative Study, Mary Wanjiru Kaniu

Master of Medicine in Paediatrics and Child Health

Introduction: Antimicrobial resistance is an important global health threat and it is estimated that by 2050 it will account for 10 million deaths globally. Low and middle income countries are disproportionately affected by the burden of antimicrobial resistance. One of the major causes of antimicrobial resistance is irrational and overuse of antibiotics. Understanding the knowledge, attitudes and priorities of healthcare workers and healthcare administrators on antimicrobial resistance and antimicrobial stewardship is pivotal in implementation of strategies to curb the spread of antimicrobial resistance. Methods: A qualitative study using in-depth semi-structured interviews was conducted among clinicians and clinic administrators in 12 …

In-Vision : Issue 11 - Jan - Dec 2023, Department Of Education Development

IN-VISION – Department of Educational Development Archives

• Message from Dr Naveed Yousuf Chair, Department of Education Development
• Faculty in Focus Dr. Sana Saeed
• Hallmark of the Year 2023
• Education Grand Rounds (EGR)
• Introductory Short Course in Health Professions Education (ISC-HPE)
• Master of Health Professions Education (MHPE)
• MHPE Elective Course
• Meet the MHPE Graduates - 2023
• Continuous Faculty Development Programme in Health Professions Education
• Other Faculty Development Initiatives
• Mega Question Review
• Faculty & Staff Highlights
• Awards & Appointments
• Meet the new DED members
• Publications
• Learning Resources
• Upcoming events
• Med Ed How to Increasing the Impact of Teaching Presentations
• Med Ed How to: Case Based Learning

Mind Matters : Vol 1, Issue 2 - 2023, Department Of Psychiatry

Department of Psychiatry Archives

• Message from the Chair
• Message from the Quality Improvement Representative
• Comprehensive Unit-Based Safety Program (CUSP)
• Empowering Multi-Disciplinary Care: Success Stories in Catatonia Management
• Impact of CARR Attributes Workshop
• Movements of Meeting for CUSP and Quality Initiatives: A Year Review
• Where Quality Begins: From Brainstorming to Brilliant Ideas, Every Thought Matters
• Educational sessions on International Patient Safety Goals
• From Approval: Key to Enhanced Quality and Effective Care
• Innovations and Improvements in Outpatient Psychiatric Services
• Improving Clinic Appointment Booking Capacity of Psychiatry Department
• Online Advanced Payment Module Enhances Patient Convenience …

Mind Matters : Vol 1, Issue 1 - 2023, Department Of Psychiatry

Department of Psychiatry Archives

• Message from the Chair
• Meet our Faculty Members
• Non-full-time Faculty Members
• Professor Emeritus
• Visiting Faculty
• Psychiatry Services
• Allied Services
• Occupational Therapists
• Outreach Services
• Education Activities / CME
• Conferences & Workshops
• Quality Improvement Initiatives
• PGME Activities/Achievements
• Meet Our Residents & Fellows
• UGME Activities
• Research Activities
• Key Achievements
• Upcoming Event
• Newsletter Editors

A Qualitative Enquiry Of Health Care Workers’ Narratives On Knowledge And Sources Of Information On Principles Of Respectful Maternity Care (Rmc), Adelaide Lusambili, Stefania Wisofschi, Terrance J. Wade, Marleen Temmerman, Jerim Obure

Institute for Human Development, East Africa

Research from sub-Saharan Africa indicate that many women experience varied forms of disrespectful maternity care, which amount to a violation of their rights and dignity. Notably, there is little research that sheds light on health care workers (HCWs) training and knowledge of principles of respectful maternity care (RMC). Formulating appropriate interventional strategies to promote the respectful provision of services for women during pregnancy, childbirth, and postpartum period requires an understanding of the current state of knowledge and sources of information on respectful maternity care among HCWs. This paper reports findings from a qualitative study that examined the knowledge and sources …

Delivering Health Services During Early Days Of Covid-19 Pandemic: Perspectives Of Frontline Healthcare Workers In Kenya’S Urban Informal Settlements, Vibian Angweny, Sabina Odero, Stephen Mulupi, Derrick Ssewanyana, Constance Shumba, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

The COVID-19 pandemic has caused widespread disruptions to health, economic and social lives globally. This qualitative study explores frontline healthcare workers’ (HCWs) experiences delivering routine care in Kenya’s informal settlements during the early phases of the pandemic, amidst stringent COVID-19 mitigation measures. Thirteen telephone interviews were conducted with facility and community-based HCWs serving three informal settlements in Nairobi and Mombasa. Data were analyzed using the framework approach. Results indicate there were widespread fears and anxieties surrounding COVID-19 and its management. Secondly, access to facility-based care at the onset of the pandemic was reported to decline, with service availability hampered by …