Medicine and Health Sciences Commons^™

Maternal Health Challenges During Covid-19 And Way Forward, Muskaan Dosani, Salima Muhammad Farooq, Shahnaz Shahid Ali

Journal of Asian Midwives (JAM)

The COVID-19 pandemic has affected nearly every country around the globe. Although every individual is at risk of getting the virus, maternal, fetal and newborn clients face specific and potentially unknown challenges which can make them highly compromised. The purpose of this paper is to discuss the maternal health challenges faced by women during COVID-19 and to propose possible strategies using the socio-ecological model (SEM) to promote the physical, social, and mental well-being of women and their infants during the perinatal period. SEM can be used as a framework to plan and implement strategies focusing on health promotion and disease …

Permanent Pre-Operative Cerebrospinal Fluid Diversion In Paediatric Patients With Posterior Fossa Tumours, Ummey Hani, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

Management options for obstructive hydrocephalus in children with posterior fossa tumours have been debated upon throughout the course of neurosurgical practice. Permanent pre-operative CSF diversion via ventricular shunts or endoscopic third ventriculostomy have been employed to prevent the possible persistence of hydrocephalus after tumour removal, but is considered unnecessary and even dangerous amongst a large group of neurosurgeons. In this paper, we have reviewed the literature for the merits and demerits of pre-operative permanent CSF diversion in paediatric patients presenting with posterior fossa tumours.

Silent Hypoxia In Covid-19: What Is Old Is New Again!, Sadaf Sheikh, Muhammad Akbar Baig

Department of Emergency Medicine

No abstract provided.

Mental Health Challenges And Psycho-Social Interventions Amid Covid-19 Pandemic: A Call To Action For Pakistan, Salima Farooq, Saima Sachwani, Sonia Ijaz Haider, Sajid Abrar Iqbal, Yasmin Parpio, Humera Saeed

School of Nursing & Midwifery

The increase in death and spread-related coronavirus (COVID-19) has shifted the world focus to the containment of the disease by emphasising measures to prevent spread in the general population. Such a complex, threatening, and unprecedented situation has left the psycho-social wellbeing needs of general public unaddressed. This paper aims to review the current COVID-19 scenario and its effects on the psycho-social wellbeing of people; and an attempt to shed some light on the aforementioned questions. Furthermore, the review will propose some recommendations for overcoming the mental illness issues, during and after the COVID-19 outbreak. We extracted information from reliable published …

International Gestational Age-Specific Centiles For Umbilical Artery Doppler Indices: A Longitudinal Prospective Cohort Study Of The Intergrowth-21st Project, Lior Drukker, Eleonora Staines-Urias, José Villar, Fernando C. Barros, Maria Carvalho, Shama Munim, Rose Mcgready, Francois Nosten, James A. Berkley, Shane A. Norris, Ricardo Uauy, Stephen H. Kennedy, Aris T. Papageorghiou

Department of Obstetrics & Gynaecology

Background: Reference values for umbilical artery Doppler indices are used clinically to assess fetal well-being. However, many studies that have produced reference charts have important methodologic limitations, and these result in significant heterogeneity of reported reference ranges.
Objectives: To produce international gestational age-specific centiles for umbilical artery Doppler indices based on longitudinal data and the same rigorous methodology used in the original Fetal Growth Longitudinal Study of the INTERGROWTH-21^st Project.
Study design: In Phase II of the INTERGROWTH-21^st Project (the INTERBIO-21st Study), we prospectively continued enrolling pregnant women according to the same protocol from 3 of the original …

Cns Tuberculosis And Stroke, Burden, Management Challenges And Future Needs For Care And Research, A H Jokhio, Simon M Bell, Mohammad Wasay, Arshad Majid

Pakistan Journal of Neurological Sciences (PJNS)

An estimated 10 million cases of Tuberculosis (TB) and 1.6 million deaths due to this disease occurred worldwide in 2017 (1). About 1.7 billion people, 23% of the world’s population are estimated to have latent TB infection and are thus at risk of developing active TB disease during their life time. TB is mostly common in developing countries and Pakistan ranks 5th among 30 high-burden countries and 5th for Drug Resistant TB (DRTB). The incidence of TB in Pakistan is 267 per 100,000 (1) with an estimated 525,000 cases in 2017 including 57,000 cases among those who were less than …

Acute Colonic Pseudo Obstruction (Ogilvie Syndrome) In A Patient With Hemorrhagic Stroke: A Case Report., Muhammad Dawood Sohail, Haroon Khan, Zainab Alam, Sardar M Alam

Pakistan Journal of Neurological Sciences (PJNS)

Acute colonic pseudo-obstruction (ACPO) or Ogilvie syndrome is a functional motility disorder of the colonic bowel without any organic or mechanical obstruction. Autonomic disturbance which is one of the underlying factors that can lead to Ogilvie syndrome, is caused by stroke. Acute colonic pseudo- obstruction (ACPO) in the setting of stroke is not often reported in medical literature. Various modalities of treatment strategies are recommended including conservative approaches, medical therapies, endoscopic and surgical procedures. We will discuss a patient suffering from a hemorrhagic stroke in the right basal ganglia that developed Acute Colonic Pseudo Obstruction and improved subsequently with conservative …

Associations Of Outdoor Fine Particulate Air Pollution And Cardiovascular Disease In 157 436 Individuals From 21 High-Income, Middle-Income, And Low-Income Countries (Pure): A Prospective Cohort Study, Perry Hystad, Andrew Larkin, Sumathy Rangarajan, Khalid F. Alhabib, Álvaro Avezum, Kevser Burcu Tumerdem Calik, Jephat Chifamba, Antonio Dans, Rafael Diaz, Romaina Iqbal

Community Health Sciences

Background: Most studies of long-term exposure to outdoor fine particulate matter (PM2·5) and cardiovascular disease are from high-income countries with relatively low PM2·5 concentrations. It is unclear whether risks are similar in low-income and middle-income countries (LMICs) and how outdoor PM2·5 contributes to the global burden of cardiovascular disease. In our analysis of the Prospective Urban and Rural Epidemiology (PURE) study, we aimed to investigate the association between long-term exposure to PM2·5 concentrations and cardiovascular disease in a large cohort of adults from 21 high-income, middle-income, and low-income countries.
Methods: In this multinational, prospective cohort study, we studied 157 436 …

Determinants Of Occupational Hazards Knowledge And Safety Practices Among Textile Workers In Karachi, Pakistan: A Cross Sectional Study, Natasha Shaukat, Hasan Nawaz Tahir, Tanzil Jamali, Mohammed Moizul Hassan, Asaad Ahmed Nafees

Community Health Sciences

Objective: To determine the factors associated with good knowledge and safe practices regarding occupational hazards among textile workers.
Methods: The cross-sectional study was conducted in Karachi from September 2015 to February 2016, and comprised male workers from seven textile mills. A 45-item structured questionnaire was developed and pretested in Urdu, the local language. One part of the questionnaire comprised 31 items related to good knowledge, and the other part comprised 14 items related to safe practices. Data was analysed using SPSS 19.
Results: Of the 300 subjects, 123(41%) were aged 18-27 years, 183(63%) were educated, 184(61.3%) worked more than eight …

Emergency Preparedness And Response To The Covid-19 Pandemic: Our Experience From The Emergency Department Of A Tertiary Care Hospital In Pakistan, Badar Afzal Khan, Noman Ali, Asad Mian

Department of Emergency Medicine

No abstract provided.

Labrad : Vol 46, Issue 2 - June 2020, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

• Pathophysiology of Lung Injury in Context with Novel Coronavirus 2019
• Imaging in COVID-19 Pandemic: Salient Features
• Qualitative Real-Time RT-PCR For Detection of SARS-Cov-2 RNA
• Coagulopathy and Anticoagulants in COVID-19
• AKUH Blood Bank During SARS-COV-2 Outbreak
• Significance of COVID-19 Whole Genome Sequencing
• Convalescent Plasma Therapy for COVID-19
• COVID-19: An Alarm Bell for Healthcare System in Pakistan!
• Emergency Online Undergraduate Medial Education During COVID 19
• Adopting Virtual Teaching During the Pandemic-An Overview of the Utility of ‘Microsoft Teams’ from an Educator’s Perspectiv
• The Best of the Recent Past
• Polaroid

Correlates Of Health-Related Quality Of Life Among Adults Receiving Combination Antiretroviral Therapy In Coastal Kenya, Moses K. Nyongesa, Paul Mwangi, Stanley Wanjala, Agnes M. Mutua, Hans M. Koot, Pim Cuijpers, Charles R. J. C. Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Health-related quality of life (HRQoL) is an important metric of perceived wellbeing in people living with HIV/AIDS (PLWHA). However, research on HRQoL among PLWHA in sub-Saharan Africa is limited. This study investigates factors associated with HRQoL among PLWHA in Kilifi, coast of Kenya.

Methods: Between February and April 2018, 450 adults living with HIV and on combined antiretroviral therapy (cART) between 18 to 60 years were sequentially recruited from an HIV-specialized clinic. The Functional Assessment of HIV Infection (FAHI) questionnaire, previously adapted for assessing HRQoL in this setting, was slightly modified and administered to participants alongside other …

Effects Of Vitamin D Deficiency On Neurobehavioural Outcomes In Children: A Systematic Review, Agnes M. Mutua, Reagan M. Mogire, Alison M. Elliott, Thomas N. Williams, Emily L. Webb, Amina Abubakar, Sarah H. Atkinson

Institute for Human Development, East Africa

Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age.

Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as …

Prevalence Of Vitamin D Deficiency In Exclusively Breastfed Infants At A Tertiary Healthcare Facility In Nairobi, Kenya, Nusrat Abubakar, Rose Kamenwa, Mary Limbe, Mitchel Otieno Okumu, William Macharia

Paediatrics and Child Health, East Africa

Objective: To determine the prevalence of vitamin D deficiency (VDD) in exclusively breastfed infants at the Aga Khan University Hospital Nairobi, Kenya (AKUHN). The relationships between 25-hydroxyvitamin D; 25OHD, parathyroid hormone (PTH), maternal vitamin D supplementation, and sunlight exposure were also determined.

Subjects and methods: Blood from 98 infants was assayed for 25OHD, calcium, phosphate, and PTH. Socio-demographic and clinical characteristics were analyzed using descriptive statistics and inferential analysis (p < 0.05).

Results: The prevalence of VDD (25OHD <12 ng/mL), vitamin D insufficiency (VDI, 25OHD 12-20 ng/mL) and vitamin D sufficiency (VDS, 25OHD >20 ng/mL) was 11.2% (95% CI 8.0%-14.4%), 12.2% (95% CI 8.9%-15.5%), and 76.5% (95% CI 72.3%-80.8%) respectively. There was no difference in the …

Leaving No One Behind: Towards Equitable Global Elimination Of Hepatitis C, Elin Hoffmann Dahl, Hassaan Zahid, Khawar Aslam, Wasim Jafri

Section of Gastroenterology

No abstract provided.

Comparison Of Staphylococcus Aureus Nasal Carriage By Patients And Healthcare Workers In Selected Dialysis Centers In Nairobi And Neighbouring Counties, Enock Serem

Master of Medicine in Clinical Pathology

Background: Staphylococcus aureus (S. aureus) is a significant pathogen that causes both community and hospital acquired infections. The burden of S. aureus morbidity and mortality is disproportionately high in patients with end stage kidney disease undergoing dialysis. With the rising prevalence of non-communicable diseases leading to end stage renal disease and dialysis, the impact of S. aureus infections is projected to rise. Knowledge of nasal carriage of S. aureus and their antibiotic resistance profiles is essential in improving patient care through planning of infection prevention and control strategies as well as formulating appropriate empiric antibiotic guidelines. The aim of this …

Insight Into Covid-19 Responses And Initiatives From Pakistan, Salima Farooq, Sonia Ijaz Haider, Saima Sachwani, Yasmin Parpio

School of Nursing & Midwifery

The coronavirus pandemic is a rapidly evolving outbreak that has tremendously distressed people worldwide. The paper aims to present some key rapid responses and initiatives to COVID-19 undertaken in Pakistan. The information has been gathered by reviewing material and documents pertinent to COVID-19 in the context of Pakistan. The incidences of COVID-19 cases are gradually increasing; however, the case fatality rate is relatively lower in Pakistan as compared to developed countries. The government has taken massive actions, in terms of lockdowns, quarantine homes, testing facilities, closure of schools, and mass gatherings at places, to combat COVID-19. However, the measures seem …

Covid-19: The New Corona Virus Upsetting Our World, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Reflections: Bravo Breastfeeding Mother! A Covid Positive Mother And Midwifery Instinct, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Developing And Piloting A Midwifery Audit Tool In Bangladesh’S Upazila Health Complexes (Uhcs), Achiya Khatun, Mahfuja Aktar Jhumu, Sarah Gregson, Joy Kemp

Journal of Asian Midwives (JAM)

Midwifery is a new profession in Bangladesh. Diploma-prepared midwives were first deployed in 2018. Recent studies suggest that newly qualified midwives in Bangladesh may not be able to fully perform their midwifery role due to a number of complex factors. This paper describes a pilot study of a midwifery audit undertaken in 2019 by the Bangladesh Midwifery Society, supported by the Royal College of Midwives. These two organisations are in a formal twinning partnership funded by UNFPA Bangladesh with support from UK-Aid, Sweden and Canada. The audit was successful in improving the quality of midwifery care and addressing health system …

Health Care Provider’S Perspectives On The Content And Structure Of A Culturally Tailored Antenatal Care Programme To Expectant Parents And Family Members In Nepal, Annika Ekström, Laxmi Tamang, Christina Pedersen, Ulrika Byrskog, Edwin Van Teijlingen, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

Background: In Nepal childbirth is one of the most vulnerable periods of a woman's life and knowledge about the normal birth process, as well as danger signs, could be a life-saving intervention. Antenatal care programmes are therefore particularly relevant in Nepal where women deliver on their own in rural areas as well as in facility and hospital settings.

Aim: This study aimed to describe the relevant content and structure of a culturally tailored antenatal care programme in Nepal to be developed from the input of healthcare providers.

Methods: Qualitative semi-structured interviews with 26 health care providers were analyzed using Elo …

Identifying And Understanding Factors That Affect The Translation Of Therapies From The Laboratory To Patients: A Study Protocol, Manoj M. Lalu, Joshua Montroy, C Glenn Begley, Tania M. Bubela, Victoria Hunniford, David Ripsman, Neil Wesch, Jonathan Kimmelman, Malcolm Macleod, David Moher

Office of the Provost

Background: The process of translating preclinical findings into a clinical setting takes decades. Previous studies have suggested that only 5-10% of the most promising preclinical studies are successfully translated into viable clinical applications. The underlying determinants of this low success rate (e.g. poor experimental design, suboptimal animal models, poor reporting) have not been examined in an empirical manner. Our study aims to determine the contemporary success rate of preclinical-to-clinical translation, and subsequently determine if an association between preclinical study design and translational success/failure exists.
Methods: Established systematic review methodology will be used with regards to the literature search, article screening …

Obstructive Sleep Apnea In Middle Age Male Smokers, Muhammad Hassan, Saad Ali Ansari, Farzana Salman, Raafay Kamal Khan, Waleed Shahzad, Ehsan-Ur- Rehman, Omer Hassaan, Aftab Ahmed, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

OBJECTIVE: Obstructive sleep apnea is the most common type of sleep apnea. This was designed to establish the relationship between smoking and obstructive sleep apnea. Methods:This cross-sectional study was conducted at the outpatient department of Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from August 2018 to November 2018 (dates mentioned in methods are different) and comprised of males aged 30-50 years. Participants were divided into two groups of smokers and non-smokers and Berlin questionnaire was used to collect data employing systemic random sampling. SPSS 22 was used for analysis. Results:There were 768 male participants in the study equally split between …

A Review Of Brain Death Protocols Across The Globe And Need For Brain Death Guideline For Pakistan., Mohammad Wasay, Syeda Batool Mujtaba, Mughis Sheerani, Saleem Barech, Rashid Jooma

Pakistan Journal of Neurological Sciences (PJNS)

The concept of brain death was first formally presented in United States of America in 1968 (Ad Hoc Committee of the Harvard Medical School to examine the definition of Brain Death, 1968) in part to facilitate organ donation. It is a widely accepted term in most countries but some like Japan do not consider it as death. According toAAN, brain death is defined as death due to irreversible loss of function of the entire brain — comparable to circulatory death, which is defined as irreversible loss of function of the circulatory system. The purpose of our study is to review …

Factors Influencing Severity In Acute Ischemic Strokes, Inam E Khuda, Intisar Siddiqui, Saad Munzar, Rashid Nazir, Arsalan Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Background: Stroke severity is one of the factors that determines stroke related disability. We explored possible associations between stroke severity and commonly evaluated clinical parameters of stroke patients. Objective: To determine the relationships between clinical features including routine in- hospital investigations done in first 24 hours of admission and variations in the stroke severity. Patients and Methods: This was a retrospective, analytical study performed in the Department of Neurology at Shifa International Hospital, Shifa Tameer-e-Millat University, Islamabad, Pakistan. Adult patients admitted with ischemic stroke, over a period of 39 months, with Middle Cerebral Artery infarctions, were included. National Institute of …

Knowledge And Use Of The International Classification Of Functioning, Disability And Health (Icf) Among Health Professionals In A Developing Country, Sidra K. Jafri, Olaf Kraus De Camargo

Pakistan Journal of Neurological Sciences (PJNS)

The World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF) provides a biopsychosocial framework for understanding all the factors that should be considered while managing any health condition. The ICF has been employed for clinical, academic, research, and policymaking purposes in developed as well as developing countries. There is a great disparity in the representation in the literature regarding knowledge and potential application of the ICF in professional practice around the world especially from low middle-income countries like Pakistan. This study aims to evaluate the profile and knowledge of health professionals in Pakistan about the application of …

Concussion: A Review Of Epidemiology, Presentation And Treatment., Sidra Saleem, Arsalan Anwar, Fahham Asghar, Muhammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

A direct impact on the head can cause a Mild Traumatic Brain Injury or Concussion. It is a neuronal brain injury with or without loss of consciousness. Each year, approximately 69 million people are estimated to suffer from Concussion. Around 80-90% of these Concussion cases resolve within a week. The most commonly reported post-concussion symptoms include headache, cognitive changes, sleep disturbances, and depression. Essential in the approach to patients with concussion includes a detailed history taking and physical examination. Imaging modalities like Magnetic Resonance Images (MRI) of the brain may not show any significant changes; therefore more sensitive tests, like …

A Rare Presentation Of Pulmonary Sarcomatoid Carcinoma With Left Atrial Involvement And Spinal Metastasis Presenting With An Ischemic Infarct., Hina Imtiaz, Muhammad Dawood Amir Sheikh

Pakistan Journal of Neurological Sciences (PJNS)

Pulmonary Sarcomatoid Carcinoma is a rare, aggressive tumor comprising of both epithelial and mesenchymal cells. It is important to distinguish it from other lung tumors due to its poor prognosis and extensive metastasis. We present a case of a 36 year old female patient who initially presented with right sided weakness and slurred speech due to an ischemic infarct of the left basal ganglia. Further workup revealed a lung mass extending to the left atrium with spinal metastasis. Sarcomatoid Carcinoma remains a diagnostic challenge due to its early recurrence and atypical presentation.

Movement Disorder Associated With Celiac Disease And Thyroid Dysfunction:Case Report, Ramla Nayaib Hashmi, Ummul Kiram, Rabbia Tariq

Pakistan Journal of Neurological Sciences (PJNS)

Autoimmune movement disorders are uncommon yet likely treatable conditions. It is challenging to diagnose and manage these disorders, ultimately leading to a significant morbidity in terms of functional disability of patient. It is troublesome for practicing neurologists to identify whether the antibodies which are detected during the work up of these autoimmune movement disorders are merely incidental or have pathogenic role. This will help them to decide regarding whether to start immunotherapy or not. Here we have discussed two patients of movement disorder who were found to have positive work up for other autoimmune diseases. Available Literature on autoimmune movement …

Effects Of Intermittent Fasting On Taste Modulation And Perception, Sajid Hameed, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.