Medicine and Health Sciences Commons^™

Intellectual Wellness Awareness: A Neglected Area In Medical Universities Of Pakistan, Ayesha Saba Naz, Rehana Rehman, Shah Jahan Katpar, Mehwish Hussain

Department of Biological & Biomedical Sciences

Abstract

Objective: To compare the presence of intellectual wellness awareness in students of public and private sector

medical colleges in a metropolitan city.

Methods: The cross-sectional questionnaire-based survey was conducted from March to November 2011 at Bahria

University Medical and Dental College, Karachi, and overall covered five private and 3 public sector medical colleges of the

city. The study randomly selected 800 medical students. The responses -- never, sometimes, mostly and always (numbered

0-4) - were analysed in terms of frequency, proportion and percentages using Predictive Analysis Software version 18.

Results: Of the 800 forms distributed, 736(92%) completed forms were …

Pharmacy Newsletter : September 2014, Pharmacy Department

Department of Pharmacy Archives

Content:

• Pharmacy managed Polio immunization services
• FDA Pharmacy News Flash
• New weapons against MRSA
• Pencillin allergy and cross reactivity among beta lactams
• Inhales at Aga Khan University Hospital pharmacy services
• Proud to report

Approaches To Improve Quality Of Care (Qoc) For Women And Newborns: Conclusions, Evidence Gaps And Research Priorities, Zulfiqar Ahmed Bhutta, Rehana A. Salam, Zohra S. Lassi, Anne Austin, Ana Langer

Department of Paediatrics and Child Health

Despite progress in recent years, an estimated 273,500 women died as a result of maternal causes in 2010. The burden of these deaths is disproportionately bourne by women who reside in low income countries or belong to the poorest sectors of the population of middle or high income ones, and it is particularly acute in regions where access to and utilization of facility-based services for childbirth and newborn care is lowest. Evidence has shown that poor quality of facility-based care for these women and newborns is one of the major contributing factors for their elevated rates of morbidity and mortality. …

Who Guidance Grounded In A Comprehensive Approach To Sexual And Reproductive Health And Human Rights: Topical Pre-Exposure Prophylaxis, Manjula Lusti-Narasimhan, Rajat Khosla, Rachel Baggaley, Marleen Temmerman, Elizabeth Mcgrory, Tim Farley

Obstetrics and Gynaecology, East Africa

Introduction: Two new microbicide products based on topical (vaginal) application of antiretroviral drugs – 1% tenofovir gel and the dapivirine ring – are currently in late-stage clinical testing, and results on their safety and effectiveness are expected to become available in early 2015. WHO guidelines on the use of topical pre-exposure prophylaxis (topical PrEP) are important in order to ensure that these new prevention products are optimally used.

Discussion: Given that these new topical PrEP products are designed to be woman initiated and will likely be delivered in reproductive health settings, it is important to ensure that the …

Patients’ Visual Experience During Phacoemulsification Cataract Surgery And Associated Fear, Tanveer Anjum Chaudhry, Amash Aqil, Kanza Aziz, Ammar Asrar Javed, Mohammad Zain Tauqir, Khabir Ahmad

Department of Surgery Docs

Abstract Background: Data from several published studies indicate that patients undergoing phacoemulsification cataract surgery can experience a variety of visual sensations which can result in fear. This phenomenon has not been studied in Pakistan to-date. We examined the visual experience and its associated fear among patients undergoing phacoemulsification cataract surgery under topical anaesthesia. Methods: This cross-sectional study was carried out in Aga Khan University Hospital, a tertiary care hospital, in Karachi, Pakistan from August 2010 to July 2011. Adults >18 years of age scheduled to undergo cataract surgery (phacoemulsification with intraocular lens implantation) under topical anaesthesia by a single surgeon …

The Accuracy Of Three-Dimensional Bladder Ultrasonography In Determining The Residual Urinary Volume Compared With Conventional Catheterisation, Imran K. Jalbani, Hammad Ather

Department of Surgery Docs

Abstract

OBJECTIVE:

To determine the accuracy of three-dimensional bladder ultrasonography (US, using the BVI 3000, Verathon, WA, USA) for determining the residual urinary volume, compared with the conventional catheterisation method.

PATIENTS AND METHODS:

We conducted a cross-sectional study at day-care unit of a University hospital after obtaining approval from the Ethics Review Committee of the hospital. Thirty-four patients with lower urinary tract symptoms requiring cystometrography were included. The postvoid volume was measured by bladder US, with three readings taken, and then patient was catheterised using a 12-F Nelaton catheter to measure the urinary volume. The mean of the three readings …

The Leaking Pocket: The Implicit Struggle For Skilled Health Workers Between Private Not-For-Profit And Public Sector In Tanzania, Kahabi Isangula, Sharon Brownie

School of Nursing & Midwifery, East Africa

Public health services in sub-Sahara Africa countries face severe health workforce shortages exacerbated by both outward migration and internal public to private sector migration—Tanzania is no exception. This review was conducted to characterize the extent of health workforce shortages in Tanzania, and the factors impacting on the shortage. The authors reviewed publicly available data to assess the extent of health workforce shortages within Tanzania and the range of ‘pull’ and ‘push’ factors contributing to the shortages. Findings highlight significant health workforce shortages in Tanzania. Pull factors, the advantages offered that 'pull' workers towards the new jobs and well as Push …

Vogt-Koyanagi-Harada Syndrome, Sharmeen Akram, Khabir Ahmad

Department of Surgery Docs

ABSTRACT Vogt-Koyanagi-Harada (VKH) syndrome is a rare multisystem disease of melanocyte containing organs. It is characterized by diffuse granulomatous inflammation involving various organs including eye. VKH syndrome is usually sporadic, but some familial cases have also been reported indicating a hereditary basis. VKH is not associated with mortality but it may result in long-term complications such as decreased vision associated with cataract, glaucoma and choroidal neovascularization. For successful outcomes, early aggressive treatment using systemic steroids with gradual tapering is essential. This report describes a case of VKH syndrome in a 26-year-old male of Pakistan origin who was successfully treated with …

Introduction Of A New Vaccine In Epi; What We Can Achieve From A Programme In Failure, Sana Tanzil, Tanzil Jamali, Narjis Rizvi

Community Health Sciences

No abstract provided.

The Government Of Kenya Cash Transfer For Orphaned And Vulnerable Children: Cross-Sectional Comparison Of Household And Individual Characteristics Of Those With And Without, Lukoye Atwoli, Lonnie Embleton, Julius Koech, Paula Braitstein, Allan Kamanda

Internal Medicine, East Africa

Background: The ‘Cash Transfer to Orphans and Vulnerable Children’ (CT-OVC) in Kenya is a government-supported program intended to provide regular and predictable cash transfers (CT) to poor households taking care of OVC. CT programs can be an effective means of alleviating poverty and facilitating the attainment of an adequate standard of living for people’s health and well-being and other international human rights. The objective of this analysis was to compare the household socioeconomic status, school enrolment, nutritional status, and future outlook of orphaned and separated children receiving the CT compared to those not receiving a CT.

Methods: This project analyzes …

Chromosomal Abnormalities In Primary Myelodysplastic Syndrome, Anila Rashid, Mohammad Khurshid, Usman Shaikh, Salman Adil

Department of Pathology and Laboratory Medicine

Objective: To determine the frequency of cytogenetic abnormalities in patients diagnosed as primary myelodysplastic syndrome (MDS) using conventional karyotyping. Study Design: Case series. Place and Duration of Study: The Clinical Laboratory, The Aga Khan University Hospital, Karachi, between January 2006 - June 2012. Methodology: Patients of all ages and either gender who fulfilled WHO criteria for MDS were included. Cytogenetic analysis was conducted at the time of diagnosis. Patients who had secondary MDS were excluded from analysis. Chromosome identification and karyotype description was done according to the International System for Chromosome Nomenclature (ISCN, 1995) and described as frequency percentage. Results: …

Coronary Artery Dissection After Blunt Chest Trauma., Fahad Shamsi,, Javed Tai, Syedah Saira Bukhari

Department of Medicine

Blunt thoracic trauma may result in cardiac injuries ranging from simple arrhythmias to fatal cardiac rupture. Coronary artery dissection culminating in acute myocardial infarction (AMI) is rare after blunt chest trauma. Here we report a case of a 37-year-old man who had an AMI secondary to coronary dissection resulting from blunt chest trauma after involvement in a physical fight.

Prospective Validation Of A Blood Ordering Protocol For Elective Spine Arthrodesis And Its Impact On Cost Reduction, Muhammad Waqas, Muhammad Shahzad Shamim, Badar Uddin Ujjan, Saqib Kamran Bakhshi

Section of Neurosurgery

Background: On the basis of an institutional audit, the authors published an individual patient-based protocol for preoperative arrangement of blood products in patients undergoing elective spine arthrodesis. The present study was conducted for the prospective validation of the proposed protocol in reducing cross match to transfusion ratio, and its implications on overall cost.
Methods: This cross-sectional study was conducted over 1 year (2012). All adult patients who underwent elective spinal arthrodesis were included and prospectively observed. The actual transfusion index was calculated for individual patients with the formula C1/T, where C1 is the number of units of packed RBCs cross …

Prevalence And Evolution Of Intimate Partner Violence Before And During Pregnancy: A Cross-Sectional Study, An-Sofie Van Parys, Ellen Deschepper, Kristien Michielsen, Marleen Temmerman, Hans Verstraelen

Obstetrics and Gynaecology, East Africa

Background: Intimate partner violence (IPV) before and during pregnancy is associated with a broad range of adverse health outcomes. Describing the extent and the evolution of IPV is a crucial step in developing interventions to reduce the health impact of IPV. The objectives are to study the prevalence of psychological abuse, as well as physical & sexual violence, and to provide insight into the evolution of IPV 12 months before and during pregnancy.

Methods: Between June 2010 and October 2012, a cross-sectional study was conducted in 11 antenatal care clinics in Belgium. Consenting pregnant women were asked to complete a …

Community Perceptions Of Rape And Child Sexual Abuse: A Qualitative Study In Rural Tanzania, Muzdalfat Abeid, Projestine Muganyizi, Pia Olsson, Elisabeth Darj, Pia Axemo

Faculty of Health Sciences, East Africa

Background

Rape of women and children is recognized as a health and human rights issue in Tanzania and internationally. Exploration of the prevailing perceptions in rural areas is needed in order to expand the understanding of sexual violence in the diversity of Tanzania’s contexts. The aim of this study therefore was to explore and understand perceptions of rape of women and children at the community level in a rural district in Tanzania with the added objective of exploring those perceptions that may contribute to perpetuating and/or hindering the disclosure of rape incidences.

Methods

A qualitative design was employed using focus …

Women's Empowerment And Contraceptive Use: The Role Of Independent Versus Couples' Decision-Making, From A Lower Middle Income Country Perspective, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque Sheikh, Ghazunfer Abbas, Marleen Temmerman, Bilal Iqbal Avan

Community Health Sciences

Introduction: There is little available evidence of associations between the various dimensions of women's empowerment and contraceptive use having been examined--and of how these associations are mediated by women's socio-economic and demographic statuses. We assessed these phenomena in Pakistan using a structured-framework approach.
Methods: We analyzed data on 2,133 women who were either using any form of contraceptive or living with unmet need for contraception. The survey was conducted during May - June 2012, with married women of reproductive age (15-49 years) in three districts of Punjab. The dimensions of empowerment were categorized broadly into: economic decision-making, household decision-making, and …

Women's Empowerment And Contraceptive Use: The Role Of Independent Versus Couples' Decision-Making, From A Lower Middle Income Country Perspective, Waqas Hameed, Syed Khurram Azmat, Moazzam Ali, Muhammad Ishaque Sheikh, Ghazunfer Abbas, Marleen Temmerman, Bilal Iqbal Avan

Obstetrics and Gynaecology, East Africa

Introduction: There is little available evidence of associations between the various dimensions of women’s empowerment and contraceptive use having been examined - and of how these associations are mediated by women’s socio-economic and demographic statuses. We assessed these phenomena in Pakistan using a structured-framework approach.

Methods: We analyzed data on 2,133 women who were either using any form of contraceptive or living with unmet need for contraception. The survey was conducted during May - June 2012, with married women of reproductive age (15–49 years) in three districts of Punjab. The dimensions of empowerment were categorized broadly into: economic decision making, …

The Role Of Inflammation In Contrast-Induced Nephropathy, Elijah Kwasa, Sudhir Vinayak, Robert Armstrong

Imaging & Diagnostic Radiology, East Africa

Objective: Global incidence of contrast-induced nephropathy (CIN) is 2-5%, but a recent Kenyan study highlighted a local incidence of 12-14% without offering an explanation for the higher incidence. This study proposes that inflammatory states confer a higher relative risk for development of CIN. Our objective was to determine the risk of developing CIN given the presence of an inflammatory state in patients in Kenya.

Methods: Prospective cohort study of patients undergoing a contrast-enhanced CT (CECT) scan in a private university teaching hospital in Kenya and having no known risk factors for CIN. 423 patients were recruited and grouped into those …

Lumbar Morphometry: A Study Of Lumbar Vertebrae From A Pakistani Population Using Computed Tomography Scans, Muhammad M. Alam, Muhammad Waqas, Hussain Shallwani, Gohar Javed

Section of Neurosurgery

Study design: A cross-sectional study.
Purpose: To describe the characteristics of lumbar vertebrae of Pakistani patients reporting at a tertiary care hospital and compare with studies from other populations.
Overview of literature: Several studies have been conducted to determine morphometry of lumbar vertebrae. Most of the studies involve Caucasian populations, still data on other populations still sparse. This is the first study describing lumbar morphometry of a Pakistani population.
Methods: An observational study was conducted based on a review of thin-cut (3 mm) computed topographic images of lumbar vertebrae. Two-hundred and twenty vertebrae from forty-nine patients were studied, and various …

Teachers’ Accounts Of Their Perceptions And Practices Of Providing Written Feedback To Nursing Students On Their Assignments, Sajid Iqbal, Raisa Gul, Arusa Lakhani, Nusrat Fatima Rizvi

School of Nursing & Midwifery

Written feedback can facilitates students’ learning in several ways. However, the teachers’ practice of written feedback may be affected by various factors. This study aimed to explore the nurse teachers’ accounts of their perceptions and practices of providing written feedback.

A descriptive exploratory design was employed in the study. A purposive sample of 12 teachers from nursing institutions in Karachi, Pakistan, participated in the study. Using a semi-structured guide, in-depth interviews were conducted with the participants, between January-September, 2013. The interviews were tape recorded and transcribed verbatim and were manually content analyzed.

The analysis of findings led to three sections: …

Diuretic Induced Hyponatremia In Hypertensive Patients., Aysha Almas, Nayla Ahmed, Fareed Khawaja, Aamir Hameed

Department of Medicine

Diuretics are the recommended antihypertensive by several international guidelines. This study was designed to determine the association of hyponatremia in hypertensive patients on diuretic therapy. This was a case control study conducted at the Aga KhanUniversity Hospital, Karachi in adult inpatients (> 18 years) who were known hypertensive. Cases were defined as hypertensives with hyponatremia and controls were defined as hypertensives without hyponatremia. Outcome was hyponatremia. Exposed were those using diuretics. Out of 1800 hypertensive patients sampled by the ICD-9-Coding; 1191 (66%) fulfilled the inclusion criteria. Cases n (%) were 553 (46.4) and controls were 638 (53.5). Among 553 cases …

Of Predatory Publishers And Spurious Impact Factors, Saba Sohail

Department of Radiology

No abstract provided.

Empyema Thoracis In Children: Clinical Presentation, Management And Complications, Ali Faisal Saleem, Abdul Sattar Shaikh, Reema Sajjad Khan, Fazal Khan, Ahmad Vaqas Faruque, Muhammad Arif Mateen Khan

Department of Paediatrics and Child Health

Objective: To determine the etiology, clinical manifestation, management (medical and surgical) and complications of children with empyema thoracis in a tertiary care hospital from Karachi, Pakistan.

Study Design: Descriptive, analytical study.

Place and Duration of Study: Department of Surgery, The Aga Khan University Hospital, Karachi, from January 1996 to December 2010.

Methodology: Medical records of admitted children aged > a month to 15 years with discharge diagnosis of empyema thoracis and data was collected on demographic features, clinical manifestation, management and complications. Children managed medically were compared with those managed surgically by using interquartile range and median comparison. Mann-Whitney U test …

Subacute Sclerosing Panencephalitis: Clinical And Demographic Characteristics, Arshad Rafique, Nida Amjad, Prem Chand, Syed Sohail Zahoor Zaidi, Muhammad Suleman Rana, Khalid Ahmed, Shahnaz Ibrahim

Department of Paediatrics and Child Health

Objective: To determine the clinical and demographic characteristics of children diagnosed with Subacute sclerosing panencephalitis (SSPE).

Study Design: Case series.

Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 2000 to June 2012.

Methodology: A retrospective analysis was done, regarding medical charts of 43 children under the age of 16 years with a discharge diagnosis of SSPE. Demographic and clinical characteristics were recorded. Results were expressed as percentages.

Results: Most of the 43 patients were male (72%). The average age at presentation was 8.7 years with average duration of symptoms being 100.6 days. History of …

The Impact Of Alcohol On Hiv Prevention And Treatment For South Africans In Primary Healthcare, Michelle Schneider, Matthew Chersich, Marleen Temmerman, Olivier Degomme, Charles D. Parry

Obstetrics and Gynaecology, East Africa

Background: Antiretroviral treatment (ART) has substantially reduced morbidity and mortality for HIV patients. In South Africa, with the largest ART programme globally, attention is needed not only on the further expansion of ART coverage, but also on factors which undermine its effectiveness, such as alcohol use.

Objective: Given the decentralised approach of nurse-initiated and -sustained ART in the South African primary health sector, it is important to document key aspects of alcohol use to be conveyed to HIV-positive individuals and those at risk for HIV.

Method: This study comprised a narrative review of relevant literature.

Results: Alcohol acts through both …

Factors Associated With Intimate Partner Violence Against Women In A Mega City Of South-Asia: Multi-Centre Cross-Sectional Study, Niloufer S. Ali, Farzana N. Ali, Ali K. Khuwaja, Kashmira Nanji

Department of Family Medicine

Objectives: To assess the proportion of women subjected to intimate partner violence and the associated factors, and to identify the attitudes of women towards the use of violence by their husbands. Design: Cross-sectional study.
Setting: Family practice clinics at a teaching hospital in Karachi, Pakistan.
Participants: A total of 520 women aged between 16 and 60 years were consecutively approached to participate in the study and interviewed by trained data collectors. Overall, 401 completed questionnaires were available for analysis. Multivariate logistic regression analysis was used to identify the association of various factors of interest.
Results: In all, 35% of …

Bilateral Maxillary Canine-First Premolar Transposition In Permanent Dentition, Sarwat Memon, Mubassar Fida

Department of Surgery Docs

ABSTRACT Transposition is a dental anomaly characterized by the exchange of position between two adjacent teeth, especially in relation to their roots, or development and eruption of a tooth in a position normally occupied by a nonadjacent tooth. Transposition of the maxillary canine and first premolar has a low prevalence in the population and it primarily affects maxillary canines and premolars. The aetiology of the transposition remains unclear, although it has been associated with genetic factors. It may also be related to a combination of localised factors such as malformation of adjacent teeth, tooth agenesis, retention of the deciduous canine …

Gestational Headaches: Characteristics And Influencing Factors In South-Western Nigeria, Philip Adebayo, Aramide Mikhail Tijani, Olukayode Abayom, Adeseye Abiodun Akintunde

Internal Medicine, East Africa

Background: factor s Headache is one of the common neurological diseases in pregnancy but its pattern and influencing are yet to be determined in our environment in Nigeria. The aim of this study was to determine the prevalence and characteristics, as well as the modifying factors for gestational headaches in Ogbomoşo, Nigeria.

Methods: This study was a biinsti pregnant women attending the antetutional crosssectional descriptive study. Three hundred and eight (308) eligible natal care of the Ladoke Akintola University of T local government hospitals in Ogbomoso were recruited consecu 2013. Using an interviewer administered questionnaire, sociodemographic, obstetrics and headache related …

Risk And Impact Of Inter-Ictal Depression On Quality Of Life Of Nigerian Women With Epilepsy Of Childbearing Age, Philip Adebayo, Olukayode Abayomi, Shamsideen Abayomi Ogun

Internal Medicine, East Africa

Background: Depression, the most common psychiatry comorbidity in patients with epilepsy is common among women, especially those of reproductive age. Although it could be said that the female gender is a risk factor for depression, the risk of inter-ictal depression and its impact on the quality of life (QoL) of women with epilepsy (WWE) has not been sufficiently studied among Nigerians.

Materials and Methods: In this cross-sectional case–control study, data were collected from 70 women (29 WWE and 41 women without epilepsy) within the age range ≥18 and ≤55 between July 2010 and March 2011. A questionnaire that includes items-related …

Metabolic Remodeling Of White Adipose Tissue In Obesity, Timothy D. Cummins, Candice R. Holden, Brian E. Sansbury, Andrew A. Gibb, Jasmit Shah, Nagma Zafar, Yunan Tang, Jason Hellmann, Shesh N. Rai, Matthew Spite

Brain and Mind Institute

Adipose tissue metabolism is a critical regulator of adiposity and whole body energy expenditure; however, metabolic changes that occur in white adipose tissue (WAT) with obesity remain unclear. The purpose of this study was to understand the metabolic and bioenergetic changes occurring in WAT with obesity. Wild-type (C57BL/6J) mice fed a high-fat diet (HFD) showed significant increases in whole body adiposity, had significantly lower V̇o2, V̇co2, and respiratory exchange ratios, and demonstrated worsened glucose and insulin tolerance compared with low-fat-fed mice. Metabolomic analysis of WAT showed marked changes in lipid, amino acid, carbohydrate, nucleotide, and energy metabolism. Tissue levels of …