Medicine and Health Sciences Commons^™

Genotyping And Drug Resistance Patterns Of M. Tuberculosis Strains In Pakistan., Mahnaz Tanveer, Zahra Hasan, Amna R Siddiqui, Asho Ali, Akbar Kanji, Solomon Ghebremicheal, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background:The incidence of tuberculosis in Pakistan is 181/100,000 population. However, information about transmission and geographical prevalence of Mycobacterium tuberculosis strains and their evolutionary genetics as well as drug resistance remains limited. Our objective was to determine the clonal composition, evolutionary genetics and drug resistance of M. tuberculosis isolates from different regions of the country.

Methods:

M. tuberculosis strains isolated (2003-2005) from specimens submitted to the laboratory through collection units nationwide were included. Drug susceptibility was performed and strains were spoligotyped.

Results:

Of 926 M. tuberculosis strains studied, 721(78%) were grouped into 59 "shared types", while 205 (22%) were identified …

Bullying Of Medical Students In Pakistan: A Cross-Sectional Questionnaire Survey., Syed Ahmer, Abdul Wahab Yousafzai, Naila Bhutto, Sumira Alam, Amanullah Khan Sarangzai, Arshad Iqbal

Department of Psychiatry

Background: Several studies from other countries have shown that bullying, harassment, abuse or belittlement are a regular phenomenon faced not only by medical students, but also junior doctors, doctors undertaking research and other healthcare professionals. While research has been carried out on bullying experienced by psychiatrists and psychiatry trainees in Pakistan no such research has been conducted on medical students in this country. Methodology/Principal Findings: We conducted a cross-sectional questionnaire survey on final year medical students in six medical colleges of Pakistan. The response rate was 63%. Fifty-two percent of respondents reported that they had faced bullying or harassment …

Mesenteric Panniculitis With Pedal Edema In A 33-Year-Old Pakistani Man: A Case Report And Literature Review., Abdul M Zafar, Muhamad A Rauf, Tabish Chawla, Gule Khanda

Department of Radiology

Introduction:Mesenteric panniculitis is a rare pathology of unknown etiology characterized by inflammation and fibrosis in the mesentery. Its protean clinical and radiological manifestations make it a diagnostic challenge. There is no established treatment available for its management. The clinical outcome is inconsistent, with the prognosis ranging from complete resolution without any treatment to rapid progression culminating in death. Case Presentation: A 33-year-old Pakistani man presented with vague abdominal pain, an ill-defined epigastric mass and bilateral pedal edema. A detailed review of his history and laboratory investigations did not point to any diagnosis. The Patient underwent an exploratory laparotomy based …

Improving Oral Health In Pakistan Using Dental Hygienists, Musarrat Anjum Shah

Dental Hygiene Master's Papers and Projects

This document presents a review of the literature addressing education, healthcare, healthcare delivery and finance in Pakistan and the oral health status of the Pakistani people. Considering the enormous unmet oral health needs, the insufficient supply of dental professionals and the current unstructured dental hygiene curriculum in Pakistan, this document offers a mission, vision, and goals for the new dental hygiene theoretical framework for Pakistan. Moreover, it offers recommendations for competency-based dental hygiene education and practice, professional licensing, a practice act, and a dental hygiene scope of practice to help protect the welfare of the Pakistani public, i.e., increasing the …

Transport Time To Trauma Facilities In Karachi: An Exploratory Study., Roomasa Channa, Hira Altaf Jaffrani, Aamir Javed Khan, Talal Hasan, J. Razzak

Department of Emergency Medicine

Background: Rapid urban growth in developing countries has outpaced the development of health infrastructure, including trauma centers, leading to potential delays in trauma care. This study was conducted in Karachi, a city of 16 million people in Pakistan. Aims: Our aim was to determine the time taken to reach the nearest 24-h emergency care facility (ECF) and the government-designated trauma center (TC). We also sought to determine the availability of supplies and equipment required for "basic" trauma care at these centers.
Methods:We selected five towns in Karachi that had the highest number of road traffic injuries (RTIs) (as identified …

Changing Patterns And Outcome Of Dengue Infection; Report From A Tertiary Care Hospital In Pakistan, Mohammad Wasay, Roomasa Channa, Maliha Jumani, Afia Zafar

Department of Medicine

Objective: To identify predictors of outcome in patients with Dengue Infections at a tertiary care hospital and to analyze that if pattern of Dengue infection is changing in the past two years.

Methods: We reviewed 225 cases of confirmed dengue virus infection. The diagnosis was confirmed by presence of IgM antibodies against Dengue by ELISA in addition to fever according to WHO criteria.

Results: From years 2000-2004, 30(73%) had Dengue Fever (DF), 10(24%) had Dengue Haemorrhagic Fever (DHF) and 1(2.4%) had Dengue shock syndrome (DSS) while after 2005, 107(58%) had DF, 71(39%) had DHF and 6(3%) had DSS. Six …

Characteristics Of Tia And Its Management In A Tertiary Care Hospital In Pakistan, Ayeesha Kamal, Farhad Khimani, Rushna Raza, Sahar Zafar, Salman Bandeali, Sayeedullah Jan

Section of Neurology

Background:Transient ischemic attack (TIA) is described as a brief episode of neurological dysfunction caused by focal brain ischemia, with clinical symptoms typically lasting less than an hour, and without evidence of acute infarction. Recent studies depict TIA as a particularly unstable condition. Risk of stroke is greater than 10% in the first 90 days after an index TIA. The presentation, prognosis and intervention for TIA have not been reported in South-Asians in a developing country. Method: A retrospective chart review was done for 158 Patients who were admitted with the diagnosis of TIA, as defined by ICD 9 code …

Association Between Antipsychotics And Weight Gain Among Psychiatric Outpatients In Pakistan: A Retrospective Cohort Study., Syed Ahmer, Rashid A. M Khan, Saleem Perwaiz Iqbal

Department of Psychiatry

Background: It has been known for a long time that use of antipsychotics, particularly atypical antipsychotics, is associated with weight gain and increase in risk of metabolic disturbances. In this study we have tried to find out if use of antipsychotics is associated with increase in weight and body mass index (BMI) in the Pakistani population. Methods: We performed a case note review of all Patients who had been prescribed antipsychotic medication at the psychiatry outPatient clinic of a tertiary care university hospital in Pakistan over a 4-year period. Results: A total of 50% of Patients had a BMI in …

Drug-Prescribing Patterns During Pregnancy In The Tertiary Care Hospitals Of Pakistan: A Cross Sectional Study., Dileep K Rohra, Nirmal Das, Syed I Azam, Nazir A Solangi, Zahida Memon, Abdul M Shaikh, Nusrat H Khan

Department of Biological & Biomedical Sciences

Background: The rationale for use of drugs during pregnancy requires a careful assessment as in addition to the mother, the health and life of her unborn child is also at stake. Information on the use of drugs during pregnancy is not available in Pakistan. The aim of this study was to evaluate the patterns of drug prescriptions to pregnant women in tertiary care hospitals of Pakistan. Methods: This was a cross-sectional study conducted at five tertiary care hospitals of Pakistan. Copies of outPatient medicinal prescriptions given to pregnant Patients attending the antenatal clinics were collected. The drugs were classified according …

Assessing Emergency Medical Care In Low Income Countries: A Pilot Study From Pakistan., Junaid A. Razzak, Adnan A Hyder, Tasleem Akhtar, Mubashir Khan, Uzma R. Khan

Department of Medicine

Background: Emergency Medical Care is an important component of health care system. Unfortunately it is however, ignored in many low income countries. We assessed the availability and quality of facility-based emergency medical care in the government health care system at district level in a low income country - Pakistan. Methods: We did a quantitative pilot study of a convenience sample of 22 rural and 20 urban health facilities in 2 districts - Faisalabad and Peshawar - in Pakistan. The study consisted of three separate cross-sectional assessments of selected community leaders, health care providers, and health care facilities. Three data collection …

Stroke In Pakistan, Bhojo A Khealani, Bilal Hameed, Uzma U Mapari

Section of Neurology

Stroke is the most common cause of disability and a leading cause of mortality world wide. Though the incidence is falling in West but probably is rising in Asia. The burden of stroke risk factors in Pakistan is enormous e.g. by 2020 Pakistan will be 4th most populous country in terms of diabetic patients. Similarly every 3rd person above age of 45 years has hypertension. Ironically a great majority of these patients are unaware of their diagnosis. This is further complicated by the fact that most of diagnosed patients have uncontrolled hypertension, as a result of poor compliance on patients …

Time Trends In The Incidence Of Cancer Cervix In Karachi South, 1995-2002, Yasmin Bhurgri, Shahid Pervez, Naila Kayani, Muneeza Afif, Imran Tahir, Kauser Nazir, Ahmed Usman, Naveen Faridi, Hadi Bhurgri, Jawaid Malik, Imtiaz Bashir, Asif Bhurgri, Rashida Ahmed, Sheema H Hasan, Mohammad Khurshid, S. M. H. Zaidi

Department of Pathology and Laboratory Medicine

Introduction:The objective of the study was to determine the trends of cancer cervix in Karachi South during an eight (1995-2002) year period. Methododology: Cancer cervix cases recorded at Karachi Cancer Registry during 1st January 1995 to 31st December 2002 were analyzed. Trends were studied by analyzing the age standardized incidence rates (ASR)s in 2 time periods, 1995-97 and 1998-2002.

Results:

Cancer cervix ranked sixth in the 1995-97 period the age standardized incidence rate (ASR) world and crude incidence rate (CIR) per 100,000 were 6.81 and 3.22. It reached the fifth ranking in the 1998-2002 period with an ASR and …

Syncope: Experience At A Tertiary Care Hospital In Karachi, Pakistan., Muhammad Junaid Patel, Nadeem Ullah Khan, Abdul Jawwad Samdani, Muhammad Furqan, Aamir Hameed, Muhammad Sohaib, Syed Imran Ayaz, Muhammad Omer Jamil

Department of Emergency Medicine

Introduction:Our aim was to determine the characteristics of Patients presenting with syncope at a tertiary care hospital in Karachi, Pakistan.
Methods: A review of medical records was conducted retrospectively at the Department of Medicine, Aga Khan University Hospital, Karachi. Patients aged 16 and above, admitted from January 2000 to December 2005 with the diagnosis of syncope made by the attending physician were included.
Results:A total of 269 Patients were included (75% males, mean age: 57.4 years). Neurogenic (vasovagal) syncope was the most common cause (47%), followed by cardiogenic syncope (18%) and orthostatic syncope (9%). A total of 24% …

An All Time Low Budget For Healthcare In Pakistan, Jamil Ahmed, Babar T Shaikh

Community Health Sciences

No abstract provided.

Prescription Of Medicines By Medical Students Of Karachi, Pakistan: A Cross-Sectional Study, Syed Nabeel Zafar, Reema Syed, Sana Waqar, Faria A. Irani, Sarah Saleem

Community Health Sciences

Background: Prescription of medicines by non-doctors is an issue with serious global implications. To our knowledge prescription of drugs by medical and non-medical students has not been studied before. We aimed to determine the practice and attitudes of drug prescription by medical students and: a) how non-medical students respond to this practice, b) How this compares with the attitudes and practices of non-medical students. Methods: A cross-sectional study was conducted on a sample of 600 students randomly selected from 2 medical and 2 non-medical universities. Ethical requirements were ensured and data was collected using self administered questionnaires. The Chi square …

The Unifying Dilemma Of The Pakistani Science Journals, Saba Sohail

Department of Radiology

No abstract provided.

Social Health Insurance: Can We Ever Make A Case For Pakistan, Farina G Abrejo, Babar Tasneem Shaikh

Community Health Sciences

Social Health Insurance has been used as an approach to increase efficiency of healthcare system and consumer satisfaction in provision of healthcare services. Many developed countries have successfully planned and implemented insurance models which provide almost universal coverage and addresses issues of equity. The phenomenon is established however, developing countries especially Eastern Mediterranean region is still struggling to present one successful model of social health insurance which can be compared with European or Scandinavian countries. Pakistan likewise faces huge challenges in public sector healthcare provision and considerable proportion of population prefers to go to private sector. Quality of care, access …

Cardiopulmonary Resuscitation: Outcome And Its Predictors Among Hospitalized Adult Patients In Pakistan., Nadeem Ullah Khan, J. Razzak, Humaid Ahmed, Muhammad Furqan, Ali Faisal Saleem, Hammad Alam, Anwar Ul Huda, Uzma R. Khan, Rifat Rehmani

Department of Emergency Medicine

Introduction:Our aim was to study the outcomes and predictors of in-hospital cardiopulmonary resuscitation (CPR) among adult Patients at a tertiary care centre in Pakistan.
Methods:We conducted a retrospective chart review of all adult Patients (age > or =14 years), who underwent CPR following cardiac arrest, in a tertiary care hospital during a 5-year study period (June 1998 to June 2003). We excluded Patients aged 14 years or less, those who were declared dead on arrival and Patients with a "do not resuscitate" order. The 1- and 6-month follow-ups of discharged Patients were also recorded.
Results:We found 383 cases …

Tetanus And Rabies Eradication In Pakistan; A Mission Not Impossible, Mohammad Wasay, Ismail A. Khatri, Naseem Salahuddin

Department of Medicine

No abstract provided.

Factors Influencing In-Hospital Length Of Stay And Mortality In Cancer Patients Suffering From Febrile Neutropenia, Amar Lal, Yasmin Bhurgri, Nida Rizvi, Mohni Virwani, Rasheed Uddin Memon, Wajeeha Saeed, Muhammad Rizwan Sardar, Pawan Kumar, Asim Jamal Shaikh, Salman Adil, Nehal Masood, Mohammad Khurshid

Section of Haematology/Oncology

Introduction: Febrile neutropenia (FN) is a major complication of chemotherapy, costly in terms of morbidity, mortality and associated financial expenditure. The present study was conducted with the goal of highlighting FN as a serious problem in Pakistan, with the longer term objective of improved cancer survival, reduction in length of stay (LOS) in hospital, morbidity, mortality and costs in our existing developing country scenario. Methods: A cross-sectional descriptive study was conducted on Patients, > or =18 years, admitted with FN as a consequence of chemotherapy at a referral hospital in Karachi from 1st September 2006 to 30th April 2007. Results: A …

Cervical Cancer Vaccine In Pakistan: Let's Start Thinking, Ali Jawaid

Medical College Documents

No abstract provided.

Informed Consent And Some Of Its Problems In Pakistan, Robyna Irshad Khan

Department of Anaesthesia

Informed consent has become an essential element of human subject research. Certain components are essential for a well-understood informed consent. There are problems in procurement of a comprehensive and meaningful consent in the Pakistani research settings. The inefficient healthcare systems, low literacy rate with masses having no concept of individual rights, higher social status enjoyed by physicians inhibiting the patients from questioning them, and unwillingness to hear bad news are some of these factors. Establishing Bioethics education at all levels, encouraging the involvement of families in decision making, using improvisation in procurement of consent are suggested solutions. There needs to …

Why Pakistani Medical Graduates Must Remain Free To Emigrate, Zarmeneh Aly, Fawad Taj

Medical College Documents

No abstract provided.

Introduction Of Emergency Contraceptive Pills In The Public Health System Of Pakistan: A South-To-South Collaboration, M.E. Khan, Gul Rashida, Sharif M.I. Hossain, Ali M. Mir, Ubaidur Rob

Reproductive Health

This report describes a south-to-south collaboration to assist the Ministry of Health of Pakistan to introduce emergency contraception (EC) into its family planning program, supported by the Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) program. The collaboration consisted of a three-day visit by senior managers from the Pakistani health authorities to Bangladesh to familiarize them with the EC program in that country, followed by a two-day consultative meeting in Islamabad to draw up concrete plans for introduction of the method into the Pakistan system. Participants at the consultation developed plans to introduce EC into both community-based distribution and clinical …

Study Of Sexually Transmitted Infections Among Urban Men In Pakistan: Identifying The Bridging Population, Ali M. Mir, Laura Reichenbach, Abdul Wajid, Mumraiz Khan

Reproductive Health

Pakistan currently has low levels of HIV infection, however the country is considered at high potential risk for an HIV epidemic. In major cities there are large concentrations of individuals whose behaviors make them extremely vulnerable to the rapid spread of HIV and of classical sexually transmitted infections (STIs), including male and female sex workers, men who have sex with men, and injecting drug users. HIV can spread to the general population through individuals who have contact with both high-risk groups and the general heterosexual population (the “bridging population”). Identifying the bridging population and bridging behaviors among urban men and …

Assessing Routine Health Information System In Selected Paiman Districts By Using Lot Quality Assurance Sampling (Lqas) Technique, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to the hospital. PAIMAN is compiling data from three data sources and making efforts to improve the functioning of these Health Information Systems (HISs) for efficient management of health services at the district level through generation of quality data and their …

Heritability Estimates Of Post Weaning Performance Traits Of Hissardale Sheep In Pakistan, Pervez Akhtar, Safdar Ali, Asghar Hussain, Muhammad A. Mirza, Muhammad Iqbal Mustafa, Javed Iqbal Sultan

Turkish Journal of Veterinary & Animal Sciences

Data obtained from 5260 birth records of 1179 Hissardale sheep maintained at the Livestock Experiment Station, Jahangirabad, in the district of Khanewal during 1978-1995 were analyzed. The objective was to evaluate the performance and to estimate the heritability of Hissardale sheep in Pakistan. Mean 180-day, 270-day, and yearling weights were 23.5 ± 3.31 kg, 25.7 ± 3.49 kg, and 30.7 ± 3.83 kg, respectively. Mean greasy fleece weight was 3.6 ± 0.57 kg. Post-weaning mean daily weight gain was 45 ± 0.02 g. Mean weight at first service was 38.9 ± 4.9 kg. The number of services per conception averaged …

Assessment Of Knowledge And Attitudes Of Married Women On Maternal And Newborn Health (Mnh) In Selected Union Councils Of Project Districts, Pakistan Initiative For Mothers And Newborns (Paiman)

Reproductive Health

The World Health Organization estimates that 585,000 women die from pregnancy-related conditions each year. Pregnancy-related conditions, including dysfunctional labor, hemorrhage, infection, toxemia, and unsafe abortion, are the leading cause of death among women of reproductive age in many developing countries. The Pakistan Initiative for Mothers and Newborns (PAIMAN) is a five-year project funded by USAID. Its goal is to reduce maternal and newborn mortality in Pakistan, through viable initiatives and capacity building of existing programs and structures within health systems and communities to ensure improvements and supportive linkages in the continuum of health care for women from the home to …

Seroprevalence Of Brucellosis In Human, Cattle, And Buffalo Populations In Pakistan, Iftikhar Hussain, Muhammad Imran Arshad, Muhammad Shahid Mahmood, Masood Akhtar

Turkish Journal of Veterinary & Animal Sciences

A total of 1500 serum samples were collected from cattle, buffaloes, and humans. The Rose Bengal plate test (RBPT) and enzyme-linked immunosorbent assay (ELISA) detected Brucella antibodies in 56 (10.18%) and 44 (8%) of the cattle, respectively. In samples collected from buffaloes 9.38% and 6.92% were positive, whereas 14% and 11% of the samples from humans were found to be positive by RBPT and ELISA, respectively. Among village workers a higher prevalence of brucellosis was recorded in females than in males. Abattoir-associated personnel also had a higher incidence of brucellosis. Results of the present study revealed that RBPT and ELISA …