Medicine and Health Sciences Commons^™

Self-Medication With Antibiotics Among Non-Medical University Students Of Karachi: A Cross-Sectional Study, Syed Jawad Shah, Hamna Ahmad, Rija Binte Rehan, Sidra Najeeb, Mirrah Mumtaz, Muhammad Hashim Jilani, Muhammad Sharoz Rabbani, Muhammad Zakariya Alam, Saba Farooq, M Masood Kadir

Community Health Sciences

Background: The prevalence of self -medication with antibiotics is quite high in developing countries as opposed to developed countries. Antibiotics are often taken erroneously for certain ailments, without having the appropriate knowledge of their use. This carries potential risks for the individual as well as the community, in form of several side effects such as antibiotic resistance. Therefore the prevalence of self-medicated antibiotics in developing countries needs to be studied.Methods: A descriptive cross-sectional study was carried out at six different non-medical universities of Karachi. 431 students were included in the study. Data was collected using self-administered questionnaires and analyzed using …

Posterior Mediastinal Branchial Cleft Cyst: An Unusual Site, Abdul Rashid, Vaqas Ahmad, Saqib Qazi, Abdul Gaffar Billoo, Sajida Rashid, Ali Faisal Saleem

Department of Paediatrics and Child Health

A two and a half year old Kenyan girl presented with recurrent chest infections and difficulty in swallowing. Her clinical and laboratory workup was suggestive of lower respiratory tract infection for which she received a course of antibiotics; however, she remains symptomatic after the management of her suspected diagnosis. Therefore, further radiological workup including a chest CT scan and barium study were performed. This showed a homogeneous mass surrounded by ascending and descending aorta in the posterior mediastinum that was compressing the middle esophagus. She had a posterolateral thoracotomy which revealed a cystic mass with smooth surfaces (5x5 cm) in …

Pneumococcal Serotypes And Serogroups Causing Invasive Disease In Pakistan, 2005-2013, Sadia Shakoor, Furqan Kabir, Asif R. Khowaja, Shahida M. Qureshi, Fyezah Jehan, Farah Qamar, Cynthia G. Whitney, Anita K M Zaidi

Department of Paediatrics and Child Health

While pneumococcal conjugate vaccines have been implemented in most countries worldwide, use in Asia has lagged in part because of a lack of data on the amount of disease that is vaccine preventable in the region. We describe pneumococcal serotypes elicited from 111 episodes of invasive pneumococcal disease (IPD) from 2005 to 2013 among children and adults in Pakistan. Seventy-three percent (n = 81) of 111 IPD episodes were cases of meningitis (n = 76 in children 0-15 years and n = 5 among adults). Serotypes were determined by target amplification of DNA extracted from pneumococcal isolates (n = 52) …

الصحة النفسية، والقلق والاكتئاب لدى مجهولي النسب في دولة الإمارات العربية المتحدة, موزة علي خلفان النعيمي

Theses

هدفت الدراسة الحالية إلى التعرف على مستويات القلق، والاكتئاب والصحة النفسية لدى مجهولي النسب في دولة الإمارات العربية المتحدة، وعلاقتها ببعض المتغيرات الديموغرافية والمتمثلة بالجنس (النوع الاجتماعي).

تكونت عينة الدراسة من (73) فرد من مجهولي النسب والمقيمين في دار زايد للرعاية الأسرية في إمارة أبو ظبي (أبو ظبي والعين). وتم تطبيق قائمة بيك للاكتئاب، واختبار سمة القلق لسبيلبيرغر، ومقياس الصحة النفسية العامة، تم استخراج المتوسطات الحسابية والانحرافات المعيارية والتكرارات واختبار ( ) للإجابة عن أسئلة الدراسة.

توصلت الدراسة إلى وجود مستويات من القلق والاكتئاب لدى أفراد العينة حيث بلغت نسبة الأفراد الذين يعانون من الاكتئاب (المتوسط إلى الشديد) (28.7%) والأفراد …

Nanotechnology And Its Implication In Medical Science, Syed Ahsan Ali, M. Tariq

Department of Medicine

No abstract provided.

Acute Cerebellitis With Hydrocephalus, Nida Amjad, Anwarul Haque, Khalid Ahmed

Department of Paediatrics and Child Health

We report a case of an 8 years old child who presented with sudden onset of headache and vomiting. He had broad-based gait and intention tremors on admission. MRI brain revealed isointense signals on T1-weighted imaging and hyperintense signals on T2-weighted imaging. Cerebellar swelling was also identified with significant mass effect obliterating the fourth ventricle. CT head showed prominent third and lateral ventricles. He was treated with high dose corticosteroids and required an external ventricular drain (EVD) insertion. He made an uneventful recovery and suffered no neurologic deficit. The clinical and radiologic findings in this boy were consistent with cerebellitis …

Early Recovery In Post Varicella Transverse Myelitis, Prem Chand, Shahnaz Brahim, Syed Sohail Zaidi, Nida Amjad

Department of Paediatrics and Child Health

A two and a half year old Kenyan girl presented with recurrent chest infections and difficulty in swallowing. Her clinical and laboratory workup was suggestive of lower respiratory tract infection for which she received a course of antibiotics; however, she remains symptomatic after the management of her suspected diagnosis. Therefore, further radiological workup including a chest CT scan and barium study were performed. This showed a homogeneous mass surrounded by ascending and descending aorta in the posterior mediastinum that was compressing the middle esophagus. She had a posterolateral thoracotomy which revealed a cystic mass with smooth surfaces (5 x 5 …

Short-Term Neonatal Outcome In Late Preterm Vs. Term Infants, Anila Haroon, Syed Rehan Ali, Shakeel Ahmed, Humaira Maheen

Department of Paediatrics and Child Health

Objective: To determine the short-term neonatal outcomes in late preterm infants (LPI's) as compared to term infants and their association with maternal risk factors.

Study Design: A case control, descriptive study.

Place and Duration of Study: The Aga Khan University Hospital, Karachi, Pakistan, from January to December 2009.

Methodology: The study included 326 late preterm babies (defined as those born between 340 ⁄7 to 376 ⁄7 weeks of gestation) and equal number of term control babies at the Aga Khan University Hospital, Karachi, Pakistan. Data, including obstetric history, maternal complications, neonatal morbidities, etc., was retrieved from patients' medical records. The …

Mediastinal Synovial Sarcoma., Niaz Hussain Soomro, Sanaullah Junejo, Aneeqa Ahsan Zafar, Shirin Siddiqi, Ghulam H

Department of Medicine

The mediastinum is an uncommon site of synovial sarcoma which is a rare soft tissue malignancy. An 18 year old boy was admitted for right sided chest pain since one year. Based on the CT scan chest findings, tru-cut biopsy of the mass was performed and histopathology initially reported as neurofibroma. The tumor was excised via posterolateral thoracotomy and excisional biopsy established the diagnosis of primary synovial sarcoma arising from the mediastinum. Patient was started on adjuvant chemotherapy at the oncologist tumor board’s recommendation and he received 6 cycles of adriamycin and ifosfamide. At last follow up he is free …

Immune Responses To Vi Capsular Polysaccharide Typhoid Vaccine In Children 2 To 16 Years Old In Karachi, Pakistan, And Kolkata, India, R. Leon Ochiai, M. Imran Khan, Sajid B. Soofi, Dipika Sur, Suman Kanungo, Young Ae You, Atif Habib, Shah Muhammad Sahito, Byomkesh Manna, Camilo J. Acosta, Mohammad Ali, Sujit K. Bhattacharya, Zulfiqar A. Bhutta, John D. Clemens

Department of Paediatrics and Child Health

The geometric mean concentration (GMC) and the proportion maintaining a protective level (150 enzyme-linked immunosorbent assay (ELISA) units [ELU]/ml) 2 years following a single dose of 25 μg of injectable Vi capsular polysaccharide typhoid vaccine was measured against that of the control hepatitis A vaccine in children 2 to 16 years old in cluster randomized trials in Karachi and Kolkata. The GMC for the Vi group (1,428 ELU/ml) was statistically significantly different from the GMC of the control hepatitis A vaccine group (86 ELU/ml) after 6 weeks. A total of 117 children (95.1%) in the Vi group and 9 (7.5%) …

Effect Of L-Type Calcium Channel Blocker (Amlodipine) On Myocardial Iron Deposition In Patients With Thalassaemia With Moderate-To-Severe Myocardial Iron Deposition: Protocol For A Randomised, Controlled Trial, Amarah Shakoor, Maaman Zahoor, Alina Sadaf, Najveen Alvi, Zehra Fadoo, Arjumand Rizvi, Farheen Quadri, Fateh Ali Tipoo, Mohammad Khurshid, Zaffar Sajjad, Steven Colan, Babar S Hasan

Department of Paediatrics and Child Health

Introduction: Sideroblastic cardiomyopathy secondary to repeated blood transfusions is a feared complication in thalassaemia. Control of myocardial iron is thus becoming the cornerstone of thalassaemia management. Recent evidence suggests a role for L-type Ca²⁺ channels in mediating iron uptake by the heart. Blocking the cellular iron uptake through these channels may add to the benefit of therapy to standard chelation in reducing myocardial iron. We aim to determine the efficacy of amlodipine (a calcium channel blocker) as an adjunct to standard aggressive chelation in retarding myocardial iron deposition in thalassaemics with or without cardiomyopathy.
Outcomes: The primary outcome …

Community Based Interventions For The Prevention And Control Of Non-Helmintic Ntd, Jai K. Das, Rehana A. Salam, Ahmed Arshad, Hasina Maredia, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

In this paper, we aim to systematically analyze the effectiveness of community based interventions (CBI) for the prevention and control of non-helminthic diseases including dengue, trypanosomiasis, chagas, leishmaniasis, buruli ulcer, leprosy and trachoma. We systematically reviewed literature published up to May 2013 and included 62 studies in this review. Findings from our review suggest that CBI including insecticide spraying; insecticide treated bednets and curtains; community education and cleanliness campaigns; chemoprophylaxis through mass drug administration; and treatment have the potential to reduce the incidence and burden of non-helminthic diseases. Lack of data limited the subgroup analysis for integrated and non-integrated delivery …

Community Based Interventions For The Prevention And Control Of Tuberculosis, Ahmed Arshad, Rehana A. Salam, Zohra S. Lassi, Jai K. Das, Imama Naqvi, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

In 2012, an estimated 8.6 million people developed tuberculosis (TB) and 1.3 million died from the disease. With its recent resurgence with the human immunodeficiency virus (HIV); TB prevention and management has become further challenging. We systematically evaluated the effectiveness of community based interventions (CBI) for the prevention and treatment of TB and a total of 41 studies were identified for inclusion. Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates (RR: 3.1, 95% CI: 2.92, 3.28) with non-significant impact on TB incidence. CBI for treating patients with active TB showed an …

Community-Based Interventions For The Prevention And Control Of Helmintic Neglected Tropical Diseases, Rehana A. Salam, Hasina Maredia, Jai K. Das, Zohra S. Lassi, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

In this paper, we aim to systematically analyze the effectiveness of community-based interventions (CBIs) for the prevention and control of helminthiasis including soil-transmitted helminthiasis (STH) (ascariasis, hookworms, and trichuriasis), lymphatic filariasis, onchocerciasis, dracunculiasis, and schistosomiasis. We systematically reviewed literature published before May 2013 and included 32 studies in this review. Findings from the meta-analysis suggest that CBIs are effective in reducing the prevalence of STH (RR: 0.45, 95% CI: 0.38, 0.54), schistosomiasis (RR: 0.40, 95% CI: 0.33, 0.50), and STH intensity (SMD: -3.16, 95 CI: -4.28, -2.04). They are also effective in improving mean hemoglobin (SMD: 0.34, 95% CI: 0.20, …

Impact Of Community-Based Interventions For The Prevention And Control Of Malaria On Intervention Coverage And Health Outcomes For The Prevention And Control Of Malaria, Rehana A. Salam, Jai K. Das, Zohra S. Lassi, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

In this paper, we aim to evaluate the effectiveness of community-based interventions (CBIs) for the prevention and management of malaria. We conducted a systematic review and identified 42 studies for inclusion. Twenty-five of the included studies evaluated the impact of the community-based distribution of insecticide-treated nets (ITNs), indoor residual spraying (IRS), or impregnated bed sheets; 14 studies evaluated intermittent preventive therapy (IPT) delivered in community settings; two studies focused on community-based education for malaria prevention; and one study evaluated environmental management through drain cleaning. Our analysis suggests that, overall, the community-based delivery of interventions to prevent and control malaria resulted …

Impact Of Community-Based Interventions On Hiv Knowledge, Attitudes And Transmission, Rehana A. Salam, Sarah Haroon, Hashim H. Ahmed, Jai K. Das, Zulfiqar A. Bhutta

Department of Paediatrics and Child Health

In 2012, an estimated 35.3 million people lived with HIV, while approximately two million new HIV infections were reported. Community-based interventions (CBIs) for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk, or already infected with, HIV. This paper evaluates the impact of CBIs on HIV knowledge, attitudes, and transmission. We included 39 studies on educational activities, counseling sessions, home visits, mentoring, women's groups, peer leadership, and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence. Our review findings suggest …

Evolutionary Approaches For Feature Selection In Biological Data, Vinh Q. Dang

Theses: Doctorates and Masters

Data mining techniques have been used widely in many areas such as business, science, engineering and medicine. The techniques allow a vast amount of data to be explored in order to extract useful information from the data. One of the foci in the health area is finding interesting biomarkers from biomedical data. Mass throughput data generated from microarrays and mass spectrometry from biological samples are high dimensional and is small in sample size. Examples include DNA microarray datasets with up to 500,000 genes and mass spectrometry data with 300,000 m/z values. While the availability of such datasets can aid in …

Homebirth In Wa: Why Women Make This Choice, Colleen Ball

Theses: Doctorates and Masters

Background: Homebirths in Western Australia (WA) account for approximately 0.8% of all births. Two consecutive reports from the Perinatal and Infant Mortality Monitoring Committee found increased rates of perinatal mortality in homebirths and recommended a prospective cohort study to assess mortality and morbidity outcomes for women with planned home births in WA. The Homebirth in WA Study, of which this thesis is a component, has been funded by a directed research grant.

Aim: The aim of this study was to explore the specific reasons why women in WA choose homebirth. Research on homebirths is focused on perinatal outcomes and …

Neuromuscular Fatigue Following A Singles Badminton Match, Zengyuan Lin

Theses: Doctorates and Masters

A typical badminton singles match involves numerous intense and high impact movements. Lunges were accounted for approximately 15% of overall movements and were believed to presumably induce significant muscle damage following a match. However, no previous study has investigated changes in knee extensor muscle function after a badminton match.The present study investigated changes in knee extensor neuromuscular function and muscle soreness after a simulated 1-h badminton singles match in relation to the number of lunges performed in the match.

Ten state-level male badminton players were recruited (n=10), with each player played a total of eight simulated 1-h matches under the …

Pain Assessment And Possible Mechanism Of Delayed Onset Muscle Soreness, Wing Yin Lau

Theses: Doctorates and Masters

Muscle pain is felt during exercise or daily activities for several days after performing unaccustomed exercise, which is referred to as delayed onset muscle soreness (DOMS). Many people experience DOMS, but its underlying mechanisms are not fully understood. One of the challenges in the investigation of DOMS is its subjective nature, which makes the assessment ambiguous, thus establishing a standardised protocol is necessary. The present thesis scrutinised muscle pain assessments (Study 1, Study 2), developed a new assessment of muscle pain focusing on muscle fascia (Study 3), and investigated why DOMS is reduced after the second than the first bout …

Neuromuscular Factors Affecting Stretch-Induced Torque Loss, Gabriel Siqueira Trajano

Theses: Doctorates and Masters

The mechanisms underpinning the immediate torque loss induced by acute, static muscle stretching are still not clear. The current research was designed to examine the neuromuscular factors influencing this torque loss. In Study 1, the contributions of central versus peripheral factors to the stretch-induced torque loss were investigated. Measures of central drive, including the EMG amplitude normalised to the muscle compound action potential amplitude (EMG:M), percent voluntary activation (%VA) and first volitional wave amplitude (V:M), and measures of peripheral function, including the twitch peak torque and 20:80 Hz tetanic torque ratio were made before, and immediately and 15 min after …

The Creation And Validation Of A Youth Fundamental Hitting Scale: The Assessment Of Youth Baseball And Softball Hitting Fundamentals And The Perceived Psychological Barriers To Hitting A Pitched Ball, Andrew Walsh

Theses: Doctorates and Masters

The primary purpose of the thesis was to create a hitting scale for youth players that assess the fundamentals of a baseball swing. Secondly, the purpose of this thesis was to determine the interactions between the changes in anxiety, perceived competence and fear variables have with actual hitting competence over a four week sport specific training program.

Space-Time Statistical Analysis Of Malaria Morbidity Incidence Cases In Ghana: A Geostatistical Modelling Approach, Simon K. Appiah

Theses: Doctorates and Masters

Malaria is one of the most prevalent and devastating health problems worldwide. It is a highly endemic disease in Ghana, which poses a major challenge to both the public health and socio-economic development of the country. Major factors accounting for this situation include variability in environmental conditions and lack of prevention services coupled with host of other socio-economic factors. Ghana’s National Malaria Control Programme (NMCP) risk assessment measures have been largely based on household surveys which provided inadequate data for accurate prediction of new incidence cases coupled with frequent incomplete monthly case reports. These raise concerns about annual estimates on …

Relative Importance And Plasticity Of Anatomical And Neuromuscular Factors Affecting Joint Torque Production, Joanne C. Trezise

Theses: Doctorates and Masters

The present research aimed to determine (i) the relative influence anatomical and neuromuscular variables on maximal isometric, concentric and eccentric knee extensor torque (Study 1); (ii) whether the change in strength following a 10-week strength training program is associated with changes in specific anatomical and neuromuscular variables (Study 2a); (iii) whether anatomical and neuromuscular adaptations are dependent on their pre-training magnitudes; and (iv) whether it is possible to ‘predict’ an individual’s adaptation to strength training based on their anatomical and neuromuscular pre-training magnitudes (Study 2b).

The variables assessed throughout the studies include muscle cross-sectional area (CSA), fascicle length and angle …

Acute Physiological Effects And Perceived Enjoyment Of A Single Bout Of Aerobic Interval And Continuous Moderate-Intensity Cycling In Overweight And Obese Individuals, Fujie Koh

Theses: Doctorates and Masters

Aerobic interval training, a form of high intensity interval training, is commonly prescribed to both the general and clinical populations. However, the acute physiological effects from a single bout of aerobic interval session are not fully understood. In training studies, these acute physiological effects may confound actual training adaptations when they occur following the final training session [1]. Furthermore, while recreationally active men perceived aerobic interval training to be more enjoyable than continuous moderate-intensity exercise [2], the preference of overweight and obese individuals has not been extensively researched. Since overweight and obese individuals tend to have lower exercise tolerance, it …

Developing Effective Hospital Management Information Systems: A Technology Ecosystem Perspective, Christopher Bain

Theses: Doctorates and Masters

This thesis presents the results of the program of research performed in the completion of a Doctor of Philosophy (Business) entitled: Developing Effective Hospital Management Information Systems: A Technology Ecosystem Perspective.

The central contention of this thesis is that the current ecosystem models in the information technology (IT) and information systems (IS) literature can be extended and improved. In turn they can be better applied to the field of IS and the development and implementation of information systems. This research seeks to highlight an example of how these models can be extended, through an analysis of the specific context of …

Learning From The Experts: Qualitative Study Of The Lived Experience Of Mental Illness, Zdenka Bartova

Theses: Doctorates and Masters

Severe mental illness has a profound effect on the affected individuals yet it does not necessarily prevent them from leading a meaningful and fulfilling life, and therefore recovering. Recovery has received a great interest in clinical and consumer research yet little is known about how those individuals who do not primarily identify with recovery respond to the concept and come to accept it as something that is personally meaningful. Using a qualitative approach following the principles of Gadamer’s (1975) hermeneutics, the present study explored people’s subjective experience of mental illness with the aim of identifying factors related to their views …

Role Of Physical Exercise In Reducing Depression And Improving Mental Health In Cancer Survivors, Gregory Levin

Theses: Doctorates and Masters

Cancer survivors are more than twice as likely as the general population to suffer the debilitating effects of depression. This comorbid condition is associated with several negative consequences, such as reduction in compliance with cancer treatments, and hastened mortality. Recent research has examined the therapeutic effect of exercise on depression and reported excellent results of similar magnitude to those achieved with pharmacotherapy or psychological intervention. However, no research, to date, has examined the effectiveness of exercise on reducing depression in depressed cancer survivors. In order to address this important question this thesis reviewed previous literature in the area of cancer …

Impact Of Nutrition On Cognition And Its Association With Blood And Brain Alzheimer Disease Related Biomarkers, Samantha Gardener

Theses: Doctorates and Masters

Alzheimer’s disease (AD), the most common form of senile dementia, currently affects over 35 million people worldwide. While there is no cure or effective treatment, early intervention programs hold considerable promise. Following particular dietary patterns represents one potential intervention strategy accessible to all.

Results from previous studies investigating the association of diet, cognition and biomarkers of AD are inconsistent: Positive results have been reported (1-7), whilst others have shown no associations. Prior to this thesis, no study has assessed the relationship of four dietary patterns to cognition, blood-based and neuroimaging biomarkers of AD in a large highly-characterised ageing cohort. Participants …

A Mixed Methods Obesity Prevention Intervention For Australian Children Aged 6-12 Years: Influence Of Parents Misperceptions About Food And Exercise On The Efficacy Of Educational Obesity Simulations, Claire Ellen Roockley

Theses: Doctorates and Masters

Increasing numbers of Australian children are being classified as overweight or obese. Given the health complications associated with excess weight, interventions to prevent children becoming overweight are crucial. Despite literature showing that parents shape their children’s food and exercise habits, no child obesity prevention programs have directly targeted parents. Moreover, although fear appeals have been used across several health promotion areas to change attitudes and behaviours, they have not been incorporated into an obesity preventive program. This study addressed these gaps by testing whether fear-based obesity simulations, targeted at parents as a tool for preventing childhood obesity, was more effective …