Family Medicine Commons^™

Primary Health Care Providers’ Knowledge And Practices On Asthma Management Within Dar Es Salaam Region Health Facilities, John C. Rwegasha

Master of Medicine in Family Medicine

Background: Asthma is a common chronic health problem worldwide with considerable variation in the way it is managed. In the sub- Saharan Africa there is substantial gaps in asthma care; countries like Tanzania with inadequate health care structure are lagging far behind in both correct diagnosis and management of asthma. The increasing prevalence of asthma within populations is attributed to a number of the following factors; Patient behavior, Health service structure and access, Environmental factors and Provider's knowledge and practices. There is lack of required standard asthma care under provider's factors, hindering effective control of the disease. This could be …

Frequency Of Abnormal Pap Smears And Assessment Of Risk Factors For Cervical Cancer In An Out-Patient Clinic, Firdous Jahan, Naheed Nabi, Waris Qidwai, Iqbal Azam

Department of Family Medicine

No abstract provided.

Awareness About Reproductive Health And Rights Among Students Of A Public University In Karachi, Pakistan: A Cross Sectional Study, Naheed Nabi, Waris Qidwai, Farhat Batool,, Iqbal Azam

Department of Family Medicine

Objective: To determine the knowledge, attitude and practices of Karachi University students about reproductive health and rights.
Design: Cross sectional study Methods: A survey was conducted from February to May 2005 to determine the understanding and knowledge related to reproductive health and rights among the students of the department of Biochemistry, University of Karachi, Pakistan. A pre-coded questionnaire was developed and pre-tested. The questionnaire was introduced to those students, who agreed to participate in the study. Data collected was double entered and analyzed on SPSS and Epi-info latest version.
Results: Fifty five percent (55%) of participants believed …

Primary Care Research: Opportunities And Challenges, Waris Qidwai

Department of Family Medicine

No abstract provided.

Knowledge, Attitude And Practice Regarding Immunization Among Family Practice Patients, Waris Qidwai, Syed Sohail Ali, Semi Ayub, Salma Ayub

Department of Family Medicine

Objective: To determine the knowledge, attitude and practices about immunization among family practice patients.
Design: A questionnaire based survey.
Patients and Method: A questionnaire was developed in line with the study objectives. It was administered to patients visiting family physicians, after they were administered, informed consent and assurance with regards to confidentiality was provided. Epi-info and SPSS software was used for data management.
Results: A total of 97 patients were surveyed. The majority were men (59.8%) with a mean age of 29.69 years. Majority was unmarried (51.5%), with graduate and post-graduate education (73%), and in government and …

Metabolic Syndrome: Frequency And Gender Differences At An Out - Patient Clinic, Firdous Jahan, Riaz Qureshi, Tasneem Borhany, Hasan Bin Hamza

Department of Family Medicine

Objective: To determine the frequency of metabolic syndrome among patients attending an out-patient clinic of a teaching hospital and to compare the clinical features regarding metabolic syndrome among males and females.
Study Design: Cross-sectional study.
Place and Duration: Aga Khan University Hospital (AKUH), Executive and Family Medicine Clinics, from December 2004 to April 2005.
Patients and Methods: All adults, above 25 years, attending the clinics for an executive check-up and giving informed consent were included in the study. Data was collected through a structured questionnaire administered to those eligible to participate. Metabolic syndrome was defined according to ATP-III guidelines. …

Prevalence And Predictors Of Smokeless Tobacco Use Among High-School Males In Karachi, Pakistan, S Rozi, S Akhtar

Community Health Sciences

A cross-sectional study was conducted in 3 towns in Karachi, Pakistan to investigate the prevalence of and factors associated with the use of smokeless tobacco among 772 high-school adolescent males. A structured questionnaire collected data on sociodemographic factors and history of cigarette and smokeless tobacco use. Prevalence of smokeless tobacco use (gutka, snuff, niswar) was 16.1% (95% CI: 13.5%-18.9%). On multiple logistic regression analysis, the factors significantly related to smokeless tobacco use among the sample were: attending government school [adjusted odds ratio (OR) 6.3], smoking cigarettes (OR 3.2), not seeing anti-tobacco advertisements (OR 1.5), family history of tobacco use (OR …

Private Drug Sellers Education In Improving Prescribing Practices, Waris Qidwai, Mukesh Kumar Krishanani, Saman Hashmi, Rubina Abu Ali

Department of Family Medicine

OBJECTIVE: To determine the education of private drug sellers as an intervention tool in promoting rational use of medicines for diarrhoea at private drug outlets in a rural setting.
PLACE AND DURATION OF STUDY: The study was conducted at Mithi, Tharparkar in rural Sindh in August 2005.
PATIENTS AND METHODS: Diarrhea was selected to study drug-prescribing habit of private drug sellers. Evidence-based guidelines for control of diarrhea were developed along with simulation cases and keys. In phase-1, simulators were sent to 6 private drug sellers and their prescription was noted. After phase-1, 3 private drug sellers were educated …

Low Blood Pressure Syndrome: A Myth Or A Reality? Results Of A Patient's Survey At A Teaching Hospital In Karachi, Waris Qidwai, Bheesham Tara Chand

Department of Family Medicine

Objective: To study patient’s knowledge, perceptions attitude and practice with regard to low blood pressure.
Design: A Questionnaire-based survey.
Settings: Family Practice Center, Aga Khan University Hospital, Karachi, Pakistan, in June 2004.
Main outcome measures: Low blood pressure is a disease, causes and treatment of low blood pressure, patient ever suffered from low blood pressure, low blood pressure can be diagnosed with BP apparatus, without apparatus and stress can cause low blood pressure.
Results: A 110 patients were interviewed. Majority of the subjects were educated young married men, well placed socio-economically. A majority (73%) of the …

Psychological Stress Among Family Practice Patients Visiting A Teaching Hospital In Karachi, Waris Qidwai, Malika Kassamali

Department of Family Medicine

Objective: To study psychological stress among family practice patients to highlight its importance.
Design: A cross sectional study. Setting: Family Practice Center of Aga Khan University Hospital, Karachi - Pakistan, in July 2003. Patients and Methods: Family practice patients were interviewed without using any systematic randomization. A questionnaire was developed that included data on demographic profile of the patient and questions on patient perceptions whether they were in stress or not, the degree of stress if perceived to be present and its causes including need to seek medical help. They were simultaneously administered a stress screening questionnaire that …

Castleman's Disease -- A Rare Disease Of Lymph Nodes, Mohammad Zakiullah, Zafaruddin Khan, Riaz Qureshi, Suhail Muzaffar

Department of Family Medicine

Castleman's disease is a rare disorder of unknown etiology and different clinical manifestations, occurring in young adults (usually prior to age 30 years). In this case report we present one such case who was a 16 years old male with abdominal pain, weight loss, cervical lymph adenopathy and hepatosplenomegaly. Lymph node biopsy revealed hyaline-vascular type of Castleman's disease. He was put on chemotherapy but was lost to follow-up.

Psycho-Social Consequences Of Secondary Infertility In Karachi., Neelofar Sami, Tazeen Saeed Ali

Community Health Sciences

OBJECTIVE:

To explore the experiences of social consequences among women suffering from secondary infertility.

METHODS:

Descriptive case series of 400 women with secondary infertility attending tertiary care hospitals in Karachi, Pakistan.

RESULTS:

More than two thirds (67.7%) of women stated that their inability to give live births or give birth to sons had resulted in marital dissonance. The respondents had been threatened for divorce (20%), husband's remarrying (38%) or to be returned to their parent's home (26%) by their in laws or husbands. Majority (68%) of the women threatened did not have any live births. However, those who had live …

Screening For Diseases In Family Practice, Ali Khan Khuwaja, Nadya Khan Khuwaja

Department of Family Medicine

The active check-over for disease among apparently healthy people is a fundamental aspect of prevention. This is perceivable by screening, which is a search of unrecognized disease or condition by means of rapidly applied test, examination or other procedures in apparently healthy individuals. This is carried out in the hope that earlier diagnosis and subsequent management favorably alters the natural history of the disease in a significant proportion of those who are identified as 'test-positive'. Family Practitioners have privilege to provide comprehensive and holistic health care services including preventive, curative and rehabilitative on continuous and long-term basis to all members …

Life Style Related Risk Factors For Cardiovascular Disease Among Patients At A Teaching Hospital In Karachi, Waris Qidwai, Ar Mangi, R Bux

Department of Family Medicine

BACKGROUND: Cardiovascular disease is a leading cause for morbidity and mortality all over the world. It is important to study life style related, modifiable cardiovascular risk factors among patients, in order to devise preventive strategies.
METHODS: We surveyed family practice patients visiting the out-patient clinics of Aga Khan University Hospital, Karachi. The interview was questionnaire-based and recorded the demographic profile of the patients, in addition to information on life style related cardiovascular risk factors. The ethical requirements for the study were met. SPSS computer software was used for data management. RESULTS: Fifty patients were surveyed and included …

Tale Of A Woman With Stomatitis And Response Of Health Care System, Waris Qidwai

Department of Family Medicine

A 55 year-old housewife presented to the Family Medicine Clinic due to recurrent oral ulcers for a year. She also had generalized itching, weakness, anorexia and abdominal distension after meals. She had visited several practitioners including family physicians and sub-specialists but a diagnosis was not reached. She was diagnosed to have Lichen Planus and Hepatitis C at family practice clinic. Since a health care system does not properly exist, patients seek treatment from sub-specialists without first consulting a primary care practitioner. This report identifies a failure in health care system and it is also recommended that all patients should be …

Continuity Of Patient Care Among Family Practice Patients At A Teaching Hospital, Waris Qidwai, J Rehman, M Khan, Iqbal Azam

Department of Family Medicine

No abstract provided.

Characteristics Of Smokers And Their Knowledge About Smoking At A Teaching Hospital In Karachi, Waris Qidwai, N Zahid

Department of Family Medicine

Objective: To study the characteristics of smokers and their knowledge about smoking, among Family Practice Patients, at a teaching hospital in Karachi, Pakistan. Main outcome measures: Age at starting smoking, duration and number of cigarettes smoked, started smoking under influence of friends, colleagues, family members or self motivation, number of friends and colleagues who smoked, whether smoking is unhealthy, and actual chance of harm to an individual due to smoking is very rare or not.
Results: One hundred patients who visited Family Practice Center were interviewed. Sixty one percent were young married men, well educated and either student, …

Healing During Physician-Patient Consultation, Waris Qidwai, Ss Ali, S Ayub, S Ayub

Department of Family Medicine

OBJECTIVE: To determine the patient perceptions regarding healing during a physician-patient consultation.
DESIGN: A questionnaire-based survey.
PLACE AND DURATION OF STUDY: Family Practice Center of the Aga Khan University Hospital, Karachi, Pakistan, in June 2004.
PATIENTS AND METHODS: A questionnaire was designed that included the demographic profile of patients comprising age, gender, education and occupation as well as questions in line with the study objective. It was administered to 111 patients, visiting outpatient department of the hospital. Participants were explained the study objective, a written consent was taken and full confidentiality was assured.
RESULTS: The mean age of …

Patient Expectations From An Emergency Medical Service, Waris Qidwai, Ss Ali, M Baqi, S Ayub

Department of Family Medicine

BACKGROUND: Patient expectation survey at the Emergency Medical Services can improve patient satisfaction. A need was established to conduct such a survey in order to recommend its use as a quality improvement tool.
METHODS: The study was conducted on patients visiting the Emergency Medical Services, Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and expectations of patients. The ethical requirements for conducting the study were met.
RESULTS: A hundred patients were surveyed. The majority was relatively young, married men and women, well educated and better socio-economically placed. The majority of the …

Survival Of Patients Treated With Intra-Aortic Balloon Counterpulsation At A Tertiary Care Center In Pakistan - Patient Characteristics And Predictors Of In-Hospital Mortality., Fahim H. Jafary, Sohail A. Khan, Haresh Kumar, Numaan F. Malik, K. Kazmi, Sajid Dhakam, Azam Shafquat, Aamir Hameed, Javed Tai, Najaf Nadeem

Department of Medicine

BACKGROUND: Intra-aortic balloon counterpulsation (IABC) has an established role in the treatment of patients presenting with critical cardiac illnesses, including cardiogenic shock, refractory ischemia and for prophylaxis and treatment of complications of percutaneous coronary interventions (PCI). Patients requiring IABC represent a high-risk subset with an expected high mortality. There are virtually no data on usage patterns as well as outcomes of patients in the Indo-Pakistan subcontinent who require IABC. This is the first report on a sizeable experience with IABC from Pakistan.

METHODS: Hospital charts of 95 patients (mean age 58.8 (+/- 10.4) years; 78.9% male) undergoing IABC between 2000-2002 …

Risk Factors And Behaviours For Coronary Artery Disease (Cad) Among Ambulatory Pakistanis, S P. Iqbal, S Dodani, Riaz Qureshi

Department of Family Medicine

Objective: To determine the frequency and distribution of various risk factors and behaviours for coronary artery disease (CAD) among ambulatory Pakistanis.
Methods: It is a cross-sectional descriptive study carried out at the Aga Khan University Hospital, a teaching hospital in Karachi. All the subjects were adults (18-60 years) presenting at the general checkup clinic with no history or evidence of CAD by convenient sampling method. Demographic variables included risk factors and behaviors including diabetes, hypertension, dyslipidemia, family history of heart disease, obesity, smoking and sedentary lifestyle.
Results: Among 370 ambulatory Pakistanis, the proportions of major risk factors for CAD were: …

Ever Increasing Need For Family Physicians, Waris Qidwai

Department of Family Medicine

No abstract provided.

Barriers To Smoking Cessation: Results Of A Survey Among Family Practice Patients, Waris Qidwai

Department of Family Medicine

Background and Objectives: Tobacco smoking is a major public health problem. We have studied barriers to smoking cessation among family practice patients.
Methods: It was a questionnaire based survey, conducted at Family Pr actice Center, Aga Khan University Hospital, Karachi, Pakistan, in July 2003. A trained volunteer administered the questionnaire that included data on demographic profile of the patient and information barriers to smoking cessa tion.Ethical requirement including the administration of written informed consent and the provision of confidentiality were ensured. SPSS computer software was used for data management.
Results: A total of 100 patients were interviewed, of which …

Level Of Preparedness Of Patients For Medical Emergency, Waris Qidwai, Ss Ali, M Baqir, S Ayub

Department of Family Medicine

No abstract provided.

Evidence Based Medicine: Transforming Research Into Practice, Waris Qidwai

Department of Family Medicine

No abstract provided.

Structured Feedback From Students In Tutorial Teaching, Waris Qidwai

Department of Family Medicine

No abstract provided.

Awareness Of The Process Of Informed Consent Among Family Practice Patients In Karachi, H. Bhurgri, Waris Qidwai

Department of Family Medicine

Objective: To study the awareness of 'Informed Consent', among patients presenting to Family Physicians.
Methods: A cross-sectional study was carried out at the Community Health Centre, Aga Khan University Hospital, Karachi in July 2002. Written Consent was taken and confidentially was assured
Results: Out of the 100 patients interviewed, 80 agreed to participate in the study, forty-four men and thirty-six women. Approximately half the participants (45%) were graduates and 40% had less than five years of school education. The awareness of the process of 'informed consent' was observed in only 20% of the respondents, all in the educational …

Perception About Family Physicians: Results Of A Survey Of Patients Visiting Specialist Clinics For Treatment, S. A. Huda, Z. A. A. Samani, Waris Qidwai

Department of Family Medicine

Objective: To study the perceptions about Family Medicine among patients visiting Specialist Physicians for treatment.
Methods: A questionnaire based survey was conducted at the Specialist Clinic, Aga Khan University Hospital, Karachi, Pakistan, in June 2004. Trained volunteers administered the questionnaire among patients visiting Specialist Physicians for treatment. Confidentiality was ensured to all patients and written informed consent was taken as part of the ethical requirements for the conduct of the study. SPSS computer software and Microsoft Excel were used for data management.
Results: A total of 100 patients visiting the Specialist Clinic were interviewed, of which fifty four …

Distribution Of Lower Urinary Tract Symptoms (Luts) In Adult Women, M Andrades, R Paul, A Ambreen, S Dodani, Rh Dhanani, Waris Qidwai

Department of Family Medicine

OBJECTIVE: To determine the distribution of lower urinary tract symptoms in adult women and the frequency with which the women consulted a health care provider for their symptoms.
DESIGN: Cross-sectional analytical study.
PLACE AND DURATION OF STUDY: Community Health Center of Aga Khan University Hospital from November 1st to 30th, 2002.
SUBJECTS AND METHODS: A trained interviewer administered a structured questionnaire to women patients or attendants aged 18 years and older coming to the center.
RESULTS: Fifty-two percent of the study subjects reported having at least one or more urinary complaints in the past. Stress incontinence …

A Need To Change Behavior And Attitudes In Medical Practice, Waris Qidwai

Department of Family Medicine

No abstract provided.