Family Medicine Commons^™

Frontotemporal Dementia In A Hispanic Female, Lynn M. Wilson Do, Nyann Biery Ms

Department of Family Medicine

No abstract provided.

Integrating Primary Care And Wellness Into A Community Mental Health Clinic, Brett Williamson Msw, Mba, Brenda Frutos Mph, Ches, Nyann Biery Ms

Department of Family Medicine

No abstract provided.

Tracking The Trajectory Of Resident Learning Through The Lens Of Self-Determination Theory., Susan E. Hansen Ma, Nicole L. Defenbaugh Phd, Susan S. Mathieu Md, Linda Garufi Md, Med, Julie Dostal Md

Department of Family Medicine

No abstract provided.

Increasing Interest In Family Medicine Through Innovative Student Curriculum And Promotion Of Shared Work Among All Levels Of Medical Learners, Katerina C. Valavanis Md, Veronica Brohm Do, Yasir Abunamous Md

Department of Family Medicine

No abstract provided.

Frequency And Factors Associated With Adult Immunization In Patients Visiting Family Medicine Clinics At A Tertiary Care Hospital, Karachi, Samar Zaki, Asma Usman, Swaleha Tariq, Sameena Shah, Iqbal Azam Syed, Waris Qidwai, Kashmira Nanji

Department of Family Medicine

Objective: The goal of this study was to determine the frequency and factors associated with adult immunization in patients visiting family medicine clinics at a tertiary care hospital in Karachi.
Methods: A cross-sectional study was conducted from March 2014 to March 2015 in a tertiary care hospital in Karachi, Pakistan. Participants more than 18 years were invited to participate in the study. A pretested questionnaire was used to collect information. Data were entered and analyzed using IBM SPSS Statistics for Windows, version 19.0 (Armonk, NY: IBM Corp).
Results: A total of 340 patients were surveyed. The majority of patients …

Health Literacy In Pakistan: Exploring New Ways Of Addressing An Old Challenge, Saniya Raghib Sabzwari

Department of Family Medicine

Pakistan continues to struggle with low health literacy that often results in late presentation of disease, poor adherence to treatment and meagre understanding of wellness and disease prevention. In a country burdened by diseases of the developing and the developed world, with poor healthcare infrastructure and low literacy levels improving healthcare literacy could have major influence on health and wellness of our masses. Utilising our rapidly expanding mobile technology and media for dissemination of health information is a viable solution. Public service announcements for media and health information apps for mobile technology can be developed by the government, health sector …

Increasing Colorectal Cancer Screening Among Hispanic Primary Care Patients: Re-Aim Analysis., Beth Careyva M.D., Melanie B. Johnson Mpa, Randa D. Sifri Md, Melissa Dicarlo Mph, Ms, Kyle Shaak Bs, Alicia Rivera, Liselly Diaz, Andrea Barsevick, Rosa Anderson-Deortiz, Evelyn T. Gonzalez Ma, Amy Leader Drph, Mph, Anett Petrich Rn, Msn, Anna Quinn Mph, Ryt, Brian Stello Md, Ronald E. Myers Phd

Department of Family Medicine

Context: Hispanic adults experience disparities in rates of colorectal cancer (CRC) screening. This RE-AIM analysis encompassed a multilevel decision support and navigation intervention (DSNI) for CRC screening. Interim findings were previously presented; we now aim to share the final analysis, particularly for effectiveness and implementation. Objective: Apply RE-AIM framework to a completed randomized controlled trial of a CRC screening intervention for Hispanic adults Setting: Five primary care practices Patients or Other Participants: Potential participants included a sampling frame of 2,720 screening-eligible patients, ages 50-75, Hispanic ethnicity, without history of CRC and polyps. 400 participants were enrolled. Intervention/Instrument: Decision support and …

Repeat Crc Screening After Standard And Decision Support And Navigation Interventions Among Hispanic Primary Care Patients., Melanie B. Johnson Mpa, Beth Careyva M.D., Melissa Dicarlo Mph, Ms, Kyle Shaak Bs, Sarah Hegarty Mphil, Evelyn T. Gonzalez Ma, Anna Quinn Mph, Ryt, Randa Sifri Md, Brian Stello Md, Ronald E. Myers Phd

Department of Family Medicine

No abstract provided.

Let's Talk! Engaging The Community In Advance Care Planning Through Games., Seth Vanzant, Aleksandra Bacewicz, Alexandria Holmes, Priscilla Shen, Lora Bojilova, Robert Levy, Nicole Defenbaugh Phd, Robert Motley Md

Department of Family Medicine

No abstract provided.

Impact Of Caregiving On Various Aspects Of The Lives Of Caregivers, Babar Irfan, Omar Irfan, Ahmed Ansari, Waris Qidwai, Kashmira Nanji

Department of Family Medicine

Objective: This study was designed to assess the impact of caregiving on the lives of the caregivers.

Methods: A cross-sectional study was conducted between July and September 2015 at a teaching hospital in Karachi, Pakistan. Participants who were more than 18 years old and were involved in caregiving (former or current) of a family member were invited to participate in the study. The participants were recruited through consecutive sampling technique. A total of 400 caregivers were interviewed. Written informed consent was obtained from all the participants. A pretest structured questionnaire was used for data collection and included sections …

New Leadership Model For Family Physicians In The Eastern Mediterranean Region: A Pilot Study Across Selected Countries, Salman Rawaf, Waris Qidwai, Tam Khoja, Kashmira Nanji, Ny Kurashi, F Alnasir, Ma Al Shafaee, M Al Shetti, M Bashir, Nes Saad, S Alkaisi, W Halasa, H Al-Duwaisan, A Al-Ali, Tm Farahat, M Tarawneh, A Khathami, A Abutiheen, Iqbal Azam Syed, A Swaka

Department of Family Medicine

Background: Family Medicine is growing rapidly across the Eastern Mediterranean Region. However, it needs support in terms of overall health system development. This will require strong leadership in family medicine to implement the change required to improve current conditions.

Objective: To collect data that will support the development of a leadership program for the future family physicians in the region.

Methods: A cross-sectional study was conducted from July 2016 to September 2016 in eight countries of the Eastern Mediterranean Region, (Bahrain, Egypt, Iraq, Jordan, Kuwait, Qatar, Pakistan, and Saudi Arabia). These countries were selected to obtain perceptions …

Role Of Assessment For Retreatment With Transarterial Chemoembolization Score In Decision Of Retreatment With Trans-Arterial Chemo-Embolization Sessions In Patients With Hepatocellular Carcinoma, Anwar Hussain Abbasi, Shahab Abid, Tanveer Ul Haq, Safia Awan

Department of Family Medicine

Background: The objective behind this study was to determine that Assessment for Retreatment with Transarterial chemoembolization (ART) score is really applicable in patients with hepatocellular carcinoma.
Methods: A cross sectional observational study was conducted on all patients with hepatocellular carcinoma of intermediate stage and undergone ≥2 Transarterial chemoembolization. ART score was assessed before and after each session of Transarterial chemoembolization. Multi-logistic regression analysis was performed to compare the final outcome of patients with ART score of ≥2.5 into groups with two and more than two Trans-arterial chemo-embolization sessions.
Results: A total of 100 HCC patients were recruited for final analysis. …

Exploring Health Beliefs Among Hispanic Adults With Prediabetes (Poster)., Kyle Shaak Bs, Beth Careyva M.D., Susan E. Hansen Ma, Melanie B. Johnson Mpa, Samantha A. Goodrich, Alicia Rivera, Liselly Diaz, Jessecae K. Marsh Phd, Clare Lenhart Phd, Brian Stello Md

Department of Family Medicine

No abstract provided.

Implementation Of Technology-Based Patient Engagement Strategies Within Practice-Based Research Networks (Poster), Beth Careyva M.D., Kyle Shaak Bs, Geoffrey Mills Md, Phd, Melanie B. Johnson Mpa, Samantha A. Goodrich, Brian Stello Md, Lorraine S. Wallace Phd

Department of Family Medicine

Careyva, B. Shaak, K. Mills, G. Johnson, M. Goodrich, S. Stello, B. Wallace, L. (2016, Nov). Implementation of Technology-Based Patient Engagement Strategies within Practice-Based Research Networks. Poster Presented at: North American Primary Care Research Group, Colorado Springs, CO.

Burden And Associated Factors For Caregivers Of The Elderly In A Developing Country, S Sabzwari, A Munir Badini, Z Fatmi, T Jamali, S Shah

Department of Family Medicine

The elderly population in South Asia is growing. In Pakistan trained caregivers are scarce and culturally not acceptable. This study assessed the level of stress experienced by caregivers of the elderly and determined the association of care giving burden with different characteristics of the elderly. A cross-sectional, questionnaire based study was conducted using nonprobability purposive sampling. All consenting participants aged 60 years and above needing help with at least one activity of daily living or two instrumental activities of daily living were included. 350 participants were assessed for perceived care giver burden. Care providers were mostly female (68.9%). Half (50.3%) …

Effectiveness Of An Interventional Program For The Management Of Hypertension Through Strengthening Of The Health Care Delivery System : A Pilot Study, Waris Qidwai, Khawar Kazmi, Kashmira Nanji, Sana Anees

Department of Family Medicine

Background: The aim of the study was to assess the effectiveness of an interventional program to improve hypertension management through strengthening of the health care delivery system.
Methods: A pilot study was conducted from February to December 2014 in two off-site Family Medicine clinics of the Aga Khan Hospital Karachi, Pakistan. Patients aged > 40 years, with known hypertension were included. At the intervention site, Family Physicians were trained; individual and group education sessions were conducted for catchment population, while usual care was provided at the control site. Referral system between primary, secondary and tertiary levels of care was …

Translational Research And Complexity Of Clinical Practice: Issues, Challenges, And Way Forward, Waris Qidwai

Department of Family Medicine

No abstract provided.

Impact Of Cable Television On Lives Of Patients Visiting A Teaching Hospital In Karachi, Pakistan, Waris Qidwai, Kashmira Nanji, Madeeha Anwar Adam

Department of Family Medicine

A cross sectional survey was conducted during August 2014 to October 2014, to identify the impact of cable television channels on lives of the people, in Karachi, Pakistan. Three hundred participants were selected through convenience sampling and a pre-tested structured questionnaire was used for data collection. Data was analyzed in SPSS version 19.0. About 15% of participants were more than 40 years. About 62% were females in the study sample. Regression analysis showed that viewing television at night impacts work performance (OR: 1.39; 95% CI: 0.81-2.37), sleep (OR: 1.07; 95% CI: 0.63-1.81), family life (OR: 1.52; 95% CI: 0.89-2.60) and …

Primary Healthcare Policy Implementation In South Asia, Chris Van Weel, Ryuki Kassai, Waris Qidwai, Raman Kumar, Kanu Bala, Pramendra Prasad Gupta, Ruvaiz Haniffa Haniffa, Neelamani Rajapaksa Hewageegana, Thusara Ranasinghe, Michael Kidd, Amanda Howe

Department of Family Medicine

Primary healthcare is considered an essential feature of health systems to secure population health and contain costs of healthcare while universal health coverage forms a key to secure access to care. This paper is based on a workshop at the 2016 World Organization of Family Doctors (WONCA) South Asia regional conference, where the health systems of Bangladesh, India, Nepal, Pakistan and Sri Lanka were presented in relation to their provision of primary healthcare. The five countries have in recent years improved the health of their populations, but currently face the challenges of non-communicable diseases and ageing populations. Primary healthcare should …

Hip Fragility Fractures: Anaemia, Calcium And Vitamin D Supplementation, Iqra Khan, Ambreen Jawaid, Khabir Ahmad, Shahryar Noordin

Department of Family Medicine

Objective: To assess the burden of anaemia and osteoporosis in hip fracture patients, to determine the rate of blood transfusion per-operatively, to assess the use of calcium and vitamin D supplements and the use of anti-osteoporotic medications postoperatively.
Methods: A retrospective study was conducted at Aga Khan University and Hospital (AKUH) between June 2009 and May 2011, and comprised record of patients treated for intertrochanteric and femur neck fractures. Patients with associated pathological, open or long bone fractures were excluded. The main study outcome measures were the use of pre-operative and post-operative calcium, vitamin D, bisphosphonates and management of anaemia …

Isoniazid Induced Motor-Dominant Neuropathy, Rabeeya Arsalan, Saniya Sabzwari

Department of Family Medicine

Isoniazid though a very effective treatment for tuberculosis can cause severe motor-dominant neuropathy which can be reversible with pyridoxine supplementation. A 45-year-old female diagnosed with psoas abscess, culture positive for mycobacterium tuberculosis, was started on anti- tuberculous treatment with four drugs, including isoniazid at a dose of 5 mg/kg/day. Three months later she developed severe motor weakness of lower limbs with loss of ankle and knee reflexes. She was treated with vitamin B6 injections and isoniazid treatment was continued. Her motor weakness gradually improved in a few months, but mild sensory impairment persisted even after two years. There is need …

Energy Drinks Consumption Practices Among Medical Students Of A Private Sector University Of Karachi, Pakistan, Asma Usman, Swaleha Tariq Bhombal, Ambreen Jawaid, Samar Zaki

Department of Family Medicine

Consumption of energy drinks has become popular among students and athletes over the past few years. To explore the phenomenon, a cross-sectional survey was conducted through a self-administered pilot-tested questionnaire. Frequency of energy drinks consumption was found to be 121(52%) in a sample of 233 medical students. Red bull was the most common brand consumed 101(43%). The major reasons reported for its usage were to gain/replenish energy by 36(15.4%), and studying for examination by 34(14.6%). Television was reported as the major source of information 153(66%) followed by friends 113(48%). There was a high frequency of energy drinks' consumption among medical …

The Case For Family Medicine In Pakistan, Saniya Raghib Sabzwari

Department of Family Medicine

The specialty of Family Medicine enjoys a special position in the medical practice of the West, serving as one of the key primary care specialties. Family physicians act as providers of first contact catering to the medical needs of the entire family in all aspects of preventive, curative and rehabilitative stages of illness and to health maintenance. The growth of this specialty, however, has lagged behind in Pakistan for various reasons. Having both a high burden of communicable and non-communicable diseases in Pakistan; family physicians should form the frontline force in dealing with these health issues. Several success stories of …

Role Of Evidence-Based Public Health In Controlling Emerging Infectious Diseases, Tawfik A. M. Khoja, Waris Qidwai, Mohamed S. Hussein, Lesley Pocock

Department of Family Medicine

No abstract provided.

Health Promotion, Disease Prevention And Periodic Health Checks: Perceptions And Practice Among Family Physicians In Eastern Mediterranean Region, Waris Qidwai, Kashmira Nanji, Tawfik A M Khoja, Salman Rawaf, Nabil Yasin Al Kurashi, Faisal Alnasir, Mohammed Ali Al Shafaee, Mariam Al Shetti, Muntazar Bashir, Nagwa Eid Sobhy Saad, Sanaa Alkaisi, Wafa Halasa, Huda Al L-Duwaisan, Amal Al - Ali, Taghreed M. Faraha

Department of Family Medicine

Introduction: The aim of this study was to identify the current practices and perceptions of family physicians regarding health promotion, disease prevention including periodic screening and health checks in Eastern Mediterranean Region.
Methods: A multi-country cross-sectional study was conducted in six countries of EMR, from September 2014 to March 2015. Family Physicians who were currently practicing in different countries of EMR were invited to participate in the study through email. A pre-tested structured questionnaire was used for data collection. Data was entered and analyzed on SPSS 19 and logistic regression analysis was performed.
Results: A total of 100 physicians’ …

Delivering Healthcare Services In Resource Constraint Countries Like Pakistan: Sustainable Options, Waris Qidwai

Department of Family Medicine

No abstract provided.

Barriers, Challenges And Way Forward For Implementation Of Person Centered Care Model Of Patient And Physician Consultation: A Survey Of Patients’ Perspective From Eastern Mediterranean Countries, Waris Qidwai, Kashmira Nanji, Tawfik A M Khoja, Salman Rawaf, Nabil Yasin Al Kurashi, Faisal Alnasir, Mohammed Ali Al Shafaee, Mariam Al Shetti, Muntazar Bashir, Nagwa Eid Sobhy Saad, Sanaa Alkaisi, Wafa Halasa, Huda Al Duwaisan, Amal Al- Ali

Department of Family Medicine

Background: Person-Centered Care (PCC) is now considered a mandatory approach in Patient-Physician consultation. The aim of the study was to identify patients’ perception regarding barriers and possible remedies for implementation of PCC in Eastern Mediterranean Region (EMR).
Methods: A cross-sectional multi-country study was conducted in six countries of EMR during May 2014 to October 2014. Expert Family Physicians from each country were identified and asked to participate in the study. The Family Physicians then recruited Patients from their own clinics (>18 years). Data analysis was performed on SPSS 19 and results are reported in the form of …

Psychosocial Risk Factors For Acute Myocardial Infarction: Results Of A Case-Control Study In A Teaching Hospital At Karachi, Pakistan, Kiran Abdul Sattar, Waris Qidwai, Kashmira Nanji

Department of Family Medicine

Objective: To determine psychosocial risk factors for acute myocardial infarction at a teaching hospital in Karachi. Methods: One hundred and fifty three cases were recruited from cardiology clinics and 153 controls from internal medicine and family medicine clinics of Aga Khan University Hospital, Karachi, through non-probability sampling using a structured questionnaire. Cases were those who were diagnosed with acute myocardial infarction for the first time in past month. Controls were selected from family medicine and internal medicine clinics of the same hospital and included patients above the age of 40 years without acute myocardial infarction. Associations between psychosocial risk …

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 …

Role Of Complementary And Alternative Medicine In Controlling Dyslipidemia, Waris Qidwai, Firdous Jahan, Kashmira Nanji

Department of Family Medicine

No abstract provided.