Family Medicine Commons^™

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 …

Bullous Eruption On The Posterior Thigh, James Studdiford, Amber Stonehouse

Department of Family & Community Medicine Faculty Papers

No abstract provided.

The Relationship Of Attitude, Self-Efficacy, Physician, And Significant Other Influence To Type 2 Diabetes Outcomes, Heidi A. Larson

All-Inclusive List of Electronic Theses and Dissertations

The purpose of this study was to investigate the Theory of Planned Behavior (TPB) and its' relationship to Type 2 diabetes outcomes. One hundred and sixty-two adults ages 45 to 75 with Type 2 diabetes were recruited from two physicians' offices in the Midwest. Participants completed instruments that assessed (a) diabetes-specific attitude, (b) diabetes-specific self-efficacy, ( c) physician influence, ( d) significant other influence, and ( e) diabetes-specific quality of life. A measurement of metabolic control was also obtained. Multiple regressions were performed using (a) quality of life and (b) metabolic control as criterion variables. Attitude, self-efficacy, and physician influence …

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 …

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.

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 …

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 …

Revisiting Vaccine Hesitancy, Barriers And Motivators To Obtaining A Flu Vaccine In A New Covid-19 Pandemic World, Ann M. Mayo Rn, Dnsc, Faan, Steffanie R. Cobler Np

School of Nursing and Health Science: Faculty Scholarship

Purpose

To describe and compare patient perceived barriers and motivators and decision-making conflict between two groups of hospitalized patients, those who receive flu vaccines and those who do not.

Data Sources

Data collection during 2003 included extracting data from databases and mailing two surveys to 436 discharged patients. One hundred eight (108) patients participated in the study.

Conclusions

Top barriers included fear of side effects from vaccine (35%) and fear of contracting the flu (30%). Top motivators for obtaining a flu vaccine included previous vaccination (93%) and provider recommendation (62%). Barriers, motivators and patient decisional conflict differed depending upon patient …

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: …

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.

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

Department of Family Medicine

No abstract provided.

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 …

Ever Increasing Need For Family Physicians, 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 …

The Hippocratic Oath: Has It Ceased To Be Relevant?, Waris Qidwai

Department of Family Medicine

The Greek physician Hippocrates (460-377 B.C) is traditionally regarded as the founder of medicine, scientific discipline and medical ethics.The Hippocratic Oath, taken by ancient and medieval doctors, requires high ethical standards from medical doctors. Its principles are considered important in professional and ethical education of medical doctors even today. The Hippocratic Oath has survived, with over-riding power, the test of time since it addresses the intrinsic nature of medicine. Even those who know little of it or reject parts of it acknowledge it to be a symbol of the values of medicine. It has been argued that it is its …

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 Young Man With Hoarseness Of Voice, Waris Qidwai, S. Rehman

Department of Family Medicine

A 45 year-old driver presented with a two months history of hoarseness, fever, productive cough, anorexia and weight loss. He chewed tobacco. He was previously seen and treated without benefit by a family Physician and two ear, nose and throat consultants. Crackles were heard in the left scapular region. An X-Ray of the chest showed a right apical cavity, perihilar infiltrates and blunting of left costophrenic angle. His sputum smear showed acid fast bacilli. A high index of suspicion for tuberculosis is recommended while dealing with such cases. Complete recovery of patient's voice with anti-tubercular therapy confirmed it was a …

Patients' Views About Physicians' Spiritual Role In Medical Practice, Waris Qidwai, Arsalan Tayyab

Department of Family Medicine

OBJECTIVE: To study patient perceptions with regard to spirituality in medical practice.
DESIGN: A questionnaire-based survey.
PLACE AND DURATION OF STUDY: Family Practice Center of Aga Khan University Hospital, Karachi, Pakistan, during July 2003.
SUBJECTS AND METHODS: Family practice patients were interviewed using a questionnaire which included data on demographic profile of the patient and perceptions on spirituality in medical practice. The study investigators administered the questionnaire without using systematic randomization. Ethical requirements including the administration of a written informed consent and the provision of confidentiality were ensured. SPSS computer software was used for data management.
RESULTS …

Knowledge, Attitude And Practice Regarding Obesity Among Patients, At Aga Khan University Hospital, Karachi, Waris Qidwai, Iqbal Azam

Department of Family Medicine

BACKGROUND: Obesity is a major public health problem and responsible for significant morbidity and mortality among our patients. It is important to study the knowledge, attitude and practices with regard to obesity among patients, in order to devise interventional strategies.
METHODS: Patients visiting the out-patient clinics of Aga Khan University Hospital, Karachi, were included in the study. The interview was questionnaire-based and recorded the demographic profile of the patients and questions relevant to the objective of the study. The ethical requirements for the study were met. SPSS computer software was used for data management. A hundred patients were surveyed. …

Consequences Of A Medical Emergency Among Emergency Room Patients, Waris Qidwai, Ali Ss, M Baqir, Shahana Ayub

Department of Family Medicine

Objective: To study the consequences of a medical emergency among Emergency Room patients, at a teaching hospital in Karachi, Pakistan.
Design: A questionnaire-based survey
Settings: Emergency Room of Aga Khan University Hospital in Karachi, Pakistan. Main outcome measures: Consequences of a medical emergency in terms of impact on employment, financial position, family life, social life, recreational life, self-confidence and psyche.
Results: A hundred patients were surveyed. Emergency Room patients feel that they will not have a major impact on their job or employment, as a result of the medical emergency but it will have adverse financial consequences. The …

The Art Of Practicing Scientific Medicine, Waris Qidwai

Department of Family Medicine

No abstract provided.

Utilization Of Services Of Homeopathic Practitioners Among Patients In Karachi, Pakistan, Waris Qidwai

Department of Family Medicine

BACKGROUND: The practice of homeopathy is becoming very popular. There is a need to study and understand as to why this is happening and to raise debate on the issue.
METHODS: The study was conducted on patients, visiting the Family Practice Centre, The Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the utilization of the services of homeopathic practitioners. The ethical requirements for conducting the study were met.
RESULTS: Three hundred and eighty-seven patients were surveyed. The study population included more women then men, with average age of 32.6 years. …