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  1. Research fatigue among injecting drug users in Karachi, Pakistan

    PubMed Central

    2013-01-01

    Background Karachi is the largest metropolis of Pakistan and its economic hub attracting domestic migrants for economic opportunities. It is also the epicenter of HIV epidemic in the country. Since 2004, one pilot study and four behavioral and biological surveillance rounds have been conducted in Karachi. In addition many student research projects have also focused on key risk groups including injection drug users (IDUs). As a result of this extra ordinary exposure of same kind of questions, IDUs know how to respond to high value questions related to sharing of needles or unsafe sexual practices. The purpose of the study was to explore the element of research fatigue among IDUs in Karachi, Pakistan. Methods The study was conducted on 32 spots in Karachi, selected on the basis of estimate of IDUs at each spot. A trained field worker (recovered IDU) visited each spot; observed sharing behavior of IDUs and asked questions related to practices in January 2009. Verbal consent was obtained from each respondent before asking questions. Results On average 14 IDUs were present at each spot and out of 32 selected spots, 81% were active while more than two groups were present at 69% spots. In each group three to four IDUs were present and everyone in the group was sharing. One dose of injecting narcotics was observed. Sharing of syringes, needles and distilled water was observed at 63% spots while professional injector/street doctor was present at 60% spots. Conclusion There is a need to check internal consistency in surveillance research. It is highly likely that IDUs and other risk groups know how to respond to key questions but their responses do not match with the practices. PMID:23758666

  2. The effect of antibacterial soap on impetigo incidence, Karachi, Pakistan.

    PubMed

    Luby, Stephen; Agboatwalla, Mubina; Schnell, Beverly M; Hoekstra, Robert M; Rahbar, Mohammad H; Keswick, Bruce H

    2002-10-01

    We conducted a study to determine if soap containing 1.2% triclocarban would be effective in reducing the incidence of impetigo. We randomized 162 households in a low-income neighborhood of Karachi, Pakistan, to receive a regular supply of 1.2% triclocarban-containing soap (n = 81) or an identically appearing placebo (n = 81); 79 households in a nearby neighborhood were enrolled as standard practice controls. After adjustment for household clustering and covariates, the incidence of impetigo among children living in households receiving triclocarban-containing soap (1.10 episodes per 100 person-weeks) was 23% lower than in households receiving placebo soap (P = 0.28) and 43% lower than the standard habit and practice controls (P = 0.02). The routine use of triclocarban-containing soap by children living in a community with a high incidence of impetigo was associated with a reduced incidence of impetigo. PMID:12452499

  3. Harnessing Photovoice for tuberculosis advocacy in Karachi, Pakistan.

    PubMed

    Mohammed, Shama; Sajun, Sana Zehra; Khan, Faisal S

    2015-06-01

    In Pakistan, despite publically available free testing and treatment throughout the country, there were an estimated 58,000 deaths due to tuberculosis in 2010. Understanding the experiences of people affected by TB is essential in addressing barriers to effective treatment. The Indus Hospital used Photovoice to understand the experiences of people affected by TB in Karachi. Two hundred and thirty photographs and stories were collected from 55 people affected by TB. Five major themes and 12 sub-themes emerged from the data: the physical aspects of TB (weakness and the side effects of the medication), the social aspects of TB (loneliness, stigma, and the fear/guilt of infecting family members), the socio-economic aspects of TB (financial difficulties/poverty and poor living conditions), supportive factors during treatment (support from family and friends, support from welfare organizations, prayer, visiting peaceful places), and recovery (happiness about getting better). The photographs, stories, and a Call for Action were shared at a Gallery event with patients, practitioners, and policy-makers. This study provides a look at the complexities surrounding TB and emphasizes the need for holistic interventions for TB that address all aspects of the disease, including its social determinants. It also highlights the potential of Photovoice as an effective means to bring much-needed attention to this disease. PMID:23793302

  4. Menstrual Knowledge and Practices of Female Adolescents in Urban Karachi, Pakistan

    ERIC Educational Resources Information Center

    Ali, Tazeen Saeed; Rizvi, Syeda Naghma

    2010-01-01

    Menstruation is a normal physiological process that is managed differently according to various social and cultural understandings. Therefore, this cross-sectional study was conducted to explore the menstrual practices among 1275 female adolescents of urban Karachi, Pakistan from April to October 2006 by using interviews. Data was entered and…

  5. The Main Reasons of Declining Educational Standards at Secondary Level in Karachi, Pakistan

    ERIC Educational Resources Information Center

    Faizi, Waqar-un-Nisa; Shakil, Anila Fatima; Lodhi, Farida Azim

    2011-01-01

    The cause of this investigation was to identify the main reasons which decline the educational standards at secondary level in Karachi, Pakistan. It was carried out through survey. The population of the study was both "government and private" schools students and teachers. The views of male and female students and teachers were sought out. One…

  6. Knowledge and Attitude of General Practitioners regarding Autism in Karachi, Pakistan

    ERIC Educational Resources Information Center

    Rahbar, Mohammad Hossein; Ibrahim, Khalid; Assassi, Parisa

    2011-01-01

    General practitioners (GPs) could have an important role in early diagnosis of autism. There have been no studies evaluating the knowledge of GPs regarding autism in Pakistan. We aimed to fill that gap by assessing knowledge and attitude of GPs in Karachi regarding autism. We conducted a cross-sectional survey of 348 GPs; only 148 (44.6%) had…

  7. Heavy Metals Contamination in Coastal Sediments of Karachi, Pakistan

    NASA Astrophysics Data System (ADS)

    Siddique, A.; Mumtaz, M.; Zaigham, N. A.; Mallick, K. A.; Saied, S.; Khwaja, H. A.

    2008-12-01

    Toxic compounds such as heavy metals exert chronic and lethal effects in animals, plants, and human health. With the rapid industrialization, urbanization, and economic development in Karachi, heavy metals are continuing to be introduced to estuarine and coastal environment through rivers, runoff and land-based point sources. Pollution in the Karachi coastal region (167 km long) is mainly attributed to Lyari and Malir Rivers flowing through the city of Karachi. Both rivers are served by various channels of domestic and industrial wastes carrying more than 300 million gallons per day untreated effluent of 6000 industries and ultimately drain into the beaches of Arabian Sea. Concentrations of selected heavy metals (Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, and Zn) in surface sediments from eighty-eight sites in Karachi coastal region were studied in order to understand metal contamination due to industrialization, urbanization, and economic development in Karachi. Sediment samples were collected in 2005 and 2006. We have found that heavy metal concentrations in surface sediments varied from 0.006 to 24.3 ug/g for Cd, 5.1 to 95 ug/g for Co, 2.9 to 571 ug/g for Cr, 6.9 to 272 ug/g for Cu, 0.55 to 6.5% for Fe, 1.2 to 318 ug/g for Mn, 7.5 to 75 ug/g for Ni, 6.3 to 121 ug/g for Pb, and 3.3 to 389 ug/g for Zn. Enrichment factors (EFs) were calculated to assess whether the concentrations observed represent background or contaminated levels. The highest levels of metals were found to be at the confluence of the Lyari and Malir River streams at the Arabian Sea, indicating the impact of the effluents of the highly urbanized and industrialized city of Karachi. Furthermore, this study assessed heavy metal toxicity risk with the application of Sediment Quality Guideline (SQG) indices (effect range low/effect range median values, ERL/ERM). Results indicated that the potential toxicity of marine environment can cause adverse biological effects to the biota directly and the human health

  8. Consequences of traffic noise in residents of Karachi, Pakistan

    PubMed Central

    Siddiqui, Imtiaz Ather; Nizami, Sohaib; Chandio, Rida Rouf; Nizami, Saad; Sikander, Nazish; Ashraf, Sana

    2015-01-01

    Objective: To find out effect of road traffic noise on human beings in busy places of Karachi, working at these places and to compare its results with the previously done studies on this subject. Methods: This prospective epidemiological study was designed to evaluate effects of Noise induced hearing Loss due to road traffic at different places (Gurumander, Tibet Centre, Marry Weather Tower) of Karachi. A sample of 125 cases were randomly selected who had noise exposure of 90 dB or above of their surroundings for more than 6 months. The study was conducted from October 1st 2013 to January 1st 2013. Results: The minimum age was 18 years while maximum age was 47 years. The age group found most affected was from 23 years to 27 years. The males were 84% and females 16%. Subjects exposed to noise for more than 12 hours per day were 36.8%. Varying degree of hearing loss was evaluated in subjects where 17.6% were normal, 33.6% had mild hearing loss, 45.6% had moderate and 3.2% had moderately severe hearing loss. Traffic noise was found to bother 55.2% of subjects. Conclusion: Analysis of data indicates an enormous increase in noise levels as compared to previous studies. This study establishes that there exists a concrete direct link between NIHL and duration of exposure to noise above permissible levels. Traffic authorities should initiate measures to reduce the noise levels in the city particularly at more noisy places. PMID:26101509

  9. Exploring Fathers’ Role in Breastfeeding Practices in the Urban and Semiurban Settings of Karachi, Pakistan

    PubMed Central

    Mithani, Yasmin; Premani, Zahra Shaheen; Kurji, Zohra; Rashid, Shehnaz

    2015-01-01

    ABSTRACT This study explored fathers’ perceptions about breastfeeding infants. A qualitative exploratory study design was used. Study setting was urban and semiurban areas of Karachi, Pakistan. In-depth interviews were conducted with 12 fathers. The following themes emerged from the data collected: knowledge and awareness and enabling and impeding factors. Most fathers seemed eager to get involved and assist their partners in proper breastfeeding practices because they believed that doing so is in accordance with their faith. Fathers felt that adequate support from their family members and employers could enable them to encourage their partners to initiate and maintain exclusive and optimum breastfeeding practices. Exploring fathers’ perception regarding breastfeeding in the context of Pakistan is still a new field of study. PMID:26834446

  10. Predictors of Vaccination Card Retention in Children 12-59 months old in Karachi, Pakistan

    PubMed Central

    Sheikh, Sana Sadiq; Ali, Syed Asad

    2014-01-01

    Objective To determine the factors associated with retaining the vaccination card among care takers of 12-59 months old children in Karachi, Pakistan. Methods This was an analytical cross-sectional study in Karachi. Households were randomly selected throughout a multistage cluster sampling technique. Data was collected for 504 children of 12- 59 months of age. Questionnaire was administered to caretakers to gather information regarding the children’s vaccination status, socio-demographic characteristics and reviewing their vaccination cards. Statistical analysis was done by SPSS 19 using logistic regression. Results: Among 462 vaccinated children, caretakers of 33% provided vaccination cards. Odds of card retention decrease if the caretaker has a large household i.e., >5 people sharing one room (AOR 0.277, 95% CI: 0.096, 0.797) and if the child is of four to five years of age (AOR 0.544, 95% CI: 0.305, 0.970). Gender of the child, and the caretaker’s education and access to electronic media were not significant predictors of vaccination card retention in our study. Conclusion Our study showed that vaccination card retention for children 12-59 months of age was low (33%) in Karachi. There is a need to educate caretakers of young children regarding the importance of keeping vaccination card and to disseminate this information through healthcare providers. Improving vaccination card retention is one of the key measures which will help towards accurately estimating coverage and to inform health policy decisions. PMID:24936268

  11. Source apportionment of particulate matter in a South Asian Mega City: A case study of Karachi

    NASA Astrophysics Data System (ADS)

    Shahid, imran

    2016-04-01

    Pakistan is facing unabated air pollution as a major issue and its cities are more vulnerable as compared to urban centers in the developed world. During the last few decades, there has been a rapid increase in population, urbanization, industrialization, transportation and other human activities. In year June 2015 heat wave in largest South Asian mega city Karachi more than 1500 people died in one week. Unfortunately no air quality monitoring system is operation in any city of Pakistan. There is a sharp increase in both the variety and quantity of air pollutants and their corresponding sources. In this study contributions of different sources to particulate matter concentration has estimated in urban area of Karachi. Carbonaceous species (elemental carbon, organic carbon, carbonate carbon), soluble ions (Ca++, Mg++, Na+, K+, NH4+, Cl-, NO3-, SO4--), saccharides (levoglucosan, galactosan, mannosan, sucrose, fructose, glucose, arabitol and mannitol) were measured in atmospheric fine (PM2.5) and coarse (PM10) particles collected under pre-monsoon conditions (March - April 2009) at an urban site in Karachi (Pakistan). Average concentrations of PM2.5 were 75μg/m3 and of PM10 437μg/m3. The large difference between PM10 and PM2.5 originated predominantly from mineral dust. "Calcareous dust" and „siliceous dust" were the overall dominating material in PM, with 46% contribution to PM2.5 and 78% to PM10-2.5. 20 Combustion particles and secondary organics (EC+OM) comprised 23% of PM2.5 and 6% of PM10-2.5. EC, as well as OC ambient levels were higher (59% and 56%) in PM10-2.5 than in 22 PM2.5. Biomass burning contributed about 3% to PM2.5, and had a share of about 13% of "EC+OM" in PM2.5. The impact of bioaerosol (fungal spores) was minor and had a share of 1 and 2% of the OC in the PM2.5 and PM10-2.5 size fractions. Of secondary inorganic constituents (NH4)2SO4 contributes 4.4% to PM2.5 and no detectable quantity to PM10-2.5. The sea salt contribution is about 2% both to

  12. Prevalence of syphilis among antenatal clinic attendees in Karachi: Imperative to begin universal screening in Pakistan

    PubMed Central

    Shah, SA; Kristensen, S; Memon, MA; Usman, G; Ghazi, A; John, R; Sathiakumar, N; Vermund, SH

    2013-01-01

    Objectives Sexually transmitted infections are thought by some to be rare in socially conservative Muslim countries. Little is known about prevalence of syphilis in Pakistani women from the general population. We determined syphilis prevalence in a multi-center cross-sectional study of low risk pregnant women in Karachi, Pakistan. Methods We administered a structured questionnaire and obtained a blood sample for syphilis serology (rapid plasma reagin test with Treponema pallidum hemagglutination assay confirmation) from all women giving informed consent over six weeks in 2007. Results The prevalence of confirmed syphilis was less than one percent (0.9%; 95%CI: 0.4, 1.8) in a sample size of 800 women recruited from three urban sites (≈1% refusal rate). Women who lived in an area where male drug use is prevalent (Ibrahim Hyderi Hospital) had 1% (1.5%) higher prevalence rates than women from the other two sites 0.5%. Conclusions We documented higher-than-expected syphilis seroprevalence rates in a low risk population of antenatal clinic attendees in Pakistan. Bridge populations for syphilis may include drug users, who are usually married, and Hijras or their clients. Hijras are transgender and/or transvestite men who may provide sex for money to men. In accordance with our results, the national policy for syphilis control in Pakistan should be modified to include universal syphilis screening in antenatal clinics with subsequent partner notification. PMID:22356034

  13. Risk factors for typhoid fever in an endemic setting, Karachi, Pakistan.

    PubMed

    Luby, S P; Faizan, M K; Fisher-Hoch, S P; Syed, A; Mintz, E D; Bhutta, Z A; McCormick, J B

    1998-03-01

    We conducted a study to evaluate risk factors for developing typhoid fever in a setting where the disease is endemic in Karachi, Pakistan. We enrolled 100 cases with blood culture-confirmed Salmonella typhi between July and October 1994 and 200 age-matched neighbourhood controls. Cases had a median age of 5.8 years. In a conditional logistic regression model, eating ice cream (Odds ratio [OR] = 2.3; 95% confidence interval [CI] 1.2-4.2, attributable risk [AR] = 36%), eating food from a roadside cabin during the summer months (OR = 4.6, 95% CI 1.6-13.0; AR = 18%), taking antimicrobials in the 2 weeks preceding the onset of symptoms (OR = 5.7, 95% CI 2.3-13.9, AR = 21%), and drinking water at the work-site (OR = 44.0, 95% CI 2.8-680, AR = 8%) were all independently associated with typhoid fever. There was no difference in the microbiological water quality of home drinking water between cases and controls. Typhoid fever in Karachi resulted from high-dose exposures from multiple sources with individual susceptibility increased by young age and prior antimicrobial use. Improving commercial food hygiene and decreasing unnecessary antimicrobial use would be expected to decrease the burden of typhoid fever. PMID:9593481

  14. Firearm Injuries Presenting to a Tertiary Care Hospital of Karachi, Pakistan

    PubMed Central

    Nasrullah, Muazzam; A Razzak, Junaid

    2009-01-01

    Abstract: Background: Violence is a public health problem in low and middle income countries. Our study attempted to define the circumstances, risk groups, extent and severity of firearm-related injuries in patients coming to the Aga Khan University Hospital (AKUH) Karachi, Pakistan. Methods: This was a retrospective study conducted in the department of Emergency Medicine (EM) at AKUH Karachi, Pakistan. Past medical records of all patients who were injured by firearms and were presented to the AKUH Emergency Department (ED) from June 2002 till May 2007 were reviewed. Data were recorded on the basic demographics of injured, length of hospital stay, body parts injured and the outcome (alive vs. dead). Results: Total of 286 patients with firearm injuries were identified. Majority of them were males (92%; n=264). More than half of the patients (63%) were in the age group of 21-40 years. Upon arrival to the hospital 85% (n=243) of patients had Glasgow Coma Scale (GCS)>= 13. The mean injury severity score (ISS) was found to be 6 (SD ±4). The length of hospital stay of patients ranged from 0 to 54 days with a mean of 7 days. Lower limb were the most affected body parts (30%, n=86) followed by abdomen pelvis (27%, n=77). Seven percent (n=21) of the patient who were brought to the hospital were labeled as "deceased on arrival". Most of the injuries were caused during the act of robbery (40%, n=103) in the city. Conclusions: Robbery was the most common cause of firearm injuries. Lower limb, abdomen and pelvis were the most affected body regions. Educational efforts, and individual, community and societal approaches are needed to alleviate firearm-related injuries. PMID:21483188

  15. Predictors of diarrheal mortality and patterns of caregiver health seeking behavior in in Karachi, Pakistan

    PubMed Central

    Qamar, Farah Naz; Zaman, Umber; Quadri, Farheen; Khan, Asia; Shaikh, Babar Tasneem; Azam, Iqbal; Nasrin, Dilruba; Kotloff, Karen; Levine, Myron; Brown, Nick; Zaidi, Anita K M

    2016-01-01

    Background Pakistan is unfortunately among the five countries that contributed to the most deaths due to diarrhea and pneumonia in 2010. To explore factors associated with diarrheal deaths we assessed care–seeking behavior and other predictors of diarrhea–related mortality in children in selected low–income peri–urban communities of Karachi, Pakistan. Methods A mixed methods study (qualitative and quantitative) using matched case–control design and focus group discussions with parents of children with moderate to severe diarrhea (MSD) was undertaken. Cases were children  <5 years of age who died within 60 days of developing an episode of MSD. Controls were age–matched children who survived after 60 days of an episode of MSD. Demographic, clinical, and care–related behavioral predictors of mortality were assessed. Conditional logistic regression was performed, matched adjusted odds ratios (mOR) are reported. Results Parents of 77 cases and 154 controls were interviewed. Cases were less likely to receive appropriate care compared to controls (mOR = 0.2, 95% confidence interval (CI) 0.05–0.91). Refusal for hospital admission (OR = 8.9, 95% CI 2.6–30.8), and delays in reaching the health facility (OR = 3.6, 95% CI 1.0–12.9) were significant independent predictors of mortality. We found strong beliefs in traditional and spiritual healing in the population; use of both modern and traditional/spiritual treatments concurrently was common. Conclusion Appropriate care seeking behavior predicts survival in children with diarrhea in Pakistan. There is a complex belief system relating to traditional and standard therapies. Health education for appropriate health care seeking should be implemented in order to achieve a substantial decline in diarrheal disease mortality in Pakistan. PMID:27606059

  16. Status of free-living amoebae (Acanthamoeba spp., Naegleria fowleri, Balamuthia mandrillaris) in drinking water supplies in Karachi, Pakistan.

    PubMed

    Yousuf, Farzana Abubakar; Siddiqui, Ruqaiyyah; Subhani, Faysal; Khan, Naveed Ahmed

    2013-06-01

    The ability of pathogenic free-living amoebae to produce infections is a growing concern. In this study, we investigated the presence of free-living amoebae (Acanthamoeba spp., Naegleria fowleri, Balamuthia mandrillaris) in drinking water supplies in Karachi, Pakistan. Fifty-two domestic tap water samples were examined. Amoebae were identified by morphological characteristics and polymerase chain reaction. Thirty percent of the examined samples were positive for Acanthamoeba spp., 8% for N. fowleri while B. mandrillaris were not recovered. Additionally we examined secretory IgA antibody to Acanthamoeba and B. mandrillaris. Acanthamoeba antibody prevalence rate was 100% in both males and females, while B. mandrillaris antibody prevalence rate was 5.5% in males only (females were negative). Our findings suggest that free-living amoebae are a potential health hazard in domestic water supplies in Karachi, Pakistan. PMID:23708583

  17. Understanding the knowledge and perceptions about clubfoot in Karachi, Pakistan: a qualitative exploration.

    PubMed

    Burfat, Aziza; Mohammed, Shama; Siddiqi, Osman; Samad, Lubna; Khan, Mansoor Ali; Chinoy, Mohammad Amin

    2013-01-01

    This paper explores local knowledge and perceptions about clubfoot in the Indus Hospital's catchment population in Karachi, Pakistan. Data was collected through seven focus group discussions with community members and Lady Health Workers, nine in-depth interviews with parents of children with treated or untreated clubfoot, and one interview with an adult with untreated clubfoot. We found that participants were unable to distinguish clubfoot from other disabilities. Moreover, participants had a number of beliefs about the causes of clubfoot, which included lunar and solar eclipses, religious explanations, the health status and behaviours of parents, and genetics. While participants were aware of surgery and other allopathic treatments for clubfoot, many also believed in traditional and religious treatments or were unaware that clubfoot is a treatable condition. This study is the first of its kind in Pakistan and provides important insights that clubfoot programs need comprehensive strategies to raise awareness about clubfoot amongst community members, health providers, and religious leaders in order to be successful. PMID:24027475

  18. Aflatoxins in composite spices collected from local markets of Karachi, Pakistan.

    PubMed

    Asghar, Muhammad Asif; Zahir, Erum; Rantilal, Summan; Ahmed, Aftab; Iqbal, Javed

    2016-06-01

    This survey was carried out to evaluate the occurrence of total aflatoxins (AFs; B1+B2+G1+G2) in unpacked composite spices. A total of 75 samples of composite spices such as biryani, karhai, tikka, nihari and korma masalas were collected from local markets of Karachi, Pakistan, and analysed using HPLC technique. The results indicated that AFs were detected in 77% (n = 58) samples ranging from 0.68 to 25.74 µg kg(-1) with a mean of 4.63 ± 0.95 µg kg(-1). In 88% (n = 66) samples, AFs level was below the maximum limits (ML = 10 µg kg(-1)) as imposed by EU. Furthermore, 61% (n = 46) tested samples contained AFs level between 1 and 10 µg kg(-1), 9% (n = 7) exhibited AFs contamination ranged 10-20 µg kg(-1) and only 3% (n = 2) of the investigated samples contained AFs levels higher than the ML of 20 µg kg(-1) for total aflatoxins as set by the USA. It was concluded that there is need to establish a strict and continuous national monitoring plan to improve safety and quality of spices in Pakistan. PMID:26883485

  19. Objects of temporary contraception: an exploratory study of women's perspectives in Karachi, Pakistan

    PubMed Central

    Marvi, Kamyla; Howard, Natasha

    2013-01-01

    Objectives To explore perspectives of three modern contraceptive objects, using an emic approach, among women in a low-income community in Karachi, Pakistan. Design A qualitative interview study design was employed, using qualitative content analysis with an inductive approach and manual thematic coding. Setting Shah Faisal Colony, Karachi. Participants 20 women, potential contraceptive users of reproductive age and living within a health centre catchment, were purposively selected to provide a similar number of non-users (n=5), contraceptive injection users (n=7), pill users (n=4), and intrauterine device users (n=4). One interview was excluded because it was not recorded. No other exclusion criteria were used. Primary and secondary outcome measures The primary outcome was interpretation of potency and effects of selected family planning objects. Secondary outcome measures were knowledge of family planning and description of therapeutic approaches used and preferred. Results Awareness of family planning was high. Women described different therapeutic approaches, stating they generally preferred modern medicine for contraception as it was fastest and most powerful. They reported that fear of some contraceptive objects, particularly injections and intrauterine contraceptive devices, influenced their choices. Women explained their perceptions of how the heating effects of contraceptives could cause unwanted side effects including menstrual irregularities, weight gain and weakness, leading to disease. Conclusions Most women wanted family planning, but remained dissatisfied with the available contraceptives and their effects. While women reported that they relied on modern medicine for contraception, their descriptions of how contraceptives affected their health relied on the hot–cold explanatory idiom of traditional medicine. PMID:23906959

  20. Cancer of the oral cavity - trends in Karachi South (1995-2002).

    PubMed

    Bhurgri, Yasmin

    2005-01-01

    The objective was to study the time trends in site-specific oral cancer incidence and to determine the age-and socio-economic profile over time in Karachi South. Oral cancer ranks second in this population, in both genders. The incidence is the highest reported worldwide. Incident oral cancer cases received at the Karachi Cancer Registry during 1(st) January 1995 to 30(th) June 2004 were reviewed. To ensure maximally complete data, cases registered between 1(st) January 1995 and 31(st) December 2002 were considered for the present study. Cases of lymphoma, leukemia and melanoma were not included. Trends were studied by grouping cases into two periods, 1995-1997 and 1998-2002. A total of 2253 cases of oral cancer were registered in Karachi South for the 8 year study period accounting for 8.8% of all cancer cases. Overall, the most common site was the mucosa cheek (55.9%), followed by the tongue (28.4%), palate (6.8%), gum (4.4%), lip (3.1%) and floor of the mouth (1.4%). About 30% of cases occurred in patients 40 years and younger and 23% occurred in patients 65 years and older. Sub-categories of oral cancer showed variation in trends, but an earlier onset of disease in period two was evident for all categories. The incidence of lip cancer in men decreased, the rates remained level in females. An increased incidence was observed for tongue, but a more dramatic increase in the cheek was evident in both sexes, despite no improvement during the past decade in detection of early, localized lesions. A strong socio-economic factor with a poorer, low literacy profile of oral cancer was apparent in the entire study period. The evidence that the largest increase in incidence has occurred in this population may unfavorably affect the mortality rates. Oral cancer trends are an interplay of prevalent risk factors, the level of prevalence, preventive education and intervention. Cost effective and efficient cancer control focused around the target populations would be beneficial

  1. Attitudes towards child restrains and seat belts usage in the learned population of Karachi, Pakistan

    PubMed Central

    Siddiqui, Emaduddin; Ejaz, Kiran; Waheed, Shahan; Kazi, Ghazala Irfan; Khursheed, Munawar

    2014-01-01

    BACKGROUND: Motor vehicles crashes (MVCs) are the leading cause of injury related morbidity and mortality in developed countries. Recent evidence proves that properly used child seat belts can dramatically reduce the risk of severe and life-threatening injury from MVCs. There are rarities of thought and inspiration regarding the use of child seat belts in our society and region, therefore we lack of data regarding factors and paucity of usage of child seat belts in motor vehicles. This study aimed to assess the knowledge and attitudes of child seat belt usage among the educated population in Karachi, Pakistan. METHODS: Altogether 304 employees were investigated. They were employees of Aga Khan University who were using their cars and having children younger than 10 years old. A cross sectional observational study was designed, and a 36-item questionnaire in English was used to collect data on participants’ demographic details, designation, educational level, economic status, validity of driving license, number of children and cars, availability of adult seat belts and child seat belts along with their functionality, awareness, knowledge and attitude toward its use, and reason of not using these devices. SPSS version 20 for Windows was used to analyze the data and the Chi-square test was used. RESULTS: Totally 290 participants were recruited with a response rate of 72% (212). Of 212 participants, 126 (59%) were male. 154 (72.6%) participants had valid driver licenses, and 154 (72.6%) had adult seat belts in their vehicles. Only 32 (15%) reported regular use of adult seat belts. Although 168 (79.2%) participants had some knowledge about child restrains (CRs), only 65 (22%) had CRs in their cars. Eighty-two (38.7%) participants got the knowledge about CRs and seat belts from media. Mothers were more concerned about the use of CRs than fathers. Only 14 (6.6%) parents were found to use both adult and child seat belts all the time. Of the 157 parents who did not us use

  2. Perception and attitude of general practitioners regarding generic medicines in Karachi, Pakistan: A questionnaire based study

    PubMed Central

    Jamshed, Shazia Qasim; Ibrahim, Mohamed Izham Mohamed; Hassali, Mohamed Azmi Ahmad; Masood, Imran; Low, Bee Yean; Shafie, Asrul Akmal; Babar, Zaheer-ud-din

    2012-01-01

    Objectives: In developing countries out-of-pocket payments (OOP) are as high as 80% of healthcare spending. Generic medicines can be instrumental in reducing this expenditure. The current study is aimed to explore the knowledge, perception, and attitude of general practitioners towards generic medicines in Karachi, Pakistan. Methods: This exploratory, descriptive study was conducted on a sample of 289 randomly selected general practitioners who were dispensing at their private clinics in Karachi, Pakistan. The questionnaires were distributed and collected by hand. Data was entered to SPSS version 17. Fischer’s exact test was applied to see the association between variables. Results: A total of 206 questionnaires were included in the study. A response rate of 71.3% was achieved. Out of 206 respondents, 139 (67.5%) were male while 67 (32.5%) respondents were female. Close to three quaters of the respondents (n= 148; 71.8%) showed correct knowledge about generic medicines being a ‘copy of the brand name medicines’ and ‘interchangeable with brand name medicines’ (n= 148; 71.8%). In terms of safety, the majority of respondents (n=85; 41.26%) incorrectly understood that the generic medicines are less safe than brand name medicines. The total percentage of correct responses was seen in 53% of the respondents. More than half of the respondents agreed that locally manufactured medicines are of the same effectiveness as brand name medicines (n=114; 55.4%). Male practitioners with practice experience of 11-15 years showed positive perception towards the quality of multinational products. The Majority of respondents believed that their prescribing decision is influenced by medical representatives (n=117; 56.8%). More than three-quarters of the respondents expressed their wish to prescribe low cost medicines in their practice (n=157; 76.2%). More than one third of the respondents expressed their uneasiness to prescribe products from all local manufacturers (n=72; 35

  3. Home injury risks to young children in Karachi, Pakistan: a pilot study

    PubMed Central

    Khan, Uzma Rahim; Chandran, Aruna; Zia, Nukhba; Huang, Cheng-Ming; De Ramirez, Sarah Stewart; Feroze, Asher; Hyder, Adnan Ali; Razzak, Junaid Abdul

    2015-01-01

    Objective To pilot an in-home unintentional injury hazard assessment tool and to quantify potential injury risks for young children in a low-income urban setting. Methods Two low-income neighbourhoods in Karachi, Pakistan, were mapped, and families with at least one child between the ages of 12 and 59 months were identified. Using existing available home injury risk information, an in-home injury risk assessment tool was drafted and tailored to the local setting. Home injury assessments were done in June–July 2010 after obtaining informed consent. Results Approximately 75.4% of mothers were educated through at least grade 12. The main risks identified were stoves within the reach of the child (n=279, 55.5%), presence of open buckets in the bathroom (n=240, 47.7%) within the reach of the child, and pedestal fans accessible to the child (n=242, 48.1%). In terms of safety equipment, a first-aid box with any basic item was present in 70% of households, but only 4.8% of households had a fire extinguisher in the kitchen. Conclusions This was the first time that an in-home, all-unintentional injury risk assessment tool was tailored and applied in the context of a low-income community in Pakistan. There was a significant burden of hazards present in the homes in these communities, representing an important opportunity for injury prevention. This pilot may have future relevance to other LMICs where child injury prevention is a critical need. PMID:23995075

  4. Myths and Fallacies about Male Contraceptive Methods: A Qualitative Study amongst Married Youth in Slums of Karachi, Pakistan

    PubMed Central

    Nishtar, Noureen; Sami, Neelofar; Faruqi, Anum; Khowaja, Shaneela; Farid-Ul-Hasnain

    2013-01-01

    Pakistan presently has one of the largest cohorts of young people in its history, with around 36 million people between the ages of 15 and 24 years. One of the main reasons for high population growth in Pakistan is almost stagnant contraceptive prevalence rate of 30% nationally and 17.4% amongst youth. The study was conducted to explore the perceptions regarding myths and fallacies related to male contraceptive methods among married youth aged 18-24 year in Karachi, Pakistan. Qualitative exploratory study design was adopted and a total of eight Focus Group Discussions (FGDs) were conducted. Study was conducted in two Union Councils of Korangi Town in the squatter settlement of Karachi, Pakistan from July to September 2010. Thematic analysis was done manually. General, physical, sexual, psychological, socio-cultural and religious were the common categories which lead to myths and fallacies related to condoms use and vasectomy among the married youth. The foremost myth amongst male and female youth was that use of both condoms and vasectomy cause impotence in males. Additionally, condoms were thought to cause infections, backache and headache in males. Some youth of the area think that vasectomy is meant for prisoners only. In conclusion our findings suggest that the potential reasons behind low use of male contraceptive methods among youth of squatter settlement of Karachi were myths and fallacies about male contraceptive methods. There are some important policy implications like counseling of the couple through peers and well trained family planning service providers to address these myths and misconceptions from the minds of youth. PMID:23445697

  5. Perceptions and experiences of women in karachi, pakistan regarding secondary infertility: results from a community-based qualitative study.

    PubMed

    Sami, Neelofar; Saeed Ali, Tazeen

    2012-01-01

    Background. The prevalence of infertility in Pakistan is 22% with primary infertility at 4% and secondary infertility at 18%. This study explored perceptions and experiences of women in Karachi, Pakistan regarding the causes, treatment-seeking behavior for and consequences of secondary infertility. Methods. Focus group discussions and in-depth interviews with married women explored their perceptions and experiences for issues related to secondary infertility. Results. The knowledge of women about the causes and scientific treatment options for infertility was limited resulting in inclination for traditional unsafe health care. Infertility was stated to result in marital instability, stigmatization and abuse specially for women with no live child. Conclusions. Since infertility can have a serious effect on both the psychological well-being and the social status of women in Pakistan, effective interventions are the need of the day. There is a dire need for health education and counseling to be integrated into infertility management plans. PMID:22474450

  6. Geochemical assessment of metal concentrations in sediment core of Korangi Creek along Karachi Coast, Pakistan.

    PubMed

    Chaudhary, M Z; Ahmad, N; Mashiatullah, A; Ahmad, N; Ghaffar, A

    2013-08-01

    Sediment core from Korangi Creek, one of the polluted coastal locations along the Karachi Coast Pakistan, was collected to trace the history of marine pollution and to determine the impact of industrial activity in the area. Down core variation of metals such as Ca, K, Mg, Al, S, Ti, V, Cr, Mn, Fe, Ni, Cu and Zn was studied in the 72.0 cm core. Nuclear analytical techniques, proton induced X-rays emission (PIXE), was employed to ascertain the chemical composition in sediment core. Grain size analysis and sediment composition of cored samples indicated that Korangi creek sediments are clayey in nature. Correlation matrix revealed a strong association of Ni, Cu, Cr and Zn with Fe and Mn. To infer anthropogenic input, enrichment factor (EF), degree of contamination and pollution load index were calculated. EF showed severe enrichment in surface sediment for Ni, Cu, Cr and Zn, indicating increased industrial effluents discharge in recent years. The study suggests that heavy metal discharge in the area should be regulated. If the present trend of enrichment is allowed to continue unabated, it is most likely that the local food web complexes in the creek might be at highest risk. PMID:23279880

  7. Epidemiologic study of chronic hepatitis B virus infection in male volunteer blood donors in Karachi, Pakistan

    PubMed Central

    Akhtar, Saeed; Younus, Muhammad; Adil, Salman; Hassan, Farrukh; Jafri, Sarffraz Hussain

    2005-01-01

    Background The magnitude of chronic infection with hepatitis B virus (HBV) varies substantially between the countries. A better understanding of incidence and/ or prevalence of HBV infection and associated risk factors provides insight into the transmission of this infection in the community. The purpose of this investigation was to estimate the prevalence of and to identify the risk factors associated with chronic infection with HBV, as assessed by HBV surface antigen (HBsAg) positivity, in asymptomatic volunteer male blood donors in Karachi, Pakistan. Methods Consecutive blood donations made at the two large blood banks between January 1, 1998 and December 31, 2002 were assessed to estimate the prevalence of HBsAg positivity. To evaluate the potential risk factors, a case-control study design was implemented; cases (HBsAg positives) and controls (HBsAg negatives), were recruited between October 15, 2001 and March 15, 2002. A pre-tested structured questionnaire was administered through trained interviewers to collect the data on hypothesized risk factors for HBV infection. Sera were tested for HBsAg using commercially available kits for enzyme linked Immunosorbant assay-III. Results HBsAg prevalence in the male volunteer blood donors was 2.0 % (7048/351309). Multivariate logistic regression analysis showed that after adjusting for age and ethnicity, cases were significantly more likely than controls to have received dental treatment from un-qualified dental care provider (adjusted odds ratio (OR) = 9.8; 95% confidence interval (CI): 2.1, 46.1), have received 1–5 injections (adjusted OR = 3.3; 95% CI: 1.1, 9.6), more than 5 injections (adjusted OR = 1.4; 95% CI: 1.4, 12.7) during the last five years or have received injection through a glass syringe (adjusted OR = 9.4; 95% CI: 2.6, 34.3). Injury resulted in bleeding during shaving from barbers (adjusted OR = 2.3; 95% CI: 1.1, 4.8) was also significant predictor of HBsAg positivity. Conclusion Prevalence of HBs

  8. Maternal nutritional status during pregnancy and surma use determine cord lead levels in Karachi, Pakistan

    SciTech Connect

    Janjua, Naveed Zafar Delzell, Elizabeth; Larson, Rodney R.; Meleth, Sreelatha; Kabagambe, Edmond K.; Kristensen, Sibylle; Sathiakumar, Nalini

    2008-09-15

    Objectives: To estimate the umbilical cord blood lead levels (BLLs) of Pakistani neonates and to identify determinants for umbilical BLLs. Methods: We conducted a cross-sectional study of mothers and infants at one of the two obstetric units of two tertiary care hospitals in Karachi during January-August 2005. Information from 540 mothers selected randomly from those registered for delivery was obtained about their pregnancy, diet, and current and past lead exposures. We collected umbilical cord blood for lead levels analyzed using graphite furnace atomic absorption spectrophotometry. We computed geometric and arithmetic means. We performed multiple linear regression analysis to identify factors associated with log-transformed umbilical cord BLLs. We also performed logistic regression analysis to identify determinants of high lead cord BLLs ({>=}10 {mu}g/dl). Results: The geometric mean cord BLL of the neonates was 9.6 {mu}g/dl; arithmetic mean (S.D.) was 10.8 {mu}g/dl (5.7) with a median of 9.7 {mu}g/dl and a range of 1.8-48.9 {mu}g/dl. Women who reported intake of less than 58.5 mg of elemental iron supplement per day during pregnancy had cord BLL of 10.0 {mu}g/dl; in comparison those women who had higher iron intake had lower cord BLL (8.4 {mu}g/dl). Those who used surma (an eye cosmetic) daily had higher cord BLL (11.5 {mu}g/dl) as compared to those who used it less frequently (9.4 {mu}g/dl). In multivariable linear regression model, higher iron intake, owning a car, and being in 2nd quartile of mid-arm circumference were associated with low lead levels while father's occupation in lead-based industry was associated with significantly higher umbilical cord BLLs. There was interaction of daily surma use and ethnicity. Geometric mean BLLs were varied among surma users by ethnicity. Conclusions: Umbilical cord BLLs are high in Karachi, Pakistan, in comparison to those in developed countries such as United States. Measures are needed to reduce fetal lead exposure

  9. Violence permeating daily life: a qualitative study investigating perspectives on violence among women in Karachi, Pakistan

    PubMed Central

    Ali, Tazeen S; Krantz, Gunilla; Mogren, Ingrid

    2012-01-01

    Background: This study explored how married women perceive situations which create family conflicts and lead to different forms of violence in urban Pakistan. In addition, it examines perceptions of consequences of violence, their adverse health effects, and how women resist violence within marital life. Methods: Five focus group discussions were conducted with 28 women in Karachi. Purposive sampling, aiming for variety in age, employment status, education, and socioeconomic status, was employed. The focus group discussions were conducted in Urdu and translated into English. Manifest and latent content analysis were applied. Results: One major theme emerged during the analysis, ie, family violence through the eyes of females. This theme was subdivided into three main categories. The first category, ie, situations provoking violence and their manifestations, elaborates on circumstances that provoke violence and situations that sustain violence. The second category, ie, actions and reactions to exposure to violence, describes consequences of ongoing violence within the family, including those that result in suicidal thoughts and actions. The final category, ie, resisting violence, describes how violence is avoided through women’s awareness and actions. Conclusion: The current study highlights how female victims of abuse are trapped in a society where violence from a partner and family members is viewed as acceptable, where divorce is unavailable to the majority, and where societal support of women is limited. There is an urgent need to raise the subject of violence against women and tackle this human rights problem at all levels of society by targeting the individual, family, community, and societal levels concurrently. PMID:23152709

  10. Fitting the Bill: Commissioned Theatre Projects on Human Rights in Pakistan--The Work of Karachi-Based Theatre Group "Tehrik e Niswan"

    ERIC Educational Resources Information Center

    Mundrawala, Asma

    2007-01-01

    Theatre practitioners in Pakistan's southern city Karachi have seen a recent surge of interest in the past two decades by donor agencies from the Western world to fund theatre companies and employ various forms of theatre for development to service their agendas and areas of interest within their target communities. This trend may have lent a…

  11. Physicians reading and writing practices: a cross-sectional study from Civil Hospital, Karachi, Pakistan

    PubMed Central

    2012-01-01

    Background To determine the behavior of physicians regarding medical literature reading and participation in research activities at one of the largest teaching hospitals in Pakistan. Method This descriptive, cross-sectional study was conducted by interviewing the house officers, residents and fellows of six major specialties (Medicine, Surgery, Pediatrics, Psychology, Obstetrics & Gynecology and Anesthesia) in Civil Hospital, Karachi between August and December, 2011. The questionnaire elicited responses regarding the reading habits of physicians, preferred sources of information, their participation in research activities (publication & supervision) and views regarding journal club. SPSS 17.0 was used for data entry and analysis. Result A total of 259 completely filled questionnaires were returned with a response rate of 85.19%. Mean age of the participants was 29.67 ± 7.65 years. Books were selected by 71.4% doctors as their preferred source of information, regardless of their clinical specialties. (p < 0.05). E-journals were preferred by 75.7% of the doctors over printed journals. This holds true for doctors from all specialties (p < 0.05). The ease of searching for relevant articles was the major contributor (50.5%) in preference of e-journals. 137 (52.9%) doctors read 5 or less articles per week. 30 (11.6%) doctors have subscription of journals (printed or electronic). At least one research paper has been published by 151 (58.3%) of the physicians interviewed. Most common reason for not participating in research activities was busy schedule (56.4%). Almost half (49.4%) doctors reported lack of journal club in their units. Of these, majority (88.35%) wanted a journal club in their respective units. Conclusion Urgent intervention is required to promote healthcare literature reading and writing practice in our physicians. Easy access to workplace computers with internet and subscription of paid journals will facilitate physicians. Lack of

  12. Report: a study of morbidity of induced abortion data from women belonging to Karachi, Pakistan.

    PubMed

    Aslam, Farah; Aslam, Muhammad

    2015-01-01

    The purpose of this study was to evaluate the morbidity of induced abortion in relation to facilities, service providers and social responses of general population of women, from Karachi, Pakistan. Cross-sectional survey, conducted from February to December 2010, through a researcher-administered questionnaire from 61 randomly selected women, who underwent for Induced Abortion, aged 18-50 years. The questionnaire included open and closed ended questions, regarding demography, facilities, service providers and various complications observed. Overall, 98 immediate health problems were reported by 40 (65.5%) of the respondents, 153 late adverse effects or chronic by 46 (75.4%); while 101 mental complications had been reported by 45 (73.8%) of the 61 aborting women; respectively. Private clinics surfaced as the most frequently adopted source as reported by 40.7% of the respondents. Two third majorities had the procedure in satisfactory, good hygienic conditions by skilled professionals. Around 59% of the aborting women were aware of the religious perspective of the subject. Marked incidence of complications had been registered, regardless of type of method adopted, hygienic condition of the procedure or skill of the provider. Although, awareness of religious perspective of the subject was there, still quite a lot opted for abortion. This suggests that strong socioeconomic factors influence women to take peril of such an attempt. It also reveals the existence of a big gap for the awareness services for educating the risks involved to the women's health. Study revealed that services are easily accessible; without any legal, religious or social barriers. Semi or un-educated women, mostly from low socioeconomic sector are opting the procedure in majority, being less aware and stalwartly influenced by environmental factors; hence excessive availability of abortion services should be revisited. Lack of deep awareness of the consequences also contributes for deteriorating

  13. Condom use during commercial sex among clients of Hijra sex workers in Karachi, Pakistan (cross-sectional study)

    PubMed Central

    Qian, Han-Zhu; Altaf, Arshad; Cassell, Holly; Shah, Sharaf Ali; Vermund, Sten H

    2011-01-01

    Objective To describe the prevalence and predictors of condom use and sexual risk in the male clients of Hijra sex workers (HSWs) in Karachi, Pakistan. Design Cross-sectional study. Setting Karachi, Pakistan. Participants Clients of HSWs were recruited with assistance from HSWs and a non-governmental organisation (NGO) focused on men who have sex with men (MSM) during October–November 2010. Measurements The interviewer administered the questionnaire to each participant to solicit information on demographics, HIV/AIDS knowledge/attitudes and sexual risk behaviours/practices, including condom use in the last sexual act with the HSW. Results Of the 203 participants, 42.4% reported that they used condoms during their last sexual act with HSW, 40% were married, 18% had ever used drugs or alcohol, and 52% reported also engaging with female sex workers in the last month. Casual HSW clients were more likely to use condoms than regular clients (adjusted OR (AOR), 2.50; 95% CI 1.34 to 4.65), as were persons with a higher education level (AOR 5.8; 95% CI 1.6 to 20.3). Drug/alcohol users and non-users were equally likely to use condoms (AOR 1.11; 95% CI 0.51 to 2.24). Conclusion Clients of HSWs in Pakistan are at risk of acquiring HIV/STI infections. Concerted efforts are needed to increase condom use in this key bridge population to curtail the spread of HIV in the general population. PMID:22021875

  14. Metal pollution and ecological risk assessment in marine sediments of Karachi Coast, Pakistan.

    PubMed

    Mashiatullah, Azhar; Chaudhary, Muhammad Zaman; Ahmad, Nasir; Javed, Tariq; Ghaffar, Abdul

    2013-02-01

    Concentrations of 12 metals (Fe, Mn, Cr, Mo, Ni, Pb, Se, Sr, U, V, Zn, and Zr) in surface sediments of Karachi Coast, Pakistan were determined to evaluate their distribution and pollution assessment. The measured metals in the sediments were found to be in the range of Fe, 0.84-6.96 %; Mn, 300-1,300 μg/g; Cr, 12.0-319.84 μg/g; Mo, 0.49-2.03 μg/g; Ni, 1.53-58.86 μg/g; Pb, 9.0-49.46 μg/g; Se, 0.25-.86 μg/g; Sr, 192-1185 μg/g; U, 0.19-1.66 μg/g; V, 15.80-118.20 μg/g; Zn, 15.60-666.28 μg/g; and Zr, 44.02-175.26 μg/g. The mean contents of the metal studied were: Fe, 3.07 %, Mn, 0.05 %; Cr, 96.75 μg/g; Mo, 1.34 μg/g; Ni, 31.39 μg/g; Pb, 23.24 μg/g; Se, 0.61 μg/g; Sr, 374.83 μg/g; U, 0.64 μg/g; V, 61.75 μg/g; Zn, 204.75 μg/g; and Zr:76.27 μg/g, and arrangement of the metals from higher to lower mean content in this area is: Fe > Zn > Mn > Sr > Zn > Cr > Zr > V > Ni > Pb > Mo > U > Se. There is no significant correlation among most of these metals, indicating different anthropogenic and natural sources. To assess ecotoxic potential of marine sediments, Numerical Sediment Quality Guidelines were also applied. The concentration of Pb in all the sediments except one was lower than the threshold effect concentration (TECs) showing that there are no harmful effects to marine life from Pb. On the other hand, the concentrations of Cr, Ni, and Zn exceeded TEC in three stations, indicating their potential risk. The degree of pollution in sediments for metals was assessed by calculating enrichment factor (EF) and pollution load index (PLI). The results indicated that sediments of Layari River Mouth Area, Fish Harbour, and KPT Boat Building Area are highly enriched with Cr and Zn (EF > 5). Sediments of Layari River Outfall Zone were moderately enriched with Ni and Pb (EF > 2). The pollution load index was found in the range of 0.98 to 1.34. Lower values of PLI (≤ 1) at most of sampling locations imply no appreciable input from anthropogenic sources. However

  15. Factors associated with elevated blood lead concentrations in children in Karachi, Pakistan.

    PubMed Central

    Rahbar, Mohammad Hossein; White, Franklin; Agboatwalla, Mubina; Hozhabri, Siroos; Luby, Stephen

    2002-01-01

    OBJECTIVES: To confirm whether blood lead concentrations in Karachi were as high as reported in 1989 and to identify which types of exposure to lead contribute most to elevated blood lead concentrations in children in Karachi. METHODS: A total of 430 children aged 36-60 months were selected through a geographically stratified design from the city centre, two suburbs, a rural community and an island situated within the harbour at Karachi. Blood samples were collected from children and a pretested questionnaire was administered to assess the effect of various types of exposure. Cooked food, drinking-water and house dust samples were collected from households. FINDINGS: About 80% of children had blood lead concentrations 10 g/dl, with an overall mean of 15.6 g/dl. At the 5% level of significance, houses nearer to the main intersection in the city centre, application of surma to children's eyes, father's exposure to lead at workplace, parents' illiteracy and child's habit of hand- to-mouth activity were among variables associated with elevated lead concentrations in blood. CONCLUSION: These findings are of public health concern, as most children in Karachi are likely to suffer some degree of intellectual impairment as a result of environmental lead exposure. We believe that there is enough evidence of the continuing problem of lead in petrol to prompt the petroleum industry to take action. The evidence also shows the need for appropriate interventions in reducing the burden due to other factors associated with this toxic element. PMID:12471396

  16. Enhanced disease surveillance through private health care sector cooperation in Karachi, Pakistan: experience from a vaccine trial.

    PubMed Central

    Khan, Mohammad Imran; Sahito, Shah Muhammad; Khan, Mohammad Javed; Wassan, Shafi Mohammad; Shaikh, Abdul Wahab; Maheshwari, Ashok Kumar; Acosta, Camilo J.; Galindo, Claudia M.; Ochiai, Rion Leon; Rasool, Shahid; Peerwani, Sheeraz; Puri, Mahesh K.; Ali, Mohammad; Zafar, Afia; Hassan, Rumina; von Seidlein, Lorenz; Clemens, John D.; Nizami, Shaikh Qamaruddin; Bhutta, Zulfiqar A.

    2006-01-01

    INTRODUCTION: In research projects such as vaccine trials, accurate and complete surveillance of all outcomes of interest is critical. In less developed countries where the private sector is the major health-care provider, the private sector must be included in surveillance systems in order to capture all disease of interest. This, however, poses enormous challenges in practice. The process and outcome of recruiting private practice clinics for surveillance in a vaccine trial are described. METHODS: The project started in January 2002 in two urban squatter settlements of Karachi, Pakistan. At the suggestion of private practitioners, a phlebotomy team was formed to provide support for disease surveillance. Children who had a reported history of fever for more than three days were enrolled for a diagnosis. RESULTS: Between May 2003 and April 2004, 5540 children younger than 16 years with fever for three days or more were enrolled in the study. Of the children, 1312 (24%) were seen first by private practitioners; the remainder presented directly to study centres. In total, 5329 blood samples were obtained for microbiology. The annual incidence of Salmonella typhi diagnosed by blood culture was 407 (95% confidence interval (95% CI), 368-448) per 100 000/year and for Salmonella paratyphi A was 198 (95% CI, 171-227) per 100 000/year. Without the contribution of private practitioners, the rates would have been 240 per 100 000/year (95% CI, 211-271) for S. typhi and 114 (95% CI, 94-136) per 100 000/year for S. paratyphi A. CONCLUSION: The private sector plays a major health-care role in Pakistan. Our experience from a surveillance and burden estimation study in Pakistan indicates that this objective is possible to achieve but requires considerable effort and confidence building. Nonetheless, it is essential to include private health care providers when attempting to accurately estimate the burden of disease in such settings. PMID:16501718

  17. HEALTH CARE PERSONNEL AND WORKPLACE VIOLENCE IN THE EMERGENCY DEPARTMENTS OF A VOLATILE METROPOLIS: RESULTS FROM KARACHI, PAKISTAN

    PubMed Central

    Zafar, Waleed; Siddiqui, Emaduddin; Ejaz, Kiran; Shehzad, Muhammad Umer; Khan, Uzma Rahim; Jamali, Seemin; Razzak, Junaid A.

    2015-01-01

    Background Workplace violence (WPV) is an important challenge faced by health care personnel in the emergency department (ED). Study Objectives To determine the prevalence and nature of WPV reported by physicians and nurses working in the EDs of four of the largest tertiary care hospitals in Karachi, Pakistan and to understand the mental health impact of experiencing WPV. Methods This cross-sectional survey was conducted between September and November 2008 using a widely used questionnaire developed by the World Health Organization. Overall, 266 (86% response rate) questionnaires were included in this study. Results A total of 44 (16.5%) physicians and nurses said they had been physically attacked, and 193 (72.5%) said that they had experienced verbal abuse in the last 12 months. Among those who reported physical attack, 29.6% reported that the last incident involved a weapon, and in 64% of cases the attacker was a patient’s relative. Eighty-six percent thought that the last attack could have been prevented, and 64% said that no action was taken against the attacker. After adjusting for covariates, physicians were less likely than nurses to report physical attack (odds ratio [OR] 0.46; 95% confidence interval [CI] 0.2–1.0), and personnel with greater work experience (OR 4.8; 95% CI 2.0–11.7) and those who said that there were procedures to report WPV in their workplace (OR 3.2; 95% CI 1.6–6.5) were more likely to report verbal abuse. WPV was associated with mental health effects in the form of bothersome memories, super-alertness, and feelings of avoidance and futility. Conclusion WPV is an important challenge in the EDs of large hospitals in Karachi. A majority of respondents feel that WPV is preventable, but only a minority of attackers face consequences. PMID:24011477

  18. Chemical characterization and mass closure of PM10 and PM2.5 at an urban site in Karachi - Pakistan

    NASA Astrophysics Data System (ADS)

    Shahid, Imran; Kistler, Magdalena; Mukhtar, Azam; Ghauri, Badar M.; Ramirez-Santa Cruz, Carlos; Bauer, Heidi; Puxbaum, Hans

    2016-03-01

    A mass balance method is applied to assess main source contributions to PM2.5 and PM10 levels in Karachi. Carbonaceous species (elemental carbon, organic carbon, carbonate carbon), soluble ions (Ca++, Mg++, Na+, K+, NH4+, Cl‑, NO3‑, SO4‑), saccharides (levoglucosan, galactosan, mannosan, sucrose, fructose, glucose, arabitol and mannitol) were determined in atmospheric fine (PM2.5) and coarse (PM10) aerosol samples collected under pre-monsoon conditions (March-April 2009) at an urban site in Karachi (Pakistan). The concentrations of PM2.5 and PM10 were found to be 75 μg/m3 and 437 μg/m3 respectively. The large difference between PM10 and PM2.5 originated predominantly from mineral dust. "Calcareous dust" and "siliceous dust" were the over all dominating material in PM, with 46% contribution to PM2.5 and 78% to PM10-2.5. Combustion particles and secondary organics (EC + OM) comprised 23% of PM2.5 and 6% of PM10-2.5. EC, as well as OC ambient levels were higher (59% and 56%) in PM10-2.5 than in PM2.5. Biomass burning contributed about 3% to PM2.5, and had a share of about 13% of "EC + OM" in PM2.5. The impact of bioaerosol (fungal spores) was minor and had a share of 1 and 2% of the OC in the PM2.5 and PM10-2.5 size fractions. In case of secondary inorganic aerosols, ammonium sulphate (NH4)2SO4 contributes 4.4% to PM2.5 and no detectable quantity were found in fraction PM10-2.5. The sea salt contribution is about 2% both to PM2.5 and PM10-2.5.

  19. Impact and correlation of environmental conditions on pollen counts in Karachi, Pakistan.

    PubMed

    Perveen, Anjum; Khan, Muneeba; Zeb, Shaista; Imam, Asif Ali

    2015-02-01

    A quantitative and qualitative survey of airborne pollen was performed in the city of Karachi, and the pollen counts were correlated with different climatic conditions. The aim of the study was to determine the possible effect of meteorological factors on airborne pollen distribution in the atmosphere of Karachi city. Pollen sampling was carried out by using Burkard spore Trap for the period of August 2009 to July 2010, and a total of 2,922 pollen grains/m(3) were recorded. In this survey, 22 pollen types were recognized. The highest pollen count was contributed by Poaceae pollen type (1,242 pollen grains/m(3)) followed by Amaranthaceae/Chenopodiaceae (948 pollen grains/m(3)), Cyperus rotundus (195 pollen grains/m(3)) and Prosopis juliflora (169 pollen grains/m(3)). Peak pollen season was in August showing a total of 709 pollen grains/m(3) and lowest pollen count was observed in January-2010. Pearson's chi-square test was performed for the possible correlation of pollen counts and climatic factors. The test revealed significant positive correlation of wind speed with pollen types of Amaranthaceae/Chenopodiaceae; Brassica campestris; Asteraceae; and Thuja orientalis. While the correlation of "average temperature" showed significant positive value with Asteraceae and Tamarix indica pollen types. Negative correlation was observed between humidity/ precipitation and pollen types of Brassica campestris; Daucus carota; Ephedra sp.; and Tamarix indica. In the light of above updated data one could identify various aeroallergens present in the air of Karachi city. PMID:25530143

  20. Situation analysis of child labour in Karachi, Pakistan: a qualitative study.

    PubMed

    Nafees, Asaad Ahmed; Khan, Kausar Saeed; Fatmi, Zafar; Aslam, Mubashir

    2012-10-01

    In Karachi, large employment opportunities, burgeoning population and the availability of cheap labour might be the contributing factors for the increasing prevalence of child labour. A literature review was conducted in 2007 that included published and unpublished literature since 2000. Various organizations working in the field were also covered, while the perception of the child labourers was covered through three focus group discussions. Common health issues among the child labourers in Karachi included respiratory illnesses, fever and generalised pains, as well as drug and sexual abuse. Organisations working for child labour could be broadly categorised into those working for legal advice and advocacy; those generating statistics; and those that are providing interventions. Discussion with children showed that irrespective of the immediate cause, the underlying determinant for child labour was poverty. The best practices identified included evening schools and drop-in centers for working children with provision for skill-based education and basic health facilities. There is need to have more such centres. PMID:23866451

  1. Antibiotic resistance pattern of Pseudomonas aeruginosa isolated from urine samples of Urinary Tract Infections patients in Karachi, Pakistan

    PubMed Central

    Shah, Dania Aijaz; Wasim, Shehnaz; Essa Abdullah, Farhan

    2015-01-01

    Objective: The aim of this study was to evaluate the antibiotic resistance pattern of Psedomonas aeruginosa and its prevalence in patients with urinary tract infections (UTI) for effective treatment in a developing country like Pakistan. Methods: This is an observational study conducted for a period of ten months which ended on December 2013 at the Dr. Essa Laboratory and Diagnostic Centre in Karachi. A total of 4668 urine samples of UTI patients were collected and standard microbiological techniques were performed to identify the organisms in urine cultures. Antibiotic susceptibility testing was performed by Kirby-Bauer technique for twenty five commonly used antimicrobials and then analyzed on SPSS version 17. Results: P. aeruginosa was isolated in 254 cultures (5.4%). The most resistant drugs included Ceclor(100%) and Cefizox (100%) followed by Amoxil/Ampicillin (99.6%), Ceflixime (99.6%), Doxycycline (99.6%), Cefuroxime (99.2%), Cephradine (99.2%), Cotrimoxazole (99.2%), Nalidixic acid (98.8%), Pipemidic acid (98.6%) and Augmentin (97.6%). Conclusion: Emerging resistant strains of Pseudomonas aeruginosa are potentially linked to injudicious use of drugs leading to ineffective empirical therapy and in turn, appearance of even more resistant strains of the bacterium. Therefore, we recommend culture and sensitivity testing to determine the presence of P.aeruginosa prior to specific antimicrobial therapy. PMID:26101487

  2. Do mothers-in-law matter? Family dynamics and fertility decision-making in urban squatter settlements of Karachi, Pakistan.

    PubMed

    Kadir, Muhammad Masood; Fikree, Fariyal F; Khan, Amanullah; Sajan, Fatima

    2003-10-01

    The perspectives of mothers-in-law about intra-household decision-making, family size and family planning are investigated, and their views compared with those of their sons and daughters-in-law. Women (717 daughters-in-law), their husbands (717 sons) and their 522 mothers-in-law were interviewed in eight squatter settlements in Karachi, Pakistan. Decisions about the schooling and health care of children, and the purchase of jewellery, are perceived to lie within the nuclear family domain (i.e. husband and wife). There was a difference in mothers-in-law's, daughters-in-law's and sons' desire to have more children. Twenty-eight per cent of mothers-in-law versus 58%, of daughters-in-law did not want more grandsons/sons and 36%, of mothers-in-law versus 66% of daughters-in-law did not want more granddaughters/daughters. The difference was markedly greater among the mother-in-law/daughter-in-law pairs than in the mother/son pairs. Overall, the mother-in-law's role seems to be somewhat overshadowed by that of her son (family male member), except for limiting family size. It is suggested that mothers-in-law should be included in Information-Education-Communication (IEC) campaigns about family planning. PMID:14621251

  3. The Effect of Clinical Clerkship on Students' Attitudes toward Psychiatry in Karachi, Pakistan

    ERIC Educational Resources Information Center

    Sajid, Ayesha; Khan, Murad M.; Shakir, Murtaza; Moazam-Zaman, Riffat; Ali, Asad

    2009-01-01

    Objective: Attitudes of medical students toward a specialty is strongly related to their future choice of specialty. In developing countries like Pakistan, where there is a shortage of psychiatrists, there is a need to assess the effect of exposure to psychiatry on medical students. Methods: The authors conducted a survey of fourth-year medical…

  4. Effects of Mothers' Employment on Toddlers' Cognitive Development: A Study Conducted in Karachi, Pakistan

    ERIC Educational Resources Information Center

    Meherali, Salima Moez; Karmaliani, Rozina; Asad, Nargis

    2011-01-01

    Over the past several decades in Pakistan, an increasing number of women with young children are joining the workforce, which is one of the biggest social changes in the later half of the twentieth century. More children are being raised in households where mothers work for pay as compared with the scenario a generation ago. This change has…

  5. Prevalence of Smoking and Associated Risk Factors Among Medical Professionals in Hospitals of Karachi, Pakistan

    PubMed Central

    Zafar, Mubashir

    2014-01-01

    Background: Cigarette smoking is the largest preventable risk factor for morbidity and mortality in developed countries where at least one in four adults smoke cigarettes. Healthcare providers who smoke are less likely to advise patients to quit smoking. The aim of this study is to find out the frequency of tobacco smoking among medical professionals in tertiary care hospitals of Karachi, and to identify the common factors responsible for the continuation of smoking among healthcare providers. Methods: This descriptive cross-sectional study was carried out at public and private tertiary Care Hospitals/Institutes at Karachi. A self-administered questionnaire was used to collect data from 180 subjects. An informed consent was obtained from all the subjects. The data were analyzed using SPSS version 16.0. Results: Prevalence of smoking was 29%. High prevalence of smoking was among male doctors as compared to female doctors. Sixty-eight per cent of smokers started smoking between 20 to 30 years of age. Age less than 35 years, male and public sectors hospitals were more likely OR 1.23, CI (0.98-2.41), 6.40 CI (4.48-10.52) and 2.61 CI (2.20-3.78) respectively. Conclusions: The Result of the study suggests that while healthcare smoking habits appear to be high, they are not uniformly low when compared from an international perspective. Health promotion programs focused on self-efficacy may be an effective tool for reducing the initiation, frequency, and amount of cigarette smoking among healthcare providers. PMID:24829733

  6. Use of hair as an indicator of environmental lead pollution in women of child-bearing age in Karachi, Pakistan and Bangladesh

    SciTech Connect

    Jamall, I.S. ); Allen, P.V. )

    1990-03-01

    The present study was prompted by an observation made during a visit to Karchi in 1986 when three blood samples from two women and a man, all between 30-35 years yielded blood Pb levels of 31.4, 21.9 and 41.7 ug Pb/dl blood. Karachi is a highly industrialized urban center with very large numbers of motor vehicles, all of which use leaded gasoline. Lead-based paint is also extensively used in the city. The present study was conducted to determine if hair metal analyses could be used to determine elevated exposures to lead in women of child-bearing age living in Karachi (Pakistan). Rural Bangladeshi women living in areas with little or no vehicular traffic and no factories in the vicinity were used as controls.

  7. Students’ perception of educational environment at Aga Khan University Medical College, Karachi, Pakistan

    PubMed Central

    Rehman, Rehana; Ghias, Kulsoom; Fatima, Syeda Sadia; Hussain, Mehwish; Alam, Faiza

    2016-01-01

    Objective: To assess educational environment in Aga Khan University Medical College (AKUMC) by Dundee Ready Educational Environmental Measure (DREEM) scale. Methods: A cross-sectional survey of students at the AKUMC with simple random sampling was carried out from June 2014 till March 2015. Responses in five subscales were used to calculate DREEM scores. Results: The average DREEM score was 125.77±16.8 with a reliability of 91.3%. With regards to subscales, on the 12-item students’ perceptions of learning (PoL) subscale, the maximum score was 48; 11 items of students’ perceptions of teachers (PoT) had a maximum score of 44; students’ academic self-perceptions (ASP) identified by 8 items showed maximum score of 32; students’ perceptions of atmosphere (PoA) with 12 items obtained maximum score 48 and students’ social self-perceptions (SSP) subscale of 7 items had a maximum score of 28. Conclusion: Students perceived a positive learning environment at AKUMC Karachi. PMID:27375721

  8. Delayed effectiveness of home-based interventions in reducing childhood diarrhea, Karachi, Pakistan.

    PubMed

    Luby, Stephen P; Agboatwalla, Mubina; Hoekstra, Robert M; Rahbar, Mohammad H; Billhimer, Ward; Keswick, Bruce H

    2004-10-01

    We introduced home drinking water disinfection and handwashing with soap in Karachi squatter settlements to evaluate their effect on diarrhea. In April 2000, 150 households received soap, 76 received dilute bleach and a water storage vessel, and 76 were enrolled as controls. In 2000, among households wealthy enough to own a refrigerator, children in households that received bleach and a vessel had a 73% lower incidence of diarrhea than controls; those that received soap had a 56% lower incidence. There was no reduction in diarrhea in intervention households without a refrigerator. In 2001, households that received bleach and a vessel had a 71% lower incidence of diarrhea and children in households that received soap had a 35% lower incidence than controls. In 2001, the interventions were equally effective in households that had a refrigerator and those that did not. Both of these home-based interventions were ultimately effective in preventing diarrhea, but only households of slightly higher socioeconomic status changed their behavior quickly enough to benefit during the first summer. PMID:15516637

  9. Newborn care knowledge and practices among mothers attending pediatric outpatient clinic of a hospital in Karachi, Pakistan

    PubMed Central

    Gul, Saadia; Khalil, Rehana; Yousafzai, M. Tahir; Shoukat, Faiza

    2014-01-01

    Objectives To assess newborn care knowledge and practices among mothers. Methodology A cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan. A total of 170 mothers accompanying their infants attending the Paediatric Out Patient Department were interviewed through a structured questionnaire. Areas of inquiry included Antenatal care seeking, delivery care, cord care, eye care, bathing and breastfeeding practices. Results Ninety-two percent mothers reported at least one antenatal care visit. Tetanus Toxoid coverage was 88%. Home deliveries were 18%. Seventy-four percent reported applying various substances like coconut oil, mustard oil, purified butter and turmeric to the cord stump. Kohl application to newborn’s eyes was 68%, while 86% reported first bath within 24 hrs of birth. 48% mothers initiated breastfeeding within 2 hours of delivery. Colostrum was discarded by 43% and prelacteal feeds given by 73%. Exclusive Breast Feeding rate was 26%. Family income of Rs. 10, 000 (USD120) or less/month and maternal education level of primary or less were significantly associated with home delivery, unhygienic cord care and kohl application to the newborn’s eyes. Home delivery was a risk factor for poor cord care (OR=4.07) and discarding colostrum (OR= 3.18). Conclusion Antenatal care coverage was good, but knowledge regarding newborn care was poor. Harmful practices regarding newborn care were prevalent among mothers. Institutional deliveries did not guarantee optimal practices. Tradition and culture played a significant role. Health education can improve the mothers’ knowledge regarding newborn care practices. PMID:25246884

  10. Determinants of Default from Tuberculosis Treatment among Patients with Drug-Susceptible Tuberculosis in Karachi, Pakistan: A Mixed Methods Study

    PubMed Central

    Chida, Natasha; Ansari, Zara; Hussain, Hamidah; Jaswal, Maria; Symes, Stephen; Khan, Aamir J.; Mohammed, Shama

    2015-01-01

    Purpose Non-adherence to tuberculosis therapy can lead to drug resistance, prolonged infectiousness, and death; therefore, understanding what causes treatment default is important. Pakistan has one of the highest burdens of tuberculosis in the world, yet there have been no qualitative studies in Pakistan that have specifically examined why default occurs. We conducted a mixed methods study at a tuberculosis clinic in Karachi to understand why patients with drug-susceptible tuberculosis default from treatment, and to identify factors associated with default. Patients attending this clinic pick up medications weekly and undergo family-supported directly observed therapy. Methods In-depth interviews were administered to 21 patients who had defaulted. We also compared patients who defaulted with those who were cured, had completed, or had failed treatment in 2013. Results Qualitative analyses showed the most common reasons for default were the financial burden of treatment, and medication side effects and beliefs. The influence of finances on other causes of default was also prominent, as was concern about the effect of treatment on family members. In quantitative analysis, of 2120 patients, 301 (14.2%) defaulted. Univariate analysis found that male gender (OR: 1.34, 95% CI: 1.04–1.71), being 35–59 years of age (OR: 1.54, 95% CI: 1.14–2.08), or being 60 years of age or older (OR: 1.84, 95% CI: 1.17–2.88) were associated with default. After adjusting for gender, disease site, and patient category, being 35–59 years of age (aOR: 1.49, 95% CI: 1.10–2.03) or 60 years of age or older (aOR: 1.76, 95% CI: 1.12–2.77) were associated with default. Conclusions In multivariate analysis age was the only variable associated with default. This lack of identifiable risk factors and our qualitative findings imply that default is complex and often due to extrinsic and medication-related factors. More tolerable medications, improved side effect management, and innovative

  11. What Happens When "Germs Don't Get Killed and They Attack Again and Again": Perceptions of Antimicrobial Resistance in the Context of Diarrheal Disease Treatment Among Laypersons and Health-Care Providers in Karachi, Pakistan.

    PubMed

    Joseph, Heather A; Agboatwalla, Mubina; Hurd, Jacqueline; Jacobs-Slifka, Kara; Pitz, Adam; Bowen, Anna

    2016-07-01

    In south Asia, where diarrhea is common and antibiotics are accessible without prescription, antimicrobial resistance is an emerging and serious problem. However, beliefs and behaviors related to antimicrobial resistance are poorly understood. We explored laypersons' and health-care providers' (HCP) awareness and perceptions of antimicrobial resistance in the context of treatment of adult diarrheal disease in Karachi, Pakistan. In-depth, open-ended interviews were conducted with 40 laypersons and 45 HCPs in a lower-middle-class urban neighborhood. Interviews conducted in Urdu were audiotaped, transcribed, translated, and coded using applied thematic analysis. Slightly over half of laypersons and two-thirds of HCPs were aware that antimicrobial medication could lose effectiveness, but misperceptions were common. Laypersons and HCPs often believed that "the body becomes immune" or "bacteria attack more strongly" if medications are taken "improperly." Another prevalent theme was that causes and effects of antimicrobial resistance are limited to the individual taking the antimicrobial medication and to the specific diarrheal episode. Participants often attributed antimicrobial resistance to patient behaviors; HCP behavior was rarely discussed. Less than half of the HCPs were aware of treatment guidelines. To combat antimicrobial resistance in urban Pakistan, a health systems strategy and community-supported outreach campaigns on appropriate antimicrobial use are needed. PMID:27139438

  12. Good knowledge about hypertension is linked to better control of hypertension; A multicentre cross sectional study in Karachi, Pakistan

    PubMed Central

    2012-01-01

    Background According to the National Health survey only 3% of the population has controlled hypertension. This study was designed to elucidate the knowledge about hypertension in hypertensive patients at three tertiary care centers in Karachi. Secondly we sought to compare the knowledge of those with uncontrolled hypertension and controlled hypertension. Methods It was a cross-sectional study conducted at The Aga Khan University hospital (AKUH), Ziauddin Hospital (ZH) and Civil hospital, Karachi (CHK. All diagnosed Hypertensive patients (both inpatients and outpatients) coming to a tertiary care hospital in Pakistan aged > 18 years were included. Patients were categorized into 2 groups: controlled and uncontrolled hypertension based on their initial BP readings on presentation Uncontrolled Hypertension was defined as average BP ≥ 140/90 mm Hg in patients on treatment. Controlled Hypertension (HTN) was defined as average BP <140/90 mm Hg in patients on treatment. Standardized methods were used to record BP in the sitting position. Knowledge was recorded as a15 item question. Primary outcome was knowledge about hypertension. Results A total of 650 participants were approached and consented 447 were found eligible. 284(63.5%) were from Aga Khan University, 101(22.6) from Dow University of health sciences and 62(13.9) were from Ziauddin University. Mean (SD) age of participants was 57.7(12) years, 50.1(224) were men. Controlled hypertension was present in 323(72.3) and uncontrolled hypertension was present in 124(27.4). The total mean (SD) Knowledge score was 20.97(4.93) out of a maximum score of 38. On comparison of questions related to knowledge between uncontrolled and controlled hypertension, there was statistically significant different in; meaning of hypertension (p <0.001), target SBP(p0.001), target DBP(p 0.001), importance of SBP versus DBP, improvement of health with lowering of blood pressure (p 0.002), high blood pressure being asymptomatic (p <0

  13. Trends in Transfusion Transmitted Infections Among Replacement Blood Donors in Karachi, Pakistan

    PubMed Central

    Irfan, Syed Mohammad; Uddin, Jamal; Zaheer, Hasan Abbas; Sultan, Sadia; Baig, Amjad

    2013-01-01

    Objective: To determine the prevalence of Hepatitis-B, Hepatitis-C and Human Immunodeficiency infections in replacement blood donors. Materials and Methods: From January 2004 to December 2011, 108,598 apparently healthy donors donated blood at our Blood Bank. Screening was done by Microparticle Enzyme Immuno Assay (MEIA) method on Axsym System (Abbott Diagnostic, USA) and in year 2011 by Chemiluminescent Immunoassay (CIA) method on Architect i2000 (Abbott Diagnostic, USA). From 2010 onward, HIV reactive donors were advised for confirmatory tests and reported back with the results. Results: Of the 108,598 total donors, 108,393 (99.8%) were replacement donors with a mean age of 28.92 (17-55) years. Of this, only 164 (0.15%) were females. Among the replacement donors, 4,906 (4.5%) were found to be reactive for Hepatitis-B, C and Human Immunodeficiency Virus. All the reactive patients, except one, were males. HbsAg was positive in 2,068 (1.90%) and anti-HCV in 2832 (2.61%) donors, while 111 (0.10%) were positive for Human Immunodeficiency Virus. Co-infectivity was observed in 103 (0.09%) cases. The prevalence appeared to be higher in younger age group (17-30 yrs). Only 16.6% cases should be patients returned with results of the confirmatory tests for HIV and were found positive. Conclusion: Hepatitis-B and C sero-prevalence in our series of replacement donors appears high compared to most studies from neighboring countries and relatively low in comparison to earlier studies from Pakistan. Prevalence of HIV, however, appears low and turn out of HIV positive cases for confirmatory tests is low. Conflict of interest:None declared. PMID:24385780

  14. Post partum anxiety and depression in peri-urban communities of Karachi, Pakistan: a quasi-experimental study

    PubMed Central

    Ali, Niloufer S; Ali, Badar S; Azam, Iqbal S

    2009-01-01

    Background Postpartum anxiety and depression is a major public health concern because of its adverse effects on the cognitive and social development of the infant. Globally postpartum depression has been widely investigated but as anxiety is a more prominent feature of postpartum depression we assessed the prevalence of anxiety and depression and their associated factors in post partum women. Methods A quasi-experimental study investigating the impact of postpartum anxiety and depression on child growth and development was conducted in two peri-urban, multiethnic, communities of Karachi, a mega city of Pakistan. A house to house questionnaire based survey was done by trained field workers; 420 consenting pregnant women were identified and data for socio-demographic, home environment and family relationship variables was collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother's levels of anxiety and depression were assessed after one month, two months, six months and twelve months of childbirth; this was two step process: initially an indigenous, validated screening instrument Aga Khan University Anxiety and Depression Scale was used and diagnostic confirmation was done through a psychologist's interview based on DSM IV criteria. Women found to be anxious and depressed at least once out of four assessments were considered for the computation of overall prevalence of postpartum anxiety and depression as well as its risk factors. However, point prevalence's of postpartum anxiety and depression were also reported at each assessment time. Two sixty seven women could be followed for one year. Data was analyzed using SPSS. Chi-square test, simple and multiple logistic regression were used to see the association of different factors. Results The overall prevalence of postpartum anxiety and depression was found to be 28.8 percent. Domestic violence, difficulty in breast feeding at birth and unplanned current pregnancy were found to be significantly

  15. Pakistan.

    PubMed

    1992-06-01

    Pakistan's background notes which profile the population, geography, government, and the economy contain a capsule of selected country statistics and a descriptive text. Pakistan has 117 million people distributed at 134/sq km with a growth rate of 3%. The major cities are Islamabad, Rawalpindi, Karachi, Lahore, and Faisalabad. Ethnic groups include the Punjabi, Sindhi, Pathan, Baluch, and Huhajirs. 97% are Muslim. Urdu is the official language, but 65% speak Punjabi, 11% Sindhi, and 24% other languages. 26% are literate. Infant mortality is 109/1000. 54% are involved in agriculture, 33% services, and 13% in industry. A parliamentary democracy was established in 1947 with an executive, legislative, and judicial branch of government. The Islamic Democratic Alliance is the most important national party. Voting rights are for those 21 years. Seats are reserved for non-Muslims. There are 4 political subdivisions. Gross national product (GNP) was $43 billion in 1990. The economic growth rate is 5% and 2%/capita. The natural resources are arable land, natural gas, petroleum, coal, iron ore, and hydropower potential. Agricultural products include wheat, cotton, rice, and sugarcane. Industry includes textiles, fertilizer, steel products, food processing, and oil and gas products. Major trade partners are Japan, the US, the United Kingdom, and Saudi Arabia. Economic aid was $36 billion between 1947-85, of which the US contributed 3 billion between 1981-87. Major donors are id entified. The population concentration is around Karachi. Political unrest has prevailed for 26 years and includes the creation of Bangladesh in 1970 from East Pakistan. Pakistan is considered to have the resources and entrepreneurial skills to develop economically rapidly. Defense strength is characterized as the world's 11th largest. Pakistan is nonaligned, but a member of the Organization of the Islamic Conference and the UN. Relations with India have been difficult. There is a desire for a stable

  16. Impact of marine pollution in green mussel Perna viridis from four coastal sites in Karachi, Pakistan, North Arabian Sea: histopathological observations.

    PubMed

    Khan, Muhammad Iftikhar; Ayub, Zarrien; Siddiqui, Ghazala

    2015-04-01

    Pathological changes are regarded as a standard technique to monitor the effects of pollutants in marine animals. Histopathological examination of the population of green mussel Perna viridis (L.) from four sites in Pakistan, namely, Manora Channel, Rehri Creek, Sandspit Backwaters and Bhanbore was conducted. The first three sites are on the Karachi coast, whereas the fourth one, Bhanbore is situated outside Karachi, and is considered to be less polluted. Two types of parasites, Rickettsia-like organisms and metacestode were found in the mussels studied. In the present study, we observed various pathological lesions, such as inflammatory responses, granulocytomas, lipofuscin pigments, vacuolation in the digestive gland and gonads, lamellar fusion and dilated hemolymphatic sinus in the gills of P. viridis. These observations indicate the extent of environmental pollution in the studied areas. Although, Bhanbore is considered to be relatively less polluted compared to other three sites, the present results have revealed that the waters of Bhanbore are also polluted as evidenced by the pathological changes observed in the mussels collected from there. PMID:26011983

  17. To Explore the Experiences of Women on Reasons in Initiating and Maintaining Breastfeeding in Urban Area of Karachi, Pakistan: An Exploratory Study

    PubMed Central

    Shaheen Premani, Zahra; Kurji, Zohra; Mithani, Yasmin

    2011-01-01

    This is an exploratory study that explores the experiences of lactating women in initiating, continuing, or discontinuing breastfeeding in an urban area of Karachi, Pakistan. Objectives. To explore the experiences of lactating women and to understand their support and hindering mechanisms in initiating and maintaining breastfeeding. Methods. This is an exploratory design assisting in exploring the participant's experiences of initiating and maintaining breastfeeding to better understand their world. Purposive sampling was used, and data was analyzed through manual thematic analysis. Results. The data revealed that mother's knowledge, sociocultural environment, breastfeeding decision, and self- and professional support acted as driving forces for the participants. However, sociocultural environment, physiological changes, time management, and being a housewife to breastfeed their children were all challenges and barriers that the participants thought hindered their breastfeeding initiation and maintenance. Conclusion. Breastfeeding is a natural but taxing phenomenon, and breastfeeding mothers experience supporting and hindering factors in initiating and maintaining breastfeeding. PMID:22389780

  18. Young adults' perceptions on life prospects and gender roles as important factors to influence health behaviour: a qualitative study from Karachi, Pakistan.

    PubMed

    Hasnain, Syed Farid-ul; Johansson, Eva; Mogren, Ingrid; Krantz, Gunilla

    2012-05-01

    The purpose of this qualitative study was to explore perceptions and expectations of young males and females, in Karachi, Pakistan, regarding their life prospects and gender roles, with resulting implications for health behaviour. The main theme emerging was "Young adults' prospects in life are hampered by psychosocial and gender equality constraints". Gender inequality and the low status of women in society were described as major obstacles to the overall development. Persistent withholding of information to the younger generation on sexual and reproductive health issues was perceived to increase exposure to health risks, particularly sexually transmitted infections (STIs). The present study reveals new discourses on equality among young adults, pointing towards an increasing, sound interaction between the sexes and aspirations for more gender equal relationships. Such views and awareness among the younger generation constitutes a strong force towards change of traditional norms, including reproductive health behaviour, and calls for policy change. PMID:22980235

  19. Effect of pesticide residues on health and different enzyme levels in the blood of farm workers from Gadap (rural area) Karachi-Pakistan.

    PubMed

    Azmi, M Ahmed; Naqvi, S N H; Azmi, M Arshad; Aslam, M

    2006-09-01

    Persons from 14 different fruit and vegetable farm stations from Gadap (rural area), Karachi-Pakistan were examined for the presence of pesticide (cypermethrin, deltamethrin, polytrin-C, diazinon, monocrotophos, DDT and DDE) residues in their blood samples. The present study is concerned with effects of residue on the enzyme levels (GPT, GOT and ALP) as well as the health hazards of pesticide exposed persons. There is a significant increased in the enzyme levels at different stations. Exposed persons complained about liver and kidney dysfunctions and RTI. It may be concluded that exposure of multiple pesticides for prolonged period has affected the normal functioning of different organ systems and possibly produced characteristics clinical effects such as hepatitis, dyspnea and burning sensation in urine. PMID:16487989

  20. Risk Factors for Loss to Follow-Up among People Who Inject Drugs in a Risk Reduction Program at Karachi, Pakistan. A Case-Cohort Study

    PubMed Central

    Samo, Rab Nawaz; Agha, Ajmal; Shah, Sharaf Ali; Altaf, Arshad; Memon, Ashraf; Blevins, Meridith; Qian, Han-Zhu; Vermund, Sten H.

    2016-01-01

    Introduction Retention of male people who inject drugs (PWIDs) is a major challenge for harm reduction programs that include sterile needle/syringe exchange in resource-limited settings like Pakistan. We assessed the risk factors for loss to follow-up among male PWIDs enrolled in a risk reduction program in Karachi, Pakistan. Methods We conducted a prospective cohort study among 636 HIV-uninfected male PWIDs enrolled during March-June 2009 in a harm reduction program for the estimation of incidence rate. At 24 months post-enrollment, clients who had dropped out of the program were defined as lost to follow-up and included as cases for case-cohort study. Results The median age of the participants was 29 years (interquartile range: 23–36). Active outreach accounted for 76% (483/636) of cohort recruits. Loss to follow-up at 24 months was 25.5% (162/636). In multivariable logistic regression, younger age (AOR: 0.97, 95% CI: 0.92–0.99, p = 0.028), clients from other provinces than Sindh (AOR: 1.49, 95% CI: 1.01–2.22, p = 0.046), having no formal education (AOR: 3.44, 95% CI: 2.35–4.90, p<0.001), a history of incarceration (AOR: 1.68, 95% CI: 1.14–2.46, p<0.008), and being homeless (AOR: 1.47, 95% CI: 1.00–2.19, p<0.049) were associated with loss to follow-up. Conclusions Our cohort retained 74.5% of male PWIDs in Karachi for 24 months. Its loss to follow up rate suggested substantial ongoing programmatic challenges. Programmatic enhancements are needed for the highest risk male PWIDs, i.e., younger men, men not from Sindh Province, men who are poorly educated, formerly incarcerated, and/or homeless. PMID:26840414

  1. Level and Determinants of Kidney Function in a South Asian Population in Pakistan

    PubMed Central

    Jafar, Tazeen H; Islam, Muhammad; Jessani, Saleem; Bux, Rasool; Inker, Lesley A; Mariat, Christophe; Levey, Andrew S

    2015-01-01

    Background People of South Asian origin are at high risk of chronic kidney disease (CKD). Some have suggested that the usual level of glomerular filtration rate (GFR) in South Asians may be lower than in populations of European origin. However, measured GFR in a general adult population of South Asian origin has not been studied. Design Cross-sectional observational study Setting and Participants 530 subjects aged >40 years randomly selected from communities in Karachi, Pakistan, using multi-stage cluster sampling. Subjects with both diabetes and hypertension were excluded. Predictor Age, sex, diabetes, hypertension. Outcome Measured GFR using urinary clearance of inulin. Results The mean age of participants was 49.7 +/− 9.5 (SD) years, 51% were men, 34.9% had hypertension, 30.5% had diabetes. The mean measured GFR was 94.1 +/− 28.6 (SD) ml/min/1.73 m2. GFR was lower by 0.79 +/− 0.11 ml/min/1.73 m2 for each 1 year higher age. The 5-year age- and sex- specific mean GFR of the study population was generally within 1 standard deviation of the mean of previously reported values for US adults. The factors independently associated with GFR were younger age (beta coefficient, −3.84 [95% CI, −5.46 to −2.21] ml/min/1.73 m2 per 5 year older), higher serum albumin (4.58 [95% CI, 0.74 to 8.42] ml/min/1.73 m2 per 0.5 g/dl increase), higher fasting plasma glucose (0.81 [95% CI, 0.44 to 1.18] ml/min/1.73 m2 per 10 mg/dl increase ), high versus low meat intake (7.81 [95% CI, 1.14 to 14.48] ml/min/1.73 m2 for >11 versus <5 servings per week), and higher estimated protein intake (1.46 [95% CI, 0.41 to 2.51] ml/min/1.73 m2 per 1.0 g/d increase) from urine urea nitrogen. Limitations Moderate sample size, lack of validation of some items in the dietary assessment for this study population. Conclusions The mean measured GFR in South Asian adults from the general population in Karachi, Pakistan, is only modestly lower than in European-origin counterparts, with similar age

  2. Sociocultural influences on newborn health in the first 6 weeks of life: qualitative study in a fishing village in Karachi, Pakistan

    PubMed Central

    2014-01-01

    Background Given regional variability and minimal improvement in infant mortality rates in Pakistan, this study aimed to explicate sociocultural influences impacting mothers’ efforts to maintain or improve newborn health. Methods We used a qualitative phenomenological approach. A total of 10 mothers and 8 fathers from a fishing village in Karachi, Pakistan were purposefully sampled and interviewed individually. A focus group was undertaken with four grandmothers (primary decision makers). Transcripts were independently reviewed using interpretive thematic analysis. Results A multigenerational approach was used in infant care, but mothers did not have a voice in decision-making. Parents connected breast milk to infant health, and crying was used as cue to initiate feeding. Participants perceived that newborns required early supplementation, given poor milk supply and to improve health. There were tensions between traditional (i.e., home) remedies and current medical practices. Equal importance was given to sons and daughters. Conclusion Findings suggest that social and cultural influences within families and the community must be considered in developing interventions to improve newborn health. Introducing non-breast milk substances into newborn diets may reduce the duration of exclusive or partial breastfeeding and increase risks to infant health. PMID:25030836

  3. Parental perceptions surrounding polio and self-reported non-participation in polio supplementary immunization activities in Karachi, Pakistan: a mixed methods study

    PubMed Central

    Khowaja, Asif Raza; Khan, Sher Ali; Nizam, Naveeda; Omer, Saad Bin

    2012-01-01

    Abstract Objective To assess parent’s knowledge and perceptions surrounding polio and polio vaccination, self-reported participation in polio supplementary immunization activities (SIAs) targeting children aged < 5 years, and reasons for non-participation. Methods The mixed methods study began with a cross-sectional survey in Karachi, Pakistan. A structured questionnaire was administered to assess parental knowledge of polio and participation in polio SIAs conducted in September and October 2011. Additionally, 30 parents of Pashtun ethnicity (a high-risk group) who refused to vaccinate their children were interviewed in depth to determine why. Descriptive and bivariate analyses by ethnic and socioeconomic group were performed for quantitative data; thematic analysis was conducted for qualitative interviews with Pashtun parents. Findings Of 1017 parents surveyed, 412 (41%) had never heard of polio; 132 (13%) did not participate in one SIA and 157 (15.4%) did not participate in either SIA. Among non-participants, 34 (21.6%) reported not having been contacted by a vaccinator; 116 (73.9%) reported having refused to participate, and 7 (4.5%) reported that the child was absent from home when the vaccinator visited. Refusals clustered in low-income Pashtun (43/441; 9.8%) and high-income families of any ethnic background (71/153; 46.4%). Low-income Pashtuns were more likely to not have participated in polio SIAs than low-income non-Pashtuns (odds ratio, OR: 7.1; 95% confidence interval, CI: 3.47–14.5). Reasons commonly cited among Pashtuns for refusing vaccination included fear of sterility; lack of faith in the polio vaccine; scepticism about the vaccination programme, and fear that the vaccine might contain religiously forbidden ingredients. Conclusion In Karachi, interruption of polio transmission requires integrated and participatory community interventions targeting high-risk populations. PMID:23226894

  4. Gendered Disparities in Quality of Cataract Surgery in a Marginalised Population in Pakistan: The Karachi Marine Fishing Communities Eye and General Health Survey

    PubMed Central

    Ahmad, Khabir; Zwi, Anthony B.; Tarantola, Daniel J. M.; Soomro, Abdul Qadeem; Baig, Rashid; Azam, Syed Iqbal

    2015-01-01

    Background Marine fishing communities are among the most marginalised and hard-to-reach groups and have been largely neglected in health research. We examined the quality of cataract surgery and its determinants, with an emphasis on gender, in marine fishing communities in Karachi, Pakistan, using multiple indicators of performance. Methods and Findings The Karachi Marine Fishing Communities Eye and General Health Survey was a door-to-door, cross-sectional study conducted between March 2009 and April 2010 in fishing communities living on 7 islands and in coastal areas in Keamari, Karachi, located on the Arabian Sea. A population-based sample of 638 adults, aged ≥ 50 years, was studied. A total of 145 eyes (of 97 persons) had undergone cataract surgery in this sample. Cataract surgical outcomes assessed included vision (presenting and best-corrected with a reduced logMAR chart), satisfaction with surgery, astigmatism, and pupil shape. Overall, 65.5% of the operated eyes had some form of visual loss (presenting visual acuity [PVA] < 6/12). 55.2%, 29.0%, and 15.9% of these had good, borderline, and poor visual outcomes based on presenting vision; with best correction, these values were: 68.3 %, 18.6%, and 13.1%, respectively. Of 7 covariates evaluated in the multivariable generalized estimating equations (GEE) analyses, gender was the only significant independent predictor of visual outcome. Women’s eyes were nearly 4.38 times more likely to have suboptimal visual outcome (PVA<6/18) compared with men’s eyes (adjusted odds ratio 4.38, 95% CI 1.96-9.79; P<0.001) after adjusting for the effect of household financial status. A higher proportion of women’s than men’s eyes had an irregular pupil (26.5% vs. 14.8%) or severe/very severe astigmatism (27.5% vs. 18.2%). However, these differences did not reach statistical significance. Overall, more than one fourth (44/144) of cataract surgeries resulted in dissatisfaction. The only significant predictor of

  5. Health of people working/living in the vicinity of an oil-polluted beach near Karachi, Pakistan.

    PubMed

    Khurshid, R; Sheikh, M A; Iqbal, S

    2008-01-01

    A short-term study was conducted after the oil spillage from the tanker Tasman Spirit to analyse seawater and sand samples taken from Karachi beach for hydrocarbon/organic contents. Blood samples were collected from people who were working or living in the vicinity of the beach. Lymphocyte and eosinophil levels were slightly increased. About 11 people had raised serum glutamic pyruvic transaminase, but this was not significant. Such steps are vital to ensure that there are no long-term hazardous effects of oil on human health. PMID:18557466

  6. The applicability of the Greulich & Pyle Atlas for bone age assessment in primary school-going children of Karachi, Pakistan

    PubMed Central

    Manzoor Mughal, Arsalan; Hassan, Nuzhat; Ahmed, Anwar

    2014-01-01

    Objective: To assess the degree of applicability of bone age calculated by Greulich & Pyle Atlas in estimation of chronological age for therapeutic and medico legal purposes. Methods: Two Hundred and Twenty children (139 males, 81 females) between ages of 56 and 113 months (4.5 to 9.5 years) were randomly selected from 4 primary schools of Shireen Jinnah & Clifton, Karachi. Digital images of hand and wrist radiographs were obtained by a computed radiography at Ziauddin Hospital Clifton. Bone ages were computed using Greulich & Pyle Atlas by radiologists at Ziauddin Hospital, North Nazimabad, Karachi. Results: On average, the Greulich & Pyle Atlas underestimates chronological age by 6.65 ± 13.47 months in females and 15.78 ± 12.83 months in males (p-values < 0.001). High correlation was found between chronological age and bone age in both genders (Females r=0.778; p-value< 0.001, Males r=0.816; p-value < 0.001). Conclusion: Bone age calculated by Greulich & Pyle Atlas should not be used for estimating chronological age in children of ages 56-113 months in situations where high accuracy is required (e.g. medicolegal cases). However, serial measurements of bone age by this atlas can be used in management of growth related endocrine disorders in these children. PMID:24772153

  7. Practices of self-medication with antibiotics among nursing students of Institute of Nursing, Dow University of Health Sciences, Karachi, Pakistan.

    PubMed

    Ali, Akbar Shoukat; Ahmed, Javed; Ali, Akbar Shoukat; Sonekhi, Gomand Beekho; Fayyaz, Nargis; Zainulabdin, Zeeshan; Jindani, Rahim

    2016-02-01

    Self-medication practice among nursing students is of growing concern. Access to drugs and handling them in their future practices make nursing students susceptible to self-prescription and self-medication. This cross-sectional study assesses the prevalence and pattern of self-medication with antibiotics among nursing students of Institute of Nursing, Dow University of Health Sciences, Karachi, Pakistan. A random sample of convenience of 160 nursing students underwent a predesigned questionnaire. More than half of nursing students 79 (52.7%) experienced self-medication with antibiotics. It was more prevalent among males 49 (62%) . Knowledge about the drug 59 (74.7%) and convenience 13 (16.5%) were the key reasons to self-medicate. Fever 37 (46.8%) and sore throat 27 (34.2%) were the common symptoms predisposing to self-medication. Beta-lactam group of antibiotics 35 (44.3%) was most frequent used. Only 26 (32.9%) respondents completed the entire antibiotic course. Efforts must be directed towards educating nursing students about responsible and informed self-medication practices. PMID:26819180

  8. A Pilot Study of a 6-Week Parenting Program for Mothers of Pre-school Children Attending Family Health Centers in Karachi, Pakistan

    PubMed Central

    Khowaja, Yasmin; Karmaliani, Rozina; Hirani, Shela; Khowaja, Asif Raza; Rafique, Ghazala; McFarlane, Judith

    2016-01-01

    Background: Recently, parenting programs to address behavioural and emotional problems associated with child maltreatment in developing countries have received much attention. There is a paucity of literature on effective parent education interventions in the local context of Pakistan. This study aimed to assess the feasibility of offering a 6-week parenting program for mothers of pre-school children attending family health centres (FHCs) in Karachi, the largest metropolitan city of Pakistan. Methods: A pilot quasi-experimental trial was conducted. Two FHCs were selected, one as the intervention and the second as the control. A total of 57 mothers of pre-school children (n = 30 intervention; n = 27 control) participated in this study. Mothers in the intervention group received SOS Help for parents module, while mothers in the control group received information about routine childcare. A parenting scale (PS) was administered before the program was implemented and repeated 2 weeks after the program was completed in both groups. Statistical analysis was performed to compare participants’ attributes. Descriptive analysis was conducted to compare pre- and post-test mean scores along with standard deviation for parenting subscales in the intervention and control groups. Results: A total of 50 mothers (n = 25 intervention; n = 25 control) completed the 6-week program. Attrition was observed as 5/30 (17%) in the intervention arm and 2/27 (2%) in the control arm. Mothers commonly reported the burden of daily domestic and social responsibilities as the main reason for dropping out. Furthermore, the majority of participants in the control group recommended increasing the duration of weekly sessions from 1 to 1.5 hours, thereby decreasing the program period from 6 to 4 weeks. Mothers in intervention group reported substantial improvement in parenting skills as indicated by mean difference in their pre- and post-test scores for laxness and over-reactivity. Conclusion

  9. Prevalence of Mistreatment or Belittlement among Medical Students – A Cross Sectional Survey at a Private Medical School in Karachi, Pakistan

    PubMed Central

    Shoukat, Sana; Anis, Mariam; Kella, Danesh K.; Qazi, Fahad; Samad, Fatima; Mir, Faizia; Mansoor, Maryah; Parvez, Mohammad B.; Osmani, Bushra; Panju, Sukaina A.; Naqvi, Haider

    2010-01-01

    Background Mistreatment or belittlement of medical students either by faculty or fellow students has often been reported. Perception of mistreatment has also been associated with increased degree of psychological morbidity. There is a lack of such studies being conducted amongst the medical students of Pakistan. The aim of this study was to determine the prevalence and forms of perceived mistreatment and presence of mental health morbidity in a private medical school in Pakistan. Also, any association between mental health morbidity and mistreatment was to be identified. Methods A cross sectional study was carried out on medical students from Aga Khan University Hospital, Karachi, Pakistan during the period of June–September 2007. A self administered questionnaire, adapted from Frank et al and Baldwin et al was distributed to a total of 350 students. The questionnaire consisted of three parts: the first dealing with the demographics of the population, the second concerning the various forms of mistreatment, while the third assessed the mental health of students using the General Health Questionnaire 12(GHQ12). Descriptive statistics were performed. The Chi-square test and Fisher's exact tests were applied. Results A total of 350 students were approached out of which 232 completed the questionnaire giving a response rate of 66.2%. Mistreatment was reported by 62.5% (145/232) of the respondents. Of these, 69.7% (83/145) were males and 54.9% (62/145) were females. There was a significant relationship between gender, year division, stress at medical school and possible use of drugs/alcohol and reported mistreatment but no statistical relationship was seen with psychiatric morbidity. The overall prevalence of psychological morbidity was 34.8% (77/221). Conclusion This study suggests high prevalence of perceived mistreatment and psychological morbidity among Pakistani medical students. However, no association was found between these two aspects of medical student

  10. Prevalence and factors related to dental caries among pre-school children of Saddar town, Karachi, Pakistan: a cross-sectional study

    PubMed Central

    2012-01-01

    Background Dental caries is highly prevalent and a significant public health problem among children throughout the world. Epidemiological data regarding prevalence of dental caries amongst Pakistani pre-school children is very limited. The objective of this study is to determine the frequency of dental caries among pre-school children of Saddar Town, Karachi, Pakistan and the factors related to caries. Methods A cross-sectional study of 1000 preschool children was conducted in Saddar town, Karachi. Two-stage cluster sampling was used to select the sample. At first stage, eight clusters were selected randomly from total 11 clusters. In second stage, from the eight selected clusters, preschools were identified and children between 3- to 6-years age group were assessed for dental caries. Results Caries prevalence was 51% with a mean dmft score being 2.08 (±2.97) of which decayed teeth constituted 1.95. The mean dmft of males was 2.3 (±3.08) and of females was 1.90 (±2.90). The mean dmft of 3, 4, 5 and 6- year olds was 1.65, 2.11, 2.16 and 3.11 respectively. A significant association was found between dental caries and following variables: age group of 4-years (p-value ² 0.029, RR = 1.248, 95% Bias corrected CI 0.029-0.437) and 5-years (p-value ² 0.009, RR = 1.545, 95% Bias corrected CI 0.047-0.739), presence of dental plaque (p-value ² 0.003, RR = 0.744, 95% Bias corrected CI (−0.433)-(−0.169)), poor oral hygiene (p-value ² 0.000, RR = 0.661, 95% Bias corrected CI (−0.532)-(−0.284)), as well as consumption of non-sweetened milk (p-value ² 0.049, RR = 1.232, 95% Bias corrected CI 0.061-0.367). Conclusion Half of the preschoolers had dental caries coupled with a high prevalence of unmet dental treatment needs. Association between caries experience and age of child, consumption of non-sweetened milk, dental plaque and poor oral hygiene had been established. PMID:23270546

  11. Geographic Variation in Access to Dog-Bite Care in Pakistan and Risk of Dog-Bite Exposure in Karachi: Prospective Surveillance Using a Low-Cost Mobile Phone System

    PubMed Central

    Zaidi, Syed Mohammad Asad; Labrique, Alain B.; Khowaja, Saira; Lotia-Farrukh, Ismat; Irani, Julia; Salahuddin, Naseem; Khan, Aamir Javed

    2013-01-01

    Background Dog-bites and rabies are under-reported in developing countries such as Pakistan and there is a poor understanding of the disease burden. We prospectively collected data utilizing mobile phones for dog-bite and rabies surveillance across nine emergency rooms (ER) in Pakistan, recording patient health-seeking behaviors, access to care and analyzed spatial distribution of cases from Karachi. Methodology and Principal Findings A total of 6212 dog-bite cases were identified over two years starting in February 2009 with largest number reported from Karachi (59.7%), followed by Peshawar (13.1%) and Hyderabad (11.4%). Severity of dog-bites was assessed using the WHO classification. Forty percent of patients had Category I (least severe) bites, 28.1% had Category II bites and 31.9% had Category III (most severe bites). Patients visiting a large public hospital ER in Karachi were least likely to seek immediate healthcare at non-medical facilities (Odds Ratio = 0.20, 95% CI 0.17–0.23, p-value<0.01), and had shorter mean travel time to emergency rooms, adjusted for age and gender (32.78 min, 95% CI 31.82–33.78, p-value<0.01) than patients visiting hospitals in smaller cities. Spatial analysis of dog-bites in Karachi suggested clustering of cases (Moran's I = 0.02, p value<0.01), and increased risk of exposure in particular around Korangi and Malir that are adjacent to the city's largest abattoir in Landhi. The direct cost of operating the mHealth surveillance system was USD 7.15 per dog-bite case reported, or approximately USD 44,408 over two years. Conclusions Our findings suggest significant differences in access to care and health-seeking behaviors in Pakistan following dog-bites. The distribution of cases in Karachi was suggestive of clustering of cases that could guide targeted disease-control efforts in the city. Mobile phone technologies for health (mHealth) allowed for the operation of a national-level disease reporting and surveillance system

  12. New record of Afrimenopon waar (Eichler) (Phthiraptera: Menoponidae) from budgerigar Melopsittacus undulatus (Psittaciformes: Psittacidae) from Karachi, Pakistan.

    PubMed

    Sychra, Oldrich; Naz, Saima; Rizvi, S Anser

    2007-08-01

    Chewing lice of the species Afrimenopon waar (Eichler) were collected from captive budgerigar Melopsittacus undulatus (Shaw) in Pakistan. This is the first record of amblyceran lice from this host. It is also the first record of the genus Afrimenopon from Pakistani region. The primary host species of Afrimenopon waar is the rosy-faced lovebird Agapornis roseicollis (Vieillot). The finding of A. waar on budgerigars is, most likely, a result of a contamination in captivity. Morphological variation and origin of these lice are discussed. PMID:17334969

  13. Knowledge, Attitude, and Practices of Healthcare Personnel Regarding the Transmission of Pathogens via Fomites at a Tertiary Care Hospital in Karachi, Pakistan

    PubMed Central

    Aftab, Hassaan Bin; Zia, Bushra; Zahid, Mohammad Faizan; Raheem, Ahmed; Beg, Mohammad Asim

    2016-01-01

    Background. Fomites are objects that can become colonized and serve as vectors in the transmission of pathogenic microorganisms. Literature examining the knowledge of healthcare personnel about this method of spread of infection is lacking. We conducted a study to assess the knowledge, attitude, and practices of healthcare personnel across different areas of patient care regarding the spread of infections at a tertiary care hospital in Karachi, Pakistan. Methods. A descriptive, cross-sectional study was conducted among healthcare personnel using a self-administered questionnaire. The questionnaire contained sections pertaining to demographic details and knowledge, attitude, and practices regarding fomites and their role in the transmission of pathogens. Results. Three hundred and fifty-three participants completed the questionnaire: 168 were male and 185 were female. Laboratory coats, stethoscopes, and bedside curtains were most frequently identified as fomites by the participants. Medical students had significantly lower mean scores in the knowledge and attitude sections than consultant physicians, resident physicians, and nurses. Nurses scored higher than consultant physicians, resident physicians, and medical students regarding practices that minimize fomite-borne spread of infections. 95% of the participants scored above 50% on the knowledge component of the questionnaire, but only 32.3% scored above 50% in the practices section. Conclusions. Our results show a large gap between the knowledge about fomites acting as vectors in the spread of pathogens and practices done to minimize this spread. Possessing adequate knowledge is ineffectual until and unless it is translated into the proper application of infection control practices. Incorporating awareness sessions and exercises into curricula are a reasonable way to raise awareness regarding this subject. PMID:27169136

  14. Sustained improvements in handwashing indicators more than 5 years after a cluster-randomised, community-based trial of handwashing promotion in Karachi, Pakistan

    PubMed Central

    Bowen, Anna; Agboatwalla, Mubina; Ayers, Tracy; Tobery, Timothy; Tariq, Maria; Luby, Stephen P.

    2015-01-01

    OBJECTIVE To evaluate handwashing behaviour 5 years after a handwashing intervention in Karachi, Pakistan. METHODS In 2003, we randomised neighbourhoods to control, handwashing promotion, or handwashing promotion and water treatment. Intervention households were given soap +/− water treatment product and weekly handwashing education for 9 months. In 2009, we re-enrolled 461 households from the three study groups: control (160), handwashing (141), and handwashing + water treatment (160) and assessed hygiene-related outcomes, accounting for clustering. RESULTS Intervention households were 3.4 times more likely than controls to have soap at their handwashing stations during the study visit [293/301 (97%) vs. 45/159 (28%), P < 0.0001]. While nearly all households reported handwashing after toileting, intervention households more commonly reported handwashing before cooking [relative risk (RR) 1.2 (95% confidence interval (CI) 1.0–1.4)] and before meals [RR 1.7 (95% CI, 1.3–2.1)]. Control households cited a mean of 3.87 occasions for washing hands; handwashing households, 4.74 occasions; and handwashing + water treatment households, 4.78 occasions (P < 0.0001). Households reported purchasing a mean of 0.65 (control), 0.91 (handwashing) and 1.1 (handwashing + water treatment) bars of soap/person/month (P < 0.0001). CONCLUSIONS Five years after receiving handwashing promotion, intervention households were more likely to have soap at the household handwashing station, know key times to wash hands and report purchasing more soap than controls, suggesting habituation of improved handwashing practices in this population. Intensive handwashing promotion may be an effective strategy for habituating hygiene behaviours and improving health. PMID:23294343

  15. Knowledge, Attitude, and Practices of Healthcare Personnel Regarding the Transmission of Pathogens via Fomites at a Tertiary Care Hospital in Karachi, Pakistan.

    PubMed

    Aftab, Hassaan Bin; Zia, Bushra; Zahid, Mohammad Faizan; Raheem, Ahmed; Beg, Mohammad Asim

    2016-01-01

    Background.  Fomites are objects that can become colonized and serve as vectors in the transmission of pathogenic microorganisms. Literature examining the knowledge of healthcare personnel about this method of spread of infection is lacking. We conducted a study to assess the knowledge, attitude, and practices of healthcare personnel across different areas of patient care regarding the spread of infections at a tertiary care hospital in Karachi, Pakistan. Methods.  A descriptive, cross-sectional study was conducted among healthcare personnel using a self-administered questionnaire. The questionnaire contained sections pertaining to demographic details and knowledge, attitude, and practices regarding fomites and their role in the transmission of pathogens. Results.  Three hundred and fifty-three participants completed the questionnaire: 168 were male and 185 were female. Laboratory coats, stethoscopes, and bedside curtains were most frequently identified as fomites by the participants. Medical students had significantly lower mean scores in the knowledge and attitude sections than consultant physicians, resident physicians, and nurses. Nurses scored higher than consultant physicians, resident physicians, and medical students regarding practices that minimize fomite-borne spread of infections. 95% of the participants scored above 50% on the knowledge component of the questionnaire, but only 32.3% scored above 50% in the practices section. Conclusions.  Our results show a large gap between the knowledge about fomites acting as vectors in the spread of pathogens and practices done to minimize this spread. Possessing adequate knowledge is ineffectual until and unless it is translated into the proper application of infection control practices. Incorporating awareness sessions and exercises into curricula are a reasonable way to raise awareness regarding this subject. PMID:27169136

  16. Lessons and implications from a mass immunization campaign in squatter settlements of Karachi, Pakistan: an experience from a cluster-randomized double-blinded vaccine trial [NCT00125047

    PubMed Central

    Khan, Mohammad Imran; Ochiai, Rion Leon; Hamza, Hasan Bin; Sahito, Shah Muhammad; Habib, Muhammad Atif; Soofi, Sajid Bashir; Bhutto, Naveed Sarwar; Rasool, Shahid; Puri, Mahesh K; Ali, Mohammad; Wasan, Shafi Mohammad; Khan, Mohammad Jawed; Abu-Elyazeed, Remon; Ivanoff, Bernard; Galindo, Claudia M; Pang, Tikki; Donner, Allan; von Seidlein, Lorenz; Acosta, Camilo J; Clemens, John D; Nizami, Shaikh Qamaruddin; Bhutta, Zulfiqar A

    2006-01-01

    Objective To determine the safety and logistic feasibility of a mass immunization strategy outside the local immunization program in the pediatric population of urban squatter settlements in Karachi, Pakistan. Methods A cluster-randomized double blind preventive trial was launched in August 2003 in 60 geographic clusters covering 21,059 children ages 2 to 16 years. After consent was obtained from parents or guardians, eligible children were immunized parenterally at vaccination posts in each cluster with Vi polysaccharide or hepatitis A vaccine. Safety, logistics, and standards were monitored and documented. Results The vaccine coverage of the population was 74% and was higher in those under age 10 years. No life-threatening serious adverse events were reported. Adverse events occurred in less than 1% of all vaccine recipients and the main reactions reported were fever and local pain. The proportion of adverse events in Vi polysaccharide and hepatitis A recipients will not be known until the end of the trial when the code is broken. Throughout the vaccination campaign safe injection practices were maintained and the cold chain was not interrupted. Mass vaccination in slums had good acceptance. Because populations in such areas are highly mobile, settlement conditions could affect coverage. Systemic reactions were uncommon and local reactions were mild and transient. Close community involvement was pivotal for information dissemination and immunization coverage. Conclusion This vaccine strategy described together with other information that will soon be available in the area (cost/effectiveness, vaccine delivery costs, etc) will make typhoid fever control become a reality in the near future. PMID:16725026

  17. Simplified Antibiotic Regimens for the Management of Clinically Diagnosed Severe Infections in Newborns and Young Infants in First-level Facilities in Karachi, Pakistan

    PubMed Central

    2013-01-01

    Background: Infection in young infants is a major cause of morbidity and mortality in low-middle income countries, with high neonatal mortality rates. Timely case management is lifesaving, but the current standard of hospitalization for parenteral antibiotic therapy is not always feasible. Alternative, simpler antibiotic regimens that could be used in outpatient settings have the potential to save thousands of lives. Methods: This trial aims to determine whether 2 simplified antibiotic regimens are equivalent to the reference therapy with 7 days of once-daily (OD) intramuscular (IM) procaine penicillin and gentamicin for outpatient management of young infants with clinically presumed systemic bacterial infection treated in primary health-care clinics in 5 communities in Karachi, Pakistan. The reference regimen is close to the current recommendation of the hospital-based intravenous ampicillin and gentamicin therapy for neonatal sepsis. The 2 comparison arms are (1) IM gentamicin OD and oral amoxicillin twice daily for 7 days; and (2) IM penicillin and gentamicin OD for 2 days, followed by oral amoxicillin twice daily for 5 days; 2250 “evaluable” infants will be enrolled. The primary outcome of this trial is treatment failure (death, deterioration or lack of improvement) within 7 days of enrollment. Results are expected by early 2014. Discussion: This trial will determine whether simplified antibiotic regimens with fewer injections in combination with high-dose amoxicillin are equivalent to 7 days of IM procaine penicillin and gentamicin in young infants with clinical severe infection. Results will have program and policy implications in countries with limited access to hospital care and high burden of neonatal deaths. PMID:23945571

  18. Neonatal Mortality and Prevalence of Practices for Newborn Care in a Squatter Settlement of Karachi, Pakistan: A Cross-Sectional Study

    PubMed Central

    Ayaz, Afsheen; Saleem, Sarah

    2010-01-01

    Background During the past two decades there has been a sustained decline in child and infant mortality, however neonatal mortality has remained relatively unchanged. Almost all neonatal deaths (99%) occur in developing countries, where the majority are delivered at homes. Evidence suggests that these deaths could be prevented by simple, inexpensive practices and interventions during the pregnancy, delivery and postnatal period. In Pakistan over the last decade extensive efforts have been made by the international donors and government to implement these practices. However, limited attempts have been made to explore if these efforts have made a difference at the grass root level. This study assessed the burden of neonatal mortality and prevalence of practices for newborn care in a squatter settlement of Karachi, Pakistan. Methodology/Principal Findings A community based cross-sectional study was performed. A pre-tested structured questionnaire was administered to 565 women who had recently delivered. Information was collected on neonatal morbidity, mortality and practices of women regarding care during pregnancy, child birth and for newborn, till 28th day of birth. Although 70% of women mentioned receiving antenatal care by a skilled provider, only 54.5% had four or more visits. Tetanus toxoid was received by 79% of women while only 56% delivered at a health care facility by a skilled attendant. Newborn care practices like bathing the baby immediately after birth (56%), giving pre-lacteals (79.5%), late initiation of breast feeding (80.3%), application of substances on umbilical cord (58%) and body massage (89%) were common. Most neonates (81.1%) received BCG injection and polio drops after birth. Neonatal mortality rate was 27/1000 live births with the majority of deaths occurring during the first three days of life. Conclusion Even after years of efforts by government and nongovernmental sector to reduce newborn morbidity and mortality, inadequate antenatal care

  19. Gender roles and their influence on life prospects for women in urban Karachi, Pakistan: a qualitative study

    PubMed Central

    Ali, Tazeen S.; Krantz, Gunilla; Gul, Raisa; Asad, Nargis; Johansson, Eva; Mogren, Ingrid

    2011-01-01

    Background Pakistan is a patriarchal society where men are the primary authority figures and women are subordinate. This has serious implications on women's and men's life prospects. Objective The aim was to explore current gender roles in urban Pakistan, how these are reproduced and maintained and influence men's and women's life circumstances. Design Five focus group discussions were conducted, including 28 women representing employed, unemployed, educated and uneducated women from different socio-economic strata. Manifest and latent content analyses were applied. Findings Two major themes emerged during analysis: ‘Reiteration of gender roles’ and ‘Agents of change’. The first theme included perceptions of traditional gender roles and how these preserve women's subordination. The power gradient, with men holding a superior position in relation to women, distinctive features in the culture and the role of the extended family were considered to interact to suppress women. The second theme included agents of change, where the role of education was prominent as well as the role of mass media. It was further emphasised that the younger generation was more positive to modernisation of gender roles than the elder generation. Conclusions This study reveals serious gender inequalities and human rights violations against women in the Pakistani society. The unequal gender roles were perceived as static and enforced by structures imbedded in society. Women routinely faced serious restrictions and limitations of autonomy. However, attainment of higher levels of education especially not only for women but also for men was viewed as an agent towards change. Furthermore, mass media was perceived as having a positive role to play in supporting women's empowerment. PMID:22065609

  20. A diagnostic study of heavy rainfall in Karachi due to merging of a mesoscale low and a diffused tropical depression during South Asian summer monsoon

    NASA Astrophysics Data System (ADS)

    Rasul, Ghulam; Chaudhry, Qamar-Uz-Zaman; Sixiong, Zhao; Qingcun, Zeng; Linlin, Qi; Gaoying, Zhang

    2005-06-01

    This paper presents the results of a diagnostic study of a typical case of very heavy rainfall during the South Asian summer monsoon when a mesoscale low in a desert climate merged with a diffused tropical depression. The former low was located over Pakistan’s desert region and the latter depression originated over the Bay of Bengal. Surface and NCEP reanalysis data supported by satellite and radar images were incorporated in the diagnosis. The relationship between the heavy precipitation process and large-scale circulations such as monsoon trough, subtropical high, westerly jet, low level jet and water vapor transport were investigated to further understand the mechanism of this peculiar interaction. It was found that: (1) the mesoscale low developed as a result of cold air advection aloft from northern latitudes and strong convection over the region of humidity convergence on 24 July 2003 over the Indian Rajistan area. (2) On the same day, a low that formed over the Bay of Bengal was transformed into a monsoon depression and moved westward to the mesoscale low which existed over southwest India and the adjoining southeastern parts of Pakistan. (3) Initially, the mesoscale low received moisture supply from both the Bay of Bengal as well as the Arabian Sea, whereas the Bay of Bengal maintained the continuous supply of moisture to the monsoon depression. (4) After the depression crossed central India, the Bay’s moisture supply was cut off and the Arabian Sea became the only source of moisture to both the closely located systems. On 27 July, both of the systems merged together and the merger resulted in a heavy downpour in the Karachi metropolitan and in its surroundings. (5) With the intensification as well as the southeastward extension of the subtropical high and the shift of the monsoon trough axis from southwest-west to northeast-east, the monsoon depression moved southwestward. In this situation, there existed a very favourable condition for a merger of the

  1. The utilization of LANDSAT imagery in nuclear power plant siting. [in Pakistan, South Carolina, and Spain

    NASA Technical Reports Server (NTRS)

    Eggenberger, A. J.; Rowlands, D.; Rizzo, P. C.

    1975-01-01

    LANDSAT imagery was used primarily to map geologic features such as lineaments, linears, faults, and other major geologic structures which affect site selection for a nuclear power plant. Areas studied include Pakistan, the South Carolina Piedmont, and Huelva, Spain.

  2. Need for multilevel strategies and enhanced acceptance of contraceptive use in order to combat the spread of HIV/AIDS in a Muslim society: a qualitative study of young adults in urban Karachi, Pakistan.

    PubMed

    Farid-ul-Hasnain, Syed; Johansson, Eva; Gulzar, Saleema; Krantz, Gunilla

    2013-09-01

    This qualitative study explored knowledge, attitudes, beliefs and perceptions of sexual and reproductive health, focusing specifically on contraceptive use and HIV prevention among young unmarried men and women, 17-21 years, in urban Karachi, Pakistan. The main theme, identified as underlying meaning in the focus group discussions was "Societal norms and perceptions create barriers to knowledge and awareness about sexual and reproductive health matters among young adults". A knowledge gap was revealed concerning HIV/AIDS and contraceptive use among young males and females, who have to rely on media and peers for information seeking. Study participants perceived that HIV/AIDS is incurable and carries a social stigma. It was further revealed, that there is an opposition towards contraceptive use from religious leaders. Young adults in Pakistan are in need of improved knowledge about HIV/AIDS and contraceptive use. Youth clinics and schools/colleges may play a significant role in this regard. The religious leaders need to be informed about the beneficial effects of contraceptives and they should be part of any family planning/contraceptive use program to ensure better community acceptance. At the structural level there is an urgent need for policies targeting the issue of sexual and reproductive health, particularly HIV/AIDS information and contraceptive use to target the young population. The health care services should be able to respond by offering relevant services. PMID:23985107

  3. Need for Multilevel Strategies and Enhanced Acceptance of Contraceptive Use in Order to Combat the Spread of HIV/AIDS in a Muslim Society: A Qualitative Study of Young Adults in Urban Karachi, Pakistan

    PubMed Central

    Farid-ul-Hasnain, Syed; Johansson, Eva; Gulzar, Saleema; Krantz, Gunilla

    2013-01-01

    This qualitative study explored knowledge, attitudes, beliefs and perceptions of sexual and reproductive health, focusing specifically on contraceptive use and HIV prevention among young unmarried men and women, 17-21 years, in urban Karachi, Pakistan. The main theme, identified as underlying meaning in the focus group discussions was “Societal norms and perceptions create barriers to knowledge and awareness about sexual and reproductive health matters among young adults”. A knowledge gap was revealed concerning HIV/AIDS and contraceptive use among young males and females, who have to rely on media and peers for information seeking. Study participants perceived that HIV/AIDS is incurable and carries a social stigma. It was further revealed, that there is an opposition towards contraceptive use from religious leaders. Young adults in Pakistan are in need of improved knowledge about HIV/AIDS and contraceptive use. Youth clinics and schools/colleges may play a significant role in this regard. The religious leaders need to be informed about the beneficial effects of contraceptives and they should be part of any family planning/contraceptive use program to ensure better community acceptance. At the structural level there is an urgent need for policies targeting the issue of sexual and reproductive health, particularly HIV/AIDS information and contraceptive use to target the young population. The health care services should be able to respond by offering relevant services. PMID:23985107

  4. Pakistan.

    PubMed

    1987-03-01

    This information sheet about Pakistan, by the U.S. State Dept., summarizes its geography, political history, government, economy and international relations. Pakistan, lying on the Arabian Sea between Iran and India, and neighboring Afghanistan and China, has been independent from British control since 1947. Her people, 98 million, come from several Indo-European ethnic groups, but are 97% Muslim. Most live in the fertile Indus river valley; 53% work in agriculture; 13% in industry; mean per capita income is $331. The infant mortality rate is about 119/1000; life expectancy around 51 years. The country is endowed with resources, besides farmland, of oil, gas, coal, iron and hydroelectric power. It produces cotton, rice, fruits and vegetables as well for export. Pakistan's history is filled with strife, armed or political, marked by the independence of East Pakistan, now Bangladesh, in 1970, and rivalry for power by military and democratic factions, ending with a real election of Benazir Bhutto in 1986. Despite basic resources and a net export of food and textiles, the country has a significant debt and runs a deficit, and supports a rapidly growing young population (3.1% growth rate). Pakistan partakes in a complicated net of international relations due to the alignment of countries on her borders. Religious and ethnic conflicts with India, ideological difficulties and millions of refugees flowing from Afghanistan, but good relations with Iran and China make up this pattern. PMID:12177945

  5. High rate of non-susceptibility to metronidazole and clindamycin in anaerobic isolates: Data from a clinical laboratory from Karachi, Pakistan.

    PubMed

    Sheikh, Sadia Omer; Jabeen, Kauser; Qaiser, Saba; Ahsan, Syed Tanwir; Khan, Erum; Zafar, Afia

    2015-06-01

    Due to increasing resistance amongst anaerobic pathogens periodic surveillance of resistance has been recommended in regional/local settings. Anaerobic antimicrobial susceptibility testing is not routinely performed in many laboratories in Pakistan, hence absence of local data may lead to inappropriate empirical therapy in serious cases. 121 clinically significant anaerobic strains (26/121; 21% bacteremic isolates) were isolated and saved from 2010 to 2011. Susceptibility testing against metronidazole, clindamycin, co-amoxiclav, meropenem, piperacillin/tazobactam, linezolid and gatifloxacin was performed by determining minimum inhibitory concentrations (MICs). A high proportion of non-susceptible strains to metronidazole (10% of 121 isolates) and clindamycin (12% of 121 isolates) was seen, most noticeable in Bacteroides fragilis. Three Bacteroides species strains were non-susceptible to both metronidazole and clindamycin. One strain of Clostridium species was fully resistant to metronidazole and had intermediate resistance to clindamycin. No resistance to any of the other tested antibiotics was seen. Resistance to metronidazole was higher in bacteremic vs. non bacteremic isolates (p = value 0.07). In our setting where there is a high usage of empirical metronidazole and clindamycin for the treatment of serious anaerobic infections clinicians should be aware of increased resistance to these agents. Periodic surveillance of resistance to anti-anaerobic drugs especially metronidazole and clindamycin should be performed to generate antibiogram and guide appropriate empiric therapy. PMID:25800668

  6. Formative research and development of an evidence-based communication strategy: the introduction of Vi typhoid fever vaccine among school-aged children in Karachi, Pakistan.

    PubMed

    Pach, Alfred; Tabbusam, Ghurnata; Khan, M Imran; Suhag, Zamir; Hussain, Imtiaz; Hussain, Ejaz; Mumtaz, Uzma; Haq, Inam Ul; Tahir, Rehman; Mirani, Amjad; Yousafzai, Aisha; Sahastrabuddhe, Sushant; Ochiai, R Leon; Soofi, Sajid; Clemens, John D; Favorov, Michael O; Bhutta, Zulfiqar A

    2013-01-01

    The authors conducted formative research (a) to identify stakeholders' concerns related to typhoid fever and the need for disease information and (b) to develop a communication strategy to inform stakeholders and address their concerns and motivate for support of a school-based vaccination program in Pakistan. Data were collected during interactive and semi-structured focus group discussions and interviews, followed by a qualitative analysis and multidisciplinary consultative process to identify an effective social mobilization strategy comprised of relevant media channels and messages. The authors conducted 14 focus group discussions with the parents of school-aged children and their teachers, and 13 individual interviews with school, religious, and political leaders. Parents thought that typhoid fever was a dangerous disease, but were unsure of their children's risk. They were interested in vaccination and were comfortable with a school-based vaccination if conducted under the supervision of trained and qualified staff. Teachers and leaders needed information on typhoid fever, the vaccine, procedures, and sponsors of the vaccination program. Meetings were considered the best form of information dissemination, followed by printed materials and mass media. This study shows how qualitative research findings can be translated into an effective social mobilization and communication approach. The findings of the research indicated the importance of increasing awareness of typhoid fever and the benefits of vaccination against the disease. Identification and dissemination of relevant, community-based disease and vaccination information will increase demand and use of vaccination. PMID:23330632

  7. Pakistan. Spotlight.

    PubMed

    Greene, M

    1985-01-01

    Focus in this discussion of Pakistan is on demographic factors, the issue of ethnic versus national solidarity, and economic and social development. The population was estimated at 99.2 million in 1985. The birthrate was 43/1000 in 1984 and the deaths were 15/1000. The infant mortality rate is 105 infant deaths/1000 live births, and life expectancy at birth is 51 years. In 1983 the gross national product per capita was US$390. The population of Pakistan is concentrated around Karachi on the Arabian Sea and in the crescent formed by Lahore, Rawalpindi, and Peshawar. Pakistan was a British colony, part of the Indian subcontinent until partition in 1947, when Britain gave Pakistan and India their freedom. Pakistan is not a theocracy, but the military government turns to traditional Islam for affirmation of its authority. Its martial law regime, established in 1977, is headed by President Ziaul Haq. The issue of ethnic versus national solidarity has been a problem since independence. Bengali-speaking East Pakistanis felt they did not have equal power in their country whose official language was Urdu and whose capital was in West Pakistan. East and West Pakistan ended up in armed conflict with the formation of Bangladesh in 1971 as the result. Regional and ethnic conflict is exacerbated by the low rate of literacy and the low status of certain ethnic groups in Pakistan. In addition, Pakistan suffers problems typical of many developing nations: a low per capita income, a large and growing population, and a highly stratified traditional society. In 1981 doctors, engineers, and craftsmen were in short supply, but there was a surplus of 300,000 agricultural workers. Agriculture makes up 30% of the GNP and employs 55% of the work force. In Pakistan's 6th Five Year Plan, initiated in July 1983, the government acknowledged for the 1st time the extremely poor conditions for women as indicated by literacy, health, and fertility. The total fertility rate is 6.4 average births

  8. The role of son preference in reproductive behaviour in Pakistan.

    PubMed

    Hussain, R; Fikree, F F; Berendes, H W

    2000-01-01

    The sex of surviving children is an important determinant of reproductive behaviour in South Asia in general and Pakistan in particular. This cohort study evaluates the role of the sex of children on reproductive intentions and subsequent behaviour of women in urban slums of Karachi, Pakistan. The analysis is based on two rounds of surveys conducted in 1990-91 and 1995 of a cohort of married women aged 15-49 years. The results show that pregnancies became increasingly unwanted as the number of surviving sons increased. The sex of surviving children was strongly correlated with subsequent fertility and contraceptive behaviour. However, rather than an exclusive son preference, couples strove for one or more sons and at least one surviving daughter. The policy implications of the link between overt son preference and low status of women are discussed. PMID:10812738

  9. The Muslim Response to English in South Asia: With Special Reference to Inequality, Intolerance, and Militancy in Pakistan

    ERIC Educational Resources Information Center

    Rahman, Tariq

    2005-01-01

    This article argues that since the British colonial era, Muslims in South Asia have responded to English in three ways: (a) rejection and resistance, (b) acceptance and assimilation, and (c) pragmatic utilization. These responses continue in Pakistan and are respectively associated with the traditionalist ulema, the Westernized middle and upper…

  10. DELIBERATE SELF-HARM PATIENTS VISITING PUBLIC AND PRIVATE EMERGENCY DEPARTMENTS OF KARACHI

    PubMed Central

    SHAHID, MUHAMMAD; KHAN, MUHAMMAD ZAMAN; AFZAL, BADAR; KHAN, SUMAIYA TAUSEEQ; NAKEER, ROOHAM

    2015-01-01

    OBJECTIVE To study the mode of attempted deliberate self-harm (DSH) in patients presenting to the Emergency Departments (ED) of public and private hospitals of Karachi, Pakistan. DESIGN A cross sectional study. PLACE AND DURATION OF STUDY Aga Khan University Hospital Karachi, Jinnah Post Graduate Medical Centre Karachi and Civil Hospital Karachi; March 2011 to February 2012. SUBJECTS AND METHODS One hundred DSH cases from ED of a private sector hospital were compared with 101 patients from two public sector hospitals. RESULTS DSH patients in the private hospital were mostly females (70%), had higher level of education (32%), did not share their problems (67%) with someone and had more mental disorders (28%). Patients from public hospitals were treated more for physical illnesses compared to private facility. Organophosphorus poisoning (90%) was a common mode of DSH in patients presenting to public hospitals; however significant number of organophosphorus poisoning (40%) was also seen in private hospital besides the benzodiazepine overdose (32%). CONCLUSION Emergency Physicians working in the EDs, both public and private sector hospitals of Karachi, should have adequate knowledge of managing organophosphorus poisoning. As more and more cases are presenting to the EDs, there should be a public health initiative to control the illegal sale and availability of such compounds in Pakistan. PMID:26985203

  11. Patho-epidemiology of lung cancer in Karachi (1995-2002).

    PubMed

    Bhurgri, Yasmin; Bhurgri, Asif; Usman, Ahmed; Sheikh, Nassar; Faridi, Naveen; Malik, Jawaid; Ahmed, Rasheeda; Kayani, Naila; Pervez, Shahid; Hasan, Sheema H

    2006-01-01

    women. A higher risk was also observed for men who were residing along the coastal belt, and for ethnicities belonging to Southern Pakistan (Sindhi and Mohajir) residing in Karachi South. In conclusion, Pakistan at present falls into a low risk lung cancer region in females and a moderate risk region for males and the highest registered increase between 1995 and 2002 was observed in the older age groups (65+). It is however a cause of concern that the overall lung cancer incidence rates continue to rise. The age specific rates though stable in the younger age groups (35-49 years), are at present equivalent to contemporary rates in high- risk countries. These rates correspond with the trends of smoking prevalence in the younger age groups in the last 2 decades. Published studies have given alerts to increase in the smoking habits of the present day youngsters and with an expanding population the country can expect a substantial increase in lung cancer. This threat can only be averted by implementation of stringent anti-tobacco rules and health education; prohibition of smoking in educational institutions at all levels and a ban on the sale of cigarettes to minors. PMID:16629517

  12. Population structure of the mosquito Aedes aegypti (Stegomyia aegypti) in Pakistan.

    PubMed

    Rasheed, S B; Boots, M; Frantz, A C; Butlin, R K

    2013-12-01

    Eleven microsatellite markers were used to determine the genetic population structure and spread of Aedes aegypti (Stegomyia aegypti) (Diptera: Culicidae) in Pakistan using mosquitoes collected from 13 different cities. There is a single genetic cluster of Ae. aegypti in Pakistan with a pattern of isolation by distance within the population. The low level of isolation by distance suggests the long-range passive dispersal of this mosquito, which may be facilitated by the tyre trade in Pakistan. A decrease in genetic diversity from south to north suggests a recent spread of this mosquito from Karachi. A strong negative correlation between genetic distance and the quality of road connections shows that populations in cities connected by better road networks are less differentiated, which suggests the human-aided passive dispersal of Ae. aegypti in Pakistan. Dispersal on a large spatial scale may facilitate the strategy of introducing transgenic Ae. aegypti or intracellular bacteria such as Wolbachia to control the spread of dengue disease in Pakistan, but it also emphasizes the need for simple measures to control container breeding sites. PMID:23662926

  13. Marine geology and oceanography of Arabian Sea and coastal Pakistan

    SciTech Connect

    Haq, B.U.; Milliman, J.D.

    1985-01-01

    This volume is a collection of papers presented at the first US-Pakistan workshop in marine science held in Karachi, Pakistan, in November 1982. Of the twenty-four contributions in this book, fourteen cover topics specific to the Arabian Sea-coastal Pakistan region. These include six papers on the geology, tectonics, and petroleum potential of Pakistan, four papers on sedimentary processes in the Indus River delta-fan complex, and four papers on the biological oceanography of the Arabian Sea and coastal Pakistan. The additional ten papers are overviews of shelf sedimentation processes, paleoceanography, the marine nutrient cycle, and physical and chemical oceanography.

  14. War against Rape (WAR): The Experience of an Activist Group in Karachi in Raising Awareness of Sexual Crimes against Women.

    ERIC Educational Resources Information Center

    Zaman, Riffat Moazam

    This paper describes the experiences of an activist group in Karachi (Pakistan) in raising awareness of sexual crimes against women, pursuant to a rape of a professional woman which occurred during an armed robbery. It describes how, since rape was regarded as rare or nonexistent in a conservative, Islamic society, the efforts of the Women's…

  15. Disasters, women's health, and conservative society: working in Pakistan with the Turkish Red Crescent following the South Asian Earthquake.

    PubMed

    Miller, Andrew C; Arquilla, Bonnie

    2007-01-01

    In recent years, numerous catastrophic disasters caused by natural hazards directed worldwide attention to medical relief efforts. These events included the: (1) 2003 earthquake in Bam, Iran; (2) 2004 earthquake and tsunami in Southeast Asia; (3) Hurricanes Katrina and Rita in the southern United States in 2005; (4) 2005 south Asian earthquake; and (5) 2006 Indonesian volcanic eruption and earthquakes. Health disparities experienced by women during relief operations were a component of each of these events. This article focuses on the response of the Turkish Red Crescent Society's field hospital in northern Pakistan following the South Asian Earthquake of October 2005, and discusses how the international community has struggled to address women's health issues during international relief efforts. Furthermore, since many recent disasters occurred in culturally conservative South Asia and the local geologic activity indicates similar disaster-producing events are likely to continue, special emphasis is placed on response efforts. Lessons learned in Pakistan demonstrate how simple adjustments in community outreach, camp geography, staff distribution, and supplies can enhance the quality, delivery, and effectiveness of the care provided to women during international relief efforts. PMID:18019091

  16. Simulation of rainfall-runoff for major flash flood events in Karachi

    NASA Astrophysics Data System (ADS)

    Zafar, Sumaira

    2016-07-01

    Metropolitan city Karachi has strategic importance for Pakistan. With the each passing decade the city is facing urban sprawl and rapid population growth. These rapid changes directly affecting the natural resources of city including its drainage pattern. Karachi has three major cities Malir River with the catchment area of 2252 sqkm and Lyari River has catchment area about 470.4 sqkm. These are non-perennial rivers and active only during storms. Change of natural surfaces into hard pavement causing an increase in rainfall-runoff response. Curve Number is increased which is now causing flash floods in the urban locality of Karachi. There is only one gauge installed on the upstream of the river but there no record for the discharge. Only one gauge located at the upstream is not sufficient for discharge measurements. To simulate the maximum discharge of Malir River rainfall (1985 to 2014) data were collected from Pakistan meteorological department. Major rainfall events use to simulate the rainfall runoff. Maximum rainfall-runoff response was recorded in during 1994, 2007 and 2013. This runoff causes damages and inundation in floodplain areas of Karachi. These flash flooding events not only damage the property but also cause losses of lives

  17. Railway associated injuries in Pakistan.

    PubMed

    Bhatti, Junaid A; Razzak, Junaid A

    2010-03-01

    Pakistan is ranked 12th worldwide for passenger kilometres (km) travelled by railway network. The objective of this study was to assess the railway network related morbidity and mortality in Pakistan. Reported deaths and injuries due to this network were extracted from two secondary datasets: (1) an international disaster database and (2) ambulance log registers for the city of Karachi. Over the period from 1997 to 2006, a total of 11 railway disasters resulted in 449 deaths and 840 injuries. An estimated 2.05 passengers died and another 3.84 passengers were injured per billion km travelled in Pakistan, a rate six times higher than Western European countries. The ambulance log showed that one person died every two weeks in Karachi over a period from September 2007 to Jun 2008 (N = 26). The male-to-female ratio of all injury victims (N = 50) was 9:1 with a mean age of 35.6 years. Surveillance of these injuries is essential to implement prevention and control measures in Pakistan. PMID:19787521

  18. Comprehensive Bibliography of Pakistan Archaeology: Paleolithic to Historic Times. South Asia Series, Occasional Paper No. 24.

    ERIC Educational Resources Information Center

    King, Denise E.

    The comprehensive bibliography is a compilation of twentieth century documents about Pakistan prehistory from Paleolithic times to the arrival of the Greeks in approximately 330 B.C., also includes some of the major archaeological studies in adjacent countries which have a bearing on the interpretation and comparative analysis of Pakistan…

  19. Frequency of Stillbirths in a Tertiary Care Hospital, Karachi

    PubMed Central

    Mustufa, Muhammad Ayaz; Kulsoom, Shazia; Sameen, Ifra; Moorani, Khemchand N; Memon, Ashfaqe Ahmed; Korejo, Razia

    2016-01-01

    Background and Objective: Pakistan accounts for the highest stillbirth rate in the world. Therefore, this observational study was planned to determine the prevalence of stillbirths and its associated demographic characteristics in the given context. Hence our objective included: To determine the frequency of stillbirths with reference to parity and gestational age in a tertiary care public hospital, Karachi. To determine the socio-demographic characteristics of families with stillbirths. Methods: All pregnant mothers who delivered stillbirth babies at Gynaecology and Obstetrics ward of Jinnah Postgraduate Medical Center, Karachi a tertiary care facility were prospectively enrolled from October 2012 to September 2013. Deliveries occurred before 28 weeks of gestational age were excluded. Gestational age was confirmed from hospital record and attending physicians. Data was collected on predesigned proforma and analyzed using descriptive statistics. Results: Among 7708 registered deliveries, 137 were stillbirths. A total of 84 mothers were primiparous and 12% of mothers were below 20 years at the time of delivery. Majority of stillbirths were macerated type (80.3%) and 20% were fresh stillbirth. About 55% of still births occurred between 33-37 weeks and 20% between 28-32 weeks. Almost 80% (109) of stillbirths were low birth weight and only 20% (28) were normal birth weight. Conclusion: This study shows that stillbirths are more common in primiparous mothers in a given context. Conducting awareness sessions with special focus on antenatal and obstetrical care of primiparous may be helpful to reduce still births. PMID:27022352

  20. Prevalence and pattern of self-medication in Karachi: A community survey

    PubMed Central

    Afridi, M. Iqbal; Rasool, Ghulam; Tabassum, Rabia; Shaheen, Marriam; Siddiqullah; Shujauddin, M.

    2015-01-01

    Objective: To study the prevalence and pattern of self-medication among adult males and females in Karachi, Pakistan. Methods: This cross-sectional community- based survey was carried out at five randomly selected towns of Karachi (Defence, Gulshan-e-Iqbal, North Nazimabad, Malir, Orangi town) over a period of 3 months (October, November & December 2012). A sample size of 500 adult cases (250 males & 250 females), with systemic random selection from different towns of Karachi were inducted in this study. The city was divided in 5 zones and one town from each zone was selected by systemic randomization. First available male and female from each randomly selected house were included in the study. After consent and confidentiality assurance they were interviewed on semi-structured Performa designed for this purpose. Results were analyzed and tabulated through SPSS v14.0. Result: The prevalence of self-medication in males and females in Karachi is found to be 84.8% (males 88.4% and females 81.2%). The most frequent symptoms for which self-medication used were headache (32.7%), fever (23.3%) and the medicines used were painkillers (28.8%), fever reducer medicines (19.8%). The most common reason 33.3% was previous experience with similar symptom. Conclusion: Self-medication is highly prevalent (84.8%) in Karachi. It was frequently used for headache followed by fever. Predominantly painkillers, fever reducer and cough syrups were used in the form of tablets and syrups. Main source of medicines for males were friends and for females were relatives. PMID:26649022

  1. Some aspects of South Asia's groundwater irrigation economy: analyses from a survey in India, Pakistan, Nepal Terai and Bangladesh

    NASA Astrophysics Data System (ADS)

    Shah, Tushaar; Singh, O. P.; Mukherji, Aditi

    2006-03-01

    Since 1960, South Asia has emerged as the largest user of groundwater in irrigation in the world. Yet, little is known about this burgeoning economy, now the mainstay of the region's agriculture, food security and livelihoods. Results from the first socio-economic survey of its kind, involving 2,629 well-owners from 278 villages from India, Pakistan, Nepal Terai and Bangladesh, show that groundwater is used in over 75% of the irrigated areas in the sample villages, far more than secondary estimates suggest. Thanks to the pervasive use of groundwater in irrigation, rain-fed farming regions are a rarity although rain-fed plots within villages abound. Groundwater irrigation is quintessentially supplemental and used mostly on water-economical inferior cereals and pulses, while a water-intensive wheat and rice system dominates canal areas. Subsidies on electricity and canal irrigation shape the sub-continental irrigation economy, but it is the diesel pump that drives it. Pervasive markets in tubewell irrigation services enhance irrigation access to the poor. Most farmers interviewed reported resource depletion and deterioration, but expressed more concern over the high cost and poor reliability of energy supply for groundwater irrigation, which has become the fulcrum of their survival strategy.

  2. The first competency-based higher education programme for midwives in the South Asian region--Pakistan.

    PubMed

    Jan, Rafat; Lakhani, Arusa; Kaufman, Karyn; Karimi, Sadia

    2016-02-01

    Midwives in Pakistan and the South Asian region who complete a diploma program face many challenges for career growth and development. The absence of higher education in professional midwifery in the region has contributed to general non-acceptance and invisibility of midwifery. In response to the interest, Aga Khan University (AKU) developed bachelors program in midwifery based on the Global Standards for Midwifery Education developed by the International Confederation of Midwives (ICM) with the vision to equip midwives to provide full-scope practice, develop confidence to practice midwifery independently, become clinical leaders and contribute to the future of midwifery. The final curriculum had a balance of theory and clinical practice in order to develop a high level of clinical competence that would meet the ICM standards and guidelines. The two year bachelors program is currently in progress. The first cohort of 21 midwives graduated in 2014 and a second cohort was enrolled in 2015. There is a planning for a future graduate program in midwifery to prepare individuals for leadership roles in practice, teaching, maternal-child health provision and policy making through a master's degree in midwifery. PMID:26775558

  3. Paleosols from Pakistan, Greece, and South Dakota: Strengths and pitfalls of the use of carbon isotopes in paleoecologic reconstruction

    SciTech Connect

    Quade, J. . Dept. of Geosciences); Cerling, T.E.; Wang, Yang . Dept. of Geology and Geophysics)

    1992-01-01

    The delta C-13 of soil carbonates in paleosols can be used to reconstruct the proportion of C[sub 3] and C[sub 4] plants that grew on the site during pedogenesis. This reconstruction is only possible where: (1) soil carbonate, not other secondary carbonates, is sampled, (2) carbon isotopes have not undergone post-burial replacement or exchange, and (3) there is no detrital contamination of soil nodules. Preservation of soil organic matter provides the simplest test of all these conditions. In modern soils coexisting soil carbonate and organic matter differ by 14--17%. This difference is preserved in Mio-Pliocene paleosols from the Siwalik Sequence in Pakistan, verifying a pedogenic origin, but not in coexisting carbonate and organic layers from Pikermi in Greece. Minor detrital contamination is present in some Siwalik soil carbonates, but this can be quantified by analyzing entire paleosol profiles. Other post-pedogenic carbonate cements are also present by they display very different delta C-13 and delta O-18 values from those in soil carbonates, aging suggesting that post-pedogenic exchange has not occurred. In the Badlands of South Dakota, preliminary results show that all sampled carbonate phases, including those in paleosols, display very homogeneous delta C-13 values of around [minus]7 to [minus]8%, indicating that (1) no pedogenic carbonate is present, (2) post-burial isotopic alteration may have occurred, or (3) Oligocene atmospheric pCO[sub 2] was substantially higher than today's.

  4. Parents' perspectives on care of children with autistic spectrum disorder in South Asia - Views from Pakistan and India.

    PubMed

    Minhas, Ayesha; Vajaratkar, Vivek; Divan, Gauri; Hamdani, Syed Usman; Leadbitter, Kathy; Taylor, Carol; Aldred, Catherine; Tariq, Ahmareen; Tariq, Mahjabeen; Cardoza, Percy; Green, Jonathan; Patel, Vikram; Rahman, Atif

    2015-01-01

    Autism spectrum disorder (ASD) affects about 1.4% of the population in South Asia but very few have access to any form of health care service. The objective of this study was to explore the beliefs and practices related to the care of children with ASD to inform strategies for intervention. In Pakistan, primary data were collected through in-depth interviews of parents (N = 15), while in India a narrative review of existing studies was conducted. The results show that the burden of care is almost entirely on the mother, leading to high levels of stress. Poor awareness of the condition in both family members and front-line health-providers leads to delay in recognition and appropriate management. There is considerable stigma and discrimination affecting children with autism and their families. Specialist services are rare, concentrated in urban areas, and inaccessible to the majority. Strategies for intervention should include building community and family support networks to provide respite to the main carer. In the absence of specialists, community members such as community health workers, traditional practitioners and even motivated family members could be trained in recognizing and providing evidence-based interventions. Such task-shifting strategies should be accompanied by campaigns to raise awareness so greater inclusivity can be achieved. PMID:26107996

  5. Risk Factors for Deliberate Self-Harm in Patients Presenting to the Emergency Departments of Karachi

    PubMed Central

    Shahid, Muhammad; Iqbal, Romaina; Khan, Murad M.; Khan, Muhammad Zaman; Shamsi, Uzma Shoaib; Nakeer, Rooham

    2015-01-01

    Objective To determine the risk factors for Deliberate Self-Harm (DSH) in patients presenting to the Emergency Departments (EDs) of three tertiary care hospitals of Karachi, Pakistan. Study Design Multicentre matched case control study. Place and Duration of Study EDs of the Aga Khan University Hospital, Karachi, Civil Hospital, Karachi and Jinnah Postgraduate Medical Centre, Karachi, from March 2011 to February 2012. Methodology A total of 201 cases and 201 matched controls were taken from three hospitals situated in Karachi. All patients of 16 years and above presenting to the EDs of the hospitals with DSH attempt were invited to participate in the study. Controls were ED patients with complaints other than DSH. A control was matched with case for hospital, gender and age. Two questionnaires were used to collect information on the risk factors of DSH. Conditional Logistic Regression (CLR) was used to assess the association of various risk factors with DSH. Results Risk factors of DSH in Karachi included current history of mental disorder (OR = 4.53, 95% CI = 1.59 – 12.92), not sharing problems with someone (OR = 4.67, 95% CI = 2.4 – 9.0), living in rented houses (OR = 2.58, 95% CI = 1.37 – 4.84), Pathan ethnicity (OR = 5.05, 95% CI = 1.01–25.38) followed by others (OR = 3.88, 95% CI = 0.77 – 19.69) and Urdu speaking (OR = 2.71, 95% CI = 0.59 – 12.45). Absence of physical illness in the past month had an inverse association with DSH (OR = 0.17, 95% CI = 0.07 – 0.37). Conclusion Mental illnesses, low socio-economic status and loneliness were the risk factors of DSH patients presenting to the three EDs of Karachi. Physical illness in the last month was protective against DSH in these patients. Psychiatric evaluation of DSH patients in the ED is important for early diagnosis and management of mental disorders. PMID:25604370

  6. Population Attributable Risk of Unintentional Childhood Poisoning in Karachi Pakistan

    PubMed Central

    Ahmed, Bilal; Fatmi, Zafar; Siddiqui, Amna R.

    2011-01-01

    Background The percentage of unintentional childhood poisoning cases in a given population attributable to specific risk factors (i.e., the population attributable risk) which can be calculated; determination of such risk factors associated with potentially modifiable risk factors, are necessary to focus on the prevention strategies. Methods We calculated PARs, using 120 cases with unintentional poisoning and 360 controls in a hospital based matched case- control study. The risk factors were accessibility to hazardous chemicals and medicines due to unsafe storage, child behavior reported as hyperactive, storage of kerosene and petroleum in soft drink bottles, low socioeconomic class, less education of the mother and the history of previous poisoning. Results The following attributed risks were observed: 12% (95% confidence interval [CI] = 8%–16%) for both chemicals and medicines stored unsafe, 19% (15%–23%) for child reported as hyperactive, 40% (38%–42%) for storage of kerosene and petroleum in soft drink bottles, 48% (42%–54%) for low socioeconomic status, 38% (32%–42%) for no formal mothers education and 5.8% (2%–10%) for history of previous poisoning. 48% of cases for overall study population which could be attributed to at least one of the six risk factors. Among girls, this proportion was 23% and 43% among boys. About half of the unintentional childhood poisoning cases in this Pakistani population could be avoided. Conclusion Exposure to potentially modifiable risk indicators explained about half of the cases of unintentional poisoning among children under five years of age in this Pakistani population, indicating the theoretical scope for prevention of the disease. PMID:22046391

  7. Grid parity analysis of stand-alone hybrid microgrids: A comparative study of Germany, Pakistan, South Africa and the United States

    NASA Astrophysics Data System (ADS)

    Siddiqui, Jawad M.

    Grid parity for alternative energy resources occurs when the cost of electricity generated from the source is lower than or equal to the purchasing price of power from the electricity grid. This thesis aims to quantitatively analyze the evolution of hybrid stand-alone microgrids in the US, Germany, Pakistan and South Africa to determine grid parity for a solar PV/Diesel/Battery hybrid system. The Energy System Model (ESM) and NREL's Hybrid Optimization of Multiple Energy Resources (HOMER) software are used to simulate the microgrid operation and determine a Levelized Cost of Electricity (LCOE) figure for each location. This cost per kWh is then compared with two distinct estimates of future retail electricity prices at each location to determine grid parity points. Analysis results reveal that future estimates of LCOE for such hybrid stand-alone microgrids range within the 35-55 cents/kWh over the 25 year study period. Grid parity occurs earlier in locations with higher power prices or unreliable grids. For Pakistan grid parity is already here, while Germany hits parity between the years 2023-2029. Results for South Africa suggest a parity time range of the years 2040-2045. In the US, places with low grid prices do not hit parity during the study period. Sensitivity analysis results reveal the significant impact of financing and the cost of capital on these grid parity points, particularly in developing markets of Pakistan and South Africa. Overall, the study helps conclude that variations in energy markets may determine the fate of emerging energy technologies like microgrids. However, policy interventions have a significant impact on the final outcome, such as the grid parity in this case. Measures such as eliminating uncertainty in policies and improving financing can help these grids overcome barriers in developing economies, where they may find a greater use much earlier in time.

  8. Useful ethnophytomedicinal recipes of angiosperms used against diabetes in South East Asian Countries (India, Pakistan & Sri Lanka).

    PubMed

    Marwat, Sarfaraz Khan; Rehman, Fazalur; Khan, Ejaz Ahmad; Khakwani, Abdul Aziz; Ullah, Imdad; Khan, Kaleem Ullah; Khan, Inam Ullah

    2014-09-01

    This paper is based on data recorded from various literatures pertaining to ethnophytomedicinal recipes used against diabetes in South East Asia (India, Pakistan and Srilanka). Traditional plant treatments have been used throughout the world for the therapy of diabetes mellitus. In total 419 useful phytorecipes of 270 plant species belonging to 74 Angiospermic families were collected. From the review it was revealed that plants showing hypoglycemic potential mainly belong to the families, Cucurbitaceae (16 spp.), Euphorbiaceae (15 spp.), Caesalpiniaceae and Papilionaceae (13 spp. each), Moraceae (11 spp.), Acanthaceae (10 spp.), Mimosaceae (09 spp.), Asteraceae, Malvaceae and Poaceae (08 spp. each), Hippocrateaceae, Rutaceae and Zingiberaceae (07 spp. each), Apocynaceae, Asclepiadaceae and Verbenaceae (06 spp. each), Apiaceae, Convolvulaceae, Lamiaceae, Myrtaceae, Solanaceae (05 spp.each). The most active plants are Syzigium cumini (14 recipes), Phyllanthus emblica (09 recipes), Centella asiatica and Momordica charantia (08 recipes each), Azadirachta indica (07 recipes), Aegle marmelos, Catharanthus roseus, Ficus benghalensis, Ficus racemosa, Gymnema sylvestre (06 recipes each), Allium cepa, A. sativum, Andrographis paniculata, Curcuma longa (05 recipes each), Citrullus colocynthis, Justicia adhatoda, Nelumbo nucifera, Tinospora cordifolia, Trigonella foenum-graecum, Ziziphus mauritiana and Wattakaka volubilis (4 recipes each). These traditional recipes include extracts, leaves, powders, flour, seeds, vegetables, fruits and herbal mixtures. Data inventory consists of botanical name, recipe, vernacular name, English name. Some of the plants of the above data with experimentally confirmed antidiabetic properties have also been recorded. More investigations must be carried out to evaluate the mechanism of action of diabetic medicinal plants. Toxicity of these plants should also be explained. Scientific validation of these recipes may help in discovering new drugs from

  9. The Role Perceptions of Government and Non-Government Headteachers in Pakistan.

    ERIC Educational Resources Information Center

    Simkins, Tim; Garrett, Viv; Memon, Muhammad; Ali, Rana Nazir

    1998-01-01

    A study of the principal's role involved interviews of six headteachers of government and nongovernment secondary schools in Karachi, Pakistan, and reviews of five one-week activity diaries. Nongovernmental principals had more managerial freedom, but governmental principals operated under less personal control by their superiors. The latter used a…

  10. Epidemiology of Karachi road traffic crash mortality in 2013.

    PubMed

    Jooma, Rashid; Shaikh, Masood Ali

    2015-05-01

    Road Traffic Crash (RTC) is the eighth leading cause of death globally. In a recent World Health Organization report, there were 5,192 RTC deaths reported from Pakistan in 2010. The Road Traffic Injury Research and Prevention Center (RTIRPC) is a unique public-private public health enterprise in Karachi, and collects data from five major public and private hospitals' emergency departments in the city. Cumulatively, 1130 deaths were recorded in the year 2013. Males accounted for 981 (86.8%) deaths. The most vulnerable decades of life were twenties and thirties; accounting for 307 (27.2%) of all deaths. In terms of involvement of vehicle type in fatalities; over half 577 (51.1%) of all fatalities involved motorbikes, while the second most common type of vehicle involved were buses/coasters which accounted for 108 (9.6%) fatalities. In the burgeoning cities of developing countries, road injury and fatality surveillance can fulfill a vital role in highlighting the human cost of rapid motorization. PMID:26028391

  11. Blood and hair lead in children with different extents of iron deficiency in Karachi

    SciTech Connect

    Ataur Rahman, Muhammad; Rahman, Bushra; Saeed Ahmad, Muhammad; Blann, Andrew; Ahmed, Nessar

    2012-10-15

    Childhood iron deficiency has a high incidence in Pakistan. Some but not all studies have shown that dietary iron deficiency may cause increased absorption of lead as both compete for the same transporters in the small intestine. Therefore, children in Pakistan, residing in heavily polluted cities like Karachi may be prone to lead poisoning. This hypothesis was tested by investigating blood and hair lead concentrations in children from Karachi who were divided into four groups of iron status; normal, borderline iron deficiency, iron deficiency and iron deficiency anaemia. A prospective observational study was conducted where 269 children were categorized into four groups of iron status using the World Health Organization criteria and one based on soluble transferrin receptor measurements. Blood iron status was determined using a full blood count, serum iron, ferritin, transferrin saturation and soluble transferrin receptor measurements. Blood lead was determined by graphite atomic absorption spectroscopy, whereas hair lead was assessed using an inductively coupled plasma atomic emission spectroscopy technique. Blood lead concentrations were significantly higher in children with iron deficiency anaemia (mean [95% confidence intervals] were 24.9 [22.6-27.2] {mu}g/dL) compared to those with normal iron status (19.1 [16.8-21.4] {mu}g/dL) using WHO criteria. In contrast, hair lead content was not significantly different in children of different iron status. Our findings reinforce the importance of not only reducing environmental lead pollution but also the development of national health strategies to reduce childhood iron deficiency in Pakistan.

  12. Evaluation of World View-2 Satellite Data for Mapping Seaweed Beds Along Karachi Coast

    NASA Astrophysics Data System (ADS)

    Danish Siddiqui, Muhammad; Abdullah, Muhammad

    2016-07-01

    INTRODUCTION One of the important components for the coastal system are seaweeds. Seaweed provides numerous ecosystem facilities such as; habitats, fishing nursery grounds, feed production for aquatic biota, and ability to absorb nutrients such as nitrogen and phosphorus and carbon fixation for seawater purification. It's an important coastal resource that has great economic potential due to its utilization in food, cosmetics and industrial products. It also plays an important role in aquaculture and fish breeding. The habitats of many sea species rely on seaweeds for their shelter and food requirements. Seaweed resources are present along Pakistan coastal areas mainly around Karachi shoreline and there exists a potential market for seaweed in the country that is yet untapped. Not only this but the seaweed resources in Pakistan are still unexplored and unmapped. The need to preserve and map seaweed sites along Karachi coast is, cannot be overlooked due to the economic potential of seaweed. To protect marine biodiversity, regular monitoring and mapping of seaweeds are important in order to regulate their growth and their dependent species to maintain their biological associations. The main purpose of this study is to map naturally existing seaweed resources along the Karachi coast and identify the environmental parameters which impact seaweed growth in coastal waters of Karachi using geospatial techniques. To estimate marine resources such as seaweed over a certain area using traditional methods require an extensive amount of labor, cost and time. Remote sensing techniques, on the other hand, offer a good alternative to performing studies on a larger scale using minimum resources as compared to the conventional methods. DATA AND DATA SOURCES WorldView-2 images of 2 meter multispectral and 0.5 meter panchromatic and MODIS (Moderate Resolution Imaging Spectroradiometer) daily composite of Sea Surface Temperature (SST) product of 250 meter resolutions are used in this

  13. Battle against poliovirus in Pakistan.

    PubMed

    Fatima, Kaneez; Qadri, Ishtiaq

    2013-11-01

    On 22 Feb 2013, the Polio Monitoring Cell of Pakistan announced that the 2012-2013 polio campaign ended, and that 1.6 million children could not be vaccinated due to security concerns in several regions where polio workers had been killed. Those who could not be vaccinated included 50,000 children from the Federally Administrated Tribal Area (FATA), 150,000 form Khyber Pakhtoon Khao, 400,000 from a Quetta, 400,000 from Karachi, and a small number from the Rawalpindi District. These statistics are worrying, as several districts in the large metropolitan cities of Karachi and Quetta were also excluded. The fear of advanced medicine, ideas, or complex devices is a new phenomenon in many conservative and poor countries such as Pakistan, Afghanistan, Sudan, and Somalia. To safeguard the safety of the rest of the world, the failure in the implementation of WHO guidelines for vaccination must be regulated by the UN. There are a number of reasons for the phobias surrounding vaccination, but as technology continues to evolve at such a rapid rate, those with self-determined ideologies cannot cope with such advances. They become vocal to gain popularity and prevent the use of these technologies and medicine by creating and spreading rumors and propaganda of expediency. The struggle to vaccinate children is not easily understood by anyone living in the developed world. The irrational fear of vaccines and the lack of vaccination pose a serious global health risk and must be curbed through a wide variety of pro-vaccination media and religious campaigns. PMID:24240051

  14. Pakistan Flooding

    Atmospheric Science Data Center

    2013-04-16

    article title:  Flooding in Pakistan     View Larger Image In late July 2010, flooding caused by heavy monsoon rains began in several regions of Pakistan, ... river is 23 kilometers (14 miles) wide or more in spots, and flooding in much of the surrounding region, particularly in the Larkana ...

  15. Characaterization of H5N1 highly pathogenic avian influenza viruses isolated from poultry in Pakistan 2006-2008

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Nine avian influenza viruses (AIV), H5N1 subtype, were isolated from dead poultry in the Karachi region of Pakistan from 2006-2008. The intravenous pathogenicity indices and HA protein cleavage sites of all nine viruses were consistent with highly pathogenic AIV. Based on phylogenetic analysis of ...

  16. Industrial Management Practices and Management Education in West Pakistan; A Study of Their Relationship in the Industrial Development Process.

    ERIC Educational Resources Information Center

    Richard, Sandra Clayton

    A study was made of relationships of industrial management practices to management education in West Pakistan's industrial development. Directors of institutions having management education courses, and over 69 managers at 30 family, government, and foreign controlled plants in Karachi were interviewed on policies, practices, and problems in…

  17. Description of Tylenchorhynchus qasimii sp. n with a new report of T. kegasawai Minagawa, 1995 from Pakistan

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A new stunt nematode, from soil around the roots of coconut (Cocos nucifera L.) and rice (Oryza sativa L.) from Karachi, Pakistan is described and illustrated as Tylenchorhynchus qasimii n. sp. This new species is characterized by having females with 3-4 head annules, anteriorly directed stylet knob...

  18. Diet and nutrition: a knowledge, attitude and practice study of pregnant women in Karachi.

    PubMed

    Zobairi, S E; Freitas, M L; Wasti, S A

    1998-05-01

    This study determines knowledge, attitude, and practice of diet and nutrition during pregnancy among women in Karachi, Pakistan. Quantitative and qualitative data were obtained from a randomized convenience sample of 150 pregnant women from outpatient clinics of 3 hospitals: Aga Khan University Hospital (AKUH), Karachi Adventist Hospital, and Civil Hospital. Daily caloric intake was based on a single day. Two dietary patterns were observed. Meals among individuals with monthly income under Rs. 5000 consisted of flatbread, lentils, and/or vegetables. Meat was eaten under twice/week. Calories came primarily from flatbread, cereals, and cooking oil. Those with income over Rs. 10,000/month ate a great variety of foods and meat frequently. The source of calories was diverse and more balanced. The women preferred milk and fresh fruit during pregnancy. Milk was desired for fetal bone development, enhanced lactation, good skin, and a settled stomach. Desired foods were described as cold and justified since the womb was a source of heat production. Lower socioeconomic status (SES) groups did not trust their judgment about beneficial foods and could not afford the foods they desired. Many women had food avoidances, such as hot foods. The percentage of women with food avoidances increased with increased SES. Most women valued increased food consumption during pregnancy, but 68% did not increase their caloric intake and 40% decreased caloric intake. The mean caloric intakes, from low to high SES, were 1087, 1656, and 1750 kcal/day/woman, respectively. PMID:9653858

  19. Prevalence of vitamin D deficiency and insufficiency among adult asthmatic patients in Karachi.

    PubMed

    Kamran, Afshan; Alam, Syed Mahboob; Qadir, Farida

    2014-11-01

    Vitamin D deficiency has assumed pandemic proportions all over the world. It has been documented as a frequent problem in studies of young adults, elderly person and children in other countries, but there is no reliable data on vitamin D status of adult asthmatic patients in Pakistan. To determine the prevalence of vitamin D deficiency and insufficiency in adult asthmatic patients with moderate to severe asthma using a cross-sectional study design in Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi.311 adult asthmatic patients with moderate to severe asthma were recruited from JPMC, tertiary care hospital in Karachi. Questionnaires were administered together demographics, height, weight, nutritional and physical activity assessment. Blood samples for vitamin D measurement were also taken. Results show high prevalence of vitamin D deficiency and insufficiency (88.10%) in adult patients with moderate to severe persistent asthma. Vitamin D deficiency and insufficiency was more frequently observed in female than in male patients.67.66% of the female patients had serum vitamin D level less than 20 ng/ml as compare to 56.1% of the male patients (p=0.01). PMID:26045376

  20. Polyester projects for India, Pakistan

    SciTech Connect

    Siddiqi, R.

    1993-02-10

    India's Indo Rama Synthetics (Bombay) is planning a $186-million integrated polyester fiber and filament complex at Nagpur, Maharashtra. The complex will have annual capacities for 38,000 m.t. of polyester chips by polycondensation, 25,000 m.t. of polyester staple fiber, and 12,000 m.t. of polyester blended yarn. The company is negotiating with the main world suppliers of polycondensation technology. The first stage of the project is slated to begin production by the end of this year and be fully completed by 1994. In Pakistan, National Fibers Ltd. (PNF; Karachi) has signed a deal with Zimmer (Frankfurt) for technology, procurement, construction, and support work to expand polyester staple fiber capacity from 14,000 m.t./year to 52,000 m.t./year. The technology involves a continuous polymerization process. The project also calls for improvements to PNF's existing batch plant. It is scheduled for completion by the end of 1994. Total cost of the project is estimated at Rs1.745 billion ($70 million), out of which the foreign exchange component is Rs1.05 billion. The Islamic Development Bank (Jeddah; Saudi Arabia) has already approved a $27-million slice of the financing, while the balance of the foreign exchange loan is being arranged through suppliers credit. Local currency loans will be provided by other financial institutions in Pakistan.

  1. Epidemiological review of head and neck cancers in Karachi.

    PubMed

    Bhurgri, Yasmin; Bhurgri, Asif; Usman, Ahmed; Pervez, Shahid; Kayani, Naila; Bashir, Imtiaz; Ahmed, Rashida; Hasan, Sheema H

    2006-01-01

    Head and neck cancers, categories lip, oral cavity, pharynx and larynx are placed amongst the top ten malignancies globally. The cancers have a similar epidemiology, risk factors, morphology, and control measures. The geographical variations in incidence are indicative of the global differences in the prevalence of risk factors. The present study was conducted with the objective of reviewing descriptive epidemiological characteristics, incidence and time trends of head and neck cancers in Karachi (1995-2002). Head and neck cancers accounted for approximately one-fifth (21%) of the cancers in males and about one-tenth (11%) in females in the study period. The age standardized incidence rate (ASR) was 37.1/100,000 in males and 21.7/100,000 in females. In males, oral cavity and larynx were the commonly affected sites, followed by pharynx. In females, oral cavity was the preponderant site. The mean age of the patients was 53.0 years (95% CI 48.0; 58.0). A rising incidence was observed in both genders, more apparent in males. About 30% of oral cancer cases, 28.6% of the nasopharyngeal, 6.3% of the oropharyngeal, and 2.6% of laryngeal cancers occurred in patients 40 years and younger. The age specific incidence rates (ASIR) for oral cancer in males showed a gradual rise from 10 to 64+ years of age, for pharynx from 20 to 64+ and for larynx at 25+. The ASIR for oral cancer in females showed a gradual rise from 14 to 64+ years of age, for pharynx from 20 to 64+, a decade after the oral cancer rise and cancer larynx showed a rise at 25+, a decade and a half after the oral cancer rise. The peak incidence was at 64-69 years for all three cancer sites, in both genders. Pakistan falls into a high risk head and neck cancer geographical zone Presentation is late and treatment is not optimum. Recommendations, therefore for NCCP Pakistan, for short term benefits are selected community-based screening for the high risk population, early diagnosis, better treatment, rehabilitation

  2. The Pakistan Risk of Myocardial Infarction Study: a resource for the study of genetic, lifestyle and other determinants of myocardial infarction in South Asia

    PubMed Central

    2009-01-01

    The burden of coronary heart disease (CHD) is increasing at a greater rate in South Asia than in any other region globally, but there is little direct evidence about its determinants. The Pakistan Risk of Myocardial Infarction Study (PROMIS) is an epidemiological resource to enable reliable study of genetic, lifestyle and other determinants of CHD in South Asia. By March 2009, PROMIS had recruited over 5,000 cases of first-ever confirmed acute myocardial infarction (MI) and over 5,000 matched controls aged 30–80 years. For each participant, information has been recorded on demographic factors, lifestyle, medical and family history, anthropometry, and a 12-lead electrocardiogram. A range of biological samples has been collected and stored, including DNA, plasma, serum and whole blood. During its next stage, the study aims to expand recruitment to achieve a total of about 20,000 cases and about 20,000 controls, and, in subsets of participants, to enrich the resource by collection of monocytes, establishment of lymphoblastoid cell lines, and by resurveying participants. Measurements in progress include profiling of candidate biochemical factors, assay of 45,000 variants in 2,100 candidate genes, and a genomewide association scan of over 650,000 genetic markers. We have established a large epidemiological resource for CHD in South Asia. In parallel with its further expansion and enrichment, the PROMIS resource will be systematically harvested to help identify and evaluate genetic and other determinants of MI in South Asia. Findings from this study should advance scientific understanding and inform regionally appropriate disease prevention and control strategies. PMID:19404752

  3. A systematic review of air pollution as a risk factor for cardiovascular disease in South Asia: limited evidence from India and Pakistan.

    PubMed

    Yamamoto, S S; Phalkey, R; Malik, A A

    2014-03-01

    Cardiovascular diseases (CVD) are major contributors to mortality and morbidity in South Asia. Chronic exposure to air pollution is an important risk factor for cardiovascular diseases, although the majority of studies to date have been conducted in developed countries. Both indoor and outdoor air pollution are growing problems in developing countries in South Asia yet the impact on rising rates of CVD in these regions has largely been ignored. We aimed to assess the evidence available regarding air pollution effects on CVD and CVD risk factors in lower income countries in South Asia. A literature search was conducted in PubMed and Web of Science. Our inclusion criteria included peer-reviewed, original, empirical articles published in English between the years 1990 and 2012, conducted in the World Bank South Asia region (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka). This resulted in 30 articles. Nine articles met our inclusion criteria and were assessed for this systematic review. Most of the studies were cross-sectional and examined measured particulate matter effects on CVD outcomes and indicators. We observed a bias as nearly all of the studies were from India. Hypertension and CVD deaths were positively associated with higher particulate matter levels. Biomarkers of oxidative stress such as increased levels of P-selection expressing platelets, depleted superoxide dismutase and reactive oxygen species generation as well as elevated levels of inflammatory-related C-reactive protein, interleukin-6 and interleukin-8 were also positively associated with biomass use or elevated particulate matter levels. An important outcome of this investigation was the evidence suggesting important air pollution effects regarding CVD risk in South Asia. However, too few studies have been conducted. There is as an urgent need for longer term investigations using robust measures of air pollution with different population groups that include a wider

  4. Pattern of biopsy proven renal diseases at PNS SHIFA, Karachi: A cross-sectional survey

    PubMed Central

    Sabir, Sohail; Mubarak, Muhammed; Ul-Haq, Irfan; Bibi, Aisha

    2013-01-01

    Introduction: Percutaneous renal biopsy (RB) is an invaluable diagnostic procedure in patients with medical renal diseases.Objectives: To determine the pattern of biopsy proven renal disease (BPRD) from a tertiary care naval hospital in Karachi, Pakistan. Methods and Materials: All the renal biopsies in adult patients (≥18 years) performed at our hospital from 2008 to 2012 were retrospectively reviewed. The biopsies were evaluated by light microscopy and immunofluorescence. Results: A total 60 cases were analyzed. The mean age was 33.3±12.9 years (range: 18 to 72 years).The male to female ratio was 3:1. The most common indication of renal biopsy was nephrotic syndrome (43.3%), followed by renal failure (26.6%) and non-nephrotic proteinuria (23.3%). Primary glomerulonephritides (PGN) were predominant overall lesions, found in 46 (76.6%) of the total biopsies. Among PGN, the most common lesion was focal segmental glomerulosclerosis (FSGS), followed by membranous glomerulonephritis (MGN), IgA nephropathy (IgAN) and chronic sclerosing glomerulonephritis (CSGN) and a variety of rare lesions. Secondary glomerulonephritides (SGN) were found in only three (5%) cases. There were two cases of amyloidosis and one of lupus nephritis (LN). Tubulointerstitial disease (TID) and vascular disease were rare. Conclusion: This study provides information about the epidemiology of BPRD in a large tertiary care naval center in Southern Pakistan. PMID:25340152

  5. Lateral relationships in the Laki formation, Ganjo Takkar and Saidpur outlier, Hyderabad District, Sind Province, Pakistan

    USGS Publications Warehouse

    Thomas, Roger E.; Khan, Mohammed Riaz; Khan, Shafique Ahmed

    1989-01-01

    The sections presented were measured in an unstudied area southeast of the city of Hyderabad and 175 km northeast of Karachi, capital of Sind Province in southern Pakistan.  These sections are preliminary to more detailed studies, particularly of the fossil fauna and the Paleocene and Eocene stratigraphy in southern Pakistan.  The data present a major elucidation of the lateral relationships of individual rock units that collectively form part of the Laki Formation exposed in the Ganjo Takkar and nearby Saidpur outlier.

  6. Evaluation of World View-2 Satellite Data for Mapping Seaweed Beds Along Karachi Coast

    NASA Astrophysics Data System (ADS)

    Danish Siddiqui, Muhammad; Abdullah, Muhammad

    2016-07-01

    INTRODUCTION One of the important components for the coastal system are seaweeds. Seaweed provides numerous ecosystem facilities such as; habitats, fishing nursery grounds, feed production for aquatic biota, and ability to absorb nutrients such as nitrogen and phosphorus and carbon fixation for seawater purification. It's an important coastal resource that has great economic potential due to its utilization in food, cosmetics and industrial products. It also plays an important role in aquaculture and fish breeding. The habitats of many sea species rely on seaweeds for their shelter and food requirements. Seaweed resources are present along Pakistan coastal areas mainly around Karachi shoreline and there exists a potential market for seaweed in the country that is yet untapped. Not only this but the seaweed resources in Pakistan are still unexplored and unmapped. The need to preserve and map seaweed sites along Karachi coast is, cannot be overlooked due to the economic potential of seaweed. To protect marine biodiversity, regular monitoring and mapping of seaweeds are important in order to regulate their growth and their dependent species to maintain their biological associations. The main purpose of this study is to map naturally existing seaweed resources along the Karachi coast and identify the environmental parameters which impact seaweed growth in coastal waters of Karachi using geospatial techniques. To estimate marine resources such as seaweed over a certain area using traditional methods require an extensive amount of labor, cost and time. Remote sensing techniques, on the other hand, offer a good alternative to performing studies on a larger scale using minimum resources as compared to the conventional methods. DATA AND DATA SOURCES WorldView-2 images of 2 meter multispectral and 0.5 meter panchromatic and MODIS (Moderate Resolution Imaging Spectroradiometer) daily composite of Sea Surface Temperature (SST) product of 250 meter resolutions are used in this

  7. Knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in coastal areas of Karachi

    PubMed Central

    2014-01-01

    Background Migrant populations are at high risk of Human Immuno Deficiency Virus infection (HIV) and Acquired Immunodeficiency Syndrome (AIDS). Studies of HIV/AIDS knowledge, attitudes and practices among fishermen in developing countries have shown gaps in knowledge and fear of contagion with ambivalent attitudes towards HIV/AIDS and inconsistent universal precautions adherence. The aim of this study was to determine the knowledge, attitude and practices regarding HIV/AIDS among adult fishermen in a coastal area of Karachi, Pakistan. Methods Community based cross sectional study was conducted among fishermen in coastal area of Karachi from June to September 2012. A total of 297 adult fishermen were selected by using simple random sampling technique from different sectors of coastal village. Data were collected using a structured validated questionnaire. The frequency distribution of both dependent and independent variables were worked out. Comparisons of knowledge, attitude and practices regarding HIV/AIDS by socio-demographic characteristics were made using logistic regression. Results Out of 297 fishermen, majority had in-appropriate knowledge (93.6%), negative attitude (75.8%) and less adherent sexual practices (91.6%). In univariate analysis, lower education and higher income were significantly associated (OR 2.25, 95% CI, 1.11, 4.55), (OR = 3.04 CI 1.03-9.02, p value 0.04) with negative attitude and un-safe practices towards HIV/AIDS respectively, whereas no significant association of socio-economic characteristics with knowledge, attitude and practices were observed in multivariate analysis. Conclusions This study suggests that fishermen had very poor knowledge, negative attitudes towards HIV and AIDS and had unsafe sexual practices which suggest that they lack the basic understanding of HIV/AIDS infection. Extensive health education campaign should be provided to the vulnerable sections of the society for the control of HIV/AIDS. PMID:24886122

  8. Production of crude oils in Pakistan: Outlook for the future

    SciTech Connect

    Ahmad, S.

    1995-12-31

    Pakistan`s sedimentary basins cover an area of 827,000 km{sub 2} that stretches from the Karakurum Mountains in the north to the Arabian Sea in the south. The first exploration well in the region was drilled near Kundal in 1866, just seven years after the Drake well in Pennsylvania. To date, 384 exploration wells have been drilled in Pakistan resulting in 45 oil and 55 gas discoveries, thus generating a highly favourable success ratio of 1:4. The drilling density in Pakistan is one well/1000 square kilometers. Pakistan has proven oil reserves of around 500 million barrels of oil, whereas proven gas reserves are about 31 trillion cubic feet. However, Pakistan`s resource potential is estimated to be 40 billion barrels of oil and 200 TCF of gas. The purpose of this paper is to describe: (i) habitat and production of crude oil in Pakistan, (ii) Pakistan`s current energy needs and future outlook, and (iii) steps being taken by the Government of Pakistan to promote exploration for oil and gas.

  9. An early South Asian dust storm during March 2012 and its impacts on Indian Himalayan foothills: a case study.

    PubMed

    Srivastava, A K; Soni, V K; Singh, Sachchidanand; Kanawade, V P; Singh, N; Tiwari, S; Attri, S D

    2014-09-15

    The impacts of an early South Asian dust storm that originated over the western part of the Middle East and engulfed northwest parts of India during the third week of March 2012 have been studied at four different stations covering India and Pakistan. The impacts of this dust storm on aerosol optical properties were studied in detail at Delhi, Jodhpur, Lahore and Karachi. The impact could also be traced up to central Himalayan foothills at Manora Peak. During dust events, the aerosol optical depth (AOD) at 500 nm reached a peak value of 0.96, 1.02, 2.17 and 0.49 with a corresponding drop in Ångström exponent (AE for 440-870 nm) to 0.01, -0.02, 0.00 and 0.12 at Delhi, Jodhpur, Lahore and Karachi, respectively. The single scattering albedo (SSA) at 675 nm was relatively lower at Delhi (0.87) and Jodhpur (0.86), with absorption Ångström exponent (AAE) less than 1.0, but a large value of SSA was observed at Lahore (0.98) and Karachi (0.93), with AAE value greater than 1.0 during the event. The study of radiative impact of dust aerosols revealed a significant cooling at the surface and warming in the atmosphere (with corresponding large heating rate) at all the stations during dust event. The effect of this dust storm was also seen at Manora Peak in central Himalayas which showed an enhancement of ~28% in the AOD at 500 nm. The transport of dust during such events can have severe climatic implications over the affected plains and the Himalayas. PMID:24973722

  10. Frequency of thyroid incidentalomas in Karachi population

    PubMed Central

    Kamran, Mahrukh; Hassan, Nuzhat; Ali, Muhammad; Ahmad, Farah; Shahzad, Sikandar; Zehra, Nosheen

    2014-01-01

    Objectives: The aim of this study was to determine frequency of thyroid incidentalomas (TI) through ultrasound (US) and its association with age, gender and ethnicities. Methods: It was a cross-sectional study. Total 269 adults who were asymptomatic for thyroid disease aged 21 years and above underwent ultrasound examination of their thyroid. Results: Frequency of TI found was 21%. TI was detected in 25% of females and 16% males (P= 0.078). 61% had thyroid nodules (TNs) in one lobe (right, left or isthmus) and 39% had TNs in more than one location. About 55% had single TN and 45% had multiple TNs. 38% had TNs greater than 1cm while 57% had TNs smaller than 1 cm. 5% had TNs greater and smaller than 1 cm. TI was equally common in individuals of different ethinicities (P= 0.758). Conclusion: Frequency of thyroid incidentalomas found in our study was higher than most of the other iodine sufficient states. Unlike other studies, incidentalomas were equally common in both the genders of our study. This may be due to the previous iodine deficient status of Pakistan which was prevalent. However further studies on the same topic will help us in identifying the correct status of thyroid incidentalomas if Pakistan retains it’s status as an iodine sufficient state. PMID:25097519

  11. Pathogenesis of New Strains of Newcastle Disease Virus From Israel and Pakistan.

    PubMed

    Pandarangga, P; Brown, C C; Miller, P J; Haddas, R; Rehmani, S F; Afonso, C L; Susta, L

    2016-07-01

    In the past few years, Newcastle disease virus (NDV) strains with epizootic characteristics belonging to subgenotypes VIIi and XIIIb emerged in the Middle East and Asia. In this study, 2 NDV strains-1 representative of subgenotype VIIi isolated in Israel (Kvuzat/13) and 1 representative of subgenotype XIIIb isolated in Pakistan (Karachi/07)-were characterized by intracerebral pathogenicity index and detailed clinicopathologic assessment. The intracerebral pathogenicity index values for Kvuzat/13 and Karachi/07 were 1.89 and 1.85, respectively, classifying these strains as virulent by international standards. In 4-week-old White Leghorn chickens, both strains caused 100% mortality within 4 (Kvuzat/13) and 5 (Karachi/07) days postinfection. Histopathology and immunohistochemistry for NDV nucleoprotein showed that both strains had wide systemic distribution, especially targeting lymphoid organs and mucosa-associated lymphoid tissues in the respiratory and intestinal tracts. Results of the animal experiment confirm that both Kvuzat/13 and Karachi/07 are highly virulent and behaved as velogenic viscerotropic NDV strains. PMID:26940837

  12. Evaluation of doctors trained at Diarrhoea Training Unit of National Institute of Child Health, Karachi.

    PubMed

    Ibrahim, S; Isani, Z

    1997-01-01

    Diarrhoeal diseases are a major contributory factor for high infant mortality and morbidity in Pakistan. To overcome this, Government of Pakistan launched a National Programme for Control of Diarrhoeal Disease. A Diarrhoea Training Unit (DTU) was established at the National Institute of Child Health, Karachi, where apart from proper case management, 17 training workshops were held between July, 1989 to July, 1991. Eighty-five doctors from various facilities in Sindh were trained in proper management of diarrhoea and establishment of Oral Rehydration Therapy (ORT) units in their regions. Evaluation of DTU training, assessment of the knowledge of trained doctors, case management and function of ORT Units were done between September, 1992 and October, 1993. Two teams each consisting of a doctor and a lady health visitor, visited 30 such facilities. An observation check list was used for assessing the ORT unit and diarrhoea case management and a test questionnaire for the knowledge of facility physician and paramedic. Of the 29 facilities, 17 had DTU trained doctors. ORT corner had been established in 26, weighing scales were used in 21, record keeping in eight and soap and water was available for hand washing in seven centres. The presence of untrained doctors provided an opportunity to compare the two groups. Dehydration assessment was fairly good, weight was recorded in fewer cases than desirable, case management was similar in the two groups, except for infrequent use of antibiotics by the trained group. Prevention was poorly advised. Physicians' knowledge in both groups was similar but deficient in advising the use of ORS, feeding in diarrhoea and nutritional assessment. The trained ones had significantly better knowledge about drugs and this was reflected in their case management. Paramedic case management were similar to those in doctors. The study thus showed positive and beneficial effects of training. PMID:9056729

  13. Effects of leather industry on health and recommendations for improving the situation in Pakistan.

    PubMed

    Syed, Madiha; Saleem, Taimur; Shuja-ur-Rehman; Iqbal, Muhammed Asif; Javed, Faisal; Khan, Muhammed Bilal Salman; Sadiq, Kamran

    2010-01-01

    The leather industry and its associated sectors contribute significantly to the Pakistani economy. There are around 600 tanneries in Pakistan that are concentrated in 3 major cities (Kasur, Karachi, Sialkot). Waste discharge from tanneries pollutes the air, soil, and water, causing serious health problems. Exposure to such contaminated environmental milieu has been seen to culminate in a multiple array of disease processes such as asthma, dermatitis, hepatic and neurological disorders, and various malignancies. An overall dearth of research on the occupational hazards of employment in the leather industry as well as its effects on pediatric population was observed during literature review with particular reference to Pakistan. It is recommended that research should be conducted about the health hazards in the leather industry in Pakistan as well as globally to gather data that can be translated into effective prevention programs for both adults as well as pediatric populations. PMID:20705577

  14. Transition towards health promoting hospitals: adapting a global framework to Pakistan.

    PubMed

    Khowaja, A R; Karmaliani, R; Mistry, R; Agha, A

    2011-10-01

    The World Health Organization encourages hospitals to become Health Promoting Hospitals (HPH) but adapting this concept to Pakistan has not been investigated. We explore perceptions of healthcare stakeholders about strategies and a priority action-plan to encourage HPHs in Pakistan. We conducted a qualitative study in 2007 where key-informant interviews and focus group discussions were held with healthcare stakeholders in Karachi. Thematic analysis was done and emerging themes were categorized. The HPH core components were perceived as the "standard framework"; however more emphasis was placed on priority actions as to satisfy "basic needs" of patients, staff and the community. This included basic facilities of comfort, health, hygiene, safety, security and emotional support. A change in the traditional mindset from cure to care and identification of key personnel, awareness-raising and cooperation would strengthen advocacy efforts for HPH in Pakistan. PMID:22256406

  15. Regression in polio eradication in Pakistan: A national tragedy.

    PubMed

    Kanwal, Sumaira; Hussain, Abrar; Mannan, Shazia; Perveen, Shazia

    2016-03-01

    Polio is one out of 200 infections results to lasting paralysis, usually in the legs. The year 2014 has been the saddest year for the Pakistan when the World was about to eliminate Polio from all over the World. In year 1994 Pakistan took the initiative to eliminate Polio from the country. The efforts were going well until 2005, when Pakistan was on the wedge to overcome the Disease. The hopes were high that soon Pakistan will become a polio-virus-free country, but the drone strikes in FATA and the rise of different militant groups as a reaction of the drone attacks in FATA made it difficult for the health workers to continue their vaccination campaigns in these areas. However various factors ruined the efforts made to eradicate Polio. In Pakistan, polio is widespread to three sections. These are Karachi, Quetta block (Quetta, Pishin and Killah Abdullah district) and FATA and Peshawar district. Numerous things are accountable for polio flourishing in these regions. These comprise near to the ground socioeconomic rank of the families, not having the knowledge concerning hazard caused by polio and disinformation by limited significant people concerning how polio vaccines fabricate damage. In 2014, only 3 countries in the world remain polio-endemic: Nigeria, Pakistan and Afghanistan. From year 2012-2014 the number of registered Polio cases is on rise contrary to rest of the other two Polio-endemic countries. In spite of the extensive work done by Polio workers the number of Polio cases has broken the 16 year record. The situation is getting worse because it can also be threatening to the rest of the World. PMID:26968287

  16. Frequency of ABH secretors and non secretors: A cross sectional study in Karachi

    PubMed Central

    Saboor, Muhammad; Ullah, Aman; Qamar, Khansa; Mir, Awal; Moinuddin

    2014-01-01

    Objective: ABO blood group and secretor status is valuable in relation to some diseases in clinical and forensic medicine. Across the globe there are geographic and racial differences in the frequency of secretors and non-secretors. Aim of this study was to evaluate the status of ABH blood group secretors and non-secretors in Karachi (Pakistan). Methods: Blood and saliva samples were randomly collected from one hundred and one (n=101) healthy adult students (76 male, 25 female) ranging in age from 15 to 40 years. Their ABO and Rhesus blood groups were determined by conventional methods, and their secretor status was studied by hemagglutination inhibition method of saliva. Results: Results showed that 64.4% of the study population were ABH blood group secretors while 35.6% were non-secretors. Frequencies of the secretor status among various ABO blood groups were 71.4% in group A, 79.5% in group B, 45.5% in group AB, and 61.5% in group O. Conclusion: Frequency of ABH secretor is high (64.4%). Blood group B has the highest secretor (79.5%) frequency while Blood group AB has the lowest (45.5%). PMID:24639859

  17. Spatial patterns monitoring of road traffic injuries in Karachi metropolis.

    PubMed

    Lateef, Muhammad U

    2011-06-01

    This article aims to assess the pattern of road traffic injuries (RTIs) and fatalities in Karachi metropolis. Assessing the pattern of RTIs in Karachi at this juncture is important for many reasons. The rapid motorisation in the recent years due to the availability of credit has significantly increased the traffic volume of the city. Since then, the roads of Karachi have continuously developed at a rapid pace. This development has come with a high human loss, because the construction of multilevel flyovers, signal-free corridors and the resulting high-speed traffic ultimately increase the severity of injuries. The reasons for this high proportion are inadequate infrastructure, poor enforcement of safety regulations, high crash severity index and greater population of vulnerable road user groups (riders and pedestrians). This research is the first of its kind in the country to have a geocoded database of fatalities and injuries in a geographical information system for the entire city of Karachi. In fact, road crashes are both predictable and preventable. Developing countries should learn from the experience of highly motorised nations to avoid the high burden of RTIs by adopting road safety and prevention measures. PMID:20589551

  18. How female education affects reproductive behavior in urban Pakistan.

    PubMed

    Sathar, Z A; Mason, K O

    1993-01-01

    Although Pakistan remains in a pretransitional stage (contraceptive prevalence of only 11.9% among married women in 1992), urban women with post-primary levels of education are spearheading the gradual move toward fertility transition. Data collected in the city of Karachi in 1987 were used to determine whether the inverse association between fertility and female education is attributable to child supply variables, demand factors, or fertility regulation costs. Karachi, with its high concentration of women with secondary educations employed in professional occupations, has a contraceptive prevalence rate of 31%. Among women married for less than 20 years, a 10-year increment in education predicts that a woman will average two-fifths of a child less than other women in the previous 5 years. Regression analysis identified 4 significant intervening variables in the education-fertility relationship: marriage duration, net family income, formal sector employment, and age at first marriage. Education appears to affect fertility because it promotes a later age at marriage and thus reduces life-time exposure to the risk of childbearing, induces women to marry men with higher incomes (a phenomenon that either reduces the cost of fertility regulation or the demand for children), leads women to become employed in the formal sector (leading to a reduction in the demand for children), and has other unspecified effects on women's values or opportunities that are captured by their birth cohort. When these intervening variables are held constant, women's attitude toward family planning loses its impact on fertility, as do women's domestic autonomy and their expectations of self-support in old age. These findings lend support to increased investments in female education in urban Pakistan as a means of limiting the childbearing of married women. Although it is not clear if investment in female education would have the same effect in rural Pakistan, such action is important from a

  19. Heterogeneity of characteristics, structure, and dynamics of male and hijra sex workers in selected cities of Pakistan

    PubMed Central

    Thompson, Laura H; Salim, Momina; Baloch, Chaker Riaz; Musa, Nighat; Reza, Tahira; Dar, Nosheen; Arian, Shahzad; Blanchard, James F; Emmanuel, Faran

    2013-01-01

    Background We sought to describe the characteristics and operational dynamics of male sex workers (MSW) and hijra sex workers (HSWs) in 11 cities across Pakistan in 2011. Methods We report descriptive statistics of self-reported sexual behaviour data from cross-sectional mapping and biological and behavioural surveys conducted among 1431 MSWs and 1415 HSWs in four cities across Pakistan in 2011. Results While Karachi had the largest numbers of MSWs and HSWs, Quetta had the largest relative population sizes, with 3.6 MSWs per 1000 male adults and 3.3 HSWs per 1000 male adults. There was considerable variability in the proportion of HSWs who operate through deras, ranging from 2.2% in Peshawar to 62.7% in Karachi. The number of HSWs per guru varies by city, from 1.5 in Quetta to 16.5 HSWs per guru in Karachi. Among HSWs, the use of mobile phones for solicitation ranged from 37.6% in Quetta to 83% in Peshawar and among MSWs the use of mobile phones ranged from 27% in Karachi to 52% in Quetta. In Quetta, a large proportion of HSWs (41%) find clients through gurus. Client volume tended to be higher among HSWs and among both MSWs and HSWs in Quetta and Peshawar. Condom use with clients was most consistent in Quetta, with 31% of MSWs and 41% of HSWs reporting always using condoms with clients. Peshawar had the greatest proportion reporting never using condoms. Conclusions There is considerable geographic heterogeneity in the characteristics and operational dynamics of MSWs and HSWs across Pakistan. PMID:23605854

  20. Typhoid vaccine introduction: An evidence-based pilot implementation project in Nepal and Pakistan.

    PubMed

    Khan, M Imran; Pach, Alfred; Khan, Ghulam Mustafa; Bajracharya, Deepak; Sahastrabuddhe, Sushant; Bhutta, Waqaas; Tahir, Rehman; Soofi, Sajid; Thapa, Chandra B; Joshi, Nilesh; Puri, Mahesh K; Shrestha, Parisha; Upreti, Shyam Raj; Clemens, John D; Bhutta, Zulfiqar; Ochiai, R Leon

    2015-06-19

    The World Health Organization (WHO) in 2008 recommended the use of currently licensed typhoid vaccines using a high risk or targeted approach. The epidemiology of disease and the vaccine characteristics make school-based vaccination most feasible in reducing typhoid disease burden in many settings. To assess feasibility of school-based typhoid vaccination, two districts in Kathmandu, Nepal and two towns in Karachi, Pakistan were selected for pilot program. Vaccination campaigns were conducted through the departments of health and in partnerships with not-for-profit organizations. In total 257,015 doses of Vi polysaccharide vaccine were given to students in grades 1-10 of participating schools. The vaccination coverage ranged from 39 percent (38,389/99,503) in Gulshan town in Karachi, to 81 percent (62,615/77,341) in Bhaktapur in Kathmandu valley. No serious adverse event was reported post vaccination. The coverage increased for vaccination of the second district in Pakistan as well as in Nepal. There was an initial concern of vaccine safety. However, as the campaign progressed, parents were more comfortable with vaccinating their children in schools. Supported and conducted by departments of health in Pakistan and Nepal, a school-based typhoid vaccination was found to be safe and feasible. PMID:25937612

  1. Barriers to Implementation of Optimal Laboratory Biosafety Practices in Pakistan.

    PubMed

    Shakoor, Sadia; Shafaq, Humaira; Hasan, Rumina; Qureshi, Shahida M; Dojki, Maqboola; Hughes, Molly A; Zaidi, Anita K M; Khan, Erum

    2016-01-01

    The primary goal of biosafety education is to ensure safe practices among workers in biomedical laboratories. Despite several educational workshops by the Pakistan Biological Safety Association (PBSA), compliance with safe practices among laboratory workers remains low. To determine barriers to implementation of recommended biosafety practices among biomedical laboratory workers in Pakistan, we conducted a questionnaire-based survey of participants attending 2 workshops focusing on biosafety practices in Karachi and Lahore in February 2015. Questionnaires were developed by modifying the BARRIERS scale in which respondents are required to rate barriers on a 1-4 scale. Nineteen of the original 29 barriers were included and subcategorized into 4 groups: awareness, material quality, presentation, and workplace barriers. Workshops were attended by 64 participants. Among barriers that were rated as moderate to great barriers by at least 50% of respondents were: lack of time to read biosafety guidelines (workplace subscale), lack of staff authorization to change/improve practice (workplace subscale), no career or self-improvement advantages to the staff for implementing optimal practices (workplace subscale), and unclear practice implications (presentation subscale). A lack of recognition for employees' rights and benefits in the workplace was found to be a predominant reason for a lack of compliance. Based on perceived barriers, substantial improvement in work environment, worker facilitation, and enabling are needed for achieving improved or optimal biosafety practices in Pakistan. PMID:27400192

  2. Use of locally made off-loading techniques for diabetic plantar foot ulcer in Karachi, Pakistan.

    PubMed

    Miyan, Zahid; Ahmed, Jameel; Zaidi, Syed I; Ahmedani, Muhammad Y; Fawwad, Asher; Basit, Abdul

    2014-12-01

    The aim of this study was to evaluate the effectiveness of applying locally made pressure off-loading techniques on plantar foot ulcer in individuals with diabetes. This prospective study of 70 diabetic patients was conducted at the foot clinic of Baqai Institute of Diabetology & Endocrinology. Plantar foot ulcer, stages 1A and 2A according to the University of Texas classification, was treated by using three off-loading techniques: modified foot wear (sandal), modified plaster of Paris cast with plywood platform and Scotchcast boot. The outcome was assessed at either complete wound healing (defined as complete epithelialisation) or at 12 weeks, whichever came first. Of the 70 patients, 24 were in modified foot wear group, 23 in modified plaster of Paris cast and 23 in Scotchcast boot group. There was almost equal proportion of patients healed within 12 weeks period treated with these three off-loading techniques, i.e. 22 (95·7%) for modified foot wear group, 19 (95%) for modified plaster cast and 18 (94·7%) for Scotchcast boot group. No significant difference was observed in median healing time and cumulative wound survival at 12 weeks in the three off-loading techniques. Modified foot wear group was the most cost effective ($7) amongst the three off-loading techniques. It is concluded that in this cohort, no significant difference in healing time was observed in the three off-loading techniques, although modified foot wear (sandal) was found to be a more cost-effective treatment modality. PMID:23369009

  3. Learning from the Past, Looking to the Future: Modeling Social Unrest in Karachi, Pakistan

    SciTech Connect

    Olson, Jarrod; Kurzrok, Andrew J.; Hund, Gretchen; Fagley, Erik M.

    2014-01-01

    Social unrest represents a major challenge for policy makers around the globe, as it can quickly escalate from small scale disturbances to highly public protests, riots and even civil war. This research was motivated by a need to understand social instability and to unpack the comments made during a spring 2013 conference hosted by Pacific Northwest National Laboratory’s Center for Global Security and the U.S. Institute for Peace, where policymakers noted that models considering social instability are often not suitable for decision-making. This analysis shows that existing state level models of instability could be improved in spatial scale to the city level, even without significantly improved data access. Better data would make this analysis more complete and likely improve the quality of the model. Another challenge with incorporating modeling into decision-making is the need to understand uncertainty in a model. Policy makers are frequently tasked with making decisions without a clear outcome, so characterization of uncertainty is critical. This report describes the work and findings of the project. It took place in three phases: a literature review of social stability research, a “hindsight scan” that looked at historical data, and a “foresight scan” looking at future scenarios.

  4. Energy drinks consumption practices among medical students of a Private sector University of Karachi, Pakistan.

    PubMed

    Usman, Asma; Bhombal, Swaleha Tariq; Jawaid, Ambreen; Zaki, Samar

    2015-09-01

    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 students of a private university. There is a strong need to create awareness regarding these drinks, especially among adolescents and teenagers. PMID:26338750

  5. Geochemical assessment of metal pollution and ecotoxicology in sediment cores along Karachi Coast, Pakistan.

    PubMed

    Mashiatullah, Azhar; Chaudhary, Muhammad Zaman; Ahmad, Nasir; Ahmad, Nisar; Javed, Tariq; Ghaffar, Abdul

    2015-05-01

    This paper is an attempt to compare the pollution status in two sediment cores, one from a polluted site (Ghizri Creek) and another from a relatively unpolluted site (Sandspit). Sediment cores (45 cm in length) from coastal locations were characterized in terms of grain size, sediment composition, pH, organic matter, calcium carbonate, and metal element contents. Metal elements, including Al, Ca, Cr, Co Cu, Fe, K, Mg, Mn, Ni, Pb, V, Ti, and Zn, were determined using PIXE. Grain size analysis and sediment composition demonstrated a sandy nature of both cores. Acidic trend in sediment core I was predominant from bottom to top, whereas neutral pH was observed throughout core II. TOC values varied in the range of 1.23-2.68 and 1.14-2.60% in core I and core II, respectively; however, there was an increasing trend in TOC level from bottom to top. The values of enrichment factor for Zn, Cu, Co, Ni, Pb, and Cr were slightly higher in core I than core II. The average geo-accumulation index values for core I and core II showed that sediments were moderately Co- and Pb-polluted but not polluted with Mg, Al, Ca, K, Cr, Cu, Fe, Mn, Ni, Ti, V, and Zn. The degree of contamination was however considerably higher in core I relative to core II. The pollution load index values, although showing an increasing trend from bottom to top in both cores, overall rendered the marine sediment pollution free. The metal toxicology results demonstrated that heavy metal pollution, except Cr, may pose low to moderate risk to marine biota. The sum of toxic unit values however indicated that sediment core I was relatively more polluted than that of core II. PMID:25869090

  6. Elevated iron levels in hair from steel mill workers in Karachi, Pakistan

    SciTech Connect

    Jamall, I.S.; Jaffer, R.A.

    1987-10-01

    Over the last two decades, much interest has been focused on the use of trace metals in human hair to diagnose nutritional deficiencies of these metals or toxicities of metals such as lead or organic mercury. Although the diagnostic value of zinc (Zn), copper (Cu), lead and mercury levels in human hair have been well established, little information is available on the significance of iron (Fe) levels in hair to diagnose nutritional deficiency or toxicity of this metal. The present study was conducted to determine if occupational exposure in the steel industry resulted in alterations i the levels of Fe, Zn, and Cu in hair and could thus serve as a simple tool for monitoring exposure to potentially hazardous levels of these metals.

  7. Nuclear programs in India and Pakistan

    NASA Astrophysics Data System (ADS)

    Mian, Zia

    2014-05-01

    India and Pakistan launched their respective nuclear programs in the 1940s and 1950s with considerable foreign technical support, especially from the United States Atoms for Peace Program. The technology and training that was acquired served as the platform for later nuclear weapon development efforts that included nuclear weapon testing in 1974 and in 1998 by India, and also in 1998 by Pakistan - which had illicitly acquired uranium enrichment technology especially from Europe and received assistance from China. As of 2013, both India and Pakistan were continuing to produce fissile material for weapons, in the case of India also for nuclear naval fuel, and were developing a diverse array of ballistic and cruise missiles. International efforts to restrain the South Asian nuclear build-up have been largely set aside over the past decade as Pakistani support became central for the U.S. war in Afghanistan and as U.S. geopolitical and economic interests in supporting the rise of India, in part as a counter to China, led to India being exempted both from U.S non-proliferation laws and international nuclear trade guidelines. In the absence of determined international action and with Pakistan blocking the start of talks on a fissile material cutoff treaty, nuclear weapon programs in South Asia are likely to keep growing for the foreseeable future.

  8. Nuclear programs in India and Pakistan

    SciTech Connect

    Mian, Zia

    2014-05-09

    India and Pakistan launched their respective nuclear programs in the 1940s and 1950s with considerable foreign technical support, especially from the United States Atoms for Peace Program. The technology and training that was acquired served as the platform for later nuclear weapon development efforts that included nuclear weapon testing in 1974 and in 1998 by India, and also in 1998 by Pakistan - which had illicitly acquired uranium enrichment technology especially from Europe and received assistance from China. As of 2013, both India and Pakistan were continuing to produce fissile material for weapons, in the case of India also for nuclear naval fuel, and were developing a diverse array of ballistic and cruise missiles. International efforts to restrain the South Asian nuclear build-up have been largely set aside over the past decade as Pakistani support became central for the U.S. war in Afghanistan and as U.S. geopolitical and economic interests in supporting the rise of India, in part as a counter to China, led to India being exempted both from U.S non-proliferation laws and international nuclear trade guidelines. In the absence of determined international action and with Pakistan blocking the start of talks on a fissile material cutoff treaty, nuclear weapon programs in South Asia are likely to keep growing for the foreseeable future.

  9. Pottery from Pakistan. A Handbook.

    ERIC Educational Resources Information Center

    Rammage, Alix

    One of three handbooks dealing with pottery traditions from around the world, this packet draws together information about historical, ethnographic, and pottery traditions of Pakistan. The handbook begins with a brief discussion of Pakistan's land and people, a short history of Pakistan, Islamic pottery traditions, and Pakistan potters and…

  10. Archives in Pakistan

    ERIC Educational Resources Information Center

    Haider, Syed Jalaluddin

    2004-01-01

    This article traces the origins and development of archives in Pakistan. The focus is on the National Archives of Pakistan, but also includes a discussion of the archival collections at the provincial and district levels. This study further examines the state of training facilities available to Pakistani archivists. Archival development has been…

  11. Islamic Education in Pakistan

    ERIC Educational Resources Information Center

    Fair, C. Christine

    2006-01-01

    On March 21, 2006 Christine Fair spoke about her recent trip to Pakistan. Fair's fieldwork was conducted with her Pakistan-based colleague Syed Rashad Bukhari and in collaboration with the National Bureau of Asian Research. Fair and Bukhari spent nearly three weeks visiting administrators at ten of the most prominent post-secondary madaris…

  12. Cost of treatment of deliberate self-harm. A study from Pakistan.

    PubMed

    Shahid, Muhammad; Khan, Murad M; Naqvi, Haider; Razzak, Junaid

    2008-01-01

    A retrospective review of 98 patients through medical and billing records, over a period of 12 months (January to December 2004), was conducted to evaluate the cost of treatment of patients presenting with deliberate self-harm (DSH) to a private tertiary care teaching hospital in Karachi, Pakistan. After initial treatment in the Emergency Department (ED), 34 patients were admitted to the medical wards for further treatment and 64 patients were either discharged or left against medical advice from ED. The mean cost for admitted and discharged patients was US $255 and US $55.60, respectively. One patient was intubated in the ED and shifted to intensive care unit. The cost of treatment of DSH is extremely high in a country like Pakistan, where the patients have to bear the hospital cost out of their own pocket. The most important determinant of cost was length of hospital stay, averaging 2.91 days. PMID:19069614

  13. Dimensions of physical wellness among medical students of public and private medical colleges in Pakistan

    PubMed Central

    Khan, Rakhshaan; Rehman, Rehana; Baig, Mukhtiar; Hussain, Mehwish; Khan, Mariam; Syed, Fatima

    2015-01-01

    Objectives: To determine adherence to dimensions of physical wellness among medical students of public and private medical colleges in Pakistan. Methods: This cross-sectional study was carried out from January to July 2011 among 820 students of private and public medical colleges in Karachi, Pakistan. Results: Overall, medical students scored low in dimensions of physical wellness. Private medical colleges students were fond of vigorous activities such as aerobics and swimming, whereas public medical colleges students were involved in moderate intensity activities such as walking and use of stairs (p<0.0001). Private students reported to consume more fast food (p=0.0001), had less sleep (p=0.0001), but attended regular annual medical checkups (p=0.009) as compared with their public institute counterparts. Safe practices such as avoidance of tobacco were almost the same. Conclusion: Comprehensive adherence to all dimensions of physical wellness was lacking among medical students. PMID:25987122

  14. Status of heavy metal residues in fish species of Pakistan.

    PubMed

    Hussain, Majid; Muhammad, Said; Malik, Riffat N; Khan, Muhammad U; Farooq, Umar

    2014-01-01

    In this review, we evaluate and summarize the available data that addresses the levels of HM that exist in aquatic species, mainly fish, of Pakistan. Data on this topic were collected from the literature of the last two decades (1990-2012). Results revealed that the highest number (>50%) of studies addressing HM-contaminated fish have occurred in the Punjab province, followed by the Sindh and Khyber Pakhtunkhwa provinces. Our review disclosed that the HM concentrations in Pakistani fish species varied considerably with location. Generally, the level of HM residues detected in fish species had the following descending order: Fe>Zn>Pb>Cd>Hg>Ni>Cu>Ag>Cr>Mn>As. Fish samples collected from the Kabul River near the Nowshera district, Stretch of Ravi River, Indus River near Mainwali district, and Arabian Sea at Karachi revealed extremely high HM concentrations (range: 0.34-8,381.30 jlg/g), compared to other fresh water bodies, such as the Llyold Barrage, Guddu Barrage, Jinnah Barrage, and Chashma Barrage (0.01-2.13 jlg/g). As a reference point, we also reviewed selected data on HM fish residues that exist in countries that neighbor Pakistan. With the exception of fish collected in India, the majority of fish analyzed for HM residues in neighboring countries displayed lower residues than did fish from Pakistan. We concluded from reviewing the available published data that the most probable sources for the HM contaminants found in Pakistani water and fish were release of domestic sewage, agricultural runoff, and industrial effluents. We strongly recommend that action be taken to better control the discharges of unregulated waste that enters the Pakistani aquatic environment, with the intent to mitigate any continuing future damage to the aquatic ecosystem. We also recommend intensifying research programs that address the toxicity of HM to the aquatic environment, so that a better understanding of metal effects on fish can be achieved that will lead to a sustainable

  15. Comparison of exhaled carbon monoxide levels among commuters and roadside vendors in an urban and a suburban population in Pakistan.

    PubMed

    Sabzwari, Saniya R; Fatmi, Zafar

    2011-09-01

    Carbon monoxide (CO) is one of the six criteria air pollutants related to urbanization and has a wide range of health effects. The study measured and compared the exhaled CO levels among commuters and roadside vendors in potentially heavy and low traffic volume areas of Karachi, a megacity in Pakistan. Saddar town [areas of M. A. Jinnah Road (Tibet Center, Denso Hall) and Empress Market] was selected to represent an area of high traffic volume and the suburban town of Gadap (Gadap and Gulshan-e-Maymar) was selected to represent an area of no or low traffic volume. The study compared the CO exposure of commuters and roadside vendors in high and low traffic volume in Karachi. CO exposure was measured in expired air using the breath analyzer module of Bacharach Monoxor-II, USA. A total of 326 individuals (115 commuters and 211 stationary roadside vendors) from Saddar town (n = 193) and Gadap town (n = 133) were selected. In addition, CO levels in ambient air in the same areas, using portable CO analyzer (Bacharach, Monoxor-II, USA), were measured. The mean ambient CO level at Saddar town was 15.6 (SE ± 2.6) ppm compared to 3.3 (SE ± 0.3) ppm at Gadap town. The mean CO level in expired air was significantly higher among nonsmokers at Saddar town (12.8 ± 0.5 ppm) compared to the nonsmokers at Gadap town (7.8 ± 0.4 ppm). The mean CO level in expired air among smokers was twice that of nonsmokers (21.6 vs. 10.6 ppm). CO in expired air was greater among high traffic volume commuters and roadside stationary population in Karachi, Pakistan. The population in Karachi is exposed to high concentration of air pollutants. These pollutants need to be characterized for health effects and interventions needs to be developed. PMID:21120689

  16. Is Stapled Hemorrhoidectomy a Safe Procedure for Third and Fourth Grade Hemorrhoids? An Experience at Civil Hospital Karachi.

    PubMed

    Bota, Rafaqat; Ahmed, Mushtaq; Aziz, Adnan

    2015-12-01

    Hemorrhoids are amongst the most frequent anorectal conditions affecting approximately 4-36 % of the general population. The study was carried out to assess the clinical consequences of stapled hemorrhoidectomy comparing results with other published literature regarding postoperative pain, bleeding, incontinence, and other complications. A total of 120 patients were included in this study with symptomatic grade 3 or 4 prolapsed hemorrhoids, who underwent stapled hemorrhoidectomy from January 2006 to January 2012 at the Civil Hospital Karachi, Pakistan. In 92 patients (76.6 %), proctological examination showed grade 3 hemorrhoids. Fourth degree hemorrhoids were found in 28 cases (23.4 %). Hospitalization time ranged between 1 and 3 days (median time was 34 h). Seventy-eight patients were discharged on the first postoperative day, without severe pain, and the remaining 42 patients were discharge on the third day. Two cases of postoperative pain and thrombosis were found as postoperative complications. Stapled hemorrhoidectomy is a safe and quick procedure associated with less pain, better outcome, and early recovery with shorter hospital stay. PMID:27011510

  17. Atmospheric Pollution and Emission Sources in South Asian Urban Region

    NASA Astrophysics Data System (ADS)

    Biswas, K. F.; Husain, Liaquat

    2009-04-01

    Rapid urbanization, and lack of efficient monitoring and control of pollution, along with phenomena like Asian Brown Haze or prolonged episodes of winter fog, makes the South Asian atmospheric chemistry a very complex one. The anthropogenic aerosols released from this region are projected to become the dominant component of anthropogenic aerosols worldwide in the next 25 years (Nakicenovic and Swart, 2000). The region is one of the most densely populated in the world, with present population densities of 100-500 persons km-2. There are six big cities, namely, Delhi, Dhaka, Karachi, Kolkata, Lahore, and Mumbai, each housing a population around or above 10 million. There is now a real concern about the sustainability of the region's ability to support the population due to air pollution, loss of biodiversity and soil degradation. Therefore, we conducted several extensive campaigns over last 10 years in Lahore, Karachi, and Islamabad in Pakistan to (1) chemically characterize the aerosols (PM2.5 mass, concentrations of trace elements, ions, black and organic carbon), and gaseous pollutants (concentrations of NH3, SO2, HONO, HNO3, HCl and (COOH)2, and (2) identify the major emission sources in this region. Exceedingly high concentrations of all species, relative to major urban areas of US and Europe, were observed. Concentrations of PM2.5, BC, Pb, SO42-, NH4+, HONO, NH3 respectively, up to 476, 110, 12, 66, 60, 19.6 and 50 μgm-3 were observed in these cities, which were far in excess of WHO and US EPA air quality standard (Biswas et al., 2008). We use air parcel back trajectories, intercomponent relationships and meteorological observations to explain chemistry and emission sources of aerosol constituents. Carbonaceous aerosols contributed up to 69% of the PM2.5 mass (Husain et al., 2007). Source apportionment was conducted using positive matrix factorization. The analysis has classified six emission sources of aerosol components, namely, industrial activities, wood

  18. Traditional perceptions of marasmus in Pakistan.

    PubMed

    Mull, D S

    1991-01-01

    One hundred and fifty mothers of under-5 children clinically identified as malnourished were interviewed in their homes in katchi abadis (squatter settlements) of Karachi. A variety of ethnic and religious groups were represented. Mothers were shown a photograph of a child with third-degree malnutrition (marasmus) and were asked what might be wrong with the child. Virtually of the mothers said that they had seen the condition, typically identifying it as sukhay ki bimari (Urdu: 'the disease of dryness and thinness'). The majority said that diarrhea predisposed to sukhay ki bimari, and vice versa, but only 3 of the 150 mothers said that diarrhea and/or lack of food could, in themselves, cause the condition. Instead, most said that the usual cause was contact with a woman who had a marasmic child or was otherwise in a state of ritual impurity. The mediating factor was said to be a saya ('shadow, influence') emanating from such a person and ultimately linked with the spirit world. Although the condition was judged to have a very poor prognosis, mothers described various magico-religious therapies that could be tried. Treatment by physicians or by giving more food was considered ineffective or even detrimental, and hiding of such children was reportedly common because of social stigma. Subsequent inquiries carried out by the author in Chitral in northwestern Pakistan produced similar findings except that there, the condition was known as moordasip and was more overtly associated with fright and spirit possession. In Karachi, 45 of the 150 mothers interviewed had children with third-degree malnutrition according to weight-for-age criteria, 15 of whom died in the course of the study. In these 45 families especially, early bottlefeeding had occurred, sometimes reportedly because of fear that the mother was a carrier of a saya and could pass it on through her milk. Most mothers had only sketchy knowledge of suitable weaning foods and an appropriate timetable for

  19. Pediatric oncology in Pakistan.

    PubMed

    Ashraf, Muhammad Shamvil

    2012-03-01

    Pediatric oncology in Pakistan has developed over last decade with substantial increase in the facility for treatment and number of expertise. Though large numbers of children still do not reach treatment center more children have now access to quality cancer treatment. There has been gradual improvement in Pediatric oncology nursing and allied services. Pediatric Palliative care in Pakistan is in initial phase of development. Pediatric Oncology services are largely supported by philanthropists. Children Cancer Hospital a project of Children Cancer Foundation Pakistan Trust is not only providing quality treatment to every child regardless of paying ability but also playing a pivotal role in capacity building and creating awareness about childhood cancer in Pakistan. PMID:22357147

  20. Pakistan's community health workers.

    PubMed

    Majumdar, B; Amarsi, Y; Carpio, B

    1997-05-01

    Pakistan's health characteristics are worse than those of other Asian countries at similar stages of development. Its mortality rate for children under five is 139 per 1,000, and its maternal mortality is 60 per 10,000. Malnutrition in women and children is widespread; 50 per cent of children under five are stunted. Pakistan's population growth rate of 3.1 per cent per year is among the highest in Asia. The high population growth rate and poor health status of many people call for extensive health care services, but, unfortunately, health services do not reach most of the people of Pakistan. Partly because the training of doctors and nurses is lengthy and expensive, there is an acute shortage of health care providers, especially women. Although female health professionals are preferred for caring for women, cultural constraints inhibit women from seeking education. Such is the multifaceted dilemma in the provision of primary health care in Pakistan. PMID:9223980

  1. Eradication and Current Status of Poliomyelitis in Pakistan: Ground Realities

    PubMed Central

    Ghafoor, Shazia

    2016-01-01

    Pakistan is among the last three countries along with Afghanistan and Nigeria, where polio virus is still endemic. More or less, with some fluctuations, numbers of reported cases in the past few years have shown a rising trend. Year 2014 pushed the country into the deep sea of difficulties, as number of cases rose to red alert level of 328. Security situation has adversely affected the whole immunization coverage campaign. In a country where 40 polio vaccinators have been killed since 2012, such a big number of cases is not a surprising outcome. Worse perception of parents about polio vaccine as in Karachi and FATA, the high risk zones, makes 100% coverage a dream. Minor and perhaps delayed payments to polio workers make them frustrated, resulting in decline of trained manpower for vaccination. Strong implementation of policies is required and those found guilty of attack on polio workers need to be punished. Targeted community awareness programme, strong surveillance network, and involvement of influential religious entities can help to root out polio disease from country. Present review is aimed at analyzing all barriers on the road to success in eradication of polio from Pakistan. PMID:27517055

  2. Eradication and Current Status of Poliomyelitis in Pakistan: Ground Realities.

    PubMed

    Ghafoor, Shazia; Sheikh, Nadeem

    2016-01-01

    Pakistan is among the last three countries along with Afghanistan and Nigeria, where polio virus is still endemic. More or less, with some fluctuations, numbers of reported cases in the past few years have shown a rising trend. Year 2014 pushed the country into the deep sea of difficulties, as number of cases rose to red alert level of 328. Security situation has adversely affected the whole immunization coverage campaign. In a country where 40 polio vaccinators have been killed since 2012, such a big number of cases is not a surprising outcome. Worse perception of parents about polio vaccine as in Karachi and FATA, the high risk zones, makes 100% coverage a dream. Minor and perhaps delayed payments to polio workers make them frustrated, resulting in decline of trained manpower for vaccination. Strong implementation of policies is required and those found guilty of attack on polio workers need to be punished. Targeted community awareness programme, strong surveillance network, and involvement of influential religious entities can help to root out polio disease from country. Present review is aimed at analyzing all barriers on the road to success in eradication of polio from Pakistan. PMID:27517055

  3. Pakistan: Frontline state again. Master`s thesis

    SciTech Connect

    Rivard, D.S.

    1995-12-01

    The objective of this study is to determine Pakistan`s place in contemporary U.S. national security strategy. Today, U.S.-Pakistan relations are strained due to the Pressler Amendment to the Foreign Assistance Act. The Pressler Amendment prohibits arms transfers from the United States to Pakistan in response to Pakistani efforts to develop a nuclear weapon capability. This thesis provides a historical background to the current impasse by examining Pakistani foreign policy since 1947. Next, the study examines the evolution of U.S. interests and security objectives in South and Southwest Asia. Current security objectives analyzed are the U.S. strategies to contain Iran and Iraq and to prevent nuclear proliferation in the region. In order to attain security objectives in the region, the author concludes that the U.S. needs a close cooperative relationship with Pakistan. Since the Pressler Amendment stands as the greatest obstacle to improved U.S.-Pakistan relations, the amendment should be repealed.

  4. Barite in Pakistan

    USGS Publications Warehouse

    Klinger, F.L.; Richards, R.L.

    1973-01-01

    Before 1953 almost no barite deposits were known in Pakistan. Discovery of such deposits relatively close to oil fields in northern Pakistan in 1953 led to increased barite production from 1957 to 1961 and to doubling of production in 1962, firmly establishing new industry for the country. During 1962 and 1963, most of the known barite deposits in Pakistan were geologically mapped, and minimum reserves were estimated to be 1,423,000 short tons. The largest single deposit, Ehuzdar, is estimated to contain more than 1,100,000 short tons of barite. Barite has been found in Pakistan principally in the Hazara, Khuzdar, and Las Bela districts. Although several vein deposits contain good quality barite, 90 percent of estimated reserves are in replacement deposits concordant to bedding in sedimentary rocks. Host rocks range in age from Precambrian to Pleistocene, but the periods of barite deposition are probably Jurassic or younger. Some barite concentrated in sandstone may be of detrital origin. In late 1962, demand for barite in Pakistan was estimated at about 8,000 tons annually. Although domestic barite resources exceed this figure, less than 40 percent of demand was being supplied by domestic nines in 1963. Transportation costs and limited production facilities are partly responsible for output, but the lack of quality control is a major obstacle. Producers are not generally familiar with commercial specifications for barite and have net recognized that their products are too impure to be successfully marketed without installing the necessarycontrol procedures of sampling and beneficiation.

  5. Forensic psychiatry in Pakistan.

    PubMed

    Hassan, Tariq; Nizami, Asad Tamizuddin; Hirji, Sarah

    2015-01-01

    This article reviews existing forensic psychiatric services in Pakistan highlighting the role played by the judicial and the medical fraternity in managing the legal and forensic issues of the population of patients with mental illnesses. Until 2001, all legal and forensic issues were dealt with the mental health legislation of 1912, the Lunacy Act of 1912. This was inherited from the British rulers in the Sub-Continent at the time. The Mental Health Ordinance of 2001 could not sustain following the 18th constitutional amendment in 2010, whereby psychiatric healthcare was devolved to the provinces from the previous federal authority. The article also highlights the difficulties and the barriers in implementation of the forensic psychiatric services in Pakistan at various levels within the healthcare system. This article also delves into the current framework of training in forensic psychiatry for postgraduates as well as the assessments and management schedules for the mentally ill offenders at tertiary care institutions in Pakistan. PMID:26024984

  6. Age and origin of post collision Baltoro granites, south Karakoram, North Pakistan: Insights from in-situ U-Pb, Hf and oxygen isotopic record of zircons

    NASA Astrophysics Data System (ADS)

    Mahar, Munazzam Ali; Mahéo, Gweltaz; Goodell, Philip C.; Pavlis, Terry L.

    2014-09-01

    Origin of post collision plutonism is critical to understand the tectonothermal evolution of the over thickened continental crust in collision zones. This has proven difficult to reconcile with the conventional whole rock geochemical and field based studies alone. We report in-situ study of zircon U-Pb, Hf and O isotopes from five samples of the Baltoro Plutonic Unit (BPU) in south Karakoram. The plutonic unit is the western part of the southern Asian margin of the India-Asia convergent zone. Baltoro granites and a biotite-rich enclave yielded similar and overlapping U-Pb ages ranging from 26 to 15 Ma. Hafnium isotopic composition (εHf (0)) is very heterogeneous ranging from - 17.1 to + 4.4 while the oxygen isotopic composition of the granites is homogeneous with mean δ18O ranging from 7.2 to 9.4‰. Based on U-Pb geochronology and Hf-O isotopic composition, the involvement of two main sources is suggested (1) Cretaceous calc-alkaline Karakoram crust and (2) Karakoram gneisses. Moreover, possible involvement of metasomatized Asian lithospheric mantle is supported by elevated oxygen composition of granites and identical Hf composition of biotite-rich enclave to the mantle derived Baltoro lamprophyre. However, direct contribution from juvenile pristine mantle is unlikely as no juvenile mantle type Hf and oxygen values were obtained. This also precludes the involvement of southward juvenile arc related component of Kohistan-Ladakh batholith. Our new U-Pb and Hf data are comparable to the Mesozoic Karakoram batholith, Miocene two-mica leucogranites in the Pangong Range and magmatism from the Lhasa terrane in south Tibet, suggesting a genetic link between the Karakoram and the rocks to the east. This magmatic event is best explained by lower crust partial melting promoted by both thermal equilibration following crustal thickening and heat advection by ultrapotassic magmas associated with the breakoff of the Indian continental margin.

  7. Cretaceous source rocks in Pakistan

    SciTech Connect

    Kari, I.B. )

    1993-02-01

    Pakistan is located at the converging boundaries of the Indian, Arabian, and Eurasian plates. Evolution of this tectonic setting has provided an array of environmental habitats for deposition of petroleum source rocks and development of structural forms. The potential Cretaceous source rocks in Central and South Indus Basin are spread over an area of about 300,000 km[sup 2]. With 2% cutoff on Total Organic Carbon, the average source rock thickness is 30-50 m, which is estimated to have generated more than 200 billion bbl of oil equivalent. To date, production of more than 30,000 bbl of oil and about 1200 million ft[sup 3] of gas per day can be directly attributed to Cretaceous source. This basin was an area of extensional tectonics during the Lower to Middle Cretaceous associated with slightly restricted circulation of the sea waters at the north-western margin of Indian Plate. Lower Cretaceous source rocks (Sembar Formation) were deposited while the basin was opening up and anoxia was prevailing. Similarly Middle to Upper Cretaceous clastics were deposited in setting favorable for preservation of organic matter. The time and depth of burial of the Cretaceous source material and optimum thermal regime have provided the requisite maturation level for generation of hydrocarbons in the basin. Central Indus basin is characterized by Cretaceous source rocks mature for gas generation. However, in South Indus Basin Cretaceous source rocks lie within the oil window in some parts and have gone past it in others.

  8. Special Education in Pakistan.

    ERIC Educational Resources Information Center

    Sultana, Qaisar

    This paper briefly describes the current status of special education in Pakistan, noting its relatively brief history, the lack of incidence figures, the administrative organization and structure, personnel preparation, the role of nongovernmental organizations, and the recognition of four categories of disability: mental retardation, physical…

  9. Country Profiles, Pakistan.

    ERIC Educational Resources Information Center

    Hardee, J. Gilbert; Satterthwaite, Adaline P.

    A profile of Pakistan is sketched in this paper. Emphasis is placed on the nature, scope, and accomplishments of population activities in the country. Topics and sub-topics include: location and description of the country; population (size, growth patterns, age structure, urban/rural distribution, ethnic and religious composition, migration,…

  10. Pakistan boosts science budget

    NASA Astrophysics Data System (ADS)

    Harris, Margaret

    2009-08-01

    Government spending on science and technology development in Pakistan will jump by about a quarter in 2009-2010 compared with the previous fiscal year, with big increases planned for nuclear physics and higher education. In late June the country's National Assembly approved a budget of 48.2bn Pakistani rupees (Rs), or about £361m, for new science projects.

  11. Impact of human mobility on the emergence of dengue epidemics in Pakistan

    PubMed Central

    Wesolowski, Amy; Qureshi, Taimur; Boni, Maciej F.; Sundsøy, Pål Roe; Johansson, Michael A.; Rasheed, Syed Basit; Engø-Monsen, Kenth; Buckee, Caroline O.

    2015-01-01

    The recent emergence of dengue viruses into new susceptible human populations throughout Asia and the Middle East, driven in part by human travel on both local and global scales, represents a significant global health risk, particularly in areas with changing climatic suitability for the mosquito vector. In Pakistan, dengue has been endemic for decades in the southern port city of Karachi, but large epidemics in the northeast have emerged only since 2011. Pakistan is therefore representative of many countries on the verge of countrywide endemic dengue transmission, where prevention, surveillance, and preparedness are key priorities in previously dengue-free regions. We analyze spatially explicit dengue case data from a large outbreak in Pakistan in 2013 and compare the dynamics of the epidemic to an epidemiological model of dengue virus transmission based on climate and mobility data from ∼40 million mobile phone subscribers. We find that mobile phone-based mobility estimates predict the geographic spread and timing of epidemics in both recently epidemic and emerging locations. We combine transmission suitability maps with estimates of seasonal dengue virus importation to generate fine-scale dynamic risk maps with direct application to dengue containment and epidemic preparedness. PMID:26351662

  12. Impact of human mobility on the emergence of dengue epidemics in Pakistan.

    PubMed

    Wesolowski, Amy; Qureshi, Taimur; Boni, Maciej F; Sundsøy, Pål Roe; Johansson, Michael A; Rasheed, Syed Basit; Engø-Monsen, Kenth; Buckee, Caroline O

    2015-09-22

    The recent emergence of dengue viruses into new susceptible human populations throughout Asia and the Middle East, driven in part by human travel on both local and global scales, represents a significant global health risk, particularly in areas with changing climatic suitability for the mosquito vector. In Pakistan, dengue has been endemic for decades in the southern port city of Karachi, but large epidemics in the northeast have emerged only since 2011. Pakistan is therefore representative of many countries on the verge of countrywide endemic dengue transmission, where prevention, surveillance, and preparedness are key priorities in previously dengue-free regions. We analyze spatially explicit dengue case data from a large outbreak in Pakistan in 2013 and compare the dynamics of the epidemic to an epidemiological model of dengue virus transmission based on climate and mobility data from ∼40 million mobile phone subscribers. We find that mobile phone-based mobility estimates predict the geographic spread and timing of epidemics in both recently epidemic and emerging locations. We combine transmission suitability maps with estimates of seasonal dengue virus importation to generate fine-scale dynamic risk maps with direct application to dengue containment and epidemic preparedness. PMID:26351662

  13. Black carbon aerosols in urban air in South Asia

    NASA Astrophysics Data System (ADS)

    Dutkiewicz, Vincent A.; Alvi, Sofia; Ghauri, Badar M.; Choudhary, M. Iqbal; Husain, Liaquat

    We report data from a yearlong (2006-2007) study of black carbon concentrations ([BC]) measured at 5-min intervals with an Aethalometer in Karachi, Pakistan. Daily mean [BC] varied from about 1 to 15 μg m -3. However, short-term spikes exceeding 40 μg m -3 were common, occurring primarily during the morning and evening rush-hour periods. The [BC] values were highest during November through February, ˜10 μg m -3, and lowest during June through September, ˜2 μg m -3. Diurnal, seasonal, and day-of-the-week trends are discussed. It is demonstrated that these trends are strongly affected by meteorological patterns. A simple expression is applied to the concentration profiles to separate the effects of meteorological conditions and elucidate the underlying emissions patterns. Daily emissions varied from 14,000 to 22,000 kg of BC per day. When integrated over the year emissions for Karachi Proper were estimated at 6.7 kilometric tons per year and emissions for greater Karachi were 17.5 kilometric tons per year. Folding in the populations of each area yields BC emissions of 0.74 and 1.1 kg per person per year, respectively. Applying the model to previously collected data at Lahore, Pakistan yields emissions during November-January that are around a factor of two higher than those in Karachi, but because the BC measurements in Lahore covered only three months, no estimates of annual emissions were attempted. Given the large populations of these cities the local health impact from PM alone is expected to be severe but because of the high [BC] emissions the impact on the global climate may be equally significant.

  14. Egrets as monitors of trace-metal contamination in wetlands of Pakistan.

    PubMed

    Boncompagni, E; Muhammad, A; Jabeen, R; Orvini, E; Gandini, C; Sanpera, C; Ruiz, X; Fasola, M

    2003-10-01

    Environments in Pakistan are subject to increasing pollution, but previous studies were very scanty. During 1999 and 2000, we assessed trace element contamination at three wetlands, Karachi Harbour (with presumed industrial-urban pollution), Taunsa Barrage (agricultural pollution), and Haleji Lake (relatively unpolluted), using as indicators the eggs and the feathers of colonial waterbirds, particularly Little Egrets, their prey, and the sediments collected within their foraging areas. The concentrations of As, Cd, Cr, Pb, Hg, Mn, Se, and Zn were generally within the normal background level, and mostly below the threshold that may affect bird survival or reproduction. However, somewhat high concentrations were found in fish from Karachi, for Pb that was at levels that may harm fish reproduction, and for Hg that was at limit concentration for human consumption. Alarming concentrations were found for Cr and Se in sediments from Karachi, that were above the critical levels for contaminated soil, and Se in eggs, that may affect egret reproduction. The differences among the three wetlands were less marked than hypothesized. The egret species within the same area differed in the concentration of certain elements in their eggs, possibly because females may have foraged in different habitats before breeding, whereas no interspecies difference was found in chick feathers, presumably because their food had been collected in similar habitats around the colony. High bioaccumulation from sediments to organic samples occurred for Hg, while Cd, Se, and Zn exhibited low accumulation; for all these elements, feathers of predatory birds such as the egrets are the best indicators of environmental contamination. On the other hand, As and Cr did not bioaccumulate, and the sediments, or the organisms low in the food chain, like fish or crustaceans, are better indicators of their presence in the environment than predatory birds. PMID:14674593

  15. Risks of drowning and safety concerns at the beaches of Karachi--perspective from lifeguards.

    PubMed

    Shaikh, Masood Ali

    2014-05-01

    Going to beaches is a popular pastime for many people in Karachi. Lifeguards have been deployed on many beaches for the safety and protection of beachgoers. This cross-sectional survey was conducted to study the opinions and experiences of lifeguards posted at eight beaches of Karachi. Ignorance among beachgoers about how dangerous it could be at seaside, was reported by 19 (61.3%) out of 31 lifeguards interviewed. Lifeguards had to put up with verbal and physical abuse while discharging their duties, with verbal abuse being the universal experience. Improved record keeping of drowning and near-drowning data would help make better evidence-informed beach-safety decisions in Karachi for reducing the morbidity and mortality burden owing to drowning. PMID:25272549

  16. Dengue transmission based on urban environmental gradients in different cities of Pakistan

    NASA Astrophysics Data System (ADS)

    Khalid, Bushra; Ghaffar, Abdul

    2015-03-01

    This study focuses on the dengue transmission in different regions of Pakistan. For this purpose, the data of dengue cases for 2009-2012 from four different cities (Rawalpindi, Islamabad, Lahore, and Karachi) of the country is collected, evaluated, and compiled. To identify the reasons and regions of higher risk of Dengue transmission, land use classification, analysis of climate covariates and drainage patterns was done. Analysis involves processing of SPOT 5 10 m, Landsat TM 30 m data sets, and SRTM 90 m digital elevation models by using remote sensing and GIS techniques. The results are based on the change in urbanization and population density, analysis of temperature, rainfall, and wind speed; calculation of drainage patterns including stream features, flow accumulation, and drainage density of the study areas. Results suggest that the low elevation areas with calm winds and minimum temperatures higher than the normal, rapid increase in unplanned urbanization, low flow accumulation, and higher drainage density areas favor the dengue transmission.

  17. Predictors of delayed culture conversion in patients treated for multidrug-resistant tuberculosis in Pakistan.

    PubMed

    Qazi, F; Khan, U; Khowaja, S; Javaid, M; Ahmed, A; Salahuddin, N; Hussain, H; Becerra, M C; Golub, J E; Khan, A J

    2011-11-01

    Culture conversion is an interim monitoring tool for treatment of multidrug-resistant tuberculosis (MDR-TB). We evaluated the time to and predictors of culture conversion in pulmonary MDR-TB patients enrolled in the community-based MDR-TB management program at the Indus Hospital in Karachi, Pakistan. Despite strict daily directly observed therapy, monthly food incentives and patient counseling, the median time to culture conversion was 196 days (range 32-471). The cumulative probabilities of culture conversion by 2, 4, 6 and 12 months were respectively 6%, 33%, 47%, and 73%. Smoking, high smear grade at baseline and previous use of second-line drugs delayed culture conversion. PMID:22008773

  18. A Review of the Status of the Indian Ocean Humpback Dolphin (Sousa plumbea) in Pakistan.

    PubMed

    Kiani, Muhammad Shoaib; Van Waerebeek, Koen

    2015-01-01

    Limited historical and new information on Indian Ocean humpback dolphins, Sousa plumbea, in Pakistan are reviewed. Although present along most of the coast, S. plumbea concentrates in the mangrove-lined creek system of the Indus Delta (Sindh), Miani Hor (Sonmiani Bay), Kalmat Lagoon, Gwadar and the Dasht River estuary (Gwater Bay, Jiwani). Other areas of distribution comprise the Karachi coast, Kund Malir, Ormara and Pasni. In the Indus Delta, 46 small-boat surveys conducted monthly (minus July and October) in 2005-2009, documented 112 sightings (439 individuals) in major creeks, smaller channels and nearshore waters. Group sizes ranged from 1-35 animals (mean=3.92±4.60). Groups of 1-10 animals composed 91% of total (27.9% single animals). An encounter rate of 0.07-0.17 dolphins km(-1) lacked a significant trend across survey years. A discovery curve remained steep after 87 dolphins were photo-identified, suggesting the population is vastly larger. In Sonmiani Bay, Balochistan, during 9 survey days in 2011-2012, group sizes ranged from 1-68 animals (mean=11.9±13.59; n=36), totalling 428 dolphins. Incidental entanglements, primarily in gillnets, pollution (especially around Karachi), overfishing and the ship breaking industry in Gaddani, pose major threats. Incidental catches occur along the entire Pakistani coast. Of 106 stranded cetaceans, 24.5% were S. plumbea. Directed takes in Balochistan, driven by demand for bait in shark fisheries, have reportedly declined following dwindling shark stocks. Habitat degradation threats include depletion of prey and increased maritime traffic. Domestic sewage and solid waste pollution are predominant on the Balochistan coast, especially at Miani Hor, Kund Malir, Ormara, Kalmat Lagoon, Pasni, Gwadar and Jiwani. An exhaustive habitat assessment combined with appropriate fishery management is the only way to safeguard the future of S. plumbea in Pakistan. PMID:26555627

  19. Intimate partner violence in urban Pakistan: prevalence, frequency, and risk factors

    PubMed Central

    Ali, Tazeen S; Asad, Nargis; Mogren, Ingrid; Krantz, Gunilla

    2011-01-01

    Background: Intimate partner violence (IPV) is an important public health issue with severe adverse consequences. Population-based data on IPV from Muslim societies are scarce, and Pakistan is no exception. This study was conducted among women residing in urban Karachi, to estimate the prevalence and frequency of different forms of IPV and their associations with sociodemographic factors. Methods: This cross-sectional community-based study was conducted using a structured questionnaire developed by the World Health Organisation for research on violence. Community midwives conducted face-to-face interviews with 759 married women aged 25–60 years. Results: Self-reported past-year and lifetime prevalence of physical violence was 56.3 and 57.6%, respectively; the corresponding figures for sexual violence were 53.4% and 54.5%, and for psychological abuse were 81.8% and 83.6%. Violent incidents were mostly reported to have occurred on more than three occasions during the lifetime. Risk factors for physical violence related mainly to the husband, his low educational attainment, unskilled worker status, and five or more family members living in one household. For sexual violence, the risk factors were the respondent’s low educational attainment, low socioeconomic status of the family, and five or more family members in one household. For psychological violence, the risk factors were the husband being an unskilled worker and low socioeconomic status of the family. Conclusion: Repeated violence perpetrated by a husband towards his wife is an extremely common phenomenon in Karachi, Pakistan. Indifference to this type of violence against women stems from the attitude that IPV is a private matter, usually considered a justifiable response to misbehavior on the part of the wife. These findings point to serious violations of women’s rights and require the immediate attention of health professionals and policymakers. PMID:21573146

  20. Selected organochlorine pesticides and polychlorinated biphenyls in urban atmosphere of Pakistan: concentration, spatial variation and sources.

    PubMed

    Nasir, Jawad; Wang, Xiaoping; Xu, Baiqing; Wang, Chuanfei; Joswiak, Daniel R; Rehman, Said; Lodhi, Arifa; Shafiq, Shoaib; Jilani, Rehmatullah

    2014-01-01

    Robust knowledge on the occurrence and distribution of persistent organic pollutants (POPs) in the atmosphere of low-latitude regions is inevitable to forecast their transportation to pristine ecosystem and assess toxicological impacts upon local biota. Despite the earlier revelation of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) in soils/sediments and water bodies in Pakistan, knowledge about atmospheric levels and sources of these POPs remains limited. For the first time, a network of XAD resin-based passive air samplers (PAS) was established across megacities of Pakistan, i.e., Karachi, the coastal city, and Lahore, lying in an agricultural region. Typical geographical locations of the two cities allowed assessing the influence of source regions on the occurrence and distribution patterns of selected POPs. Average concentrations (ng/PAS) in both cities ranged as endosulfan 39-101, DDTs 63-92, HCHs 33-65, heptachlor 10-26, and PCBs 48-61. High concentrations of endosulfan and lindane as observed throughout Lahore were certainly due to their ongoing applications in surrounding agricultural fields. Lower proportions of parental DDTs as compared to their metabolites were observed in both cities, suggesting inputs of DDTs from older or secondary sources. Owing to ultimate discharge of country's agricultural/industrial waste through river streams in to Arabian Sea, the coastal region of Karachi was found potential source of weathered POPs that could be dissipated at regional/global scales by maritime advections. The study contributes to the pool of information on fate and geographical distribution of POPs in subtropical developing countries. PMID:24467173

  1. Atmospheric variability of methane over Pakistan, Afghanistan and adjoining areas using retrievals from SCIAMACHY/ENVISAT

    NASA Astrophysics Data System (ADS)

    ul-Haq, Zia; Tariq, Salman; Ali, Muhammad

    2015-12-01

    In the present work we have studied spatial and temporal variability of methane total column (MTC) over Pakistan and neighboring regions of Afghanistan, India and Iran by using observations of SCanning Imaging Absorption SpectroMeter for Atmospheric CHartographY (SCIAMACHY) aboard EOS ENVISAT. Satellite measurements show large spatio-temporal variations in MTC over the study domain at different time scales. We find an average MTC of 1787±22 ppb (annual average±standard deviation) with 3.7% (slope 7.14±1.28, y-intercept 1751±7.19, r=0.91) increase during the period of January 2003 to April 2012. An enhanced MTC is observed mostly over the Indo-Gangetic Plain and areas with high anthropogenic activities. MTC exhibits a seasonal peak of 1804±28 ppb in summer followed by autumn (1800±25 ppb) and winter (1777±24 ppb). We have also discussed anthropogenic emission estimates in the study area obtained from EDGAR database. Substantial increments of 77% and 61% are observed in anthropogenic CH4 emissions for Pakistan and Afghanistan, respectively, during 1990-2008. Anthropogenic CH4 emissions from enteric fermentation and livestock sectors are found to be the highest. EDGAR data have also identified megacity Lahore, Sukkur, megacity Karachi, Dera Ghazi Khan, megacity Delhi and Ahmedabad as large point sources of CH4 emissions in the region. The emissions from Karachi show the highest increase of 107%, while Lahore is found with the highest annual average emissions of 8.8×10-10 kg m-2 s-1.

  2. Mobilizing male opinion leaders’ support for family planning to improve maternal health: a theory-based qualitative study from Pakistan

    PubMed Central

    Azmat, Syed Khurram

    2011-01-01

    Purpose Pakistan is a patriarchal society in which male opinion leaders play an important role in determining health-seeking behaviors pertaining to family planning (FP) among their respective communities. This research focuses on cataloguing the perceptions of opinion leaders (clergymen, health professionals, and social workers) about the barriers for using services and practical solutions for promoting FP in the slums of Karachi, Pakistan. Materials and methods A qualitative study using an open-ended, semistructured interview schedule with hypothetical scenarios and in-depth interviews with a purposive sample of 45 opinion leaders (25 mosque imams/clergymen, 12 nonallopathic health professionals, and eight social workers/activists) was conducted in 2006–2007 in Karachi, Pakistan. Transcripts were coded thematically utilizing NVivo by using an adapted constant comparison analysis process as described by Strauss and Corbin. Results Seven key themes were derived from the in-depth interviews. Five themes provide insight into the opinion leaders’ perceptions of barriers to FP and modern contraception methods. Among the barriers religious taboos and cultural pressures were particularly note-worthy. Two themes offered opportunities for more effective development and implementation of FP programs. Conclusion It is evident from the study that opinion leaders in the community and the clergy lack the understanding of the importance of birth spacing. However, because they have a great deal of influence on the community at large, it is imperative to interact with them to build their capacity in order to propagate the messages of FP and improve maternal health and reproductive health in general. PMID:22247617

  3. Aerosol optical and radiative properties during summer and winter seasons over Lahore and Karachi

    NASA Astrophysics Data System (ADS)

    Alam, Khan; Trautmann, Thomas; Blaschke, Thomas; Majid, Hussain

    2012-04-01

    The study of aerosol optical and radiative properties presented here focuses on a geographic region in which there exist significant gaps in our knowledge. These properties have been analyzed through the ground-based Aerosol Robotic Network (AERONET) over the two megacities of Lahore and Karachi for summer (April-June) and winter (December-February) of 2010-11. During the study period the monthly mean aerosol optical depth (AOD) at 500 nm over Lahore ranged from 0.57 ± 0.18 to 0.76 ± 0.38, and the monthly mean Ångström exponent () ranged from 0.39 ± 0.17 to 1.22 ± 0.13. Likewise, over Karachi the monthly mean AOD ranged from 0.33 ± 0.11 to 0.63 ± 0.28 and the values varied between 0.29 ± 0.08 to 0.95 ± 0.22. The average AOD values in summer and winter are 0.66 ± 0.30, 0.50 ± 0.18 and 0.67 ± 0.40, 0.34 ± 0.12 in Lahore and Karachi respectively. The relationship between the Absorption Ångström Exponent (AAE) and the Extinction Ångström Exponent (EAE) provided an indication of the relative proportions of urban-industrial and mineral dust aerosols over the two sites. The volume size distributions were higher over Lahore than over Karachi during both seasons. The single scattering albedo (SSA) ranged from 0.83 ± 0.02 (440 nm) to 0.91 ± 0.05 (1020 nm) over Lahore and from 0.88 ± 0.02 (440 nm) to 0.97 ± 0.01 (1020 nm) over Karachi. The lower SSA values over Lahore suggest that absorbing aerosols are more dominant over Lahore than over Karachi. The average aerosol radiative forcing (ARF) values in summer at the surface and the top of atmosphere (TOA) are -101.6 ± 8.2, -63.3 ± 9.5 and -19 ± 4.35, -20 ± 3.1 over Lahore and Karachi respectively. Likewise, the average ARF values in winter at the surface and TOA are -90.3 ± 21.03, -57 ± 6.35 and -26 ± 7, -16 ± 2.3 over Lahore and Karachi respectively. The averaged aerosol ARF values over Lahore and Karachi for the entire period covered by the observations were -22.5 ± 5.9 W m-2 and

  4. Nuclear nonproliferation strategies for South Asia

    SciTech Connect

    Davis, Z.S.

    1994-05-03

    Continued expansion of the nuclear weapons capabilities of India and Pakistan, coupled with ongoing conflict between them, raises the probability of nuclear war in South Asia. A nuclear arms race between India and Pakistan could also harm efforts to discourage other nations from acquiring nuclear weapons. United States policy opposes the spread of nuclear weapons because proliferation increases threats to U.S. national security and to world peace and stability. However, there is debate on the dangers of an escalating arms race in South Asia. Steps taken by the United States and other countries to persuade India and Pakistan to end their nuclear weapons programs have had limited success, at most slowing down their pace. A complicating factor is that India maintains a nuclear capability in part to deter China, whereas Pakistan`s nuclear weapons capability is aimed at deterring India`s superior conventional and nuclear capabilities. Analysts and policy officials are divided on how to avoid an arms race in South Asia. The Clinton Administration has renewed efforts to break the deadlock over nonproliferation, but longstanding obstacles have blocked progress. Pakistan favors a regional approach to nonproliferation, while India insists on a global approach that treats the nuclear powers on an equal basis with non nuclear weapon countries. This report analyzes the nuclear capabilities of India and Pakistan and reviews several options for U.S. nonproliferation policy in South Asia.

  5. Duality of female employment in Pakistan.

    PubMed

    Kazi, S; Raza, B

    1991-01-01

    The trends in the level and pattern of women's employment in Pakistan in terms of supply and demand factors which influence women's participation in the labor market are discussed. Women's labor participation is underestimated in official sources such as the Labor Force Survey (LFS) and the Population Census. Figures which were obtained from micro level surveys and the Agricultural Census, show the duality of employment at the top and bottom socioeconomically. LFS data show the female share of the professional work force to have risen from 15.5% to 18.3% between 1984-95 and 1987-88, which translates to 33% of teachers and 25% of physicians being women. Urban female participation rates have increased only slightly from 3 to 5% between 1971 and 72 and 1987-88, based on LFS data, while informal sector surveys have shown an increase of workers who are women who have never worked before in the formal sector. In manufacturing, the female work force remains low at 5% in factories in the Punjab and Sindh, but only 20% were in regular employment compared with 50% of men. Agricultural work on the family farm has increased from 35% in 1972 and 42% in 1980. Increases are also shown in more recent LF surveys. Constraints on both male and female employment are the recent (1978-79 and 1986-87) shift to capital investment in agriculture with tubewells and tractors and in manufacturing. Women's movement into agriculture may be precipitated by men's out migration to urban areas or the Gulf region into other nonfarm occupations. In manufacturing there is exploitation of workers through low overhead costs of temporary or part time help. Supply constraints for women involve cultural restrictions, household responsibilities, and low levels of education and skills. Women enter the work force out of financial need. Data on female-headed households are scarce, but a Karachi survey finds that most female-headed households belong to the poorest strata and women work when family size

  6. Experiences of Adopting Blended Pedagogies in Health Assessment Course in Post RN Baccalaureate Program of Nursing in Karachi, Pakistan

    ERIC Educational Resources Information Center

    Cassum, Shanaz Hussein; Allana, Saleema; Dias, Jacqueline

    2016-01-01

    Purpose: There is little known about whether faculty and students in a resource constricted context experience a change in learning due to the adoption of blended learning (BL) pedagogies in a lab based course. The study aimed to understand the experiences of faculty and students' related to the adoption of BL pedagogies in health assessment…

  7. Anaphylaxis: incidence, presentation, causes and outcome in patients in a tertiary-care hospital in Karachi, Pakistan

    PubMed Central

    Shakeel, N.; Makda, A.; Mallick, A.S.; Ali Memon, M.; Hashmi, S.H.; Khan, U.R.; Razzak, J.A.

    2013-01-01

    Background: Anaphylaxis is a potentially fatal condition requiring immediate resuscitation. Data regarding the epidemiology of anaphylaxis are limited and inconsistent. A reason for the variability was unavailability of a universally acceptable case definition till 2005. We reviewed cases using this new definition Aim: To review the incidence, clinical presentation, cause and outcome of anaphylaxis at a tertiary-care centre in a low-income country. Design: Retrospective, case series Methods: Chart review of all patients discharged from Aga Khan University Hospital between January 1988 and December 2012 (24 years) with anaphylaxis definition as per second National Institute of Allergy and Infection disease/Food Allergy and Anaphylaxis Network Symposium Results: Total of 129 cases were found with mean age of 41.6 years (SD 18.8). Majority of patients had cutaneous features (76.7%), followed by respiratory (68.9%), cardiac (64.3%) and gastrointestinal (20.9%) symptoms, respectively. About 22.4% of patients had positive history for allergens out of which 31% (n = 9) were exposed to the same allergens. The common causes identified for anaphylaxis were drugs (60.5%), food (16.3%) and intravenous contrast (10.9%), respectively. Only 22.5% of cases received epinephrine as a part of their initial management. In four patients (3.1%) the cause of death was attributed to anaphylaxis. Conclusion: Anaphylaxis is a rare but life-threatening condition. Though cutaneous features are most common, their absence does not exclude the diagnosis. Drugs were the most common cause and epinephrine was not commonly used as first-line agent for its management. PMID:24082151

  8. Moving Toward a Regional Safeguards System in South Asia

    SciTech Connect

    Killinger, Mark H.; Griggs, James R.

    2001-07-28

    In addressing the nuclear nonproliferation challenges of South Asia, it is useful to examine the similar past nonproliferation problems in South America. The nuclear rapprochement between Argentina and Brazil involved several developments in progression. We conclude that two developments are particularly applicable to the India/Pakistan problem: technical cooperation and a regional safeguards system. This paper reviews the history of Argentina/Brazil rapprochement, discusses application to India/Pakistan, and proposes specific actions to move South Asia toward regional stability.

  9. Spatial distribution and accessibility to public sector tertiary care teaching hospitals in Karachi: A Geographic Information Systems application.

    PubMed

    Shaikh, Masood Ali; Ali, Mir Shabbar

    2016-07-01

    Optimal utilization of specialized curative healthcare services is contingent on spatial access to tertiary-care hospitals by the targeted population. The objectives of this study were to determine the spatial distribution of public sector tertiary-care teaching hospitals in Karachi, and to use GIS and network analysis for modeling the accessibility to these hospitals for Karachi residents. Maps of three, six, and nine kilometer buffers were created around the five selected hospitals to determine which towns of Karachi are either entirely or partially covered/accessible. Most of the towns in Karachi were covered either partially or completely by the three buffers and service areas of 3,6, and 9 kilometers around the five selected hospitals. This study highlights the limitations of using publicly available data for road network, and the need for creating and making available in public domain, comprehensive road network vector dataset in conjunction with population breakdowns by administrative subdivisions. PMID:27427142

  10. Effects of education on reproductive behavior: lessons from Pakistan.

    PubMed

    Greenspan, A

    1992-12-01

    Evidence from the Pakistan Demographic and Health Survey 1990/91 (PDHS) and a 1987 study by Zeba A. Sathar and Karen Oppenheim on women's fertility in Karachi and the impact of educational status, corroborates the correlation between improved education for women and fertility decline. PDHS revealed that current fertility is 5.4 children/ever married woman by the end of the reproductive period. 12% currently use a contraceptive method compared to 49% in India, 40% in Bangladesh, and 62% in Sri Lanka. The social environment of high illiteracy, low educational attainment, poverty, high infant and child and maternal mortality, son preference, and low status of women leads to high fertility. Fertility rates vary by educational status; i.e., women with no formal education have 2 more children than women with at least some secondary education. Education also affects infant and child mortality and morbidity. Literacy is 31% for women and 43% for men. 30% of all males and 20% of all females have attended primary school. Although most women know at least 1 contraceptive method, it is the urban educated woman who is twice as likely to know a source of supply and 5 times more likely to be a user. The Karachi study found that lower fertility among better educated urban women is an unintended consequence of women's schooling and deliberate effort to limit the number of children they have. Education-related fertility differentials could not be explained by the length of time women are at risk of becoming pregnant (late marriage age). Fertility limitation may be motivated by the predominant involvement in the formal work force and higher income. The policy implications are the increasing female schooling is a good investment in lowering fertility; broader improvements also need to be made in economic opportunities for women, particularly in the formal sector. Other needs are for increasing availability and accessibility of contraceptive and family planning services and increasing

  11. Unsafe injections and the transmission of hepatitis B and C in a periurban community in Pakistan.

    PubMed Central

    Khan, A. J.; Luby, S. P.; Fikree, F.; Karim, A.; Obaid, S.; Dellawala, S.; Mirza, S.; Malik, T.; Fisher-Hoch, S.; McCormick, J. B.

    2000-01-01

    Following reports of frequent deaths associated with jaundice and chronic liver disease among adults in a periurban community of Karachi, Pakistan, an investigation was conducted to evaluate the relationship between injections and viral hepatitis infections, to identify the reasons why patients received frequent injections, and to observe the injection practices employed in clinics. Two hundred and three adult patients were interviewed as they left each of the 18 area clinics. Practitioners were interviewed and three consecutive injections were observed at each clinic. Eighty-one per cent of patients received an injection on the day of the interview. Of the 135 patients who provided a serum sample, 59 (44%) had antibodies against hepatitis C virus and 26 (19%) had antibodies against hepatitis B virus. Patients who received more injections were more likely to be infected with hepatitis C. If oral and injected medications were equally effective, 44% of patients preferred injected medication. None of the practitioners knew that hepatitis C could be transmitted by injections. Non-sterile syringes and needles that had been used earlier in the day on other patients were used for 94% of the observed injections. Interventions to limit injections to those which are safe and clinically indicated are needed to prevent injection-associated infections in Pakistan and other low-income countries. PMID:10994278

  12. Suicidal ideation among medical students of Pakistan: a cross-sectional study.

    PubMed

    Osama, Muhammad; Islam, Mohammad Yousuful; Hussain, Syed Ather; Masroor, Syed Muhammad Zia; Burney, Muhammad Usman; Masood, Muhammad Atif; Menezes, Ritesh G; Rehman, Razaur

    2014-10-01

    Few studies have investigated suicidal ideation among medical students in the developing world. We found only one report on suicidal ideation among medical students in Pakistan published in the year 2005. The present cross-sectional survey on suicidal ideation conducted in July 2013 involved 331 medical students of Dow University of Health Sciences, Karachi, Pakistan. In the past one year, suicidal ideation was found in 118 (35.6%) students. Forty-six (13.9%) of all the students had made a plan in their life time to commit suicide while 16 (4.8%) of the 331 students tried to commit suicide at some point of time in their life. More females than males pondered suicide while first year medical students formed the majority of those with suicidal ideation. The single greatest risk factor predisposing to suicidal ideation was substance abuse. This was followed jointly by parental neglect and previous psychiatric disorder. Campaigns against substance abuse and counseling of vulnerable students will help in eradicating suicidal intent. PMID:25287803

  13. Establishment of a Comprehensive Epilepsy Center in Pakistan: Initial Experiences, Results, and Reflections

    PubMed Central

    Tahir, M. Zubair; Sobani, Zain A.; Quadri, S. A.; Ahmed, S. Nizam; Sheerani, Mughis; Siddiqui, Fowzia; Boling, Warren W.; Enam, Syed Ather

    2012-01-01

    Background. Developing countries, home to 80% of epilepsy patients, do not have comprehensive epilepsy surgery programs. Considering these needs we set up first epilepsy surgery center in Pakistan. Methods. Seventeen teleconferences focused on setting up an epilepsy center at the Aga Khan University (AKU), Karachi, Pakistan were arranged with experts from the University of Alberta Hospital, Alberta, Canada and the University of West Virginia, USA over a two-year period. Subsequently, the experts visited the proposed center to provide hands on training. During this period several interactive teaching sessions, a nationwide workshop, and various public awareness events were organized. Results. Sixteen patients underwent surgery, functional hemispherectomy (HS) was done in six, anterior temporal lobectomy (ATL) in six, and neuronavigation-guided selective amygdalohippocampectomy (SAH) using keyhole technique in four patients. Minimal morbidity was observed in ATL and, SAH groups. All patients in SAH group (100%) had Grade 1 control, while only 5 patients (83%) in ATL group, and 4 patients (66%) in HS group had Grade 1 control according to Engel's classification, in average followups of 12 months, 24 months and 48 months for SAH, ATL, and HS, respectively. Conclusion. As we share our experience we hope to set a practical example for economically constrained countries that successful epilepsy surgery centers can be managed with limited resources. PMID:22957232

  14. Sexually transmitted infections treatment and care available to high risk populations in Pakistan.

    PubMed

    Rahimtoola, Minal; Hussain, Hamidah; Khowaja, Saira N; Khan, Aamir J

    2008-01-01

    Limited literature exists on the quality and availability of treatment and care of sexually transmitted infections (STIs) in Pakistan. This article aims to document existing services for the care and treatment of STIs available in Pakistan's public and private sectors to high risk groups (HRG), particularly the transgendered population. We conducted a cross-sectional survey to document STI services in Lahore, Karachi, Rawalpindi, Peshawar, and Quetta. Seventy-three interviews were administered with health service providers at the 3 largest public sector hospitals in each city, as well as with general physicians and traditional healers in the private sector. Twenty-five nongovernmental organizations (NGO) providing STI services were also interviewed. Fewer than 45% of private and public sector general practitioners had been trained in STI treatment after the completion of their medical curriculum, and none of the traditional healers had received any formal training or information on STIs. The World Health Organization (WHO) syndromic management guidelines were followed for STI management by 29% of public and private sector doctors and 5% of traditional healers. STI drugs were available at no cost at 44% of NGOs and at some public sector hospitals. Our findings show that although providers do treat HRGs for STIs, there are significant limitations in their ability to provide these services. These deterrents include, but are not limited to, a lack of STI training of service providers, privacy and adherence to recommended WHO syndromic management guidelines, and costly diagnostic and consultation fees. PMID:19856743

  15. Knowledge, Attitudes and Practices of Contraception among Afghan Refugee Women in Pakistan: A Cross-Sectional Study

    PubMed Central

    Raheel, Hina; Karim, Mehtab S.; Saleem, Sarah; Bharwani, Sulaiman

    2012-01-01

    Background During the 1980s, approximately three million people migrated from Afghanistan to Pakistan and sought refuge in several cities including the city of Karachi. After the initial settlement of the refugees, the international organizations transitioned the health care of these refugees to the two local non-profit service agencies in Karachi. One of these agencies subsidized health care to the refugees under their care and the other agency encouraged the refugees under their care to utilize governmental and non-governmental private health resources at the disposal of general public. Our objective was to measure the effect of health subsidy on the uptake of contraception among Afghan refugee women and compare them to the group of Afghan women without such a subsidy. Methodology/Principal Findings A randomly selected group of 650 married Afghan women-325 women in each group-participated in a detailed survey regarding the knowledge, attitude and practices of family planning and contraceptive use. 90 percent of the women in the health subsidy group had had heard of family planning, compared to the 45 percent in the non-subsidized group. The use of contraceptives was greater than two-fold in the former versus the latter. Results of logistic regression analysis revealed that the refugee women who had had access to subsidized healthcare were significantly more likely to use the contraceptive methods with advancing age as compared to the women in the non-health subsidy group. The difference remained significant after adjusting for other variables. Conclusions/Significance Refugee women who are provided subsidized healthcare are more inclined to use contraceptives. It is therefore important that Afghan refugee women living elsewhere in Pakistan be provided healthcare subsidy, whereby their reproductive health indicators could improve with reduced fertility. We strongly encourage facilities introducing such subsidies to refugees in resource poor settings to assess the

  16. Sentinel Hospital-Based Surveillance for Assessment of Burden of Rotavirus Gastroenteritis in Children in Pakistan

    PubMed Central

    Kazi, Abdul Momin; Warraich, Gohar Javed; Qureshi, Shahida; Qureshi, Huma; Khan, Muhammad Mubashir Ahmad; Zaidi, Anita Kaniz Mehdi

    2014-01-01

    Objectives To determine the burden and molecular epidemiology of rotavirus gastroenteritis in children hospitalized with severe acute watery diarrhea in Pakistan prior to introduction of rotavirus vaccine. Methods A cross-sectional study was carried out over a period of two years from 2006 – 2008 at five sentinel hospitals in the cities of Karachi, Lahore, Rawalpindi, and Peshawar. Stool samples collected from children under five years of age hospitalized with severe acute watery diarrhea were tested for rotavirus antigen via enzyme immunoassay (EIA) (IDEA REF K6020 Oxoid Ltd (Ely), Cambridge, United Kingdom). A subset of EIA positive stool samples were further processed for genotyping. Results 6679 children were enrolled and stool specimens of 2039 (30.5%) were positive for rotavirus. Rotavirus positivity ranged from 16.3% to 39.4% in the 5 hospitals with highest positivity in Lahore. 1241 (61%) of all rotavirus cases were in infants under one year of age. Among the strains examined for G-serotypes, the occurrence of G1, G2, G9 and G4 strains was found to be 28%, 24%, 14% and 13%, respectively. Among P-types, the most commonly occurring strains were P6 (31.5%) followed by P8 (20%) and P4 (12%). Prevalent rotavirus genotype in hospitalized children of severe diarrhea were G1P[8] 11.6% (69/593), followed by G2P[4] 10.4% (62/593), and G4P[6] 10.1% (60/593). Conclusions Approximately one third of children hospitalized with severe gastroenteritis in urban centers in Pakistan have rotavirus. Introduction of rotavirus vaccine in Pakistan's national immunization program could prevent many severe episodes and diarrheal deaths. PMID:25295613

  17. Prevalence of drug resistance associated mutations in Plasmodium vivax against sulphadoxine-pyrimethamine in southern Pakistan

    PubMed Central

    2013-01-01

    Background In Pakistan, Plasmodium vivax and Plasmodium falciparum co-exist and usage of sulphadoxine-pyrimethamine (SP) against P. falciparum exposes P. vivax to the drug leading to generation of resistant alleles. The main aim of this study was to investigate frequency distribution of drug resistance associated mutations in pvdhfr, pvdhps genes and provide baseline molecular epidemiological data on SP-associated resistance in P. vivax from southern Pakistan. Methods From January 2008 to May 2009, a total of 150 samples were collected from patients tested slide-positive for P. vivax, at the Aga Khan University Hospital, Karachi, or its collection units located in Baluchistan and Sindh Province. Nested PCR using pvdhfr and pvdhps specific primers was performed for all samples.91.3% (137/150) of the samples were tested PCR positive of which 87.3% (131/137) were successfully sequenced. Sample sequencing data was analysed and compared against wild type reference sequences. Results In dhfr, mutations were observed at codons F57L, S58R and S117N/T. Novel non-synonymous mutations were observed at codon positions N50I, G114R and E119K while a synonymous mutation was observed at codon position 69Y. In dhps, mutations were observed at codon position A383G and A553G while novel non-synonymous mutations were observed at codon positions S373T, E380K, P384L, N389T, V392D, T393P, D459A, M601I, A651D and A661V. Conclusion This is the first report from southern Pakistan on SP resistance in clinical isolates of P. vivax. Results from this study confirm that diverse drug resistant alleles are circulating within this region. PMID:23890361

  18. Prevalence and Susceptibility Pattern of Multi Drug Resistant Clinical Isolates of Pseudomonas aeruginosa in Karachi

    PubMed Central

    Khan, Fouzia; Khan, Adnan; Kazmi, Shahana Urooj

    2014-01-01

    Objective: To determine the frequency and susceptibility pattern of multi-drug resistant (MDR) Pseudomonas aeruginosa isolated from clinical specimens in Karachi. Methods: This cross sectional study was conducted in Microbiology Department, University of Karachi, from January 2012 to January 2013. Clinical specimens were collected from different hospitals of Karachi. Clinical isolates were identified by standard and specific microbiological methods. The antibiotic susceptibility pattern was determined by Kirby Bauer Disc diffusion method. Clinical and Laboratory Standards Institute (CLSI) guidelines were used to determine the results. Results: The frequency of MDR P. aeruginosa isolated from different clinical specimens was found to be 30%. Amikacin was found to be the most effective antibiotic, followed by Co-trimaxazole and Quinolones. Conclusion: Antibiotic resistant P. aeruginosa are emerging as a critical human health issue. There is an urgent need to resolve the issue by taking some preventive measures. Combined efforts of health care professionals and researchers are required to educate people about the proper use of antibiotics and other infection control measures. PMID:25225505

  19. National Level Assessment of Mangrove Forest Cover in Pakistan

    NASA Astrophysics Data System (ADS)

    Abbas, S.; Qamer, F. M.; Hussain, N.; Saleem, R.; Nitin, K. T.

    2011-09-01

    Mangroves ecosystems consist of inter tidal flora and fauna found in the tropical and subtropical regions of the world. Mangroves forest is a collection of halophytic trees, shrubs, and other plants receiving inputs from regular tidal flushing and from freshwater streams and rivers. A global reduction of 25 % mangroves' area has been observed since 1980 and it is categorized as one of to the most threatened and vulnerable ecosystems of the world. Forest resources in Pakistan are being deteriorating both quantitatively and qualitatively due to anthropogenic activities, climatic v and loose institutional management. According to the FAO (2007), extent of forest cover of Pakistan in 2005 is 1,902,000 ha, which is 2.5% of its total land area. Annual change rate during 2000-2005 was -2.1% which is highest among all the countries in Asia. The Indus delta region contains the world's fifth-largest mangrove forest which provides a range of important ecosystem services, including coastal stabilisation, primary production and provision of nursery habitat for marine fish. Given their ecological importance in coastal settings, mangroves receive special attention in the assessment of conservation efforts and sustainable coastal developments. Coastline of Pakistan is 1050km long shared by the provinces, Sind (350km) and Baluchistan (700 km). The coastline, with typical arid subtropical climate, possesses five significant sites that are blessed with mangroves. In the Sindh province, mangroves are found in the Indus Delta and Sandspit. The Indus Delta is host to the most extensive mangroves areas and extends from Korangi Creek in the West to Sir Creek in the East, whereas Sandspit is a small locality in the West of Karachi city. In the Balochistan province, mangroves are located at three sites, Miani Hor, Kalmat Khor and Jiwani. Contemporary methods of Earth observation sciences are being incorporated as an integral part of environmental assessment related studies in coastal areas

  20. Interpretive Analysis of New Teacher Education Curriculum Reform Introduced in Pakistan

    ERIC Educational Resources Information Center

    Huma, Afshan

    2013-01-01

    Pakistan is among those South Asian countries that are still striving for a successful education policy to be in place for achieving the goals of quantity and quality. For more than 66 years there have been many interventions and initiatives to reform current practices in public educational institutions. In 2009 a similar initiative was taken by…

  1. Vulnerability of Internally Displaced Children in Disaster Relief Camps of Pakistan: Issues, Challenges, and Way Forward

    ERIC Educational Resources Information Center

    Hirani, Shela Akbar Ali

    2014-01-01

    Pakistan is a developing country with the second highest infant and child mortality rates in South Asia. During the past years this region has undergone several humanitarian emergencies that have negatively affected all the aspects of health and development of young children. During these emergencies relief camps are set up by governmental and…

  2. Cancer profile of Larkana, Pakistan (2000-2002).

    PubMed

    Bhurgri, Yasmin; Pervez, Shahid; Kayani, Naila; Bhurgri, Asif; Usman, Ahmed; Bashir, Imtiaz; Ahmed, Rashida; Hasan, Sheema H; Khurshid, Mohd H

    2006-01-01

    This present study was conducted with the objective of providing the cancer profile of Larkana, the fourth largest city of Sindh, Province. The study included two sets of patients. The first set included the incident cancer cases, residents of Larkana, who reached Karachi for diagnosis or treatment. The second set consisted of the incident cancer cases registered at the Aga Khan University (AKU) Pathology collection points at Larkana during 1st January 2000 to 31st December 2002. The age-standardized rates (ASR) for cancer (all sites) were 134.2/100,000 in males and 110.3/100,000 in females. The most common malignancies in males were lymphoma, oral cavity, prostate, liver, and urinary bladder. Cancers in females were breast, oral cavity, lymphoma, skin and thyroid. Tobacco-associated cancers accounted for approximately 35.0% of the tumors in males and 18.6% in females. The gender ratio was 1.5, the mean age of cancer all sites was 45.5 years (95% CI 34.6; 56.4) in males and 42.9 years (95% CI 33.6; 52.2) in females. This is the first attempt to determine the cancer incidence pattern of Larkana and should serve as a guideline for estimation of the cancer burden of Pakistan and the cancer control program of the country. The data must be interpreted with care, as they are largely pathology-based with approximately 15-30% population-wise under-registration. However, the chances of selective collection bias were minimized as the AKU pathology specimens were collected from 2 centers within the city, Each collection centre provided diagnostic service to several health centres giving wide population coverage, thus ensuring adequate sampling from the entire city. PMID:17250420

  3. Can Formal Disability-Related Services Be Developed with South Asian Historical and Conceptual Foundations? Constructions from Experience and Research.

    ERIC Educational Resources Information Center

    Miles, M.

    This paper uses experiences in Pakistan to address issues in the application of European-based principles of disability-related concepts and services to cultures in South Asia, especially Pakistan and India. Emphasis is on understanding the South Asian conceptual world of disability so that "development" rather than "transfer" of knowledge and…

  4. Pakistan: update on breastfeeding.

    PubMed

    Lambert, J

    1988-01-01

    Studies conducted in Pakistan have shown a decline in breastfeeding since 1966, especially in urban areas. Overall, the National Nutrition Surveys have found, the proportion of babies being breastfed for more than 2 years has declined from 59% in 1966 to 9% in 1985. 4 basic reasons have been found for this deterioration: 1) hospitals are separating newborns from their mothers, and not instructing mothers on how to establish and sustain breastfeeding; 2) health practicioners are not informed about the importance of breastfeeding; 3) many women give their babies formula out of fear that they will not produce sufficient milk for their babies; and 4) at hospitals and clinics some infant formula companies continue to give out free samples and to distribute posters and calendars promoting their formulas. These problems must be remedied. At a hospital in Indonesia, when infants began to be roomed in with their mothers, hospital staff to be encouraged to breastfeed their own babies, mothers to be counseled on breastfeeding, and when formula promotion was stopped, infant mortality dropped from 51.6/1000 to 33.4/1000. Cases of diarrhea dropped from 40.2/1000 to 5.5/1000. Breastmilk has unique properties that no infant formula can match. PMID:12342141

  5. Democracy and Education in Pakistan

    ERIC Educational Resources Information Center

    Nazir, Muhammad

    2010-01-01

    This paper explores the potential for democratic change in educational practice in Pakistan. Using focus group discussions in urban and rural areas of Sindh and Balochistan, it builds up a picture of educational practices from policy-making to implementation level and identifies the barriers to democratic approaches in education. It suggests that…

  6. Management of wastes from hospitals: A case study in Pakistan.

    PubMed

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz

    2016-01-01

    Proper management of hospital waste is a critical concern in many countries of the world. Pakistan is the sixth most populous country in the world, with one of the highest urbanisation and population growth rates in South Asia. Data and analyses regarding hospital waste management practices in Pakistan are scarce in scientific literature. This study was meant to determine waste management practices at selected hospitals in a major city in Pakistan, Gujranwala. A total of 12 different hospitals were selected for the survey, which involved quantification of waste generation rates and investigation of waste management practices. The results were analysed using linear regression. The weighted average total, general and infectious hospital waste generation rates were found to be 0.667, 0.497 and 0.17 kg bed-day(-1), respectively. Of the total, 73.85% consisted of general, 25.8% consisted of hazardous infectious and 0.87% consisted of sharps waste. The general waste consisted of 15.76% paper, 13.41% plastic, 21.77% textiles, 6.47% glass, 1.99% rubber, 0.44% metal and 40.17% others. Linear regression showed that waste generation increased with occupancy and decreased with number of beds. Small, private and specialised hospitals had relatively greater waste generation rates. Poor waste segregation, storage and transportation practices were observed at all surveyed hospitals. PMID:26628050

  7. Prevalence of arthritis in India and Pakistan: a review.

    PubMed

    Akhter, Ehtisham; Bilal, Saira; Kiani, Adnan; Haque, Uzma

    2011-07-01

    Recent studies of rheumatoid arthritis worldwide suggest that prevalence of arthritis is higher in Europe and North America than in developing countries. Prevalence data for major arthritis disorders have been compiled in West for several decades, but figures from the third world are just emerging. A coordinated effort by WHO and ILAR (International League Against Rheumatism) has resulted in collecting data for countries like Philippines, China, Malaysia, Indonesia, and rural South Africa but the information about prevalence of arthritis in India and Pakistan is scarce. Since both countries, i.e., India and Pakistan, share some ethnic identity, we reviewed published literature to examine the prevalence of arthritis in these countries. Medline and Pubmed were searched for suitable articles about arthritis from 1980 and onwards. Findings from these articles were reviewed and summarized. The prevalence, clinical features, and laboratory findings of rheumatoid arthritis are compiled for both India and Pakistan. Data collected from these two countries were compared with each other, and some of the characteristics of the disease were compared with Europe and North America. It is found to be quite similar to developed countries. Additionally, juvenile rheumatoid arthritis is of different variety than reported in West. It is more of polyarticular onset type while in West pauciarticular predominates. Additionally, in systemic onset, JRA uveitis and ANA are common finding in developed countries; on the other hand, they are hardly seen in this region. Although the prevalence of arthritis in Pakistan and India is similar to Western countries, there are inherent differences (clinical features, laboratory findings) in the presentation of disease. The major strength of the study is that it is the first to pool reports to provide an estimate of the disease in the Indian subcontinent. Scarcity of data is one of the major limitations. This study helps to understand the pattern of

  8. Prevalence of Depression among Households in Three Capital Cities of Pakistan: Need to Revise the Mental Health Policy

    PubMed Central

    Muhammad Gadit, Amin A.; Mugford, Gerry

    2007-01-01

    Background Pakistan, among the other developing countries, has a higher prevalence rate of depression because of the current social adversities. There is, thus, a great need for systematic studies on prevalence of depression. The current study aims at exploring the prevalence of depression among households in three capital cities of Pakistan. Methodology and Principal Findings A sample of N = 820 was randomly selected, and a cross sectional telephone-based study was conducted for a duration of six months. It was found that there was a regional variation in prevalence rates for depression among the three cities. Lahore had the highest number of depressives (53.4%), as compared to Quetta (43.9%) and Karachi (35.7%). Middle age, female gender and secondary school level of education were significantly associated with depression among the study group. Conclusions/Significance The different rates of prevalence among the three cities could be attributed to local cultural influence, geographical locations and social adversities. There is a need for revision of existing health policy by the government. PMID:17299589

  9. Predictable Equilibrium Multichannel Network Characteristizes The Indus River, Pakistan

    NASA Astrophysics Data System (ADS)

    Carling, Paul

    2015-04-01

    PREDICTABLE EQUILIBRIUM MULTICHANNEL NETWORK CHARACTERIZES THE INDUS RIVER, PAKISTAN Carling, P.A.1, Trieu, H.1, Hornby, D.2, Darby, S.E.1, Sear, D.A.1, Hutton, C.2, Ali, Z.3, Iqbal, I.3 1Geography & Environment, University of Southampton, Southampton, UK; 2GeoData, University of Southampton, Southampton, UK; 3SUPARCO, Karachi, Pakistan The Indus River in Pakistan between Chasma and Taunsa is a 304 river km reach characterised by islands dividing multiple channels. Previously, the behaviour of such channel networks has been considered unpredictable. Crosato & Mosselman (2009) argue that physics-based predictors of channel splitting developed for braided-river bars apply poorly to island-divided rivers and recommend the application of regime theory (Bettess & White, 1983) to predict the number (n) of channels in rivers such as the Indus. The Indus is characterized by two to 11 channels at each cross section with, on average, about four channels being active during the dry season and five during the monsoon. Thus the expansion of the network during the monsoon is slight and is due to reoccupation of channels that are dry during low flows. The network evolves on an annual basis primarily due to bendway progression, whilst avulsions to form major new channels are relatively rare (one or two in the reach per year) and are matched by a similar number of closures. Thus the network structure, if not its shape, is relatively stable year to year. The standard deviation of channel numbers comparing sections throughout the reach is practically identical at c. two channels and there is no significant variation between years. Theory indicates that stable networks have three to four channels, thus the stability in the number of active channels through the annual monsoon and between years accords with the presence of a near-equilibrium reach-scale channel network that demonstrates local disequilibrium when 3 > n > 4, being perturbed by the annual monsoon. Application of the

  10. Land contestation in Karachi and the impact on housing and urban development

    PubMed Central

    Hasan, Arif

    2015-01-01

    Karachi is one of the world’s fastest growing large cities. This paper describes the complex processes by which land is (formally and informally) made available for housing (and for commercial development), as well as who benefits – and how the low-income majority of Karachi citizens lose out. It also describes what underpins this – especially the political complications in a city that has grown so rapidly, has had fundamental changes in its ethnic composition (and thus also in its politics) and has attracted so many illegal immigrants. The paper describes the changes in formal and informal land markets over the last 50 years and the changing responses by government agencies to housing (and land for housing) issues. Also explored are the connections among land, housing and transport (which include different processes of densification) and the complex politics involved. The paper ends with recommendations for land titling, for changes in transport policies, for better use of land already owned by government agencies, for cross-political party agreement on how to address serious security issues (that are leading to loss of investment) and for increased political effectiveness of Karachi’s active civil society organizations. PMID:26321797

  11. City tumour board Karachi: an innovative step in multidisciplinary consensus meeting and its two years audit.

    PubMed

    Asghar, Asghar Hussain; Abbasi, Ahmed Nadeem; Jamal, Abid; Haider, Ghulam; Rizvi, Sadia

    2013-12-01

    Management of cancer patients is a team work which usually comprises of surgeons, oncologists, radiologists, pathologists, psychiatrist, nutritionist and a nurse. Any patient who is suffering from any tumour needs a multimodality meeting as cancer treatment is not a single persons job. Most of the time, it is difficult to get the whole team together for a plan discussion due to their busy schedule. This problem was overcome by starting a tumour board meeting early morning of Sunday in Karachi which was named "City Tumour Board (CTB) Karachi". Its first meeting was held on Sunday March 28, 2010 and since then it takes place regularly fortnightly. Till March 2012, 44 sessions were conducted and total 264 cases were discussed. Here we present an audit of these two years. On average, in 60% of cases, tumour was up (36%) or down staged (12%) while in 52% of cases the stage remained unchanged. In 70% of cases (inclusive of above 60%), initial treatment plan was changed after discussion in the tumour board. This data signifies the importance of tumour board especially in a Pakistani setup where patient and even referring persons are not well aware of this disease and its outcome. It is advisable that every case should be discussed in tumour board before embarking on any treatment so that the best treatment plan can be given. It is also important that all relevant specialists should be present in the tumour board when planning for any treatment. PMID:24397101

  12. Current trends in treatment of obesity in Karachi and possibilities of cost minimization.

    PubMed

    Hussain, Mirza Izhar; Naqvi, Baqir Shyum

    2015-03-01

    Our study finds out drug usage trends in over weight and obese patients without any compelling indications in Karachi, looks for deviations of current practices from evidence based antihypertensive therapeutic guidelines and identifies not only cost minimization opportunities but also communication strategies to improve patients' awareness and compliance to achieve therapeutic goal. In present study two sets were used. Randomized stratified independent surveys were conducted in hospital doctors and family physicians (general practitioners), using pretested questionnaires. Sample size was 100. Statistical analysis was conducted on Statistical Package for Social Science (SPSS). Opportunities of cost minimization were also analyzed. One the basis of doctors' feedback, preference is given to non-pharmacologic management of obesity. Mass media campaign and media usage were recommended to increase patients awareness and patients' education along with strengthening family support systems was recommended for better compliance of the patients to doctor's advice. Local therapeutic guidelines for weight reduction were not found. Feedbacks showed that global therapeutic guidelines were followed by the doctors practicing in the community and hospitals in Karachi. However, high price branded drugs were used instead of low priced generic therapeutic equivalents. Patient's education is required for better awareness and improving patients' compliance. The doctors found preferring brand leaders instead of low cost options. This trend increases cost of therapy by 0.59 to 4.17 times. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines. PMID:25796152

  13. Current trends in treatment of hypertension in Karachi and cost minimization possibilities

    PubMed Central

    Hussain, Izhar M.; Naqvi, Baqir S.; Qasim, Rao M.; Ali, Nasir

    2015-01-01

    Objective: This study finds out drug usage trends in Stage I Hypertensive Patients without any compelling indications in Karachi, deviations of current practices from evidence based antihypertensive therapeutic guidelines and looks for cost minimization opportunities. Methods: In the present study conducted during June 2012 to August 2012, two sets were used. Randomized stratified independent surveys were conducted in doctors and general population - including patients, using pretested questionnaires. Sample sizes for doctors and general population were 100 and 400 respectively. Statistical analysis was conducted on Statistical Package for Social Science (SPSS). Financial impact was also analyzed. Results: On the basis of patients’ doctors’ feedback, Beta Blockers, and Angiotensin Converting Enzyme Inhibitors were used more frequently than other drugs. Thiazides and low-priced generics were hardly prescribed. Beta blockers were prescribed widely and considered cost effective. This trend increases cost by two to ten times. Conclusion: Feedbacks showed that therapeutic guidelines were not followed by the doctors practicing in the community and hospitals in Karachi. Thiazide diuretics were hardly used. Beta blockers were widely prescribed. High priced market leaders or expensive branded generics were commonly prescribed. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines. PMID:26648979

  14. Food irradiation development in Pakistan

    NASA Astrophysics Data System (ADS)

    Khan, I.

    The large scale trials were held to extend the storage life of potatoes, onions and dry fruits by gamma radiation. It was concluded that radiation preservation of potatoes and onions was much cheaper as compared to conventional methods. A dose of 1 kGy can control the insects in dry fruits and nuts. The consumers' acceptability and market testing performed during the last four years are also conducive to the commercialization of the technology in this country. The Government of Pakistan has accorded clearance for the irradiation of some food items like potatoes, onions, garlic and spices for human consumption. The Pakistan Radiation Services (PARAS), the commercial irradiator (200 Kci) at Lahore, has already started functioning in April, 1987. It is planned to start large scale sterilization of spices by gamma radiation in PARAS shortly.

  15. Carbon monoxide (CO) emissions and its tropospheric variability over Pakistan using satellite-sensed data

    NASA Astrophysics Data System (ADS)

    ul-Haq, Zia; Rana, Asim Daud; Ali, Muhammad; Mahmood, Khalid; Tariq, Salman; Qayyum, Zarmina

    2015-08-01

    This study presents major anthropogenic sources of carbon monoxide (CO) in Pakistan and discusses the spatio-temporal variability of tropospheric CO over Pakistan and neighboring regions of Afghanistan, India and Iran for a period from 2003 to 2012 using satellite-sensed (AIRS/AMSU) data. The results show a large spatio-temporal variability of CO over the study region mostly associated with anthropogenic activities such as crop residue burning, vehicular transport, and electricity and energy generation, and local meteorology. The annual mean value of tropospheric CO is observed to be 115 ± 2 ppbv that remains almost steady during the study period with decadal increase of only 2%. Due to more anthropogenic emissions of CO and its transport, the eastern zone shows a higher average value of 122 ± 2 ppbv with 2.7% decadal increase than the western zone (111 ± 3 ppbv with 1.4% decadal increase). Elevated concentrations of CO have been observed over the Indo-Gangetic Basin, Lahore, Karachi, and Delhi. During the study period large fluctuations in CO mean monthly values are found ranging from 99 ppbv to 131 ppbv. The fact that, in spite of a large increase in the CO emissions from 2003 to 2012, its average concentration remains almost stable indicates that a large scale regional transport contributes substantially to the tropospheric CO. Carbon monoxide concentrations exhibit a strong seasonal pattern with maximum amplitude in spring and minimum in autumn. July is found to have the highest decadal increasing trend of 13% followed by August at 8%, whereas May has the highest decreasing trend of -8% followed by November at -4.4%.

  16. Knowledge, attitudes and practices survey on organ donation among a selected adult population of Pakistan

    PubMed Central

    Saleem, Taimur; Ishaque, Sidra; Habib, Nida; Hussain, Syedda Saadia; Jawed, Areeba; Khan, Aamir Ali; Ahmad, Muhammad Imran; Iftikhar, Mian Omer; Mughal, Hamza Pervez; Jehan, Imtiaz

    2009-01-01

    Background To determine the knowledge, attitudes and practices regarding organ donation in a selected adult population in Pakistan. Methods Convenience sampling was used to generate a sample of 440; 408 interviews were successfully completed and used for analysis. Data collection was carried out via a face to face interview based on a pre-tested questionnaire in selected public areas of Karachi, Pakistan. Data was analyzed using SPSS v.15 and associations were tested using the Pearson's Chi square test. Multiple logistic regression was used to find independent predictors of knowledge status and motivation of organ donation. Results Knowledge about organ donation was significantly associated with education (p = 0.000) and socioeconomic status (p = 0.038). 70/198 (35.3%) people expressed a high motivation to donate. Allowance of organ donation in religion was significantly associated with the motivation to donate (p = 0.000). Multiple logistic regression analysis revealed that higher level of education and higher socioeconomic status were significant (p < 0.05) independent predictors of knowledge status of organ donation. For motivation, multiple logistic regression revealed that higher socioeconomic status, adequate knowledge score and belief that organ donation is allowed in religion were significant (p < 0.05) independent predictors. Television emerged as the major source of information. Only 3.5% had themselves donated an organ; with only one person being an actual kidney donor. Conclusion Better knowledge may ultimately translate into the act of donation. Effective measures should be taken to educate people with relevant information with the involvement of media, doctors and religious scholars. PMID:19534793

  17. The Pakistan National Emergency Department Surveillance Study (Pak-NEDS): Introducing a pilot surveillance

    PubMed Central

    2015-01-01

    Background Evidence-based decision making is essential for appropriate prioritization and service provision by healthcare systems. Despite higher demands, data needs for this practice are not met in many cases in low- and middle-income countries because of underdeveloped sources, among other reasons. Emergency departments (EDs) provide an important channel for such information because of their strategic position within healthcare systems. This paper describes the design and pilot test of a national ED based surveillance system suitable for the Pakistani context. Methods The Pakistan National Emergency Department Surveillance Study (Pak-NEDS) was pilot tested in the emergency departments of seven major tertiary healthcare centres across the country. The Aga Khan University, Karachi, served as the coordinating centre. Key stakeholders and experts from all study institutes were involved in outlining data needs, development of the study questionnaire, and identification of appropriate surveillance mechanisms such as methods for data collection, monitoring, and quality assurance procedures. The surveillance system was operational between November 2010 and March 2011. Active surveillance was done 24 hours a day by data collectors hired and trained specifically for the study. All patients presenting to the study EDs were eligible participants. Over 270,000 cases were registered in the surveillance system over a period of four months. Coverage levels in the final month ranged from 91-100% and were highest in centres with the least volume of patients. Overall the coverage for the four months was 79% and crude operational costs were less than $0.20 per patient. Conclusions Pak-NEDS is the first multi-centre ED based surveillance system successfully piloted in a sample of major EDs having some of the highest patient volumes in Pakistan. Despite the challenges identified, our pilot shows that the system is flexible and scalable, and could potentially be adapted for many other

  18. Prevalence of Post-Traumatic Stress Disorder Due to Community Violence Among University Students in the World's Most Dangerous Megacity: A Cross-Sectional Study From Pakistan.

    PubMed

    Khan, Abdul Ahad; Haider, Ghani; Sheikh, Maryam Rahim; Ali, Ambreen Fatima; Khalid, Zain; Tahir, Muhammad Munaim; Malik, Tayyaba Maqbool; Salick, Muhammad Musa; Lakhani, Laila Saleem; Yousuf, Fatimah Sireen; Khan, Muhammad Babar; Saleem, Sarah

    2016-08-01

    Community violence among the youth can lead to a number of adverse psychiatric outcomes including post-traumatic stress disorder (PTSD). However, little research has been conducted in non-Western countries to assess this problem. This study aims to fill the void by assessing the lifetime exposure to traumatic events and burden of probable PTSD among university students in Karachi, Pakistan. A cross-sectional study was conducted at four private institutions in Karachi. Self-administered questionnaires were filled out by 320 students. Lifetime exposure and symptoms of PTSD were assessed using modified Composite International Diagnostic Interview (CIDI) and Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C) questionnaires, respectively. A PCL-C score of 44 or above was used as cutoff for probable PTSD. Pearson chi-square test was used to assess the association between PTSD and different variables at a level of significance of 5%. Ninety-three percent of the respondents reported having lifetime exposure to at least one traumatic event with sudden unexpected death of a loved one (n = 187) and assaultive violence (n = 169) being the commonest reported traumatic events. Positive association for PTSD was seen with enduring physical attacks and motor vehicle accidents. Over a quarter of the students screened positive for probable PTSD, among them almost one third were male and 17% were female. Our results indicate a high exposure to violent events and elevated rates of lifetime PTSD among urban youth. Reduction in violence and better access to mental health facilities is warranted to decrease the health burden of PTSD in Pakistan. PMID:25814507

  19. Protocol for a qualitative study on promoting dietary change and positive food choices for poor people with low income who experience cardiovascular disease in Pakistan

    PubMed Central

    Barolia, Rubina Iqbal; Clark, Alexander M; Higginbottom, Gina M A

    2013-01-01

    Introduction There is a misconception that cardiovascular disease (CVD) is the burden of wealthy nations, but, in fact, it is the leading cause of death and disability-adjusted life worldwide. Healthy diets are an essential factor in the prevention of CVD. However, promoting healthy diet is challenging, particularly for people with low-socioeconomic status (SES), because poverty is linked with many risk behaviours such as smoking, unhealthy eating and obesity. Multiple factors, cultural values and beliefs interact and make healthy eating very challenging. The effects of these factors in the context of low-SES populations with CVD are largely unknown. To address this gap, this study will examine the factors that affect decisions about consuming healthy diet in Pakistanis with low SES who suffer from CVD. Methods and analysis A qualitative method of interpretive description will be used. 25 participants will be selected from two cardiac rehabilitation (CR) centres in Karachi, Pakistan. Face-to-face interviews using a critical realist framework will be used to understand individual and contextual factors in the food choices of people with low SES and CVD. ATLAS.ti qualitative data analysis software will be used to identify themes and patterns in the interview data. Ethics and discussion Ethical approvals were received from the Ethics Review board of University of Alberta, Canada and Aga Khan University, Karachi Pakistan. The findings will generate new knowledge about which and how factors influence the food choices of Pakistanis with CVD and low SES to provide an insight into the development of an operational framework for designing interventions for prevention of CVD. For knowledge-translation purposes, we will publish the findings in highly accessed, peer-reviewed scientific and health policy journals at the national and international level. This research protocol received IRDC (International Development Research Centre) doctoral award from International Development

  20. Bomb blast injuries: an exploration of patient characteristics and outcome using Pakistan National Emergency Departments Surveillance (Pak-NEDS) data

    PubMed Central

    2015-01-01

    Background Bomb blast injuries result in premature deaths and burdening of healthcare systems. The objective of this study was to explore the characteristics and outcome of patients presenting to the emergency departments in Pakistan with bomb blast injuries. Methods Active surveillance was conducted in seven major emergency departments of Pakistan from November 2010-March 2011. All the sites are tertiary care urban centers. All the patients who presented to the hospital's emergency department (ED) following a bomb blast injury as per self-report or the ambulance personnel were included in the study. Frequency of demographics, injury pattern, and outcomes were calculated. Results A total of 103 patients with bomb blast injuries presented to the selected emergency departments. The median age of patients was 30 years. Around three-fourth of the patients were males (n = 74, 74.7%). Most of the bomb blast patients were seen in Peshawar (n = 41, 39.8%) and Karachi city (n = 31, 30.1%) and the most common mode of arrival was non-ambulance transport (n = 71, 76.3%). Upper limb injuries (n = 12, 40%) were common in the under 18 age group and lower limb injuries (n = 31, 39.2%) in the 18 years and above group. There were a total of 8 (7.7%) deaths reported out of these 103 patients. Conclusion Bomb blast injuries in Pakistan generally affect young males. Non-ambulance transport is the most common way to access emergency departments (ED). Overall ED mortality is high and capturing data during a disaster in an emergency department is challenging. PMID:26692453

  1. Multi-drug resistant Mycobacterium tuberculosis complex genetic diversity and clues on recent transmission in Punjab, Pakistan.

    PubMed

    Yasmin, Memona; Gomgnimbou, Michel K; Siddiqui, Rubina T; Refrégier, Guislaine; Sola, Christophe

    2014-10-01

    Multi-Drug Resistant Tuberculosis (MDR-TB), i.e. bacilli resistant to rifampicin (RIF) and isoniazid (INH), is a major Public Health concern in Pakistan according to WHO estimates (3.5% and 32% of new and retreated cases, respectively). Previous Pakistanis reports identified a correlation between being MDR and belonging to Beijing or EAI lineages in one study, and belonging to "H4"-Ural Euro-American sublineage in another study. In addition, MDR-TB transmission was suspected in Karachi. We tested MDR characteristics on a Punjab sample of 278 clinical isolates (without selection for Multi-Drug Resistance) including new and retreated cases collected from 2008 to 2012. All samples were characterized by a new, microbead-based method named "TB-SPRINT" (molecular diagnostic including spoligotype identification, and genetic resistance determinants to first-line anti-TB drugs RIF and INH). Isolates from 2011 to 2012 (n=100) were further analyzed using 24-loci MIRU-VNTR. We detected 8.7% MDR isolates (CI95%=[5.0; 12.5]), mainly among CAS lineage that predominates in this central-East region of Pakistan. Out of 20 MDR-TB cases, 12 different TB-SPRINT profiles were identified, limiting the suspicion of MDR-TB transmission. 24 MIRU-VNTR confirmed the unrelatedness of isolates with different TB-SPRINT profiles and discriminated 3 isolates with identical TB-SPRINT profiles. In conclusion, our study did not confirm any of the correlations between Multi-Drug Resistance and lineage or sublineage in Punjab, Pakistan. MDR-TB isolates were diverse indicating that transmission is not pervasive. TB-SPRINT proved useful as a first step for detecting MDR-TB likely transmission events, before more extensive genotyping such as 15 or 24 MIRU-VNTR and thorough epidemiological investigation. PMID:24981519

  2. A palaeomagnetic reconnaissance of northeastern Baluchistan, Pakistan

    NASA Astrophysics Data System (ADS)

    Klootwijk, Chris T.; Nazirullah, Russel; de Jong, Kees A.; Ahmed, Habib

    1981-01-01

    A total of 560 samples from three areas in northeastern Baluchistan (the southern Sulaiman Range, the central Loralai Range, and the northern Kirthar Range) were analyzed using thermal demagnetization techniques. Thirteen formations of late Palaeozoic to early Tertiary age were studied palaeomagnetically. Inclinations of the obtained results show a general affinity with the Indian apparent polar wander path. Deviating declinations from the Loralai Range indicate a clockwise rotation over 50° with respect to the Indian shield. Secondary magnetization components probably of late Palaeocene to early Eocene age were consistently present in the samples from the Kirthar Range and the Sulaiman Range but were not observed in samples from the Loralai Range. Acquisition of these components is attributed to crustal upwarping during the Palaeocene, which is tentatively related to initial collision of continental Indo-Pakistan with an island arc off south central Asia. The Baluchistan data support recent palaeomagnetic results from the Indus-Tsangpo suture zone in Ladakh (NW Himalaya), which indicate that such an initial collision took place at very low northern palaeolatitudes.

  3. Study of Nocturnal Stratification of the Ionospheric F-Layer Over Karachi during Solar CYCLE-22 (1986-96)

    NASA Astrophysics Data System (ADS)

    Kanwal, Ambreen; Shahrukh Zaidi, Syed; Ara Zafar, Husan

    This study has been carried out employing the ionospheric data of Karachi (24.950 N, 67.140 E) for a complete Solar Cycle (1986- 96), acquired by means of Digisonde DGS-256. The visual observations of data as shown that some times Nocturnal Ionospheric Stratification at Karachi do occur. However, Nocturnal Ionospheric Stratification is very rare in middle and lower latitudes (TAN and HUANG, 1985).Therefore, the present study is undertaken. Only the night-time F-layer Stratification cases have been included in this study. It is revealed that the Nocturnal Stratification in F-layer at Karachi is mainly a post-midnight phenomenon, under both magnetically quite and disturbed condition. Though it may occur on pre and post- midnight periods, its occurrence in all seasons is frequent (95 %) in post-midnight period 0215- 0500 LT. Only 5% cases were observed in pre-midnight 0200-000 LT. Its occurrence during Solar Maximum (1989-90) is significantly greater than two Solar Minimum i.e. 1986-87 and 1995-96. However, its maximum occurrence is observed in 1992 i.e. 2 years after the Solar Maximum. The seasons in order of its maximum occurrence are Winter, Equinoxes and Summer. Nocturnal Stratification occurrence even in Winter is observed to be the highest in the month of January. Nocturnal Ionospheric Stratification at Karachi may and may not occur on a TID (Traveling Ionospheric Disturbances) night, irrespective of the fact whether the night is magnetically quite and disturbed. This shows that the Nocturnal Stratification is not caused by a TID as reported b TAN and HUANG (1985) over Wuchang (30.50 N, 11.40 E), China. Moreover, Karachi dose not lie under any of the zones of precipitation described by BOSS and SMITH (1980). Therefore, a future study on the cause of Nocturnal Ionospheric Stratification is clearly required.

  4. Anatomy Education Faces Challenges in Pakistan

    ERIC Educational Resources Information Center

    Memon, Ismail K.

    2009-01-01

    Anatomy education in Pakistan is facing many of the same challenges as in other parts of the world. Roughly, a decade ago, all medical and dental colleges in Pakistan emphasized anatomy as a core basic discipline within a traditional medical science curriculum. Now institutions are adopting problem based learning (PBL) teaching philosophies, and…

  5. Female Suicide Rates in Ghizer, Pakistan

    ERIC Educational Resources Information Center

    Khan, Murad M.; Ahmed, Aziz; Khan, Sultan R.

    2009-01-01

    Suicide is an understudied subject in Pakistan. There are many social, legal, and religious sanctions against it. National rates of suicides are not known. We calculated suicide rates of women in the Ghizer District of the remote Northern Areas of Pakistan. During years 2000 to 2004, 49 women committed suicide. Taking average mean population for…

  6. Staff Development Needs in Pakistan Higher Education

    ERIC Educational Resources Information Center

    Ullah, Muhammad Hameed; Khan, Muhammad Naeem Ullah; Murtaza, Ali; Ud Din, Muhammad Naseer

    2011-01-01

    Staff development is very significant for the achievement of overall goals of higher education in Pakistan. The success of innovations depends largely upon the skills of instructors; but in Pakistan, the people with a simple masters degree (without any pedagogical training) are inducted as teaching staff at the university level, so it is time to…

  7. Higher Education and Women's Empowerment in Pakistan

    ERIC Educational Resources Information Center

    Malik, Samina; Courtney, Kathy

    2011-01-01

    This paper summarises the findings of a 2005 doctoral study by Malik which explored to what extent participation in higher education offers empowerment to women in Pakistan. A survey instrument was used to question female faculty members and female students from 10 public universities in Pakistan; 1290 students and 290 faculty members responded.…

  8. Epidemiology of Transfusion Transmitted Infection among Patients with β-Thalassaemia Major in Pakistan.

    PubMed

    Ahmed Kiani, Rizwan; Anwar, Muhammad; Waheed, Usman; Asad, Muhammad Javaid; Abbasi, Saleem; Abbas Zaheer, Hasan

    2016-01-01

    Introduction. Transfusion Transmitted Infections (TTIs) continue to be a major risk in transfusions in many parts of the world. The transfusion-dependent β-thalassaemia patients are particularly at risk of acquiring TTIs. The current study was undertaken to estimate the prevalence of TTIs in transfusion-dependent β-thalassaemia patients. Material and Methods. A cross-sectional study of 1253 multitransfused thalassaemia major patients was conducted in five different centres of Islamabad, Rawalpindi, and Karachi. The study subjects were screened for HIV, HCV, and HBV. The screening was performed at two centres: Department of Pathology, Shaheed Zulfiqar Ali Bhutto (SZAB) Medical University, and Blood Transfusion Services, Jinnah Postgraduate Medical Centre, from July to December 2015. The confirmatory screening was performed by Chemiluminescent Immunoassay (CLIA). Results. Out of the 1253 multiple transfused patients, 317 (25.3%) were infected with TTIs. HCV was positive in 273 cases (21.7%), HBV in 38 cases (3.0%), and HIV in 6 cases (0.5%). Conclusion. HCV was the leading TTI in multitransfused thalassaemia major patients in the study. Presence of HIV in thalassaemia patients is a recent disturbing development in Pakistan. Improved regulation of blood banks including use of internationally or nationally evaluated kits will bring down the incidence of TTIs in transfusion-dependent β-thalassaemia patients. More stringent behavioral and serological pretransfusion screening of blood for TTIs must be implemented in blood banks. PMID:27559490

  9. The Frequency of Enterobius Vermicularis Infections in Patients Diagnosed With Acute Appendicitis in Pakistan

    PubMed Central

    Ahmed, Muhammad Umer; Bilal, Muhammad; Anis, Khurram; Khan, Ali Mahmood; Fatima, Kaneez; Ahmed, Iqbal; Khatri, Ali Mohammad; Shafiq-ur-Rehman

    2015-01-01

    Introduction: The main aim of this study was to determine the frequency of Enterobius Vermicularis infections and other unique histopathological findings in patients diagnosed with acute appendicitis. Materials: This retrospective study was conducted in a tertiary care hospital of Karachi, Pakistan over a time period of 9 years from 2005 to 2013. The recorded demographic and histopathological data for the 2956 appendectomies performed during this time frame were extracted using a structured template form. Negative and incidental appendectomies were excluded from the study. Results: Out of the 2956 patients diagnosed with acute appendicitis, 84 (2.8%) patients had Enterobius Vermicularis infections. Malignancy (n=2, 0.1%) and infection with Ascaris (n=1, 0.1%) was found very rarely among the patients. Eggs in lumen (n=22, 0.7%), mucinous cystadenoma (n=28, 1.0%), mucocele (n=11, 0.4%), lymphoma (n=9, 0.3%), obstruction in lumen (n=17, 0.6%) and purulent exudate (n=37, 1.3%) were also seldom seen in the histopathological reports. Conclusion: Enterobius Vermicularis manifestation is a rare overall but a leading parasitic cause of appendicitis. Steps such as early diagnosis and regular de worming may help eradicate the need for surgeries. PMID:26156929

  10. Epidemiology of Transfusion Transmitted Infection among Patients with β-Thalassaemia Major in Pakistan

    PubMed Central

    Ahmed Kiani, Rizwan; Anwar, Muhammad; Asad, Muhammad Javaid; Abbasi, Saleem; Abbas Zaheer, Hasan

    2016-01-01

    Introduction. Transfusion Transmitted Infections (TTIs) continue to be a major risk in transfusions in many parts of the world. The transfusion-dependent β-thalassaemia patients are particularly at risk of acquiring TTIs. The current study was undertaken to estimate the prevalence of TTIs in transfusion-dependent β-thalassaemia patients. Material and Methods. A cross-sectional study of 1253 multitransfused thalassaemia major patients was conducted in five different centres of Islamabad, Rawalpindi, and Karachi. The study subjects were screened for HIV, HCV, and HBV. The screening was performed at two centres: Department of Pathology, Shaheed Zulfiqar Ali Bhutto (SZAB) Medical University, and Blood Transfusion Services, Jinnah Postgraduate Medical Centre, from July to December 2015. The confirmatory screening was performed by Chemiluminescent Immunoassay (CLIA). Results. Out of the 1253 multiple transfused patients, 317 (25.3%) were infected with TTIs. HCV was positive in 273 cases (21.7%), HBV in 38 cases (3.0%), and HIV in 6 cases (0.5%). Conclusion. HCV was the leading TTI in multitransfused thalassaemia major patients in the study. Presence of HIV in thalassaemia patients is a recent disturbing development in Pakistan. Improved regulation of blood banks including use of internationally or nationally evaluated kits will bring down the incidence of TTIs in transfusion-dependent β-thalassaemia patients. More stringent behavioral and serological pretransfusion screening of blood for TTIs must be implemented in blood banks. PMID:27559490

  11. Environmental risk factors and hotspot analysis of dengue distribution in Pakistan.

    PubMed

    Khalid, Bushra; Ghaffar, Abdul

    2015-11-01

    This study is an attempt to find out the factors responsible for sudden dengue outbreak in different cities of Pakistan during 2011. For this purpose, spatio-temporal distribution of dengue in Islamabad, Rawalpindi, Lahore, and Karachi has been taken into account. According to the available data, the factors responsible for this spread includes climate covariates like rainfall, temperature, and wind speed; social covariates like population, and area of locality, and environmental risk factors like drainage pattern and geo-hydrological conditions. Reported dengue cases from localities and Shuttle Radar Topography Mission (SRTM) 90 m digital elevation model (DEM) of study areas have been processed for hotspots, regression model and stream density in the localities of high dengue incidence. The relationship of daily dengue incidence with climate covariates during the months of July-October of the study year is analyzed. Results show that each dry spell of 2-4 days provides suitable conditions for the development and survival of dengue vectors during the wet months of July and August in the areas of high stream density and population. Very few cases have been reported in July while higher number of cases reported in the months of August, September, until late October. Hotspot analysis highlights the areas of high dengue incidence while regression analysis shows the relationship between the population and the areas of localities with the dengue incidence. PMID:25869291

  12. Dengue transmission based on urban environmental gradients in different cities of Pakistan.

    PubMed

    Khalid, Bushra; Ghaffar, Abdul

    2015-03-01

    This study focuses on the dengue transmission in different regions of Pakistan. For this purpose, the data of dengue cases for 2009-2012 from four different cities (Rawalpindi, Islamabad, Lahore, and Karachi) of the country is collected, evaluated, and compiled. To identify the reasons and regions of higher risk of Dengue transmission, land use classification, analysis of climate covariates and drainage patterns was done. Analysis involves processing of SPOT 5 10 m, Landsat TM 30 m data sets, and SRTM 90 m digital elevation models by using remote sensing and GIS techniques. The results are based on the change in urbanization and population density, analysis of temperature, rainfall, and wind speed; calculation of drainage patterns including stream features, flow accumulation, and drainage density of the study areas. Results suggest that the low elevation areas with calm winds and minimum temperatures higher than the normal, rapid increase in unplanned urbanization, low flow accumulation, and higher drainage density areas favor the dengue transmission. PMID:24817491

  13. Environmental risk factors and hotspot analysis of dengue distribution in Pakistan

    NASA Astrophysics Data System (ADS)

    Khalid, Bushra; Ghaffar, Abdul

    2015-11-01

    This study is an attempt to find out the factors responsible for sudden dengue outbreak in different cities of Pakistan during 2011. For this purpose, spatio-temporal distribution of dengue in Islamabad, Rawalpindi, Lahore, and Karachi has been taken into account. According to the available data, the factors responsible for this spread includes climate covariates like rainfall, temperature, and wind speed; social covariates like population, and area of locality, and environmental risk factors like drainage pattern and geo-hydrological conditions. Reported dengue cases from localities and Shuttle Radar Topography Mission (SRTM) 90 m digital elevation model (DEM) of study areas have been processed for hotspots, regression model and stream density in the localities of high dengue incidence. The relationship of daily dengue incidence with climate covariates during the months of July-October of the study year is analyzed. Results show that each dry spell of 2-4 days provides suitable conditions for the development and survival of dengue vectors during the wet months of July and August in the areas of high stream density and population. Very few cases have been reported in July while higher number of cases reported in the months of August, September, until late October. Hotspot analysis highlights the areas of high dengue incidence while regression analysis shows the relationship between the population and the areas of localities with the dengue incidence.

  14. Species identification of invasive yeasts including Candida in Pakistan: limitations of phenotypic methods

    PubMed Central

    Farooqi, Joveria; Jabeen, Kauser; Saeed, Noureen; Zafar, Afia; Brandt, Mary Eleanor; Hasan, Rumina

    2015-01-01

    Objective To compare phenotypic and genotypic methods of yeast identification. Methods The in-vitro cross-sectional study was conducted from January 2006 to May 2009. Invasive yeasts isolated at the clinical microbiology laboratory at the Aga Khan University (AKU), Karachi, Pakistan, were identified. Speciation by phenotypic and molecular methods was compared. All yeasts isolated during the study period from blood and other invasive sites were identified using standard methods. Isolates were shipped to Mycotic Diseases Branch, Centres for Disease Control and Prevention, Atlanta, Georgia, USA, for identification by Luminex flow cytometric multianalyte profiling (xMAP) system. Ribosomal ITS2 DNA sequencing was performed on isolates not identified by Luminex. Result Of the 214 invasive yeasts evaluated, Candida species were 209 (97.7%) while the frequency of non-Candida species was 5 (2.3%). Overall agreement between phenotypic and molecular identification was 81.3%, 90.3% amongst the more common Candida species, and only 38.8% amongst the uncommon yeasts. Conclusion Phenotypic methods of identification proved adequate for common Candida species, but were deficient in recognising rare Candida and non-Candida yeasts, highlighting the importance of molecular methods for identification. PMID:23866432

  15. Child with idiopathic pulmonary hemosiderosis: a case report from Pakistan with multiple ethical and moral issues.

    PubMed

    Hirani, Shela Akbar Ali; Rahman, Arshalooz

    2012-08-01

    This report discusses the case of a young Pakistani child diagnosed with idiopathic pulmonary hemosiderosis (IPH). The key features of IPH were iron deficiency anemia and pulmonary symptoms due to recurrent pulmonary hemorrhages. The child showed complications of the disease process because of late diagnosis. Because various ethical and moral issues were associated with the diagnosis and management of IPH, this case provides insights about the care burden of health care professionals and a child's parents in a Pakistani pediatric setting. During the course of the child's treatment at one of the private tertiary care settings of Karachi, Pakistan, the key challenges were as follows: declaring the diagnosis to the parents, dealing with the request of the child's parents for withdrawal of ventilatory support and withholding treatment, deciding the code status of the child, and ensuring the quality of the child's life after discharge from the hospital. It was learned from this case report that shared decision making and open communication with the child's family enabled the pediatric health care professionals to determine what was in the best interest of the child, resulting in provision of effective palliative care to the child. Moreover, it was realized that early detection of the disease and availability of hospice care can facilitate palliative care of children diagnosed with IPH. PMID:21968218

  16. Concentrations of particulate airborne polycyclic aromatic hydrocarbons and metals collected in Lahore, Pakistan

    NASA Astrophysics Data System (ADS)

    Smith, D. J. T.; Harrison, Roy M.; Luhana, L.; Pio, Casimiro A.; Castro, L. M.; Tariq, Mohammad Nawaz; Hayat, S.; Quraishi, T.

    Hi-vol air sampling equipment was run at three sites (representative of "city", "industrial" and "rural" sampling locations) in Lahore, Pakistan, for over a year. The extraction and quantitative analyses of all Lahore air samples was completed for a suite of metals, various anions, ammonium, elemental and organic carbon, as well as particle-associated polycyclic aromatic hydrocarbons (PAHs). A comparison of Lahore yearly mean pollutant concentrations with those obtained in Birmingham, U.K., shows that airborne metal levels in the Pakistani city are greater by at least one order of magnitude. The concentrations in Lahore obtained from this study are broadly in line with similar studies in Karachi as well as Calcutta and Bombay. Concentrations of particle-associated PAH are also around one order of magnitude higher than in U.K. samples, and, given the difference in ambient temperature, vapour-to-particle ratios of PAH are expected to be far higher in the hotter climate of Lahore. Minerals identified by X-ray diffraction (XRD) in the Lahore air samples were broadly in line with those determined at locations in other parts of the world.

  17. Variability of aerosol optical depth and their impact on cloud properties in Pakistan

    NASA Astrophysics Data System (ADS)

    Alam, Khan; Khan, Rehana; Blaschke, Thomas; Mukhtiar, Azam

    2014-01-01

    This study analyzes seasonal and temporal variations in aerosol optical depth (AOD), and the impact of these variations on the properties of clouds over five cities in Pakistan, using Moderate Resolution Imaging Spectroradiometer (MODIS) data, obtained from the Terra satellite during the period (2001-2011). The obtained results indicated seasonal variation in AOD, with a high value of 2.3, in summer and low values of 0.2, in winter for the costal part of the region. The relationship between AOD and other cloud parameters, namely water vapor (WV), cloud fraction (CF), cloud optical thickness (COT), cloud liquid water path (CLWP), cloud top temperature (CTT), and cloud top pressure (CTP) were analyzed. On a temporal scale, latitudinal variations of both WV and AOD produce high correlations (>0.6) in some regions, and moderate correlations (0.4-0.6) in the other regions. An increasing trend in CF with AOD was found over urban regions in the period of observations. The CF values were higher for Lahore than the other selected regions during the whole period. During autumn and winter seasons the correlation was found to be positive between AOD and CLWP, while negative correlation was observed during the other seasons for all the selected regions. COT showed negative correlation with AOD at all locations except Karachi during spring and summer seasons.

  18. Outcome of pediatric procedural sedation & analgesia in a tertiary care hospital in Pakistan

    PubMed Central

    Jurair, Humaira; Bhimani, Amyna; Anwar-ul-Haque

    2015-01-01

    Background and Objective: Procedural sedation and analgesia (PSA) is pharmacologically induced state which allows patients to tolerate painful procedures while maintaining protective reflexes. It is the standard of care but there is limited data from Pakistan. Our objective was to assess the safety of the procedural sedation and analgesia in pediatric population at a tertiary care setting. Methods: A retrospective notes and record review was conducted at the Aga Khan University Hospital, Karachi over 4 years from April 2010 to August 2014. Patients were between ages 6 months to 16 years and were in low risk category. The combination of Ketamine and Propofol were used. Data collected on the standardized hospital PSA form. All procedures were performed by two trained persons. Results: A total of 3489 diagnostic and therapeutic procedures were performed. Satisfactory level of sedation was achieved for 3486 (99%) of procedures. Adverse events occurred in 21 (0.6%) patients including: 12 (0.3%) episodes of hypoxia, 07 (0.2%) episodes of apnea, 02 (0.06%) episodes of post sedation hallucination. No major events were noted. Conclusion: Procedural sedation & analgesia for children using Propofol and Ketamine is found safe and effective in our setting. PMID:26870135

  19. Profile of psychiatric patients presenting to a tertiary care emergency department of Karachi.

    PubMed

    Shahid, Muhammad; Khan, Muhammad Zaman; Ejaz, Kiran; Nakeer, Rooham; Iftikhar, Sundus

    2015-05-01

    This study reviewed the presentations of psychiatric patients admitted through the Emergency Department (ED), The Aga Khan University Hospital, Karachi. Psychiatric patients admitted through the ED to the psychiatry ward were compared to those admitted through the same units other than the psychiatry ward, from 2006 to 2010 using medical records. Psychiatric patients were defined as those in whom psychiatry consult was generated and 1127 cases were included in study. There were 550 (48.8%) female patients. Most common presentations in the ED were sleep-related problems (n=205, 15.9%) followed by aggressive behavior (n=191, 14.8%). Depression was the most common diagnosis made in the ED (n=331, 29.3%) and at the time of discharge from the hospital (n=354, 29.5%). Psychiatric patients presenting to the ED had signs and symptoms which one generally disregards. However, these minor indicators can lead to major events in a patient's life. PMID:26008672

  20. Airborne and allergenic fungal spores of the Karachi environment and their correlation with meteorological factors.

    PubMed

    Hasnain, Syed M; Akhter, Tasneem; Waqar, Muhammad A

    2012-03-01

    Airborne fungal spores are well known to cause respiratory allergic diseases particularly bronchial asthma, allergic rhinitis, rhino-conjunctivitis and allergic broncho-pulmonary aspergillosis in both adults and children. In order to monitor and analyze airborne fungal flora of the Karachi environment, an aeromycological study was conducted using a Burkard 7-Day Recording Volumetric Spore Trap from January to December 2010. The data recorded from the Spore Trap was further analyzed for percent catch determination, total spores concentration, seasonal periodicities and diurnal variations. Cladosporium spp (44.8%), Alternaria spp. (15.5%), Periconia spp (6.1%), Curvularia spp (2.1%), Stemphylium spp (1.3%) and Aspergillus/Penicillium type (1%) emerged to be major components constituting more than 70% of the airborne fungal flora. Cladosporium, Curvularia and Stemphylium displayed a clear seasonal trend, while there were no clear seasonal trends for other fungal spore types. Diurnal variations were observed to be mainly having daytime maxima. Spearman Rank Correlation Coefficient analysis was conducted using various weather parameters. The various fungal types showed a negative correlation with heat index, dew point, wind velocity and wind chill. However, a positive correlation was found with humidity, rain and barometric pressure. In fact, Alternaria, Bipolaris and Periconia showed a negative correlation with temperature, while Cladosporium and Periconia showed a negative correlation with heat index, dew point, wind velocity and wind chill. The barometric pressure was positively correlated with Cladosporium. On the basis of these findings, it can be concluded that a number of fungal spores are present in the atmosphere of Karachi throughout the year, with certain atmospheric conditions influencing the release, dispersion, and sedimentation processes of some genera. It is expected that clinicians will use the identified fungal flora for diagnosis and treatment and

  1. Spirituality of South Asian Women: Implications for Adult Learning.

    ERIC Educational Resources Information Center

    Marshall, Jody L.

    The implications of the spirituality of South Asian women for adult learning were examined through semistructured interviews of five South Asian women who resided in Canada. The women, who included students, working professionals, mothers, and single women, originated from Nepal, India, Pakistan, and Sri Lanka and were from Hindu, Moslem, and…

  2. Impact of today's media on university student's body image in Pakistan: a conservative, developing country's perspective

    PubMed Central

    2011-01-01

    Background Living in a world greatly controlled by mass media makes it impossible to escape its pervading influence. As media in Pakistan has been free in the true sense of the word for only a few years, its impact on individuals is yet to be assessed. Our study aims to be the first to look at the effect media has on the body image of university students in a conservative, developing country like Pakistan. Also, we introduced the novel concept of body image dissatisfaction as being both negative and positive. Methods A cross-sectional study was conducted among 7 private universities over a period of two weeks in the city of Karachi, Pakistan's largest and most populous city. Convenience sampling was used to select both male and female undergraduate students aged between 18 and 25 and a sample size of 783 was calculated. Results Of the 784 final respondents, 376 (48%) were males and 408 (52%) females. The mean age of males was 20.77 (+/- 1.85) years and females was 20.38 (+/- 1.63) years. Out of these, 358 (45.6%) respondents had a positive BID (body image dissatisfaction) score while 426 (54.4%) had a negative BID score. Of the respondents who had positive BID scores, 93 (24.7%) were male and 265 (65.0%) were female. Of the respondents with a negative BID score, 283 (75.3%) were male and 143 (35.0%) were female. The results for BID vs. media exposure were similar in both high and low peer pressure groups. Low media exposure meant positive BID scores and vice versa in both groups (p < 0.0001) showing a statistically significant association between high media exposure and negative body image dissatisfaction. Finally, we looked at the association between gender and image dissatisfaction. Again a statistically significant association was found between positive body image dissatisfaction and female gender and negative body image dissatisfaction and male gender (p < 0.0001). Conclusions Our study confirmed the tendency of the media to have an overall negative effect on

  3. Conventional clinical and prognostic variables in 150 oral squamous cell carcinoma cases from the indigenous population of Karachi

    PubMed Central

    Alamgir, Muhammad Mohiuddin; Jamal, Qamar; Mirza, Talat

    2016-01-01

    Objective: To analyze clinical and prognostic variables of Oral Squamous Cell Carcinoma (OSCC) cases from the indigenous population of Karachi and to correlate with the common risk factor of tobacco habit. Methods: The study was conducted at Ziauddin University, Karachi. One hundred fifty OSCC cases were collected from the Oncology Department of Ziauddin University Hospital, North Nazimabad, Karachi and Otolaryngology ward of Civil Hospital, Karachi, during 2011 and 2015. The reporting included demographic details and variables like intra-oral subsites, clinical stage and histological grade. Recurrence of tumor after initial resection was also documented. Results: The patient’s population comprised of 98 males and 52 females. The mean age was 47.1± 12.22 (range:20-78 years). Maximum numbers were seen in the 41–50 years age group. Urdu-speaking community was the most affected ethnic group (n=75). Clinico-pathological analysis revealed that majority of cases were moderately differentiated (59%) and were either clinical stage II (35%) or IV (29%) tumors. The most common intra-oral subsite came out to be buccal mucosa of cheeks (56%) followed by lateral borders of tongue (21%), lips (13%), alveolar (6%), palate (2.6%) floor of mouth (1.3%), etc. Recurrence was observed in 08 out of 150 cases. All patients underwent primary resection±neck dissection and reconstruction where possible. Conclusions: Overall experience with oral squamous cell carcinoma shows that it has a high tendency for local invasion as well as dissemination to regional lymph nodes, i.e. cervical lymph nodes, both are associated with a poor prognosis. Preventable risk factor of tobacco chewing has been observed in majority of these cases. PMID:27375712

  4. Weight misperception amongst youth of a developing country: Pakistan -a cross-sectional study

    PubMed Central

    2013-01-01

    Background Weight misperception is the discordance between an individual’s actual weight status and the perception of his/her weight. It is a common problem in the youth population as enumerated by many international studies. However data from Pakistan in this area is deficient. Methods A multi-center cross-sectional survey was carried out in undergraduate university students of Karachi between the ages of 15–24. Participants were questioned regarding their perception of being thin, normal or fat and it was compared with their Body Mass Index (BMI). Measurements of height and weight were taken for this purpose and BMI was categorized using Asian cut offs. Weight misperception was identified when the self-perceived weight (average, fat, thin) did not match the calculated BMI distribution. Chi square tests and logistic regression tests were applied to show associations of misperception and types of misperception (overestimation, underestimation) with independent variables like age, gender, type of university and faculties. P-value of <0.05 was taken as statistically significant. Results 42.4% of the total participants i.e. 43.3% males and 41% females misperceived their weight. Amongst those who misperceived 38.2% had overestimated and 61.8% had underestimated their weight. Greatest misperception of was observed in the overweight category (91%), specifically amongst overweight males (95%). Females of the underweight category overestimated their weight and males of the overweight category underestimated their weight. Amongst the total participants, females overestimated 8 times more than males (OR 8.054, 95% CI 5.34-12.13). Misperception increased with the age of the participants (OR 1.114, 95% CI 1.041-1.191). Odds of misperception were greater in students of private sector universities as compared to public (OR 1.861, 95% CI: 1.29-2.67). Odds of misperception were less in students of medical sciences (OR 0.693, 95% CI 0.491-0.977), engineering (OR 0.586, 95% CI 0

  5. Damselflies (Zygoptera: Odonata) of Pakistan: Part 1

    PubMed Central

    Zia, Ahmed; Naeem, Muhammad; Rafi, Muhammad Ather; Naz, Falak; Afsheen, Sumera; Ilyas, Muhammad

    2011-01-01

    The present study is an effort to document bio-geographical distribution for Zygoptera of Pakistan. Damselflies were collected throughout the country and territory of Azad Jammu and Kashmir during 2004–2009. A total of 2692 specimens were collected yielding 9 families, 21 genera, and 48 species and subspecies. Three of these species, Libellago lineata lineata (Burmeister), Elattoneura atkinsoni (Selys), and Elattoneura souteri (Fraser), are recorded for the first time from Pakistan. Distribution, habitats, previous records, and Zoogeographic affiliation for all collected taxa are discussed. Help was also taken from published literature on Zygoptera of Pakistan, and specimens housed at National Insect Museum were also studied. In total, 53 species are accounted for providing an updated record for all modern taxa of damselfly fauna of Pakistan. PMID:22221175

  6. NASA's IMERG Measures Flooding Rainfall in Pakistan

    NASA Video Gallery

    NASA used satellite data and added up heavy rainfall that has been occurring in northwestern Pakistan that caused flooding that killed more than 50 people. NASA's IMERG added up rainfall in northwe...

  7. The burden of stroke in Pakistan.

    PubMed

    Khealani, Bhojo A; Wasay, Mohammad

    2008-11-01

    Epidemiologic literature on stroke burden, patterns of stroke is almost non existent from Pakistan. However, several hospital-based case series on the subject are available, mainly published in local medical journals. Despite the fact that true stroke incidence and prevalence of stroke in Pakistan is not known, the burden is assumed to be high because of highly prevalent stroke risk factors (hypertension, diabetes mellitus, coronary artery disease, dyslipidemia and smoking) in the community. High burden of these conventional stroke risk factors is further compounded by lack of awareness, poor compliance hence poor control, and inappropriate management/treatment practices. In addition certain risk factors like rheumatic valvular heart disease may be more prevalent in Pakistan. We reviewed the existing literature on stroke risk factors in community, the risk factor prevalence among stroke patients, patterns of stroke, out come of stroke, availability of diagnostic services/facilities related to stroke and resources for stroke care in Pakistan. PMID:18811747

  8. Serotype and genotype analysis of dengue virus by sequencing followed by phylogenetic analysis using samples from three mini outbreaks-2007-2009 in Pakistan

    PubMed Central

    2011-01-01

    Background Since the first reported outbreak of dengue hemorrhagic fever in Pakistan, several mini outbreaks have erupted in the region. Dengue virus serotype 3 (DEN-3) was first documented in 2005 outbreak in Karachi. Reports show that serotype 3 is prevalent in Lahore since 2008. Serotype 2 (DEN-2) is the major circulating serotype in Pakistan as it is documented since 1994. We have conducted a detailed study of three outbreaks of dengue virus infection that occurred in years 2007, 2008 and 2009 in Lahore by using molecular techniques such as PCR and nucleotide sequencing of the C-prM gene junction of Dengue virus. Results Through the analysis of 114 serum samples collected over the period of three years (2007-2009), total 20 patients were found to be infected with dengue virus. In year 2007, four were positive for serotype 2 and one sample was positive for serotype DEN-3. In 2008, five samples had concurrent infection with serotypes DEN-2 and DEN-3 while three samples were infected only with serotype DEN-2. In year 2009, one sample had concurrent infection with serotypes DEN-2 and DEN-3 while six were positive for serotype DEN-2 only. Conclusions Our study showed that serotype DEN-2 was dominant in positive samples of dengue virus infection collected during the period of three years (2007-2009). The other serotype present was serotype DEN-3. Genotypes of serotype DEN-2 and serotype DEN-3 were subtype IV and subtype III, respectively. PMID:21906394

  9. Blasphemy laws and mental illness in Pakistan

    PubMed Central

    Husain, Muzaffar

    2014-01-01

    There is emerging evidence that individuals who are mentally ill are overrepresented in the group of defendants prosecuted under the blasphemy laws of Pakistan. This article discusses the background of blasphemy legislation in Pakistan, and proposes causal interactions between underlying mental illness in the defendant and prosecution for blasphemy. It sketches possible legal safeguards for such blasphemy defendants with mental illness in mental health legislation. PMID:25237489

  10. Major earthquake shakes northern Pakistan

    NASA Astrophysics Data System (ADS)

    Kumar, Mohi

    A magnitude 7.6 earthquake that shook the western Himalayas on 8 October killed at least 23,000 in Pakistan and 1,400 in India, injured more than 50,000 people, and left more 2.5 million people homeless across the Kashmir region. The official death toll could exceed 30,000, placing this among most deadly earthquakes to have ever occurred on the Indian subcontinent.Scientists warn that, given the lack of development and poor construction in the area, future earthquakes in more densely populated areas could be devastating. David Simpson, president of the Incorporated Research Institutes for Seismology, said the 8 October quake ‘was a terrible disaster, but not to the level of what could happen in the future. This is yet again another warning message of things to come.”