Sample records for karachi city pakistan

  1. Volatile Organic Compounds (VOCs) Measurements in Karachi, Pakistan (2006): a Comparison With Previous Urban Sampling Campaigns Worldwide.

    NASA Astrophysics Data System (ADS)

    Barletta, B.; Meinardi, S.; Khwaja, H. A.; Beyersdorf, A. J.; Baker, A. K.; Zou, S.; Rowland, F.; Blake, D. R.

    2008-12-01

    Mixing ratios of carbon monoxide (CO), carbon dioxide (CO2), methane (CH4), and 47 nonmethane hydrocarbons - NMHCs - (19 alkanes, 13 alkenes, ethyne, and 14 aromatics) were determined for ground level whole air samples collected during the winter of 2006 in Karachi, Pakistan. Pakistan is among the fastest growing economies in Asia, and Karachi is one of the largest cities in the world with a rapidly expanding population of over 14 million in the whole metropolitan area, and a large industrial base. Samples were collected in January 2006 throughout the urban area to characterize the overall air composition of the city, and along the busiest road to determine the traffic signature of Karachi. This sampling campaign follows a previous study carried out in the winter of 1998-1999 in the same city, when elevated concentrations of many NMHCs were observed. Exceptionally high levels of methane were still observed in 2006 with an average mixing ratio of 5.0 ppmv (6.3 ppmv were observed in 1999). The overall air composition of the Karachi urban environment characterized during this 2006 sampling is compared to 1999 aiming to highlight any possible change in the main VOC sources present throughout the city. In particular, we want to evaluate the impact of the heavy usage of natural gas on the overall air quality of Karachi and the recently increased use of liquefied petroleum gas (LPG) as alternative source of energy. We also compare the composition of the urban troposphere of Karachi to other major urban centers worldwide such as Guangzhou (China), Mexico City (Mexico), and Milan (Italy).

  2. Characterizing the Impact of Extreme Heat on Mortality, Karachi, Pakistan, June 2015.

    PubMed

    Ghumman, Usman; Horney, Jennifer

    2016-06-01

    Introduction Karachi, Pakistan was affected by a heat wave in June 2015 during the Muslim holy month of Ramadan. Many media reports attributed the excess deaths in part to the practice of daylight fasting during Ramadan. As much of the published research reports on heat-related mortality in Europe and the United States, an exploration of the effects of extreme heat on residents of a South Asian mega-city address a gap in current disaster research. Hypothesis/Problem This report investigated potential risk factors for excess mortality associated with the June 2015 heat wave in Karachi, Pakistan. Data were obtained through manual review of death certificates at public hospitals and private clinics in Karachi, Pakistan, conducted from July 1 through July 31, 2015 by a trained physician. Demographic data for any deaths with a primary cause of death of heat-related illness were recorded in Microsoft Excel (Microsoft Corp.; Redmond, Washington USA). EpiSheet (2012; Rothman. Modern Epidemiology. Lippincott Williams & Wilkins; Philadelphia, Pennsylvania USA) was used to calculate risk differences (RD), rate ratios (RR), and 95% confidence intervals (95% CI). Overall, residents of Karachi were approximately 17 times as likely to die of a heat-related cause of death during June 2015 (RR=17.68; 95% CI, 13.87-22.53) when compared with the reference period of June 2014. Residents with a monthly income lower than 20,000 Pakistani Rupees (US $196; RD=0.03; 95% CI, 0.01-0.05) and those with less than a fifth grade education (RD=0.03; 95% CI, 0.00-0.05) were at significantly higher risk of death during the 2015 heat wave compared to the reference period. Fasting during Ramadan was not a significant risk factor for mortality from heat-related causes during the Karachi heat wave of June 2015. A large number of excess deaths were reported across all demographic groups, which due to the burden of record keeping in an under-resourced health system during a public health emergency, are

  3. Sociodemographic Pattern of Depression in Urban Settlement of Karachi, Pakistan.

    PubMed

    Altaf, Areeba; Khan, Maham; Shah, Syed Raza; Fatima, Kaneez; Tunio, Sameer Altaf; Hussain, Mehwish; Khan, Muhammad Asim; Shaikh, Moazzam Ali; Arshad, Mohammad Hussham

    2015-06-01

    Depression is a global issue prevalent among developing countries like Pakistan as compared to developed countries. We conducted a study to assess the prevalence and identify the significant predictors of depression in an elite urban settlement in Karachi, Pakistan. This cross-sectional study was done in the elitist residential area of Karachi; Defence Housing Authority (DHA). Four hundred and twenty three participants were included by going to their residences. Self-administered questionnaires were handed out after taking informed consent. Level of depression was assessed by Patient Health Questionnaire (PHQ-9). Data were entered and analysed in Predictive Analytical Software v. 18.0. The mean and median total score of the scale were 5.9 ± 5.4 and 4 (7) respectively with minimum score 0 and maximum 27. In this sequence, 139 (32.86%) respondents were identified to be depressed. It was found that females were slight more depressed than males (p = 0.063). Regression Model identified only gender and marital status as significant predictors of depression. Having a female gender increased 0.658 times chance of being depressed (p = 0.047). Unmarried person had 0.296 times more likely to be depressed (p = 0.019). Boredom was considered as significant factor of depression by the participants (p< 0.0001). Odds ratio signified depression occurred 0.310 times more if one was bored. Depression should be considered as a major public health issue for the city. Public awareness should be done in all parts of the city in an attempt to reduce depression especially among the female gender.

  4. The State of Ambient Air Quality of a Mega City in Southeast Asia (Karachi, Pakistan)

    NASA Astrophysics Data System (ADS)

    Khwaja, H. A.; Hussain, M. M.; Naqvi, I.; Malik, A.; Siddiqui, S. A.; Khan, A.

    2016-12-01

    Outdoor air pollution is a serious public health problem. Studies indicate that in recent years exposure levels have increased considerably in some parts of the world, particularly in developing countries of Asia with large populations. Simultaneous measurements of PM2.5 and gaseous pollutants NO, NO2 , SO2 , O3 , HONO, HNO3, HF, and HCl were carried out in the city of Karachi. This is the first systematic study of this kind carried out in a mega city of Pakistan. Mean concentration of PM2.5 was 186 µg/m3. Concentrations of NO, NO2 , SO2 , O3 , HONO , HNO3, HF, and HCl varied from 8.6 - 194 ppb, 15.7 - 131 ppb, 7.9 - 60 ppb, 5.0 - 218 ppb, 0.05 - 6.6 ppb, 0.1 - 10.8 ppb, 0.1 - 2.8 ppb, and 0.3 - 568 ppb, respectively. Daily patterns were observed. The 24 h mean PM2.5 on weekdays was significantly higher than the weekend value, indicating that vehicular pollution is one of the important source of PM2.5. The diurnal variations of both NO and NO2 showed higher concentrations during morning and evening rush-hours and lower concentrations at night, indicating that vehicular traffic is the principal source of NOx . Peak HONO concentration of 6.6 ppb was observed in the morning hours. The highest SO2 , HNO3 , HF, and HCl values occurred during the daytime when general pollution levels, particularly those of suspended particulate matter, were also high. Concentrations of O3 are observed to increase during the daytime, consistent with its formation by photochemical reactions. The present findings are compared with similar measurements worldwide. Results have demonstrated that WHO air quality standard for PM2.5 (20 µg/m3) were exceeded by a factor of 5 - 13. Concentrations of NO2 , SO2 and O3 were found to be significantly higher than the WHO air quality guidelines. The reported high levels were attributed to vehicular traffic and industrial activity. It has been concluded that air pollution levels in Karachi are extremely high and can be considered an alarming indicator

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

    PubMed

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

    2013-09-01

    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. 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. 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. There is considerable geographic heterogeneity in the characteristics and operational dynamics of MSWs and HSWs across Pakistan.

  6. Tobacco control laws in Pakistan and their implementation: A pilot study in Karachi.

    PubMed

    Khan, Javaid Ahmed; Amir Humza Sohail, Abdul Malik; Arif Maan, Muhammad Arslan

    2016-07-01

    In order to limit the high prevalence of tobacco use in Pakistan various tobacco control laws have been implemented. The objective of this study is to serve as a pilot study to assess the implementation of these laws in the largest city of Pakistan, Karachi. A cross-sectional study was conducted in Karachi. The implementation of tobacco control laws in 'smoke-free' places, the adherence of tobacco companies to these laws, the regulation of cigarette sale, and the awareness and views of the general public regarding tobacco control laws were assessed via direct observation by visits and through self-administered questionnaires. The implementation of tobacco control laws in 'smoke-free' public places was found to be poor. Out of 37, only 23(62%) brands displayed pictorial warnings on their packs. 3(8%) of the brands were available in two different kinds of packs, both with and without pictorial warnings. Cigarette sale to minors was taking place at 80(85%) of the visited cigarette outlets. 50(53%) of the outlets displayed cigarette advertisements in the form of posters. 46(40%) of the persons questioned had awareness regarding the existence of ban on smoking in public places and 126(90%) of these were in favour of it. The implementation of tobacco control law in Pakistan is poor. Non adherence to the law in public places was alarmingly high. Also, the study demonstrates the poor compliance to the tobacco control laws by tobacco companies. The sale of cigarettes is almost unregulated.

  7. 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…

  8. 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

  9. Primary Amebic Meningoencephalitis Caused by Naegleria fowleri, Karachi, Pakistan

    PubMed Central

    Shakoor, Sadia; Beg, Mohammad Asim; Bandea, Rebecca; Sriram, Rama; Noman, Fatima; Ali, Farheen; Visvesvara, Govinda S.; Zafar, Afia

    2011-01-01

    We report 13 cases of Naegleria fowleri primary amebic meningoencephalitis in persons in Karachi, Pakistan, who had no history of aquatic activities. Infection likely occurred through ablution with tap water. An increase in primary amebic meningoencephalitis cases may be attributed to rising temperatures, reduced levels of chlorine in potable water, or deteriorating water distribution systems. PMID:21291600

  10. 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

  11. Antimicrobial resistance and Neisseria gonorrhoeae multiantigen sequence typing (NG-MAST) genotypes in N. gonorrhoeae during 2012-2014 in Karachi, Pakistan.

    PubMed

    Jabeen, Kauser; Bhawan Mal, Pushpa; Khan, Erum; Chandio, Saeeda; Jacobsson, Susanne; Unemo, Magnus

    2016-07-22

    Globally, increasing antimicrobial resistance (AMR) in Neisseria gonorrhoea has led to decreased treatment options for gonorrhoea. Continuous monitoring of resistance is crucial to determine evolving resistance trends in Neisseria gonorrhoea and to suggest treatment recommendations. Quality assured gonococcal AMR data from Pakistan are mainly lacking. This study was performed to determine prevalence and trends of gonococcal AMR and molecular epidemiology of local strains during 2012-2014 in Karachi, Pakistan. Gonococcal isolates (n = 100) were obtained from urogenital specimens submitted to the Aga Khan University Laboratory, Karachi, Pakistan. Antimicrobial susceptibility was determined using Etest and molecular epidemiology was assessed by N. gonorrhoeae multiantigen sequence typing (NG-MAST). Quality control was performed using N. gonorrhoeae WHO reference strains C, F, G, K, L, M, N, O, and P, and ATCC 49226. Susceptibility to spectinomycin, ceftriaxone and cefixime was 100 % and to azithromycin was 99 %. All isolates had low ceftriaxone MICs, i.e., ≤0.032 mg/L. Resistance to ciprofloxacin, tetracycline and penicillin G were 86 %, 51 % and 43 %, respectively. NG-MAST analysis identified 74 different sequence types (STs). A highly diversified gonococcal population, 74 NG-MAST STs (62 novel STs) with an increased resistance to penicillin G, ciprofloxacin and tetracycline circulated in Karachi, Pakistan. Fortunately, no resistance to ceftriaxone was detected. Accordingly, ceftriaxone can continuously be recommended as the treatment of choice. However it is recommended to increase the dose of ceftriaxone from 125 mg intramuscularly to 250 mg intramuscularly due to ceftriaxone MIC creep and emerging resistance reported in the region. Furthermore, due to the high level of resistance to ciprofloxacin (86 %) it is essential to exclude ciprofloxacin from the recommended first-line therapy. It is imperative to significantly broaden the gonococcal AMR

  12. Presence of rotavirus and free-living amoebae in the water supplies of Karachi, Pakistan.

    PubMed

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

    2017-06-01

    Rotavirus and pathogenic free-living amoebae are causative agents of important health problems, especially for developing countries like Pakistan where the population has limited access to clean water supplies. Here, we evaluated the prevalence of rotavirus and free-living amoebae (Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri) in drinking water supplies of Karachi, Pakistan. Six water filtration plants that supply drinking water to the population of Karachi were investigated. Additionally, drinking water samples from households were analyzed for the presence of rotavirus and free-living amoebae. Rotavirus was present in 35% of the water samples collected from water filtration plants; however, domestic tap water samples had a prevalence of only 5%. Out of 20 water samples from filtration plants, 13 (65%) were positive for Acanthamoeba spp., and one (5%) was positive for B. mandrillaris. Out of 20 drinking water samples collected from different areas of Karachi, 35% were positive for Acanthamoeba spp. Rotavirus was detected in 5% of the drinking water samples tested. Overall, these findings showed for the first time the presence of rotavirus, in addition to pathogenic free-living amoebae in drinking water supplies of Karachi that could be an important public health risk for the affected population.

  13. 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…

  14. E-Waste Driven Pollution in Pakistan: The First Evidence of Environmental and Human Exposure to Flame Retardants (FRs) in Karachi City.

    PubMed

    Iqbal, Mehreen; Syed, Jabir Hussain; Breivik, Knut; Chaudhry, Muhammad Jamshed Iqbal; Li, Jun; Zhang, Gan; Malik, Riffat Naseem

    2017-12-05

    Informal e-waste recycling activities have been shown to be a major emitter of organic flame retardants (FRs), contributing to both environmental and human exposure to laborers at e-waste recycling sites in some West African countries, as well as in China and India. The main objective of this study was to determine the levels of selected organic FRs in both air and soil samples collected from areas with intensive informal e-waste recycling activities in Karachi, Pakistan. Dechlorane Plus (DP) and "novel" brominated flame retardants (NBFRs) were often detected in high concentrations in soils, while phosphorus-based FRs (OPFRs) dominated atmospheric samples. Among individual substances and substance groups, decabromodiphenyl ether (BDE-209) (726 ng/g), decabromodiphenyl ethane (DBDPE) (551 ng/g), 1,2-bis(2,4,6-tribromophenoxy) ethane (BTBPE) (362 ng/g), and triphenyl-phosphate (∑TPP) (296 ng/g) were found to be prevalent in soils, while OPFR congeners (5903-24986 ng/m 3 ) were prevalent in air. The two major e-waste recycling areas (Shershah and Lyari) were highly contaminated with FRs, suggesting informal e-waste recycling activities as a major emission source of FRs in the environment in Karachi City. However, the hazards associated with exposure to PM 2.5 appear to exceed those attributed to exposure to selected FRs via inhalation and soil ingestion.

  15. Presence of rotavirus and free-living amoebae in the water supplies of Karachi, Pakistan

    PubMed Central

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

    2017-01-01

    ABSTRACT Rotavirus and pathogenic free-living amoebae are causative agents of important health problems, especially for developing countries like Pakistan where the population has limited access to clean water supplies. Here, we evaluated the prevalence of rotavirus and free-living amoebae (Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri) in drinking water supplies of Karachi, Pakistan. Six water filtration plants that supply drinking water to the population of Karachi were investigated. Additionally, drinking water samples from households were analyzed for the presence of rotavirus and free-living amoebae. Rotavirus was present in 35% of the water samples collected from water filtration plants; however, domestic tap water samples had a prevalence of only 5%. Out of 20 water samples from filtration plants, 13 (65%) were positive for Acanthamoeba spp., and one (5%) was positive for B. mandrillaris. Out of 20 drinking water samples collected from different areas of Karachi, 35% were positive for Acanthamoeba spp. Rotavirus was detected in 5% of the drinking water samples tested. Overall, these findings showed for the first time the presence of rotavirus, in addition to pathogenic free-living amoebae in drinking water supplies of Karachi that could be an important public health risk for the affected population. PMID:28591260

  16. Drinking water: a major source of lead exposure in Karachi, Pakistan.

    PubMed

    Ul-Haq, N; Arain, M A; Badar, N; Rasheed, M; Haque, Z

    2011-11-01

    Excess lead in drinking water is a neglected source of lead toxicity in Pakistan. A cross-sectional survey in 2007/08 was made of water samples from drinking water sources in Karachi, a large industrial city. This study aimed to compare lead levels between untreated ground water and treated surface (tap) water in 18 different districts. Of 216 ground and surface water samples collected, 86% had lead levels higher than the World Health Organization maximum acceptable concentration of l0 ppb. Mean lead concentration in ground water [146 (SD 119) ppb] was significantly higher than in surface water [77.1 (SD 54) ppb]. None of the 18 districts had a mean lead level of ground or surface water below the WHO cut-off and ground water sources in 9 districts had a severe level of contamination (>150 ppb). Urgent action is needed to eliminate sources of contamination.

  17. 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…

  18. 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

  19. Assessment of fertility control efforts in a selected area of Karachi, Pakistan.

    PubMed

    Shirmeen, Amra; Khan, Muhammad F H; Khan, Khizer H; Khan, Khurum H

    2007-09-01

    To investigate the impact of fertility control efforts on reducing fertility and to study the contributory role of fertility inhibiting factors viz, age of the marriage, breast feeding and post-partum amenorrhea, abortion and use of contraceptives in selected area in Karachi, Pakistan. The aim was to estimate the gap between knowledge of contraceptives and its practice i.e. KAP-GAP as well as to determine the level of unmet need in the PIB colony in Karachi. A sample survey was conducted in PIB colony in Karachi from October 2005 to November 2005 by interviewing 340 married women in reproductive ages. The data was tabulated and John Bongaarts technique was used to analyse the success of fertility control efforts in the selected area. Of the total of 340 respondents, 38% were currently using contraceptive methods with 26% using OCP's and 12% were condom users. A slight reduction in total fertility (TFR) was noticed. The population policy of Pakistan envisages achieving population stabilization in 2020 by reducing the annual rate of population growth from 1.9% to 1.3% and TFR at 2.1. This target requires strenuous efforts to make the concept of small family an accepted milieu through an eagerly designed communication and education campaign. Concentration on proximate determinants of fertility particularly breast feeding and prolonging birth interval will not generate opposition from the community because these concepts are in accordance with Islamic injunctions and teachings.

  20. RSV associated hospitalizations in children in Karachi, Pakistan: Implications for vaccine prevention strategies.

    PubMed

    Ali, Asad; Yousafzai, Mohammad Tahir; Waris, Rabbia; Jafri, Fatima; Aziz, Fatima; Abbasi, Imran Naeem; Zaidi, Anita

    2017-07-01

    Major progress is being made in vaccines against Respiratory Syncytial Virus (RSV), with multiple vaccine candidates currently in the clinical phase of development. Making an investment case for public sector financing of RSV vaccine will require estimation of burden, cost-effectiveness, and impact. The aim of this study is to determine the proportion, age distribution and clinical spectrum of RSV associated hospitalizations in children in Karachi, Pakistan. A three years prospective study was conducted at the Aga Khan University Hospital in Karachi, a city of 20 million in south Pakistan, from August 2009 to June 2012. Children less than five years old admitted with acute respiratory infections (ARI) were enrolled. Throat swabs were collected and tested for RSV using real-time PCR. Multivariable log binomial regression analysis was performed to identify the associated factors of RSV infection. Out of 1150 children enrolled, RSV was detected among 223 (19%). Highest rate of RSV detection was in young infants less than 3 months of age (48/168, 29%), which accounted for 22% of all RSV detected. Most common diagnosis in RSV positive infants (<12 months of age) was bronchiolitis followed by pneumonia, while in older children between the ages of one and 5 years of age, pneumonia and asthma were the most common diagnosis. Although identified year-round, RSV was most prevalent from August to October with peak in September, coinciding with the rainy season. This study identified RSV to be independently associated with younger age (P = 0.036), rainy season (P < 0.001), post-tussive emesis (P = 0.008), intubation (P = 0.003), and discharge diagnosis of bronchiolitis (P = 0.004). Vaccines against RSV that target this age group are likely to yield remarkable benefit. © 2017 Wiley Periodicals, Inc.

  1. 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

  2. Food insecurity in metropolis of the developing world--observations from central district of Karachi, Pakistan.

    PubMed

    Hakeem, R; Asar, F; Shaikh, A H

    2003-11-01

    To assess the prevalence of household food insecurity at various income levels in urban areas of Karachi. A cross sectional survey of different localities in the central district of Karachi was carried out. The data was collected through household interviews of housewives conducted by trained nutritionist. Housewives were interviewed about food security status of the household. A total of 797 families were visited from the central district of Karachi. Mean Food Security Score increased with income level. The difference was statistically significant (ANOVA) between 1st and second (P=0.000) and 2nd and 3rd group (P=0.000) but not between 3rd and fourth group. At the very low and low income levels 83% & 51% families respectively were food insecure in any degree, while this percentage was very low at the middle (6.3%) and high income level (1.8%). The difference in prevalence of food insecurity between the VLI and LI, and, LI and MI income groups was statistically significant (chi.sq. test, p<0.001 in each case). Hunger (because of lack of money) was experienced in the preceding year only by "very low income" (37%) and "low income" families (17%). Use of coping strategies was most frequently mentioned for parents and then for children and only occasionally for infants or grand parents. Females were more likely to be effected by food insecurity than males. Meat, milk and fruits were the food groups which were preferred and considered healthy but were avoided because of lack of money by a majority (51%-86%) of families. In spite of having an impression of being an affluent city of Pakistan, the prevalence of food insecurity with and without hunger is rampant not only among very low income (slum dwellers) but also among low income families of Karachi.

  3. Quality of drug stores: Storage practices & Regulatory compliance in Karachi, Pakistan

    PubMed Central

    Shah, Syed Shaukat Ali Muttaqi; Naqvi, Baqar Shyum; Fatima, Mashhad; Khaliq, Asif; Sheikh, Abdul Latif; Baqar, Muhammad

    2016-01-01

    Objective: To assess and evaluate the drug storage quality and regulatory compliance among privately operated drug stores of Karachi Pakistan. Methods: A cross-sectional survey of drug stores located in Karachi was conducted from May to December 2013. A total of 1003 drug stores that were involved in the sales, purchase and dispensing of pharmaceutical products were approached by non-probability purposive sampling technique, and the information was collected using a close ended, structured questionnaire. Results: Out of 1003 drug stores inspected only 4.1%(n=41) were found compliant to regulatory requirements. Most of the stores 74.9%(n=752) were selling general items along with the drugs. Only 12%(n=124) stores were having qualified person working on the store, out of which 33% were pharmacist. 47.4%(n=400) of the stores had drug sales license displayed in the premises and 33.4%(n=282) of the stores had expired drug sales license. 11.4%(n=94) stores were found selling vaccines without proper refrigerator and only 11.7% stores had the power backup for the refrigerator. Only 40.2%(n=403) of stores were protected from direct sunlight and 5.4%(n=54) having air conditioning in the premises. Conclusion: The regulatory compliance of majority of the drug stores operated privately in different areas of Karachi is below standard. Only a few drugs stores have adequate facilities to protect the drugs from extreme temperature, sunlight and provision of refrigeration. Very few of the drug stores carry out drug sales under the supervision of qualified pharmacist. There is a dire need to improve the storage practices in the drug stores by complying with the regulatory standards/laws as specified by the Drug Regulatory Authority of Pakistan. PMID:27881996

  4. How well can physicians manage tuberculosis? A public-private sector comparison from Karachi, Pakistan.

    PubMed

    Naseer, Maliha; Khawaja, Ali; Pethani, Amin S; Aleem, Salik

    2013-10-25

    Tuberculosis (TB) is endemic in Pakistan which ranks fifth amongst the twenty two countries designated to be highly burdened by TB according to the World Health Organization. However, there is paucity of data regarding the knowledge of diagnosis of TB and its management amongst public and private practitioners. In this study, we endeavor to identify this gap in knowledge regarding the diagnosis and management of TB between public and private doctors and the factors affecting these knowledge scores in urban Pakistan. This cross sectional survey was conducted between June and December 2011. Doctors from public hospitals, private hospitals and private clinics scattered in all eighteen towns of Karachi were included in the study. Qualified MBBS doctors working in any specialty were eligible to participate whereas doctors working in both the public and private sectors were excluded from the study. Vignette based clinical scenarios were given to assess the knowledge score regarding the diagnosis and management of TB. A total of 196 doctors participated in the study. There was a significant difference between private and public physicians in terms of age and years of practice (p-value <0.05). Significant differences in the proportion of knowledge scores were observed between the public and private doctors and National TB Control Program trained and untrained doctors in Karachi. Factors associated with inadequate knowledge scores were being female gender [OR: 2.76 (95% CI: 1.418-5.384)], private employment status [OR: 1.50 (95% CI: 1.258-2.439)], and not trained by NTP [OR: 2.98 (95% CI: 1.286-3.225)] on multivariate logistic regression analysis. It is concluded that a knowledge gap exists between the public and private doctors in Karachi. Strengthening of currently implemented public private mix model along with improvement in the trainings of public and private practitioners is highly recommended to control TB in Pakistan.

  5. Myths and fallacies about male contraceptive methods: a qualitative study amongst married youth in slums of Karachi, Pakistan.

    PubMed

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

    2012-12-04

    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.

  6. 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

  7. Chronic Bronchitis and Chronic Obstructive Pulmonary Disease (COPD) Among Textile Workers in Karachi, Pakistan.

    PubMed

    Nafees, Asaad Ahmed; Fatmi, Zafar; Kadir, Muhammad Masood; Sathiakumar, Nalini

    2016-05-01

    To determine the frequency and predictors of chronic bronchitis and COPD among textile workers in Karachi, Pakistan. Cross-sectional survey. Karachi, Pakistan, from October to December 2009. Male textile workers from 15 mills of Karachi were inducted. Data was collected using American Thoracic Society respiratory questionnaire (ATS-DLD-78-a) and spirometry. Out of 372 participants, 29 (7.8%) workers had chronic bronchitis (4, 9.1% aged ≥40 years) and 25 (6.7%) had COPD (12, 27.2% aged ≥40 years). Workers with chronic bronchitis had significantly decreased lung function compared to the healthy workers. Those reporting severe self-perceived dust exposure at work, ≥ 10 pack years of smoking, uneducated, longer duration of work (≥11 years), and ever smokers were more likely to have chronic bronchitis or COPD. In the multivariate analyses, severe self-perceived dust exposure at work (AOR = 7.4; 95% CI: 1.9, 28.0), family history of respiratory illness/symptoms (AOR = 4.8; 95% CI: 1.1, 20.9) and lack of education (AOR = 4.2; 95% CI: 1.1, 16.9) were significant predictors of chronic bronchitis. Duration of work ≥11 years (AOR = 5.5; 95% CI: 1.5, 19.7) and pack years of smoking ≥10 years (AOR = 3.5; 95% CI: 1.1, 11.7) were strong predictors for COPD. There is a high frequency of chronic bronchitis and COPD among textile workers. Multiple important predictors for prevention are identified.

  8. Injection practices among practitioners in private medical clinics of Karachi, Pakistan.

    PubMed

    Yousafzai, M T; Nisar, N; Kakakhel, M F; Qadri, M H; Khalil, R; Hazara, S M

    2013-06-01

    The aim of this study was to determine the frequency and determinants of sharps injuries among private health practitioners in slum areas of Karachi, Pakistan. All practitioners with at least 1 year of experience in a private medical clinic were asked to complete a self-administered, structured questionnaire (317/397 responded). Only 7.9% of practitioners were qualified from medical school, 12.3% were registered nurses and 8.8% lacked any professional qualifications. At least 1 sharps injury in the previous 12 months was reported by 26.7%, mostly due to needle recapping. Only 25.2% reported using a new syringe for each patient. In multivariate regression analysis shorter work experience, < 14 years of schooling, > 20 patients per day, administering > or = 30 injections per day, reuse of syringes and needle recapping after use were significantly associated with sharps injury in the past year. Better awareness and training on standard precautions is needed for private practitioners in slum areas of Karachi.

  9. Impact of terrorism on health and Hospital Anxiety Depression Scale screening in medical students, Karachi, Pakistan.

    PubMed

    Nasim, Sara; Khan, Mahjabeen; Aziz, Sina

    2014-03-01

    To determine the association of terrorism with psychiatric morbidity by Hospital Anxiety Depression scale among medical students in Karachi, Pakistan. The questionnaire based cross-sectional survey was conducted from February to March 2011 and comprised students of the Institute of Physical and Medical Rehabilitation and the Dow Medical College, Dow University of Health Sciences, Karachi. The study tool was a validated Hospital Anxiety Depression scale questionnaire. The data was analysed on SPSS 16. Factor analysis was performed to check which factors had the most influence. Overall there were 1036 respondents. The impact of terrorism on physical, social and mental health was 40 (3.9%), 178 (17.2%) and 818 (79%) respectively. There was an association of terrorism in 980 (84.6%) respondents with psychiatric morbidity. There was an association of terrorism with psychiatric morbidity in majority of respondents. The significant risk factors were age, gender, physical, mental and social health and the desire to live in Pakistan.

  10. Perspectives on domestic violence: case study from Karachi, Pakistan.

    PubMed

    Rabbani, F; Qureshi, F; Rizvi, N

    2008-01-01

    There is no adequate profile of domestic violence in Pakistan although this issue is frequently highlighted by the media. This case study used qualitative and quantitative methods to explore the nature and forms of domestic violence, circumstances, impact and coping mechanisms amongst selected women victims in Karachi. Violence was a continuum: all the women reported verbal abuse, often escalating into physical, emotional, sexual and economic abuse. The husband was the most common perpetrator. Women suffered in silence due to sociocultural norms, misinterpretation of religious beliefs, subordinate status, economic dependence and lack of legal redress. Besides short-term local measures, public policy informed by correct interpretation of religion can bring about a change in prevailing societal norms.

  11. High risk behaviors of injection drug users registered with harm reduction programme in Karachi, Pakistan

    PubMed Central

    Altaf, Arshad; Shah, Sharaf Ali; Zaidi, Najam A; Memon, Ashraf; Nadeem-ur-Rehman; Wray, Norman

    2007-01-01

    Background Surveillance data of Sindh AIDS Control Programme, Pakistan suggest that HIV infection is rapidly increasing among IDUs in Karachi and has reached 9% in 2004–5 indicating that the country has progressed from nascent to concentrated level of HIV epidemic. Findings of 2nd generation surveillance in 2004–5 also indicate 104/395 (26.3%) IDUs HIV positive in the city. Methods We conducted a cross sectional study among registered IDUs of a needle exchange and harm reduction programme in Karachi, Pakistan. A total of 161 IDUs were included in the study between October–November 2003. A detailed questionnaire was implemented and blood samples were collected for HIV, hepatitis B & C and syphilis. HIV, hepatitis B and C antibody tests were performed using Enzyme Linked Immunosorbent Assay (ELISA) method. Syphilis tests (RPR & TPHA) were performed on Randox kit. Besides calculating frequencies univariate analysis was performed using t tests for continuous variables as age, age at first intercourse and average age of initiation of addiction and chi square for categorical variables like paid for sex or not to identify risk factors for hepatitis B and C and syphilis. Results Average age of IDU was 35.9 years and average age of initiation of drugs was 15.9 years. Number of drug injections per day was 2.3. Shooting drugs in group sharing syringes was reported by 128 (79.5%) IDUs. Over half 94 (58.3%) reported paying for sex and 64% reported never using a condom. Commercial selling of blood was reported by 44 (28%). 1 of 161 was HIV positive (0.6%). The prevalence of hepatitis B was 12 (7.5%), hepatitis C 151 (94.3%) and syphilis 21 (13.1%). IDUs who were hepatitis C positive were more likely to start sexual activity at an earlier age and had never used condoms. Similarly IDUs who were hepatitis B positive were more likely to belong to a younger age group. Syphilis positive IDUs were more likely to have paid for sex and had never used a condom. Conclusion Prudent

  12. Reasons behind the increase in research activities among medical students of Karachi, Pakistan, a low-income country.

    PubMed

    Baig, Shoukat Ali; Hasan, Syed Askari; Ahmed, Syed Mustajab; Ejaz, Kiran; Aziz, Sina; Dohadhwala, Nava Asad

    2013-01-01

    Previously, in a low-income country with limited resources like Pakistan, biomedical research was conducted mostly by individuals working in private organizations. Recently, there has been an upsurge in the number of medical students conducting research in both private and public medical colleges of Karachi, Pakistan. We investigated student perceptions of the reasons behind the increase in biomedical research among medical students of private and public medical colleges in Karachi, Pakistan. This cross-sectional study was conducted at four medical universities of Karachi, using structured data collection tool. Participants included medical students who stated that they were interested in medical research. We assessed how many had been involved in research or stated that they intended to be, and tallied students' stated reasons why they were involved in research. Chi-square analyses were used to assess if year of training, institution, and other factors were associated with the likelihood of past or current actual research involvement. Out of the 398 students with research interest who participated in the study, 349 (88%) stated that they intended to do research projects in their undergraduate years. At the time of the study, only 202 (51%) reported that they had actually conducted research. The reasons given for engaging in research for a minority included personal interest (n = 136; 34%), while majority stated that their motivation was to improve their curriculum vitae (75%) and/or to be more competitive for a residency in the United States (43%). The reasons students gave for involvement in research were related to whether their schools were public versus private and to their year of study. According to students' reports, improving one's curriculum vitae to get a strong residency in the USA appeared to be a principal reason for the increase in biomedical research in Karachi. The challenges of research, such as lack of good mentors and increased work-load were

  13. Epidemiology, clinical presentation, and patterns of drug resistance of Salmonella Typhi in Karachi, Pakistan.

    PubMed

    Khan, M Imran; Soofi, Sajid Bashir; Ochiai, R Leon; Khan, Mohammad Jawed; Sahito, Shah Muhammad; Habib, Mohammad Atif; Puri, Mahesh K; Von Seidlein, Lorenz; Park, Jin Kyung; You, Young Ae; Ali, Mohammad; Nizami, S Qamarudding; Acosta, Camilo J; Sack, R Bradley; Clemens, John D; Bhutta, Zulfiqar A

    2012-10-19

    Enteric fever remains a major public health problem in Asia. Planning appropriate preventive measures such as immunization requires a clear understanding of disease burden. We conducted a community-based surveillance for Salmonella Typhi infection in children in Karachi, Pakistan. A de jure household census was conducted at baseline in the study setting to enumerate all individuals. A health-care facility-based passive surveillance system was used to capture episodes of fever lasting three or more 3 days in children 2 to 16 years old. A total of 7,401 blood samples were collected for microbiological confirmation, out of which 189 S. Typhi and 32 S. Paratyphi A isolates were identified with estimated annual incidences of 451/100,000 (95% CI: 446 - 457) and 76/100,000 (95% CI: 74 - 78) respectively. At the time of presentation, after adjusting for age, there was an association between the duration of fever and temperature at presentation, and being infected with multidrug-resistant S. Typhi. Of 189 isolates 83 were found to be resistant to first-line antimicrobial therapy. There was no statistically significant difference in clinical presentation of blood culture sensitive and resistant S. Typhi isolates. Incidence of S. Typhi in children is high in urban squatter settlements of Karachi, Pakistan. Findings from this study identified duration of fever and temperature at the time of presentation as important symptoms associated with blood culture-confirmed typhoid fever. Preventive strategies such as immunization and improvements in water and sanitation conditions should be the focus of typhoid control in urban settlements of Pakistan.

  14. 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.

  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. Makran Mountain Range, Indus River Valley, Pakistan, India

    NASA Image and Video Library

    1984-10-13

    41G-120-040 (5-13 Oct. 1984) --- Pakistan, featuring the city of Karachi, the Makran mountain range, the mouth of the Indus River and the North Arabian Sea were photographed with a medium format camera aboard the space shuttle Challenger during the 41-G mission. Photo credit: NASA

  17. Influenza vaccine acceptance among pregnant women in urban slum areas, Karachi, Pakistan.

    PubMed

    Khan, Afshin Alaf; Varan, Aiden Kennedy; Esteves-Jaramillo, Alejandra; Siddiqui, Mariam; Sultana, Shazia; Ali, Asad S; Zaidi, Anita K M; Omer, Saad B

    2015-09-22

    Facilitators and barriers to influenza vaccination among pregnant women in the developing world are poorly understood, particularly in South Asia. We assessed intention to accept influenza vaccine among ethnically diverse low-income pregnant women in Pakistan. From May to August 2013, we conducted a cross-sectional survey of pregnant women who visited health centers in urban slums in Karachi city. We assessed intention to accept influenza vaccine against socio-demographic factors, vaccination history, vaccine recommendation sources, and other factors. In an unvaccinated study population of 283 respondents, 87% were willing to accept the vaccine, if offered. All except two participants were aware of symptoms typically associated with influenza. Perceived vaccine safety, efficacy, and disease susceptibility were significantly associated with intention to accept influenza vaccine (p<0.05). Regardless of intention to accept influenza vaccine, 96% rated healthcare providers as highly reliable source of vaccine information. While a recommendation from a physician was critical for influenza vaccine acceptance, parents-in-law and husbands were often considered the primary decision-makers for pregnant women seeking healthcare including vaccination. Maternal influenza vaccination initiatives in South Asia should strongly consider counseling of key familial decision-makers and inclusion of healthcare providers to help implement new vaccination programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. 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

  19. Bacterial contamination and stethoscope disinfection practices: a cross-sectional survey of healthcare workers in Karachi, Pakistan.

    PubMed

    Rao, Danish Ahmed; Aman, Aiysha; Muhammad Mubeen, Syed; Shah, Ahmed

    2017-07-01

    Stethoscopes routinely used for clinical examination of patients may potentially transfer micro-organisms and cause iatrogenic infections. This study was undertaken to detect the presence of microorganisms on stethoscopes used clinically in hospitals of Karachi, Pakistan and to ascertain the infection control practices of healthcare workers (HCWs). In a cross-sectional study, 118 samples were collected from public and private institutions. Samples were tested for the presence and sensitivity of pathogenic microorganisms. Microorganisms were found on diaphragms of 33/64 (51.6%) and 19/57 (33.3%) stethoscopes in public and private sector hospitals, respectively. Methycillin resistance was identified in all staphylococcally contaminated samples. Only 33 (18%) respondents reported cleaning their stethoscopes regularly. We highlight the need for more and better on-the-job routines for decontaminating stethoscopes among HCWs in Karachi.

  20. Deliberate self-harm in the emergency department: experience from Karachi, Pakistan.

    PubMed

    Shahid, Muhammad; Khan, Murad M; Saleem Khan, Muhammad; Jamal, Yasir; Badshah, Aaref; Rehmani, Rifat

    2009-01-01

    Suicidal behavior is an understudied subject in Pakistan, a South-Asian developing country with a predominantly Muslim population. This study examined the characteristics and management of patients presenting with Deliberate Self-Harm (DSH) to the Emergency Department (ED) of a tertiary care teaching hospital in Karachi, Pakistan. A retrospective chart review of all patients (n = 98), over a period of 12 months was carried out. The demographic details of patients; method of DSH and, if drugs were used, their type, route, and quantity; reason for DSH; past psychiatric history; and outcome were recorded. The mean age of subjects was 23.5 years. The majority of patients were female; most had used drugs for DSH. After initial treatment in the ED, 34 patients were admitted to medical wards for further treatment, 12 were discharged from ED, while 52 patients left against medical advice. The main reasons for leaving against medical advice were financial constraints and fear of legal issues. Seven patients had at least one previous episode of DSH. Patients who left the ED without psychosocial assessment are at increased risk for repetition of DSH as well as suicide.

  1. The Variability of Childhood Diarrhea in Karachi, Pakistan, 2002–2006

    PubMed Central

    Luby, Stephen P.; Agboatwalla, Mubina; Hoekstra, Robert M.

    2011-01-01

    Diarrhea burden is often estimated using cross-sectional surveys. We measured variability in diarrhea prevalence among children < 5 years of age living in squatter settlements in central Karachi, Pakistan. We pooled data from non-intervention control households from studies conducted from 2002 through 2006. The prevalence of diarrhea varied on average by 29% from one week to the next, by 37% from one month to the next, and during peak diarrhea season by 32% from one year to the next. During 24 months when the same nine neighborhoods were under surveillance, each month the prevalence of diarrhea varied by at least an order of magnitude from the lowest to the highest prevalence neighborhood, and each neighborhood recorded the highest diarrhea prevalence during at least one month. Cross-sectional surveys are unreliable measures of diarrhea prevalence. PMID:21633021

  2. Undergraduate radiology education in private and public teaching hospitals in Karachi, Pakistan: teaching duties, methodologies, and rewards

    PubMed Central

    Nadeem, Naila; Khawaja, Ranish Deedar Ali; Beg, Madiha; Naeem, Muhammad; Majid, Zain

    2013-01-01

    Background In an integrated method of education, medical students are introduced to radiology in their preclinical years. However, no study has been conducted in Pakistan to demonstrate an academic framework of medical radiology education at an undergraduate level. Therefore, we aimed to document and compare the current level of teaching duties, teaching methodologies, and teaching rewards among radiologists and residents in private and public teaching hospitals in Karachi, Pakistan. Methods A survey was conducted among 121 radiologists and residents in two private and two public teaching hospitals in Karachi, Pakistan. Radiologists who were nationally registered with the Pakistan Medical and Dental Council either part-time or full-time were included. Radiology residents and fellows who were nationally registered with the Pakistan Medical and Dental Council were also included. Self-administered questionnaires addressing teaching duties, methods, and rewards were collected from 95 participants. Results The overall response rate was 78.51% (95/121). All of the radiologists were involved in teaching residents and medical students, but only 36% reported formal training in teaching skills. Although most of the respondents (76%) agreed that medical students appeared enthusiastic about learning radiology, the time spent on teaching medical students was less than five hours per week annually (82%). Only 37% of the respondents preferred dedicated clerkships over distributed clerkships (41%). The most common preferred teaching methodology overall was one-on-one interaction. Tutorials, teaching rounds, and problem-based learning sessions were less favored by radiologists than by residents. Teaching via radiology films (86%) was the most frequent mode of instruction. Salary (59%) was the most commonly cited teaching reward. The majority of respondents (88%) were not satisfied with their current level of teaching rewards. Conclusion All radiologists and residents working in an

  3. Strategies for prevention of road traffic injuries (RTIs) in Pakistan: situational analysis.

    PubMed

    Khan, Adeel Ahmed; Fatmi, Zafar

    2014-05-01

    Road traffic injuries (RTIs) are one of the leading causes of death among productive age group. Using systems approach framework (SAF), current preventive strategies for RTI control were reviewed in Pakistan. A review of the literature was done using four international search engines. Only ten studies on preventive strategies for RTI stemming from Pakistan were found. The first Road Traffic Injuries Research Network (RTIRN) surveillance system for road traffic injuries was established in urban city (Karachi) in Pakistan has shown promise for injury control and should be scaled up to other cities. Enforcement of traffic laws on seat-belt and helmet wearing is poor. National Highway and Motorway Police Ordinance (2000) was one of the few legislative measure so far taken in Pakistan. Using SAF, efforts are required to implement interventions targeting human, vehicle design and also making environment safer for road users.

  4. Nutritional status and physical abuse among the children involved in domestic labour in Karachi Pakistan: a cross-sectional survey.

    PubMed

    Zainab, Saima; Kadir, Masood

    2016-10-01

    To determine the prevalence of physical abuse among domestic child labours and to assess the nutritional status by calculating the Body Mass Index of children involved in domestic labour in Karachi. A cross sectional study was conducted in the squatter settlements of Karachi. Questionnaire based interviews were conducted to capture physical abuse with 385 children who worked as domestic labour in the household of their employer. The ages of the children were between 10 to 14 years belonging to both genders. The children were enrolled in study by snow-ball sampling technique. The overall prevalence of physical abuse among domestic child labour in Karachi was found to be 8.3 %. Over 9 % had low weight and about 90% were stunted. This study also highlighted that 95% of the children involved in domestic labour perform overtime work in their employer's home, more than once per week. There is high burden of physical abuse among the domestic child labour and these children are malnourished. There is a need to recognize and regulate this form of labour in Pakistan.

  5. Psychosocial correlates, psychological distress, and quality of life in patients with medically unexplained symptoms: a primary care study in Karachi, Pakistan.

    PubMed

    Husain, Muhammad Ishrat; Chaudhry, Nasim; Morris, Julie; Zafar, Shehla Naeem; Jaffery, Farhat; Rahman, Raza; Duddu, Venu; Husain, Nusrat

    2015-01-01

    To examine the psychosocial correlates and association of psychological distress and quality of life (QOL) in patients with medically unexplained symptoms (MUS) compared to those with medically explained symptoms (MES) in a primary care setting in Karachi, Pakistan. A cross-sectional study of 472 patients attending GP clinics between March and August 2009 in Karachi. Participants completed questionnaires to assess demographic details, somatic symptoms, anxiety, depression, and QOL. The patients' GP recorded whether the presenting complaint was medically unexplained or medically explained. MUS subjects in our study were more educated, had better social support and fewer financial problems, were less depressed and had a better QOL than subjects who had medically explained symptoms (non-MUS). Both groups (MUS and non-MUS) were comparable in terms of anxiety and number of somatic symptoms, but non-MUS subjects were more depressed than the MUS group. In a regression analysis, the number of somatic symptoms and lower levels of anxiety predicted poorer QOL in this sample. Whether these symptoms were medically explained (or not) did not seem to contribute significantly to the QOL. Our findings confirm that even in the developing world, patients with MUS are common among primary care attendees. However, patients with MUS in urban Karachi, Pakistan may differ from Western MUS subjects in the role of stress, support, and anxiety in their presentation, and may be reflective of a conceptually different group of difficulties. © 2015, The Author(s).

  6. 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.

  7. The organisation, operational dynamics and structure of female sex work in Pakistan.

    PubMed

    Emmanuel, Faran; Thompson, Laura H; Athar, Uzma; Salim, Momina; Sonia, Altaf; Akhtar, Naeem; Blanchard, James F

    2013-09-01

    Pakistan is known to have large populations of female sex workers (FSWs) with considerable geographic heterogeneity in their characteristics. In this paper, we describe the social organisation and structural patterns of female sex work in different geographic regions of Pakistan. We report geographic and network mapping data collected among FSWs in 15 cities across Pakistan in 2011 as part of the Canada-Pakistan HIV/AIDS Surveillance Project. A total number of 89 178 FSWs were estimated in the target cities for an average of 7.2 FSWs per 1000 adult males. 55% of the estimated number of FSWs concentrated in Karachi and Lahore. Based on the operations of female sex work, two major typologies of FSWs were identified: establishment-based and non-establishment-based. FSWs were further subtyped into those operating through brothels, homes, kothikhanas, streets and by cell phone. Cities varied considerably in terms of predominance of different FSW typologies. There is considerable heterogeneity among FSWs in Pakistan, geographically and in terms of operational typology. Understanding the social organisation of sex work and the influence of social-cultural and legal factors in Pakistan is essential for the design of HIV prevention programmes and other services for FSWs.

  8. Initial results of Pakistan's first road traffic injury surveillance project.

    PubMed

    Shamim, Shahzad; Razzak, Junaid A; Jooma, Rashid; Khan, Uzma

    2011-09-01

    Our aim is to report the findings of the initial three years of road traffic injuries (RTI) surveillance at Karachi and to compare it with previously published RTI-related data from Pakistan and other low-and middle-income countries. Data were collected through the RTI surveillance programme at Karachi (RTIRP) from the five biggest emergency departments of the city, which receive almost all the major emergencies of the city for the period September 2006 till September 2009. A total of 99,272 victims were enlisted by the RTIRP during the study period. Annual incidence of RTI is calculated to be 184.3 per 100,000 populations and mortality is 5.7 per 100,000 populations. Eighty nine per cent of victims are male and 73% are between 15 and 44 years of age. Commonest road user to be affected is riders of two wheelers (45%). Only 7% of affected motorcyclists were found to be wearing helmets at the time of the accident. Trends of injuries remained uniform over the years. Most frequent injuries were external wounds, followed by orthopaedic injuries. On the basis of our surveillance system, we have presented the largest RTI-related data from a metropolitan city of Pakistan to date.

  9. Audit of sharp weapon deaths in metropolis of Karachi--an autopsy based study.

    PubMed

    Mirza, Farhat Hussain; Hasan, Qudsia; Memon, Akhtar Amin; Adil, Syeda Ezz-e-Rukhshan

    2010-01-01

    Sharp weapons are one of the most violent and abhorrent means of deaths. This study assesses the frequency of sharp weapon deaths in Karachi. This was a cross sectional study, and involves the deaths by sharp weapons autopsied in Karachi during Mar 2008-Feb 2009. This study reports that the frequency of sharp weapon deaths in Karachi is similar to some other studies conducted in different regions of Pakistan, yet it is very high as the population of Karachi is way more than any other metropolis of Pakistan. Our study reported that out of 2090 medico-legal deaths in Karachi during the study period, 91 deaths were due to sharp weapons, including 73 (80.2%) males and 18 (19.8%) females. 100% of the deaths were homicides, so none were suicides. Deaths were more frequent in age group ranging from 20-39 years (59.3%). Sharp weapon deaths continue to be a means of quite a number of deaths in Karachi. Such violence depicts intolerant and frustrated nature of the citizens.

  10. Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan.

    PubMed

    Kerai, Salima; Pasha, Omrana; Khan, Uzma; Islam, Muhammad; Asad, Nargis; Razzak, Junaid

    2017-01-01

    The purpose of the study was to explore the association between post-traumatic stress disorder (PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan. Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised (IES-R). Work performance was assessed on the basis of five variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work ( RR adj 0.99; 0.98-1.00), days absent ( RR adj 0.98; 0.96-0.99), days sick ( RR adj 0.99; 0.98-1.00), adherence to protocol ( OR adj 1.01; 0.99-1.04) and patient satisfaction ( β 0.001%-0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression. No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.

  11. Differences in police, ambulance, and emergency department reporting of traffic injuries on Karachi-Hala road, Pakistan.

    PubMed

    Bhatti, Junaid A; Razzak, Junaid A; Lagarde, Emmanuel; Salmi, Louis-Rachid

    2011-03-22

    Research undertaken in developing countries has assessed discrepancies in police reporting of Road Traffic Injury (RTI) for urban settings only. The objective of this study was to assess differences in RTI reporting across police, ambulance, and hospital Emergency Department (ED) datasets on an interurban road section in Pakistan. The study setting was the 196-km long Karachi-Hala road section. RTIs reported to the police, Edhi Ambulance Service (EAS), and five hospital EDs in Karachi during 2008 (Jan to Dec) were compared in terms of road user involved (pedestrians, motorcyclists, four-wheeled vehicle occupants) and outcome (died or injured). Further, records from these data were matched to assess ascertainment of traffic injuries and deaths by the three datasets. A total of 143 RTIs were reported to the police, 531 to EAS, and 661 to hospital EDs. Fatality per hundred traffic injuries was twice as high in police records (19 per 100 RTIs) than in ambulance (10 per 100 RTIs) and hospital ED records (9 per 100 RTIs). Pedestrian and motorcyclist involvement per hundred traffic injuries was lower in police records (8 per 100 RTIs) than in ambulance (17 per 100 RTIs) and hospital ED records (43 per 100 RTIs). Of the 119 deaths independently identified after matching, police recorded 22.6%, EAS 46.2%, and hospital ED 50.4%. Similarly, police data accounted for 10.6%, EAS 43.5%, and hospital ED 54.9% of the 1 095 independently identified injured patients. Police reporting, particularly of non-fatal RTIs and those involving vulnerable road users, should be improved in Pakistan.

  12. Morphotaxonomy and seasonal distribution of planktonic and benthic Prorocentrales in Karachi waters, Pakistan Northern Arabian Sea

    NASA Astrophysics Data System (ADS)

    Munir, Sonia; Burhan, Zaib-un-nisa; Naz, Tahira; Siddiqui, P. J. A.; Morton, Steve L.

    2013-03-01

    Morphotaxonomy and seasonal abundance of dinoflagellates of the genera Prorocentrum and Mesoporos (Prorocentrales) were studied from nutrient-rich waters, Karachi Harbor and the mouth of the Manora Channel, Pakistan during May 2002-July 2003. Using both light and scanning electron microscopy, 13 species of Prorocentrales were identified according to cell shape, size, ornamentation of thecal plates, and architecture of apical platelets, apical pore area, marginal pores, and intercalary bands. P. sigmoides, P. arcuatum, P. scutellum, P. donghaiense, P. balticum, P. minimum, P. emarginatum, P. lima, P. faustiae, and Mesoporos perforatus constitute new records for sindh coast of Pakistan. The most abundant species were P. minimum/P. balticum (4.5×103 cells/L), P. micans (1.1×103 cells/L), P. gracile / P. sigmoides (2.5×10 2 cells/L) and P. donghaiense (6.6×103 cells/L) at temperatures of 29-31°C and salinities of 35-40. Maximum abundance was observed in winter and lower abundance in summer. There was no significant change in the distribution of species between stations except for the benthic species which occurred close to Karachi Harbor waters. Significant positive correlations were observed between Prorocentrum spp. and temperature ( R 2 =0.27) and negative correlations with salinity ( R 2 =-0.32) except for P. minimum and P. emarginatum which has negative correlation with temperature ( R 2 =-0.24) and positive with salinity ( R 2 =0.08, 0.19). The finding of potential okadaic-acid producing species of benthic Prorocentrum call for monitoring for possible human health problems in this region.

  13. 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.

  14. Induced abortions in low socio-economic settlements of Karachi, Pakistan: rates and women's perspectives.

    PubMed

    Saleem, S; Fikree, F F

    2001-08-01

    The aim of the study was to determine rates on induced abortions and to identify the perceived and actual reasons for terminating an unplanned pregnancy, health care providers sought, methods used and post-abortion complications. Three squatter settlements of Karachi, Pakistan. Interviews were conducted on 1,214 ever-married women in the reproductive age group (15-49) with a reproductive history of at least one pregnancy, irrespective of outcome. A cross-sectional survey from June-August 1997 was conducted in three selected squatter settlements of Karachi. The abortion rate for the past year was 25.5 per 1,000 women of reproductive age group. The post-abortion complication rate reported was 68.5% (61/89), of which fever and heavy vaginal bleeding was the most commonly reported complication (54.1%). The results indicate that women are aware of the high mortality and morbidity risk resulting from seeking an unsafe abortion but nevertheless opt for this approach to attain their goal of small family size rather than for a modern method of contraception. Furthermore, healthcare providers, irrespective of legality issues, provide such services due to demand. We suggest that family physicians and other relevant health care providers be trained for post-abortion care including post-abortion family planning counseling with an emphasis on emergency contraceptives.

  15. Indoor air pollution (PM2.5) due to secondhand smoke in selected hospitality and entertainment venues of Karachi, Pakistan.

    PubMed

    Nafees, Asaad Ahmed; Taj, Tahir; Kadir, Muhammad Masood; Fatmi, Zafar; Lee, Kiyoung; Sathiakumar, Nalini

    2012-09-01

    To determine particulate matter smaller than 2.5 μm (PM(2.5)) levels at various hospitality and entertainment venues of Karachi, Pakistan. This was a descriptive cross-sectional study conducted at various locations in Karachi, during July 2009. Sampling was performed at 20 enclosed public places, including hospitality (restaurants and cafés) and entertainment (snooker/billiard clubs and gaming zones) venues. PM(2.5) levels were measured using an aerosol monitor. All entertainment venues had higher indoor PM(2.5) levels as compared to the immediate outdoors. The indoor PM(2.5) levels ranged from 25 to 390 μg/m(3) and the outdoor PM(2.5) levels ranged from 18 to 96 μg/m(3). The overall mean indoor PM(2.5) level was 138.8 μg/m(3) (± 112.8). Among the four types of venues, the highest mean indoor PM(2.5) level was reported from snooker/billiard clubs: 264.7 μg/m(3) (± 85.4) and the lowest from restaurants: 66.4 μg/m(3) (± 57.6) while the indoor/outdoor ratio ranged from 0.97 to 10.2, highest being at the snooker/billiard clubs. The smoking density ranged from 0.21 to 0.57, highest being at gaming zones. The indoor PM(2.5) concentration and smoking density were not significantly correlated (Spearman's correlation coefficient = 0.113; p = 0.636). This study demonstrates unacceptably high levels of PM(2.5) exposure associated with secondhand smoke (SHS) at various entertainment venues of Karachi even after 8 years since the promulgation of smoke-free ordinance (2002) in Pakistan; however, better compliance may be evident at hospitality venues. The results of this study call for effective implementation and enforcement of smoke-free environment at public places in the country.

  16. India-Pakistan Border at Night

    NASA Image and Video Library

    2017-12-08

    An astronaut aboard the International Space Station took this nighttime panorama while looking north across Pakistan’s Indus River valley. The port city of Karachi is the bright cluster of lights facing the Arabian Sea, which appears completely black. City lights and the dark color of dense agriculture closely track with the great curves of the Indus valley. For scale, the distance from Karachi to the foothills of the Himalaya Mountains is 1,160 kilometers (720 miles). This photograph shows one of the few places on Earth where an international boundary can be seen at night. The winding border between Pakistan and India is lit by security lights that have a distinct orange tone. Astronaut photograph ISS045-E-27869 was acquired on September 23, 2015, with a Nikon D4 digital camera using a 28 millimeter lens, and is provided by the ISS Crew Earth Observations Facility and the Earth Science and Remote Sensing Unit, Johnson Space Center. via NASA Earth Observatory Read more: earthobservatory.nasa.gov/IOTD/view.php?id=86725&eocn...

  17. The experiences of urban, professional women when combining breastfeeding with paid employment in Karachi, Pakistan: a qualitative study.

    PubMed

    Hirani, Shela Akbar Ali; Karmaliani, Rozina

    2013-06-01

    Pakistan has the second highest child mortality rate in South Asia. Breastfeeding can promote infant health, prevent infection and possibly mortality. However, a gradual decline in breastfeeding is reported for Pakistan; especially among urban, educated, employed women. Little research exists regarding the experiences of professional women in Pakistan who are breastfeeding and employed. To describe the experiences of urban, professional women who breastfeed and are employed, as related to facilitators and barriers of breastfeeding. Using a qualitative descriptive design, nine full-time employed women were recruited through purposive sampling from a private tertiary care health setting in Karachi, Pakistan. A pre-tested, semi-structured interview guide was used for an in-depth interview of 40-45min with each participant. Most women spoke about the challenges of combining breastfeeding with employment, which resulted in early cessation of breastfeeding. The study indicated that positive maternal attributes such as knowledge about breastfeeding, planning, self-commitment, and open communication, as well as availability of social and workplace support is essential to enable urban, professional women in Pakistan to continue breastfeeding while employed. Pakistan has high infant and child mortality rate and decreasing prevalence of breastfeeding, especially among employed professional women. Our findings indicate an urgent need for lactation support programs that include integrated interventions for lactating women that offer informational support, social support, and formal workplace support. Copyright © 2012 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  18. Risk factors associated with typhoid fever in children aged 2-16 years in Karachi, Pakistan.

    PubMed

    Khan, M I; Ochiai, R L; Soofi, S B; Von-Seidlein, L; Khan, M J; Sahito, S M; Habib, M A; Puri, M K; Park, J K; You, Y A; Ali, M; Nizami, S Q; Acosta, C J; Bradley-Sack, R; Clemens, J D; Bhutta, Z A

    2012-04-01

    We analysed the data from the control group in a typhoid vaccine trial in Karachi to assess the differences in individual-, household- and cluster-level characteristics for developing typhoid fever. The annual incidence of typhoid in children aged 2-16 years in the control arm of the vaccine trial was 151/100 000 population. After adjustment, the risk of typhoid was lower with increasing age [risk ratio (RR) 0·89, 95% confidence interval (CI) 0·83-0·95], was higher with an increase in population density (RR 1·13, 95% CI 1·05-1·21) and was lower in the households using a safe drinking-water source (RR 0·63, 95% CI 0·41-0·99). Typhoid fever affects younger children living in areas of high population density and lack of access to safe water in Pakistan. A combination of environmental and biological interventions is required to prevent the continued epidemiological and economic impact of typhoid fever in high-risk areas of Pakistan.

  19. Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan

    PubMed Central

    Kerai, Salima; Pasha, Omrana; Khan, Uzma; Islam, Muhammad; Asad, Nargis; Razzak, Junaid

    2017-01-01

    BACKGROUND: The purpose of the study was to explore the association between post-traumatic stress disorder (PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan. METHODS: Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised (IES-R). Work performance was assessed on the basis of five variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. RESULTS: Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work (RRadj 0.99; 0.98–1.00), days absent (RRadj 0.98; 0.96–0.99), days sick (RRadj 0.99; 0.98–1.00), adherence to protocol (ORadj 1.01; 0.99–1.04) and patient satisfaction (β 0.001%–0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression. CONCLUSION: No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan. PMID:28680519

  20. Development of an economic skill building intervention to promote women's safety and child development in Karachi, Pakistan.

    PubMed

    Hirani, Saima Shams; Karmaliani, Rozina; McFarlane, Judith; Asad, Nargis; Madhani, Farhana; Shehzad, Shireen; Ali, Nazbano Ahmed

    2010-02-01

    Violence against women is a global epidemic phenomenon that can result in major mental health problems. Not only are women affected but also the health and well-being of their children are in jeopardy. To prevent violence and promote women's safety, several strategies have been tested in various cultural contexts. This article describes the process of developing and validating an economic skill building intervention for women of an urban slum area of Karachi, Pakistan. The purpose of the intervention is to increase women's economic independence, promote women's safety, and improve the behavioral functioning of their children.

  1. Determinants of childhood mortality in slums of Karachi, Pakistan.

    PubMed

    D'souza, R M; Bryant, J H

    1999-01-01

    Pakistan has an infant mortality rate (IMR) of 90.5/1000 live births, and the country's child mortality level of 117.5 is worse than in other South Asian countries. Rapid population growth combined with rural-to-urban migration has led to the creation of urban slums in which morbidity levels are usually higher than in rural populations. A study was conducted in January 1993 in 6 slums of Karachi where the Aga Khan University has operated primary health care programs since 1985. Researchers recorded the deaths of 347 children under age 5 years old due to diarrhea and acute respiratory infections (ARI) during 1989-93. 235 mothers of these children were interviewed. The following are discussed as risk factors for under-5 child mortality: the use of traditional healers, poor nutritional status, incomplete or no immunization, the quick change of healers, inappropriate child care arrangements, mother's literacy, who decides about outside treatment, short birth interval, bottle feeding, and nuclear family structure. Maternal autonomy, appropriate health-seeking behavior, and child-rearing processes identified in the study point to the need for intervention strategies which go beyond the usual primary health care initiatives and involve communities in developing social support systems for mothers.

  2. 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

  3. Hyperendemic pulmonary tuberculosis in peri-urban areas of Karachi, Pakistan

    PubMed Central

    Akhtar, Saeed; White, Franklin; Hasan, Rumina; Rozi, Shafquat; Younus, Mohammad; Ahmed, Faiza; Husain, Sara; Khan, Bilquis Sana

    2007-01-01

    Background Currently there are very limited empirical data available on the prevalence of pulmonary tuberculosis among residents of marginalized settings in Pakistan. This study assessed the prevalence of pulmonary tuberculosis through active case detection and evaluated predictors of pulmonary tuberculosis among residents of two peri-urban neighbourhoods of Karachi, Pakistan. Methods A cross-sectional study was conducted in two peri-urban neighbourhoods from May 2002 to November 2002. Systematic sampling design was used to select households for inclusion in the study. Consenting subjects aged 15 years or more from selected households were interviewed and, whenever possible, sputum samples were obtained. Sputum samples were subjected to direct microscopy by Ziehl-Neelson method, bacterial culture and antibiotic sensitivity tests. Results The prevalence (per 100,000) of pulmonary tuberculosis among the subjects aged 15 years or more, who participated in the study was 329 (95% confidence interval (CI): 195 – 519). The prevalence (per 100,000) of pulmonary tuberculosis adjusted for non-sampling was 438 (95% CI: 282 – 651). Other than cough, none of the other clinical variables was significantly associated with pulmonary tuberculosis status. Analysis of drug sensitivity pattern of 15 strains of Mycobacterium tuberculosis revealed that one strain was resistant to isoniazid alone, one to streptomycin alone and one was resistant to isoniazid and streptomycin. The remaining 12 strains were susceptible to all five drugs including streptomycin, isoniazid, rifampicin, ethambutol, and pyrazinamide. Conclusion This study of previously undetected tuberculosis cases in an impoverished peri-urban setting reveals the poor operational performance of Pakistan's current approach to tuberculosis control; it also demonstrates a higher prevalence of pulmonary tuberculosis than current national estimates. Public health authorities may wish to augment health education efforts aimed at

  4. 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. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Benzodiazepine use among adults residing in the urban settlements of Karachi, Pakistan: A cross sectional study

    PubMed Central

    2011-01-01

    Background There are hardly any studies carried out in Pakistan on the usage of benzodiazepines at the level of community. This research was aimed to determine the frequency of benzodiazepine use, along with its associations with socio-demographic and clinical characteristics among community dwelling adults, residing in two urban settlements of Karachi, Pakistan. Methods We performed a cross sectional study from August 2008 to December 2009, in 2 areas of Karachi, namely Garden and Sultanabad. We followed the systematic sampling strategy to randomly select the households, with an adult of either sex and of age 18 years or more. Data collection was carried out through interview, using a pre-tested questionnaire, with items on socio-demographic position, medical history and benzodiazepine use. Student's t-test and χ2 test was employed to determine the associations between socio-demographic and clinical characteristics, and their relationship with benzodiazepine use was determined using applied logistic regression. Results The overall percentage of benzodiazepine consumption was estimated to be 14%. There were significantly more benzodiazepine users in the peri-urban Sultanabad community to the urban community of Garden (p-value = 0.001). The mean age (± SD) for users was 51.3 (± 15.6) years compared to 37.1 (± 14.4) years among non-users. Bromazepam was the most widely used benzodiazepine (29%); followed by diazepam, with a median duration on primary use being 144 weeks (IQR = 48-240). The adjusted logistic regression model revealed that increasing age, location, female sex, unemployment and psychiatric consultation were associated with increased likelihood of benzodiazepine use. Conclusion We believe the unregulated over-the-counter sales of benzodiazepines and social conditions might be playing a role in this high consumption of benzodiazepines in the community. PMID:21801457

  6. 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

  7. Stress, job satisfaction and work hours in medical and surgical residency programmes in private sector teaching hospitals of Karachi, Pakistan.

    PubMed

    Sameer-ur-Rehman; Kumar, Rohail; Siddiqui, Nabeel; Shahid, Zain; Syed, Sadia; Kadir, Masood

    2012-10-01

    To assess stress levels, job satisfaction and working hours of the residents in Medicine and Surgery and to explore a correlation among the three factors. The questionnaire-based. Cross-sectional study was conducted in 2011 at two tertiary level teaching hospitals in Karachi, Pakistan (Ziauddin University Hospital and Aga Khan University Hospital, Karachi, Pakistan). The study population comprised 176 residents, General Health Questionnaire-12 was used to assess the mental health of the residents and a standardised Job Satisfaction Survey tool was used to assess their work satisfaction. A total of 176 residents participated in the study; 115 (65%) from Medicine, and 61 (35%) from surgery. Of the total residents, 99 (56.3%) were under stress, and there was no significant difference in stress between Medicine and Surgery residents. Besides, 133 (75.6%) residents reported to be satisfied with their jobs. There was a statistically significant difference in job satisfaction between Medicine and Surgery residents (p < 0.001). Mean number of working hours per week reported by Medicine and Surgery residents were 74.82 +/- 15.95 and 92.07 +/- 15.91 respectively (p < 0.001). A positive correlation of mean working hours with both stress (p = 0.009) and job satisfaction (p = 0.029) was found. Medicine and Surgery residents tend to differ on mean working hours and job satisfaction. The greater mean working hours of the residents could be a possible reason for increased stress and decreased job satisfaction among the residents.

  8. 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

  9. Prevalence and determinants of asthma in adult male leather tannery workers in Karachi, Pakistan: a cross sectional study.

    PubMed

    Shahzad, Khurram; Akhtar, Saeed; Mahmud, Sadia

    2006-12-05

    This study aimed to estimate the prevalence and to identify some risk factors of adult asthma in male leather tannery workers in Karachi, Pakistan. A cross sectional study was conducted from August 2003 to March 2004 on leather tannery workers of Karachi, Pakistan. Data were collected from 641 workers engaged in 95 different tanneries in Korangi industrial area selected as sample of convenience. Face to face interviews were performed using a structured pre-tested questionnaire by trained data collectors. Prevalence of adult asthma was 10.8% (69/641) in this study population. The prevalence of perceived work-related asthma was 5.3% (34/641). Multivariable logistic regression model showed that after taking into account the age effect, the leather tannery worker were more likely to be asthmatic, if they were illiterate (adjusted OR = 2.13, 95% CI: 1.17-3.88), of Pathan ethnicity (adjusted OR = 2.69; 95% CI: 1.35-5.36), ever-smoked (adjusted OR = 2.22, 95% CI: 1.16-4.26), reportedly never used gloves during different tanning tasks (OR = 3.28; 95% CI : 1.72-6.26). Also, the final model showed a significant interaction between perceived allergy and duration of work. Those who perceived to have allergy were more likely to have asthma if their duration of work was 8 years (adjusted OR = 2.26; 95% CI: 1.19 - 4.29) and this relationship was even stronger if duration was 13 years (adjusted OR = 3.67; 95% CI: 1.98-6.79). Prevalence of asthma in leather tannery workers appears to be high and is associated with educational status, ethnicity, smoking, glove use, perceived to have allergy and duration of work.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ataur Rahman, Muhammad; Rahman, Bushra; Saeed Ahmad, Muhammad

    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 intomore » 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.« less

  11. Perceived gynecological morbidity among young ever-married women living in squatter settlements of Karachi, Pakistan.

    PubMed

    Sajan, F; Fikree, F F

    1999-04-01

    Community-based information on obstetric and gynecological morbidity in developing countries is meager and nearly non-existent in Pakistan. To estimate the prevalence of specific gynecological morbidities and investigate the predictors of pelvic inflammatory disease. Users [404] and non-users [313] of modern contraceptives were identified from eight squatter settlements of Karachi, Pakistan and detailed information on basic demographics, contraceptive use, female mobility, decision-making and gynecological morbidities were elicited. The perceived prevalence of menstrual disorders were 45.3%, uterine prolapse 19.1%, pelvic inflammatory disease 12.8% and urinary tract infection 5.4%. The magnitude of gynecological morbidity was high with about 55% of women reporting at least one gynecological morbidity though fewer [20%] reported at least two gynecological morbidities. Significant predictors of pelvic inflammatory disease were intrauterine contraceptive device users (OR = 3.1; 95% CI 1.7-5.6), age < or = 20 years (OR = 2.3; 95% CI 1.1-4.8) and urban life style (OR = 2.1; 95% CI 1.0-4.6). There is an immense burden of reproductive ill-health and a significant association between ever users of intrauterine contraceptive device and pelvic inflammatory disease. We therefore suggest improvement in the quality of reproductive health services generally, but specifically for family planning services.

  12. An autoregressive integrated moving average model for short-term prediction of hepatitis C virus seropositivity among male volunteer blood donors in Karachi, Pakistan

    PubMed Central

    Akhtar, Saeed; Rozi, Shafquat

    2009-01-01

    AIM: To identify the stochastic autoregressive integrated moving average (ARIMA) model for short term forecasting of hepatitis C virus (HCV) seropositivity among volunteer blood donors in Karachi, Pakistan. METHODS: Ninety-six months (1998-2005) data on HCV seropositive cases (1000-1 × month-1) among male volunteer blood donors tested at four major blood banks in Karachi, Pakistan were subjected to ARIMA modeling. Subsequently, a fitted ARIMA model was used to forecast HCV seropositive donors for 91-96 mo to contrast with observed series of the same months. To assess the forecast accuracy, the mean absolute error rate (%) between the observed and predicted HCV seroprevalence was calculated. Finally, a fitted ARIMA model was used for short-term forecasts beyond the observed series. RESULTS: The goodness-of-fit test of the optimum ARIMA (2,1,7) model showed non-significant autocorrelations in the residuals of the model. The forecasts by ARIMA for 91-96 mo closely followed the pattern of observed series for the same months, with mean monthly absolute forecast errors (%) over 6 mo of 6.5%. The short-term forecasts beyond the observed series adequately captured the pattern in the data and showed increasing tendency of HCV seropositivity with a mean ± SD HCV seroprevalence (1000-1 × month-1) of 24.3 ± 1.4 over the forecast interval. CONCLUSION: To curtail HCV spread, public health authorities need to educate communities and health care providers about HCV transmission routes based on known HCV epidemiology in Pakistan and its neighboring countries. Future research may focus on factors associated with hyperendemic levels of HCV infection. PMID:19340903

  13. Prevalence and determinants of asthma in adult male leather tannery workers in Karachi, Pakistan: A cross sectional study

    PubMed Central

    Shahzad, Khurram; Akhtar, Saeed; Mahmud, Sadia

    2006-01-01

    Background This study aimed to estimate the prevalence and to identify some risk factors of adult asthma in male leather tannery workers in Karachi, Pakistan. Methods A cross sectional study was conducted from August 2003 to March 2004 on leather tannery workers of Karachi, Pakistan. Data were collected from 641 workers engaged in 95 different tanneries in Korangi industrial area selected as sample of convenience. Face to face interviews were performed using a structured pre-tested questionnaire by trained data collectors. Results Prevalence of adult asthma was 10.8% (69/641) in this study population. The prevalence of perceived work-related asthma was 5.3% (34/641). Multivariable logistic regression model showed that after taking into account the age effect, the leather tannery worker were more likely to be asthmatic, if they were illiterate (adjusted OR = 2.13, 95% CI: 1.17–3.88), of Pathan ethnicity (adjusted OR = 2.69; 95% CI: 1.35–5.36), ever-smoked (adjusted OR = 2.22, 95% CI: 1.16–4.26), reportedly never used gloves during different tanning tasks (OR = 3.28; 95% CI : 1.72–6.26). Also, the final model showed a significant interaction between perceived allergy and duration of work. Those who perceived to have allergy were more likely to have asthma if their duration of work was 8 years (adjusted OR = 2.26; 95% CI: 1.19 – 4.29) and this relationship was even stronger if duration was 13 years (adjusted OR = 3.67; 95% CI: 1.98–6.79). Conclusion Prevalence of asthma in leather tannery workers appears to be high and is associated with educational status, ethnicity, smoking, glove use, perceived to have allergy and duration of work. PMID:17144930

  14. Risk factors predicting mortality in patients with lung abscess in a public tertiary care center in Karachi, Pakistan.

    PubMed

    Ghazal, Shaista; Kumar, Ashok; Shrestha, Binav; Sajid, Sana; Malik, Maria; Rizvi, Nadeen

    2013-01-01

    Lung abscess is a commonly encountered entity in South-East Asia but not much data regarding its outcome is available. The objective of this study was to identify the factors associated with increased mortality in patients diagnosed with lung abscess in a tertiary care center of Karachi, Pakistan. A retrospective case analysis was performed via hospital records, on patients admitted with lung abscess between January 2009 and January 2011 at the largest state-owned tertiary care centre in Karachi, Pakistan. Out of the 41 patients hospitalized, 17 could not survive and were evaluated for clinical, radiological and microbiological factors to determine association with heightened mortality. Mortality due to lung abscess stood at 41.4% (17 of 41 cases). Adult male patients were found to have higher mortality with 13 out of 17 (43%) dead patients being male. A majority (21/41, 51.2%) of the cases belonged to the 41-60 year old age group. Highest mortality was seen in patients<20 years of age (3/4, 75%). Patients with blood sugar levels of >200 mg/dL (56%) succumb to disease. Patients with a positive history of smoking, diabetes mellitus, and alcohol intake expressed mortality rates of 44%, 56%, and 50% respectively; while 29.4% of the mortalities were positive for Pseudomonas aeruginosa on sputum culture. A significant association was found with elevated mortality and low haemoglobin levels at time of admission; mortality was 58% (p=0.005) in patients with Hb less than or equal to 10 mg/dL. The risk factors involved with heightened mortality included male gender and history of smoking, diabetes and alcohol intake. High blood sugar levels and detection of Pseudomonas aeruginosa on sputum cultures were also implicated. Anemia (Hb level less than or equal to 10 mg/dl) was statistically significant predictive factor for increased mortality.

  15. The Burden of Non-Communicable Disease in Transition Communities in an Asian Megacity: Baseline Findings from a Cohort Study in Karachi, Pakistan

    PubMed Central

    Khan, Faisal S.; Lotia-Farrukh, Ismat; Khan, Aamir J.; Siddiqui, Saad Tariq; Sajun, Sana Zehra; Malik, Amyn Abdul; Burfat, Aziza; Arshad, Mohammad Hussham; Codlin, Andrew J.; Reininger, Belinda M.; McCormick, Joseph B.; Afridi, Nadeem; Fisher-Hoch, Susan P.

    2013-01-01

    Background The demographic transition in South Asia coupled with unplanned urbanization and lifestyle changes are increasing the burden of non-communicable disease (NCD) where infectious diseases are still highly prevalent. The true magnitude and impact of this double burden of disease, although predicted to be immense, is largely unknown due to the absence of recent, population-based longitudinal data. The present study was designed as a unique ‘Framingham-like’ Pakistan cohort with the objective of measuring the prevalence and risk factors for hypertension, obesity, diabetes, coronary artery disease and hepatitis B and C infection in a multi-ethnic, middle to low income population of Karachi, Pakistan. Methods We selected two administrative areas from a private charitable hospital’s catchment population for enrolment of a random selection of cohort households in Karachi, Pakistan. A baseline survey measured the prevalence and risk factors for hypertension, obesity, diabetes, coronary artery disease and hepatitis B and C infection. Results Six hundred and sixty-seven households were enrolled between March 2010 and August 2011. A majority of households lived in permanent structures (85%) with access to basic utilities (77%) and sanitation facilities (98%) but limited access to clean drinking water (68%). Households had high ownership of communication technologies in the form of cable television (69%) and mobile phones (83%). Risk factors for NCD, such as tobacco use (45%), overweight (20%), abdominal obesity (53%), hypertension (18%), diabetes (8%) and pre-diabetes (40%) were high. At the same time, infectious diseases such as hepatitis B (24%) and hepatitis C (8%) were prevalent in this population. Conclusion Our findings highlight the need to monitor risk factors and disease trends through longitudinal research in high-burden transition communities in the context of rapid urbanization and changing lifestyles. They also demonstrate the urgency of public

  16. Case Series of Naegleria fowleri Primary Ameobic Meningoencephalitis from Karachi, Pakistan.

    PubMed

    Ghanchi, Najia K; Jamil, Bushra; Khan, Erum; Ansar, Zeeshan; Samreen, Azra; Zafar, Afia; Hasan, Zahra

    2017-11-01

    Naegleria fowleri causes primary amoebic meningoencephalitis (PAM) which is almost always fatal. Naegleria fowleri is waterborne, and its infections are usually associated with aquatic activities but it can also be transmitted via the domestic water supply. An increasing number of N. fowleri cases have been reported from Pakistan. Improved methods for diagnosis are required. We report the utility of polymerase chain reaction (PCR) for the diagnosis of N. fowleri in patients suspected of PAM. One hundred and sixteen cases suspected of having PAM were examined. Cerebrospinal fluid (CSF) specimens were tested at the Aga Khan University Hospital, Karachi. Nineteen CSF specimens were positive for N. fowleri using PCR. Naegleria fowleri positive patients had a median age of 28 years and were 84% male and 16% female. Overall, CSF wet preparation microscopy was performed in 85 (73%) cases and identified that seven specimens were positive for motile trophozoites. The CSF wet preparation results were available for 15 of the 19 N. fowleri PCR positive CSF samples; seven (40%) wet preparations were positive. Our data highlight the threat of N. fowleri infection as a cause of PAM. It also emphasizes the utility of the PCR-based diagnosis of the amoeba for early diagnosis and management of the disease.

  17. Self-medication amongst university students of Karachi: prevalence, knowledge and attitudes.

    PubMed

    Zafar, Syed Nabeel; Syed, Reema; Waqar, Sana; Zubairi, Akbar Jaleel; Vaqar, Talha; Shaikh, Mehrine; Yousaf, Wajeeha; Shahid, Saman; Saleem, Sarah

    2008-04-01

    To determine the prevalence, attitude and knowledge of self-medication amongst university students of Karachi, Pakistan. This cross-sectional, study was conducted from Jan-Feb 2007. A convenience sample was taken from 2 medical and 2 non-medical universities of the city of Karachi, Pakistan. Data was analyzed using SPSS v 14 and associations were tested using the Chi square test. Of the 572 participants (mean age=21 +/- 1.8 years, Male: Female ratio=1:1.5), 295 were medical and 277 were non-medical students. The prevalence of self-medication was 76%. Forty three percent students stated that they alter the regimen of prescribed medicines while 61.9% stated that they stop taking a prescribed medicine without consulting a doctor. The most common reason for self-medication was previous experience (50.1%) and the most common symptoms were headache (72.4%), flu (65.5%), and fever (55.2%). Commonly used medicines were analgesics (88.3%), antipyretics (65.1%) and antibiotics (35.2%). Eighty seven percent of students thought self-medication could be harmful and 82.5% students thought that it was necessary to consult a doctor before taking a new medicine. There was no significant difference between the self medication practices of medical and non medical students (p=0.8) Prevalence of self-medication is high in the educated youth, despite majority being aware of its harmful effects. There is a need to educate the youth to ensure safe practices. Strict policies need to be implemented on the advertising and selling of medications to prevent this problem from escalating.

  18. 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

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

    PubMed

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

    2014-01-01

    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. 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. 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 CRs, 42 considered unnecessary

  20. 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.

  1. Demographic survey of the level and determinants of perinatal mortality in Karachi, Pakistan.

    PubMed

    Fikree, F F; Gray, R H

    1996-01-01

    A demographic survey was used to estimate the level and determinants of perinatal mortality in eight lower socio-economic squatter settlements of Karachi, Pakistan. The perinatal mortality rate was 54.1 per 1000 births, with a stillbirth to early neonatal mortality ratio of 1:1. About 65% of neonatal deaths occurred in the early neonatal period, and early neonatal mortality contributed 32% of all infant deaths. Risk factor assessment was conducted on 375 perinatal deaths and 6070 current survivors. Poorer socio-economic status variables such as maternal and paternal illiteracy, maternal work outside the home and fewer household assets were significantly associated with perinatal mortality as were biological factors of higher parental age, short birth intervals and poor obstetric history. Multivariable logistic analysis indicated that some socio-economic factors retained their significance after adjusting for the more proximate biological factors. Population attributable risk estimates suggest that public health measures for screening of high-risk women and use of family planning to space births will not improve perinatal mortality substantially without improvement of socio-economic conditions, particularly maternal education. The results of this study indicate that an evaluation of perinatal mortality can be conducted using pregnancy histories derived from demographic surveys.

  2. Frequency, pattern and management of acute abdomen in dengue fever in Karachi, Pakistan.

    PubMed

    Shamim, Muhammad

    2010-07-01

    This study aimed to determine the frequency, pattern and management of acute abdomen in patients with dengue fever. This descriptive case series is a prospective analysis of acute abdomen in dengue fever that was performed at three secondary care hospitals in Karachi, Pakistan from June 1, 2005 to December 31, 2008. The inclusion criterion was all patients with confirmed diagnosis of dengue fever. Patients with incomplete laboratory, ultrasound or histopathology data were excluded. Among 357 patients with dengue fever, 43 (12.04%) had acute abdomen. There were 15 men and 28 women, with a median age of 29 years. These included 26 cases of acute cholecystitis, 7 cases of acute appendicitis, 7 cases of nonspecific peritonitis, and 3 cases of acute pancreatitis. Dengue hemorrhagic fever/shock syndrome was found in acute pancreatitis, and two of these patients died. Emergency surgery was required in eight patients (5 appendectomy and 3 open cholecystectomy). Substantial transfusion of blood and its components was required in eight patients who underwent emergency surgery. Early diagnosis and prompt conservative management of dengue acute abdomen is necessary to avoid mortality and emergency surgery-related morbidity. However, if needed, surgery can be performed with acceptable morbidity. Copyright © 2010 Asian Surgical Association. Published by Elsevier B.V. All rights reserved.

  3. 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

  4. Association of salivary gland hypofunction with diabetes mellitus and drugs among the elderly in Karachi, Pakistan.

    PubMed

    Lone, Muneeb Ahmed; Shaikh, Sameer; Lone, Maham Muneeb; Afaq, Ashar; Lone, Mohid Abrar

    2017-05-01

    Studies from Pakistan on salivary dysfunction are lacking, and the Pakistani elderly population is rapidly growing. Among the most common problems in the elderly that could have a deleterious impact on their quality of life are salivary gland hypofunction (SGH), diabetes mellitus (DM), and the intake of drugs with adverse effects on salivary function. In the present study, we aimed to find the association of SGH with DM and drugs among the elderly in Karachi, Pakistan. The inclusion criterion was affirmative answers to a series of standardized questions related to the symptoms of dry mouth. A total of 110 individuals were selected from a convenience sample of 200 people aged between 60 and 70 years. Diabetes, drug use, and SGH in the participants were determined by detailed medical and drug history, clinical examination, and sialometry. Similar to their international counterparts, the majority of the study participants demonstrated objective evidence of SGH. More importantly SGH was found to be statistically significant with respect to DM and medication (P < 0.05). For participants on medication, the minimum and maximum salivary flow rates were found to be 0.09 mL/min and 0.3 ml/min, respectively, whereas the minimum and maximum salivary flow rates in diabetic participants were 0.01 mL/min and 0.09 mL/min, respectively. In the present study, the majority of elderly participants whose presenting complaint was oral dryness was found to have objective evidence of SGH, with a statistically-significant association with DM and drugs. © 2016 John Wiley & Sons Australia, Ltd.

  5. Clinical types of tinea capitis and species identification in children: an experience from tertiary care centres of Karachi, Pakistan.

    PubMed

    Farooqi, Maria; Tabassum, Saadia; Rizvi, Dilawar Abbas; Rahman, Atiya; Rehanuddin; Awan, Safia; Mahar, Sikandar Azam

    2014-03-01

    To study the clinical types of Tinea Capitis and identify species in children reporting to two tertiary care centres of Karachi, Pakistan. The descriptive, cross-sectional study was conducted at the Dermatology Outpatients' Department, PNS Shifa Hospital and the Institute of Skin Diseases, Karachi, from January 1, 2008 to December 31, 2009. It comprised 202 children with clinical diagnosis of tinea capitis, confirmed by skin scrapings, showing fungal hyphae and spores in 10% potassium hydroxide on direct microscopy. Wood's lamp examination was carried out and the scrapings were cultured on Sabouraud's agar. A detailed dermatological examination was performed for evidence of fungal infection elsewhere in the body. SPSS 19 was used for data analysis. Male-to-female ratio was 1.1:1 and age ranged from 1 to 14 years.The commonest clinical type gray patch was observed in 71 (35.1%) of the patients, black dot in 63 (31.2%), kerion in 50 (24.8%), favus in 10 (5.0%), diffuse pustular in 6 (3.0%), and diffuse scale in 2 (1.0%) patients. The most frequent species grown on culture was Trichophyton (T). Soudanense, followed by T. Tonsurans, T. Schoenleinii, and T. Mentagrophytes respectively. Most of the patients of Tinea capitis presented with gray patch and black dot variety. The most common species identified by culture was Trichophyton Soudanense. Disease was equal in both gender and predominantly affected the population belonging to low and middle socioeconomic class.

  6. Factors Associated With Child Maltreatment Among Children Aged 11 to 17 Years in Community Settings of Karachi, Pakistan, Using Belsky Ecological Framework.

    PubMed

    Lakhdir, Maryam Pyar Ali; Farooq, Salima; Khan, Uzma Rahim; Parpio, Yasmin; Azam, Syed Iqbal; Razzak, Junaid; Laljee, Anjiya Aslam; Kadir, Muhammad Masood

    2017-08-01

    Child maltreatment is considered as a global social issue and results as combined effect of parental background, socioeconomic environment, family structure, and child characteristics. The aim of this study was to determine factors associated with child maltreatment among children aged 11 to 17 years in Karachi, Pakistan. A cross-sectional survey of 800 pairs (children ranging from 11 to 17 years old and their parents) was randomly selected from 32 clusters of Karachi, using multistage cluster sampling. A structured questionnaire was adopted from the International Society for the Prevention of Child Abuse and Neglect (International Child Abuse Screening Tool for Parent [ICAST-P] and for Child [ICAST-C]). Multiple linear regression technique was used to assess the association of factors with child maltreatment score, by using STATA software. Our study found that children who always get bullied and mistreated by their siblings are at increased risk of getting maltreatment by parents (adjusted β: 10.78, 95% CI = [8.5, 13.05]).The mean estimated ICAST-C score increases by 9.86 (95% CI = [6.17, 13.55]) for children with exposure of verbal abuse and quarrel within family members. The mean estimated ICAST-C score increases by 5.09 among male children as compared with female children (95% CI = [3.65, 6.52]). Among children whose family always fight with each other and whose parents have exposure to childhood maltreatment, the mean estimated ICAST-C score increases by 22.25 (95% CI = [16.53, 27.98]). This study reflects the potential factors of child maltreatment in Karachi. Our findings provide evidence to raise awareness about child maltreatment.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

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

    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.

  8. Contrasting aerosol optical and radiative properties between dust and urban haze episodes in megacities of Pakistan

    NASA Astrophysics Data System (ADS)

    Iftikhar, Muhammad; Alam, Khan; Sorooshian, Armin; Syed, Waqar Adil; Bibi, Samina; Bibi, Humera

    2018-01-01

    Satellite and ground based remote sensors provide vital information about aerosol optical and radiative properties. Analysis of aerosol optical and radiative properties during heavy aerosol loading events in Pakistan are limited and, therefore, require in-depth examination. This work examines aerosol properties and radiative forcing during Dust Episodes (DE) and Haze Episodes (HE) between 2010 and 2014 over mega cities of Pakistan (Karachi and Lahore). Episodes having the daily averaged values of Aerosol Optical Depth (AOD) exceeding 1 were selected. DE were associated with high AOD and low Ångström Exponent (AE) over Karachi and Lahore while high AOD and high AE values were associated with HE over Lahore. Aerosol volume size distributions (AVSD) exhibited a bimodal lognormal distribution with a noticeable coarse mode peak at a radius of 2.24 μm during DE, whereas a fine mode peak was prominent at a radius 0.25 μm during HE. The results reveal distinct differences between HE and DE for spectral profiles of several parameters including Single Scattering Albedo (SSA), ASYmmetry parameter (ASY), and the real and imaginary components of refractive index (RRI and IRI). The AOD-AE correlation revealed that dust was the dominant aerosol type during DE and that biomass burning and urban/industrial aerosol types were pronounced during HE. Aerosol radiative forcing (ARF) was estimated using the Santa Barbra DISORT Atmospheric Radiative Transfer (SBDART) model. Calculations revealed a negative ARF at the Top Of the Atmosphere (ARFTOA) and at the Bottom Of the Atmosphere (ARFBOA), with positive ARF within the Atmosphere (ARFATM) during both DE and HE over Karachi and Lahore. Furthermore, estimations of ARFATM by SBDART were shown to be in good agreement with values derived from AERONET data for DE and HE over Karachi and Lahore.

  9. Influence of an Enforcement Campaign on Seat-Belt and Helmet Wearing, Karachi-Hala Highway, Pakistan

    PubMed Central

    Bhatti, Junaid A.; Ejaz, Kiran; Razzak, Junaid A.; Tunio, Israr Ali; Sodhar, Irshad

    2011-01-01

    This study assessed to what extent an enforcement campaign influenced seat-belt and helmet wearing on a Pakistani highway. The study setting was the Karachi-Hala highway where a traffic enforcement campaign was conducted from Dec 2009 to Feb 2010. Seat-belt and helmet wearing were observed in Nov 2009 and Apr 2010 at Karachi toll plaza. Differences in wearing rates as a function of occupants’ age, sex, and vehicle type were compared between the two periods. On average, 9 119 (Standard deviation=1 896) traffic citations were issued per month from Aug 2009 to Feb 2010; 4.2% of which were for not wearing helmet. A 22.5% increase in citations was observed for Dec 2009 to Feb 2010 periods compared with Aug 2009 to Oct 2009 periods. Nearly six thousand four-wheeled and four hundred two-wheeled motorized vehicle occupants were observed in Nov 2009 and Apr 2010. Overall, two of the five drivers and one of the five front seat occupants wore seat belts. This proportion was significantly higher in drivers and front-seat occupants of cars than those of heavier vehicles. Similarly, one of two motorcyclists used a helmet but this proportion was 5.8% for pillion riders in Nov 2009. The increased enforcement had a limited influence on belt wearing in drivers (+4.0%; 95% Confidence Interval [95%CI]=1.8–6.1) and occupants (+6.2%; 95%CI=4.2–8.2). A higher increase was observed for motorcyclists (+9.8%; 95%CI=2.6–16.8) and pillion riders (+12.8%; 95%CI=5.4, 20.5). These results suggested that serious efforts are required to increase seat-belt and helmet use on Pakistani highways. Improving enforcement resources, increased fines, not allowing such vehicles on roads, and awareness campaigns targeting drivers of heavy vehicles might increase wearing rates in Pakistan. PMID:22105384

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

    PubMed

    Premji, Shahirose; Khowaja, Shaneela; Meherali, Salima; Forgeron, Rachelle

    2014-07-16

    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. 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. 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. 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.

  11. 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

  12. 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

  13. Determinants of contraceptives use amongst youth: an exploratory study with family planning service providers in Karachi Pakistan.

    PubMed

    Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Hasnain, Farid Ul

    2013-01-05

    In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers' perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers' improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods.

  14. Determinants of Contraceptives Use amongst Youth: An Exploratory Study with Family Planning Service Providers in Karachi Pakistan

    PubMed Central

    Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Farid-Ul-Hasnain

    2013-01-01

    Introduction: In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers’ perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Method: Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Results: Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers’ improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Conclusion: Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods. PMID:23618469

  15. 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.

  16. Perceptions of Teachers towards Assessment Techniques at Secondary Level Private School of Karachi

    ERIC Educational Resources Information Center

    Fatemah, Henna

    2015-01-01

    This paper sets out to explore the perceptions of teachers towards assessment techniques at a secondary level private school of Karachi. This was conjectured on the basis of the circumstances of parallel boards in the education system of Pakistan and its effectiveness within the context with respect to the curriculum. This was gauged in line with…

  17. Group psychological intervention for maternal depression: A nested qualitative study from Karachi, Pakistan.

    PubMed

    Husain, Nusrat; Chaudhry, Nasim; Furber, Christine; Fayyaz, Hina; Kiran, Tayyeba; Lunat, Farah; Rahman, Raza Ur; Farhan, Saira; Fatima, Batool

    2017-06-22

    To understand the experience of maternal depression, the factors implicated in accessing health, and the acceptability of the psychosocial intervention. The participants were recruited from the paediatrics outpatient department of Civil Hospital Karachi, Pakistan. The study started in December 2009 and completed in December 2010. Women with maternal depression, aged 18-44 years with children aged 0-30 mo who had received nutritional supplements, and participated in the intervention programme [called Learning through Play (LTP) plus] were included in the study. Qualitative interviews were conducted with 8 participants before the intervention and 7 participants after the intervention. A semi structured topic guide was used to conduct the interviews. Framework analysis procedures were used to analyse the qualitative data. Four themes emerged: (1) the women's contextual environment: Interpersonal conflicts, lack of social support and financial issues being the major barriers in assessing healthcare; (2) women's isolation and powerlessness within the environment: Sense of loneliness was identified as a restricting factor to access healthcare; (3) the impact of the intervention (LTP-Plus): Women felt "listened to" and seemed empowered; and (4) empowered transformed women within the same contextual environment: The facilitator provided a "gardening role" in nurturing the women resulting in a positive transformation within the same environment. The women's homes seemed to be more happy homes and there was a positive change in their behaviour towards their children. Findings informed the further development and testing of culturally-appropriate psychosocial intervention (LTP + ) for addressing maternal depression.

  18. Predictors and outcome of tetanus in newborns in slum areas of Karachi City: a case control study.

    PubMed

    Sohaila, Arjumand; Shafiq, Yasir; Azim, Shazia; Baloch, Benazir; Akhtar, Ali Syed Muhammad; Tikmani, Shiyam Sunder; Brown, Nick

    2015-08-07

    Tetanus in newborns, is an under-reported public health problem and a major cause of mortality in developing countries. This study aimed to determine the predictors and outcome of tetanus in newborn infants in the slums of Bin-Qasim town, Karachi, Pakistan. We conducted a case-control study at primary health care centers of slums of Bin-Qasim town, area located adjacent to Bin Qasim seaport in Karachi, from January 2003 to December 2013. Cases were infants aged ≤30 days with tetanus, as defined by the World Health Organization. Controls were newborn infants aged ≤30 days without Tetanus, who were referred for a checkup or minor illnesses. The case to control ratio was 1:2. We analyzed 26 cases and 52 controls. The case fatality was 70.8%. We identified four independent predictors of Tetanus in newborns: maternal education (only religious education with no formal education OR 51.95; 95% CI 3.69-731), maternal non-vaccination (OR 24.55; 95% CI 1.01-131.77), lack of a skilled birth attendant (OR 44.00; 95% CI 2.30-840.99), and delivery at home (OR 11.54; 95% CI 1.01-131.77). We identified several potentially modifiable socio-demographic risk factors for Tetanus in newborns, including maternal education and immunization status, birth site, and lack of a skilled birth attendant. Prioritization of these risk factors could be useful for planning preventive and cost-effective measures.

  19. Association Between Intensive Handwashing Promotion and Child Development in Karachi, Pakistan

    PubMed Central

    Bowen, Anna; Agboatwalla, Mubina; Luby, Stephen; Tobery, Timothy; Ayers, Tracy; Hoekstra, R. M.

    2015-01-01

    Objective To evaluate associations between handwashing promotion and child growth and development. Design Cluster randomized controlled trial. Setting Informal settlements in Karachi, Pakistan. Participants A total of 461 children who were enrolled in a trial of household-level handwashing promotion in 2003 and were younger than 8 years at reassessment in 2009. Interventions In 2003, neighborhoods were randomized to control (n=9), handwashing promotion (n=9), or handwashing promotion and drinking water treatment (n=10); intervention households received free soap and weekly handwashing promotion for 9 months. Main Outcome Measures Anthropometrics and developmental quotients measured with the Battelle Developmental Inventory II at 5 to 7 years of age. Results Overall, 24.9% (95% CI, 20.0%–30.6%) and 22.1% (95% CI, 18.0%–26.8%) of children had z scores that were more than 2 SDs below the expected z scores for height and body mass index for age, respectively; anthropometrics did not differ significantly across study groups. Global developmental quotients averaged 104.4 (95% CI, 101.9–107.0) among intervention children and 98.3 (95% CI, 93.1–103.4) among control children (P=.04). Differences of similar magnitude were measured across adaptive, personal-social, communication, cognitive, and motor domains. Conclusions Although growth was similar across groups, children randomized to the handwashing promotion during their first 30 months of age attained global developmental quotients 0.4 SDs greater than those of control children at 5 to 7 years of age. These gains are comparable to those of at-risk children enrolled in publicly funded preschools in the United States and suggest that handwashing promotion could improve child wellbeing and societal productivity. Trial Registration clinicaltrials.gov Identifier: NCT01538953 PMID:22986783

  20. Knowledge and Attitude of Teenagers Towards Electronic Cigarettes in Karachi, Pakistan.

    PubMed

    Shaikh, Asim; Ansari, Hamza T; Ahmad, Zeerak; Shaikh, Mahnoor Y; Khalid, Ilma; Jahangir, Maha; Majeed, Amna; Shakeel, Nimra; Ahmed, Arsalan; Memon, Roha Saeed; Tariq, Eleze; Irfan, Rafia; Madni, Dania

    2017-07-13

    Introduction Studies have shown that electronic cigarettes have gained immense popularity and their use has increased dramatically all over the world. However, little is known about the knowledge and attitudes towards e-cigarettes in third world countries such as Pakistan. The aim of this study was to determine the perceptions of teenagers in Karachi regarding e-cigarettes and whether the differences in said perceptions were affected by gender and level of education. Methods We conducted a cross-sectional study in January 2017 using convenience sampling and interviewed 441 young individuals, aged 13 to 19 years, to determine their knowledge, attitudes, and practices regarding e-cigarettes. The participants were questioned about their knowledge and its source. Attitudes were judged using four and five-point Likert scales while questions regarding practices focused on single and current use. Chi-square and Mann-Whitney tests were applied to compare the knowledge, attitudes, and practices of teenagers with gender and level of schooling. Results The majority of participants knew what e-cigarettes were (n=277, 68.7%) but did not know about their contents (n=225, 55.8%) and had learned about them from either friends or the internet (n=245, 60.%). Almost half of them (n=190, 47.2%) believed that the reason for e-cigarette use was either peer pressure or to quit smoking conventional cigarettes. An overwhelming majority also stated that; it was either easy or very easy to obtain e-cigarettes (n=277, 68.7%), they would not try smoking e-cigarettes even if a good friend of theirs recommended them (n=287, 71.2%), they were not current e-cigarette smokers (n=370, 91.8%) and they would never promote e-cigarette use (n=371, 92.1%). Statistically significant differences were found with males knowing more about e-cigarettes (p=0.006) and being more common to either have smoked (p <0.001) or be current e-cigarette smokers (p <0.001). Furthermore, middle school students were more

  1. Pakistan: the new target of terrorism. Are Karachi's emergency medical response systems adequately prepared?

    PubMed

    Siddiqui, Muhammad Ahmed; Jawad, Ahmed; Minhas, Saeed; Ansari, Asma; Siddiqui, Afrah; Mehtab, Sana

    2009-07-01

    To assess the efficacy and preparedness of the pre-hospital and hospital emergency medical systems and post graduate trainees in the city to deal with a massive terrorist strike. A cross-sectional survey of postgraduate trainees was conducted at Jinnah Postgraduate Medical Center and Civil Hospital Karachi from 21st July 2007 to 24th July 2007, to evaluate the preparedness and self identified deficiencies of doctors involved in massive trauma casualty management. To assess the pre-hospital care in Karachi, structured telephonic interviews were conducted of administrators of two private run charity based ambulance services. Out of the 90 respondents questioned regarding a self assessment of their training, only 3 (3.3%) of them were confident about their management of bomb blast victims. Eighty-seven (96.6%) of the respondents felt they required some further training (44.4%) or comprehensive training (52.2%). No simulated drills or courses had been conducted for disaster management in the emergency department of the surveyed Hospitals. Most of the ambulance drivers had no paramedic training. Ambulances are equipped with a stretcher and an oxygen cylinder only. No resuscitation measures are available in the ambulances. With an increasing number of terrorist attacks in the country, massive influx of casualties in a relatively short time span has become a regular feature of the Pakistani hospital system. Lack of adequate training at pre-hospital and in hospital levels may translate into increasing morbidities and mortalities. It is imperative that training of junior doctors and paramedical staff be conducted regularly and an effective regional communication base established for efficient interdepartmental coordination.

  2. Uncontrolled diabetes mellitus: prevalence and risk factors among people with type 2 diabetes mellitus in an Urban District of Karachi, Pakistan.

    PubMed

    Siddiqui, Fahad Javaid; Avan, Bilal Iqbal; Mahmud, Sadia; Nanan, Debra J; Jabbar, Abdul; Assam, Pryseley Nkouibert

    2015-01-01

    This study aimed to explore the prevalence of, and factors associated with, uncontrolled diabetes mellitus (UDM) in a community setting in Pakistan. A single-center, cross-sectional study, conducted in a community-based specialized care center (SCC) for diabetes in District Central Karachi, in 2003, registered 452 type 2 DM participants, tested for HbA1c and interviewed face-to-face for other information. Logistic regression analysis was conducted to identify factors associated with UDM. Prevalence of UDM among diabetes patients was found to be 38.9% (95% CI: 34.4-43.4%). Multivariable logistic regression model analysis indicated that age <50 years (OR: 1.9; 95% CI: 1.2-2.9), being diagnosed in a hospital (vs. a clinic) (OR: 1.8; 95% CI: 1.1-2.8), diabetes information from a doctor or nurse only (vs. multiple sources) (OR: 1.8; 95% CI: 1.2-2.9), higher monthly treatment cost (OR: 1.3; 95% CI: 1.1-1.6; for every extra 500 PKR), and higher consumption of tea (OR: 1.5; 95% CI: 1.0-2.2; for every 2 extra cups) were independently associated with UDM. The prevalence of UDM was approximately 39% among persons with type 2 diabetes visiting a community based SCC for diabetes. Modifiable risk factors such as sources of diabetes information and black tea consumption can be considered as potential targets of interventions in Karachi. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Heterogeneity in geographical trends of HIV epidemics among key populations in Pakistan: a mathematical modeling study of survey data.

    PubMed

    Melesse, Dessalegn Y; Shafer, Leigh Anne; Emmanuel, Faran; Reza, Tahira; Achakzai, Baseer K; Furqan, Sofia; Blanchard, James F

    2018-06-01

    Assessing patterns and trends in new infections is key to better understanding of HIV epidemics, and is best done through monitoring changes in incidence over time. In this study, we examined disparities in geographical trends of HIV epidemics among people who inject drugs (PWIDs), female sex workers (FSWs) and hijra /transgender/male sex workers (H/MSWs), in Pakistan. The UNAIDS Estimation and Projection Package (EPP) mathematical model was used to explore geographical trends in HIV epidemics. Four rounds of mapping and surveillance data collected among key populations (KPs) across 20 cities in Pakistan between 2005-2011 was used for modeling. Empirical estimates of HIV prevalence of each KP in each city were used to fit the model to estimate prevalence and incidence over time. HIV incidence among PWIDs in Pakistan reached its peak in 2011, estimated at 45.3 per 1000 person-years. Incidence was projected to continue to rise from 18.9 in 2015 to 24.3 in 2020 among H/MSWs and from 3.2 in 2015 to 6.3 in 2020 among FSWs. The number of people living with HIV in Pakistan was estimated to steadily increase through at least 2020. HIV incidence peak among PWIDs ranged from 16.2 in 1997 in Quetta to 71.0 in 2010 in Faisalabad (per 1000 person-years). Incidence among H/MSWs may continue to rise through 2020 in all the cities, except in Larkana where it peaked in the early 2000s. In 2015, model estimated incidence among FSWs was 8.1 in Karachi, 6.6 in Larkana, 2.0 in Sukkur and 1.2 in Lahore (per 1000 person-years). There exists significant geographical heterogeneity in patterns and trends of HIV sub-epidemics in Pakistan. Focused interventions and service delivery approaches, different by KP and city, are recommended.

  4. Heterogeneity in geographical trends of HIV epidemics among key populations in Pakistan: a mathematical modeling study of survey data

    PubMed Central

    Melesse, Dessalegn Y; Shafer, Leigh Anne; Emmanuel, Faran; Reza, Tahira; Achakzai, Baseer K; Furqan, Sofia; Blanchard, James F

    2018-01-01

    Background Assessing patterns and trends in new infections is key to better understanding of HIV epidemics, and is best done through monitoring changes in incidence over time. In this study, we examined disparities in geographical trends of HIV epidemics among people who inject drugs (PWIDs), female sex workers (FSWs) and hijra/transgender/male sex workers (H/MSWs), in Pakistan. Methods The UNAIDS Estimation and Projection Package (EPP) mathematical model was used to explore geographical trends in HIV epidemics. Four rounds of mapping and surveillance data collected among key populations (KPs) across 20 cities in Pakistan between 2005-2011 was used for modeling. Empirical estimates of HIV prevalence of each KP in each city were used to fit the model to estimate prevalence and incidence over time. Results HIV incidence among PWIDs in Pakistan reached its peak in 2011, estimated at 45.3 per 1000 person-years. Incidence was projected to continue to rise from 18.9 in 2015 to 24.3 in 2020 among H/MSWs and from 3.2 in 2015 to 6.3 in 2020 among FSWs. The number of people living with HIV in Pakistan was estimated to steadily increase through at least 2020. HIV incidence peak among PWIDs ranged from 16.2 in 1997 in Quetta to 71.0 in 2010 in Faisalabad (per 1000 person-years). Incidence among H/MSWs may continue to rise through 2020 in all the cities, except in Larkana where it peaked in the early 2000s. In 2015, model estimated incidence among FSWs was 8.1 in Karachi, 6.6 in Larkana, 2.0 in Sukkur and 1.2 in Lahore (per 1000 person-years). Conclusions There exists significant geographical heterogeneity in patterns and trends of HIV sub-epidemics in Pakistan. Focused interventions and service delivery approaches, different by KP and city, are recommended. PMID:29770215

  5. Intimate partner violence and mental health effects: a population-based study among married women in Karachi, Pakistan.

    PubMed

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

    2013-03-01

    Intimate partner violence (IPV) is recognized all over the world for its association with mental health problems in women. In Pakistan, such violence occurs commonly, but detailed information on mental health effects is scarce. The purpose of this study is to focused on married couples in urban Karachi to investigate mental health effects associated with physical, sexual and psychological violence perpetrated by husbands towards wives. Disclosure rates and health care-seeking behaviour were also investigated. This cross-sectional study involved 759 women between the ages of 25 and 60 years, selected using a multi-stage random sampling technique. The women were interviewed by trained community midwives using a structured questionnaire. In the total population of women, mental symptoms were prevalent. Women subjected to any form of violence reported, however, considerably poorer mental health than unexposed women. A statistically significant difference for almost all of the studied health parameters persisted even after controlling for socio-demographic factors. The strongest associations were found for suicidal thoughts and physical violence (OR 4.41; 3.18-6.12), sexual abuse (OR 4.39; 3.17-6.07) and psychological abuse (OR 5.17; 3.28-8.15). The interviews revealed that only 27% of the women subjected to violence had disclosed this to anyone, in most cases to their parents. The findings in this study highlight that the violence women have to face contributes to the development of multiple forms of psychological stress and serious mental health problems. Women's restrictive life circumstances seriously hamper women's empowerment. Reliable health surveillance system and health care services are needed to serve abused women. Policy initiatives focused on IPV and gender inequality in Pakistan should be initiated.

  6. 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

  7. 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

  8. 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.

  9. Cancer profile of Hyderabad, Pakistan 1998-2002.

    PubMed

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

    2005-01-01

    Hyderabad is the third largest city of Pakistan, the second largest city of Sindh Province and one of the oldest cities of the sub-continent. This administrative headquarter is located just east of the River Indus and is an important commercial and industrial center. Once a provincial capital, it is at a distance of approximately 200-km from Karachi. This present study was conducted with the objective of providing the cancer profile of Hyderabad, which has an urban population of 2,840,653 (52.2% M, 47.8% F) annual growth rate 1.13. The city is inhabited by all ethnicities of the country, however the predominant ethnicity is Sindhi, followed by Mohajirs (post-partition immigrants from India), and a lesser extent other ethnicities of Pakistan viz. Baluchs, Punjabis and Pathans. The study includes two sets of patients. First the incident cancer cases, residents of Hyderabad, who reached Karachi for diagnosis or treatment. Second the incident cancer cases registered at the Aga Khan University Pathology-based Cancer Registry (APCR) Pathology collection points at Hyderabad and subsequently registered at APCR, during 1st January 1998 to 31st December 2002. The pathology department of the AKU has 3 centers in Hyderabad, which provide diagnostic pathology especially oncopathology services to the city. The age-standardized rates (ASR) for cancer (all sites) 1998 to 2002 in Hyderabad were 91.6/100,000 in males and 96.0/100,000 in females. The most common malignancies (ASR per 100,000) in males were oral cavity (11.8), lymphoma (10.6), lung (8.0), urinary bladder (6.8), prostate (4.8), liver (4.4), pharynx (4.2), colo-rectum (3.6), larynx (3.2), and skin (3.2). The cancers in females (ASR per 100,000) were breast (22.4), oral cavity (11.5), gall bladder (4.8), esophagus (4.2), cervix (3.6), ovary (3.4), colo-rectum (3.4), lymphoma (3.4), uterus (3.4), and thyroid (2.4). Tobacco-associated cancers were responsible for approximately 40.0% of the tumors in males and 20.0% in

  10. Inpatient satisfaction at different public sector hospitals of a metropolitan city in Pakistan: a comparative cross-sectional study.

    PubMed

    Hussain, Mehwish; Rehman, Rehana; Ikramuddin, Zia; Asad, Nava; Farooq, Ayesha

    2018-04-01

    To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance. Satisfaction with doctors, staff and administration of provincial and federal hospitals were comparatively similar (P > 0.05). However, satisfaction with treatment significantly differed in all four hospitals (P < 0.0001). Highest satisfaction with treatment was observed among inpatients of hospital running by medical institute (P < 0.0001). Comparison with respect to different departments revealed significant difference for treatment satisfaction of medicine and surgery units. Patients who were admitted from emergency mode acquired lowest satisfaction in all aspects. Response of inpatients from public sector hospitals showed satisfaction with healthcare personnel and related administration. However, treatment dimension needs to be improved to get more satisfaction.

  11. School Leadership in Pakistan: Exploring the Headteacher's Role.

    ERIC Educational Resources Information Center

    Simkins, Tim; Sisun, Charles; Memon, Muhammand

    2003-01-01

    Explores the nature of school leadership in Pakistan by drawing on two studies describing experiences of headteachers in Karachi. Identifies three determinants of personal efficacy of headteachers: The powers and accountability of the school system, community expectations within the context of the national culture, and the individual's personality…

  12. Pakistan Journal of Medical Sciences: A bibliometric assessment 2001-2010

    PubMed Central

    Baladi, Zameer Hussain; Umedani, Loung V.

    2017-01-01

    Objective: The aim of this study was to measure the growth of scientific research, authors’ productivity, affiliation with the institute and geographic locations published in the Pakistan Journal of Medical Sciences during the period of 2001 – 2010. Methods: This numerical analysis was conducted during mid-August 2016 to mid-October, 2016. The data for the study was downloaded from websites of e-journal of Pakistan Journal of Medical Sciences (PJMS) and Pak Medi-Net Com. Results: A total number of 1199 articled were covered by PJMS in 10 volumes and 40 issues with contribution of 3798 (3%) authors during 2001 – 2010. The average number of papers per issue is 30%. A gender wise contribution of males was higher 3050 (80%) than the females 748 (20%). A majority of articles were multi-authored 1052 (87%) as opposed to single author contribution 147 (13%). All 1199 articles were covered under four major disciplines i.e Basic medical sciences, medicine & allied, surgery & allied and radiological sciences and 39 sub-specialties according to medical subject headings (MeSH). It observed that 467 (39%) articles were published in Pakistan and 732 (61%) articles produced by other 32 countries. The Karachi city of Pakistan has produced 199 (16%) articles as highest as its national level and followed by Tehran (Iran) 77 (6%) as followed internationally. Conclusion: This study reveals that the participation of 32 countries in the PJMS publications proves it to be an internationally circulated journal to support research with the constant approach of publishing articles to each volume in basic medical sciences, biomedical, clinical and public health sciences. Abbreviations: DOAJ: Directory of Open Access Journals IMEMR: Index Medicus Eastern Mediterranean Region HEC: Higher Education Commission (Pakistan) PJMS: Pakistan Journal of Medical Sciences MeSH: Medical Subject Headings PMDC: Pakistan Medical & Dental Council SCIE: Science Citation Index Expanded PMID:28811801

  13. Pakistan Journal of Medical Sciences: A bibliometric assessment 2001-2010.

    PubMed

    Baladi, Zameer Hussain; Umedani, Loung V

    2017-01-01

    The aim of this study was to measure the growth of scientific research, authors' productivity, affiliation with the institute and geographic locations published in the Pakistan Journal of Medical Sciences during the period of 2001 - 2010. This numerical analysis was conducted during mid-August 2016 to mid-October, 2016. The data for the study was downloaded from websites of e-journal of Pakistan Journal of Medical Sciences (PJMS) and Pak Medi-Net Com. A total number of 1199 articled were covered by PJMS in 10 volumes and 40 issues with contribution of 3798 (3%) authors during 2001 - 2010. The average number of papers per issue is 30%. A gender wise contribution of males was higher 3050 (80%) than the females 748 (20%). A majority of articles were multi-authored 1052 (87%) as opposed to single author contribution 147 (13%). All 1199 articles were covered under four major disciplines i.e Basic medical sciences, medicine & allied, surgery & allied and radiological sciences and 39 sub-specialties according to medical subject headings (MeSH). It observed that 467 (39%) articles were published in Pakistan and 732 (61%) articles produced by other 32 countries. The Karachi city of Pakistan has produced 199 (16%) articles as highest as its national level and followed by Tehran (Iran) 77 (6%) as followed internationally. This study reveals that the participation of 32 countries in the PJMS publications proves it to be an internationally circulated journal to support research with the constant approach of publishing articles to each volume in basic medical sciences, biomedical, clinical and public health sciences. Abbreviations: DOAJ: Directory of Open Access Journals IMEMR: Index Medicus Eastern Mediterranean Region HEC: Higher Education Commission (Pakistan) PJMS: Pakistan Journal of Medical Sciences MeSH: Medical Subject Headings PMDC: Pakistan Medical & Dental Council SCIE: Science Citation Index Expanded.

  14. Understanding and perceptions of final-year Doctor of Pharmacy students about generic medicines in Karachi, Pakistan: a quantitative insight

    PubMed Central

    Jamshed, Shazia Qasim; Ibrahim, Mohamad Izham Mohamad; Hassali, Mohamad Azmi; Sharrad, Adheed Khalid; Shafie, Asrul Akmal; Babar, Zaheer-Ud-Din

    2015-01-01

    General objective To evaluate the understanding and perceptions of generic medicines among final-year Doctor of Pharmacy students in Karachi, Pakistan. Methods A 23-item survey instrument that included a question on the bioequivalence limits and Likert-type scale questions regarding the understanding and perceptions of generic medicines among the students was executed. Cronbach’s alpha was found to be 0.62. Results Responses were obtained from 236 final-year Doctor of Pharmacy students (n=85 from a publicly funded institute; n=151 from a privately funded institute). When comparing a brand-name medicine to a generic medicine, pharmacy students scored poorly on bioequivalence limits. More than 80% of the students incorrectly answered that all the products that are rated as generic equivalents are therapeutically equivalent to each other (P<0.04). Half of the students agreed that a generic medicine is bioequivalent to the brand-name medicine (P<0.001). With regard to quality, effectiveness, and safety, more than 75% of the students disagreed that generic medicines are of inferior quality and are less effective than brand-name medicines (P<0.001). More than 50% of the students disagreed that generic medicines produce more side effects than brand-name medicines (P<0.001). Conclusion The current study identified a positive perception toward generic medicines but also gaps in the understanding of generic medicines. Pharmacy students lacked a thorough understanding of the concepts of bioequivalence. Pharmacy academia should address these issues, which will help build confidence in generic medicines and increase the generic medicine use in Pakistan. PMID:26028981

  15. Impact of Self-Regulation Skills on Academic Performance of Young Children in Private Schools of Karachi

    ERIC Educational Resources Information Center

    Kathawala, Abeer; Bhamani, Shelina

    2015-01-01

    This research aimed to explore if self-regulation skills had any effect on the academic outcomes of young children in private schools of Karachi, Pakistan. Quantitative research method was used to determine the impact of self-regulation upon the academic outcome of young children by utilizing Early School Self-Regulation Scale-Care Giver Version…

  16. 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.

  17. 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

    2012-04-28

    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.

  18. Missed Immunization Opportunities Among Children Under 5 Years Of Age Dwelling In Karachi City.

    PubMed

    Khaliq, Asif; Sayed, Sayeeda Amber; Hussaini, Syed Abdullah; Azam, Kiran; Qamar, Mehak

    2017-01-01

    Immunization is the safest and effective measure for preventing and eradicating various communicable diseases. A glaring immunization gap exists between developing and industrialized countries towards immunization, because the developing countries including Pakistan are still striving to provide basic immunization to their children. The purpose of this study was to access the prevalence and factors of missing immunization among under 5-year children of Karachi.. A cross sectional study was conducted from June 2015 to October 2015 among different outpatient clinics of Karachi. Parents who had child less than 5 year of age were approached by non-probability purposive sampling. Data was analysed by using Statistical Package of Social Sciences. There were around 59.09% (n=156) and 64.43% (n=165) parents who have correctly responded regarding the number of essential immunization visit during the first and second year of their child life respectively. About 28.12% (n=108) parents responded that they do not know about the name and number of missed doses of vaccines. 31.78% (n=122) parents responded that their children have missed either one or more than one doses of routine immunization vaccines. Of which 34.42% (n=42) children have missed more than one vaccine. Lack of knowledge regarding immunization schedule 28.68% (n=34), concern about vaccine side effects 21.31%, (n=26), child sickness 17.21% (n=21), and lack of trust about government 10.65%, (n=13) were the major barriers identified by parents for missed immunization opportunities. Parents have inadequate knowledge regarding routine immunization visits, immunization schedule and vaccine doses. The practices of parents for routine childhood immunization are also poor. Parents refuse to immunize their child because of lack of immunization visit knowledge and also because of their doubts regarding vaccine potency and side effects. A proper system of immunization promotion, advocacy and reminder systems with proper

  19. Knowledge, Attitude And Practice Of Common Cold And Its Management Among Doctors Of Pakistan.

    PubMed

    Rehman, Muneeb-Ur-; Tariq, Naseer Alam; Ahmed, Mamoon; Ahmad, Maryam; Zahid, Areej; Chaudhry, Quratulain; Tahir, Bisma; Islam, Zoraiz Ul; Ud Din, Zahoor Mohi

    2016-01-01

    Antibiotic misuse for upper respiratory tract infections such as the common cold is widespread in clinical practice. Excessive prescription of antibiotics by doctors has resulted in increased antimicrobial resistance. This led to our objective of determining the percentage of doctors in Pakistan prescribing antibiotics for the treatment of common cold and to know about their knowledge in preventing the spread of this disease. It was a cross-sectional descriptive study, conducted in 9 cities of Pakistan including Rawalpindi, Islamabad, Peshawar, Lahore, Karachi, Faisalabad, Sargodha, Multan and D.G. Khan over a period of 03 months -from October to December, 2013. Questionnaire regarding the disease spread and its treatment was distributed among 300 randomly selected doctors in nine cities of Pakistan from both public and private sector. Eighteen percent of the doctors prescribe antibiotics for common cold. Only 113 (37.7%) doctors correctly responded that mean incubation period for common cold was 1-2 days. Two hundred and nine (69.7%) answered correctly that cold weather increases susceptibility to common cold. Only 84 (28%) responded correctly by choosing that regular and frequent hand-washing with good quality soaps was the most effective way to prevent spread of this disease in day-to-day life. Antibiotics are being prescribed for treatment of common cold by a large proportion of doctors. There is insufficient knowledge among our doctors regarding the factors which aggravate or alleviate common cold symptoms as well as the methods by which these infections can be prevented.

  20. 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

  1. Exposure assessment of lead from food and airborne dusts and biomonitoring in pregnant mothers, their fetus and siblings in Karachi, Pakistan and Shimotsuke, Japan.

    PubMed

    Kayama, Fujio; Fatmi, Zafar; Ikegami, Akihiko; Mizuno, Atsuko; Ohtsu, Mayumi; Mise, Nathern; Cui, Xiaoyi; Ogawa, Masanori; Sakamoto, Takako; Nakagi, Yoshiko; Yoshida, Takahiko; Sahito, Ambreen; Naeem, Shahla; Ghias, Kulsoom; Zuberi, Hina; Tariq, Kanwal; Kobayashi, Yayoi; Nohara, Keiko

    2016-03-01

    Exposure assessment of lead (Pb) and Arsenic (As) from food, water, and house dust intake were assessed among pregnant women, their children and fetuses in Pakistan and Japan, as well as their body burden of the metals in their blood. Fifty families which included a pregnant woman, a fetus and the 1-3-year-old siblings were recruited in Karachi and Khairpur in Pakistan, and Shimotsuke and Asahikawa in Japan, respectively. Their dietary exposure to Pb and As was measured in 3-day food duplicates and drinking water by ICP-MP. Pb in house dust and respirable dust was evaluated with an energy dispersive X-ray fluorescence spectrometry. Non-radioactive isotope Pb profiles of blood specimens will be compared with those of the exposure origins, such as food duplicates, respirable house dust, the soils nearby, and gasoline. Judging from the data collected and analyzed so far, contribution from dietary intake is highly correlated to higher body burden of Pb among Pakistani mothers. Additional data analyses will reveal the status of Pb and As body burden in Pakistani mothers, fetuses and their siblings, and causal sources of high body burden is delineated by Pb isotope profile analysis of different sources of Pb exposure.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Janjua, Naveed Zafar; Department of Community Health Sciences, Aga Khan University, Karachi; Delzell, Elizabeth

    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 factorsmore » 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

  3. 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

  4. Young Adults’ Perceptions on Life Prospects and Gender Roles as Important Factors to Influence Health Behaviour: A Qualitative Study from Karachi, Pakistan

    PubMed Central

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

    2012-01-01

    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 prosperity and 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. The study further reveals serious misconceptions about HIV/AIDS. 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

  5. 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

  6. Knowledge, attitudes and practices related to tetanus toxoid vaccination in women of childbearing age: A cross-sectional study in peri-urban settlements of Karachi, Pakistan.

    PubMed

    Shafiq, Yasir; Khowaja, Asif Raza; Yousafzai, Mohammad Tahir; Ali, Syed Asad; Zaidi, Anita; Saleem, Ali Faisal

    2017-09-01

    A higher incidence of neonatal tetanus implies failure of the vaccination program in Pakistan. The objective of this study was to assess knowledge, attitudes and practices related to tetanus toxoid (TT) vaccine in women of childbearing age. We performed a cross-sectional survey in peri-urban Karachi, Pakistan, among women of childbearing age, stratified into three mutually exclusive groups as: married pregnant; married non-pregnant; and unmarried. Descriptive and inferential analyses were performed to estimate vaccine coverage and knowledge attributes. A total of 450 women participated, of which the largest proportion were married and non-pregnant (n = 185/450, 41%). Over 50% of women (n = 258/450) had not received TT vaccine. Most unmarried women (n = 139, 97%) were unvaccinated. Non-vaccination predictors included: women aged <25 years without any formal education (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.0-4.4), lack of knowledge about free vaccination (adjusted OR, 4.0; 95% CI, 1.64-10.20), poor knowledge of tetanus disease/vaccination (adjusted OR, 4.6; 95%, 2.2-9.6), living with extended family (adjusted OR, 2.0; 95% CI, 1.04-3.96); family non-supporting vaccination (adjusted OR, 5.7; 95% CI, 2.3-13.9); and husband/other family member deciding upon issues related to women's health (adjusted OR, 2.9; 95% CI, 1.3-6.6). Low coverage of TT vaccine is largely influenced by poor knowledge, family structure and family decision-making in the local communities of Pakistan.

  7. Brand versus generic dispensing trend for ciprofloxacin 500 mg, levofloxacin 500 mg, and moxifloxacin 400 mg (oral dosage forms) among pharmacies of Karachi, Pakistan.

    PubMed

    Zehra, Fatima; Naqvi, Atta Abbas; Tasneem, Sumbul; Ahmad, Rizwan; Ahmad, Niyaz; Shamsi, Adnan Zia; Asghar, Naqiya Ali; Khan, Ghufran Ullah

    2017-01-01

    Pakistan spends 0.7% of its gross domestic product on health. The public sector health-care system provides services to 22% of population thus paving the way for a dominant private sector. Patients in Pakistan mostly pay their medical expenses directly, and 64% of the health expenditures are borne by the household. Expenditure on medicine constitutes 43% of the total household expenditure. A quantitative cross-sectional study was conducted in Karachi, Pakistan, for a month. It was aimed at gathering response from different pharmacies to understand the brand versus generic dispensing trend of ciprofloxacin 500 mg, levofloxacin 500 mg, and moxifloxacin 400 mg oral dosage forms. The study employed convenience sampling and used a survey checklist. The data gathered was entered in SPSS version 22. The mean price per tablet for ciprofloxacin brand and generic was reported at Pakistani Rupees (PKR) 48.44 and PKR 26.85, respectively. The trend for dispensing ciprofloxacin highlighted a split in the market between brand (51%) and generic (49%). For levofloxacin brand and generic, the price per tablet was reported at PKR 36.50 and PKR 36.15 respectively, and despite same price, the market was dominated by generic levofloxacin (92%). Due to a price difference between brand and generic moxifloxacin, i.e., PKR 129.44 and PKR 71.91, respectively, the market was mostly occupied by the generic form (75%). Pricing mechanism must be revisited, and the authorities should take stern actions against any illegitimate price hike. The surging burden of drug expenditure on poorer sections of the society must be addressed by the government on an urgent basis.

  8. 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.

  9. An evaluation of systematic tuberculosis screening at private facilities in Karachi, Pakistan.

    PubMed

    Creswell, Jacob; Khowaja, Saira; Codlin, Andrew; Hashmi, Rabia; Rasheed, Erum; Khan, Mubashir; Durab, Irfan; Mergenthaler, Christina; Hussain, Owais; Khan, Faisal; Khan, Aamir J

    2014-01-01

    In Pakistan, like many Asian countries, a large proportion of healthcare is provided through the private sector. We evaluated a systematic screening strategy to identify people with tuberculosis in private facilities in Karachi and assessed the approaches' ability to diagnose patients earlier in their disease progression. Lay workers at 89 private clinics and a large hospital outpatient department screened all attendees for tuberculosis using a mobile phone-based questionnaire during one year. The number needed to screen to detect a case of tuberculosis was calculated. To evaluate early diagnosis, we tested for differences in cough duration and smear grading by screening facility. 529,447 people were screened, 1,010 smear-positive tuberculosis cases were detected and 942 (93.3%) started treatment, representing 58.7% of all smear-positive cases notified in the intervention area. The number needed to screen to detect a smear-positive case was 124 (prevalence 806/100,000) at the hospital and 763 (prevalence 131/100,000) at the clinics; however, ten times the number of individuals were screened in clinics. People with smear-positive TB detected at the hospital were less likely to report cough lasting 2-3 weeks (RR 0.66 95%CI [0.49-0.90]) and more likely to report cough duration >3 weeks (RR 1.10 95%CI [1.03-1.18]). Smear-positive cases at the clinics were less likely to have a +3 grade (RR 0.76 95%CI [0.63-0.92]) and more likely to have +1 smear grade (RR 1.24 95%CI [1.02-1.51]). Tuberculosis screening at private facilities is acceptable and can yield large numbers of previously undiagnosed cases. Screening at general practitioner clinics may find cases earlier than at hospitals although more people must be screened to identify a case of tuberculosis. Limitations include lack of culture testing, therefore underestimating true TB prevalence. Using more sensitive and specific screening and diagnostic tests such as chest x-ray and Xpert MTB/RIF may improve results.

  10. Awareness and perceptions of electroconvulsive therapy among psychiatric patients: a cross-sectional survey from teaching hospitals in Karachi, Pakistan.

    PubMed

    Arshad, Mehreen; Arham, Ahmad Zafir; Arif, Mansoor; Bano, Maria; Bashir, Ayisha; Bokutz, Munira; Choudhary, Maria Maqbool; Naqvi, Haider; Khan, Murad Moosa

    2007-06-21

    Electroconvulsive therapy (ECT) is shown to be effective in many psychiatric illnesses, but its distorted projection by the Pakistani media and its unregulated use by many physicians across the country have adversely affected its acceptability. Given this situation we aimed to assess the awareness and perceptions regarding ECT as a treatment modality among the psychiatric patients. This was a questionnaire based cross-sectional study carried out at 2 tertiary care hospitals in Karachi, Pakistan. We interviewed 190 patients of which 140 were aware of ECT. The study showed that the level of education had a significant impact on the awareness of ECT (p = 0.009). The most common source of awareness was electronic and print media (38%), followed by relatives (24%) and doctors (23%). Physical injuries (42%) and neurological (12%) and cognitive disturbances (11%) were the commonly feared side effects. The most popular belief about ECT was that it was a treatment of last resort (56%). Thirty-nine percent thought that ECT could lead to severe mental and physical illness and 37% considered it inhumane. Patients' willingness to receive ECT was dependant on whether or not they were convinced of its safety (p = 0.001) and efficacy (p = 0.0001). We identified a serious lack of dissemination of information regarding ECT by the psychiatrists and the mental health care providers. This may be the result of an inadequate postgraduate training in Pakistan or just a lack of concern about the mentally ill patients. The media seemed to be the major source of information for our patients. We also saw the prevalence of a variety of myths regarding ECT in our society, which we feel may be responsible for the patients' adverse attitudes. Given the widespread applicability of ECT there is a dire need to dispel these misconceptions and improve its acceptability.

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

    PubMed

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

    2012-11-01

    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. 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. 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. In Karachi, interruption of polio transmission requires integrated and participatory community interventions targeting high-risk populations.

  12. 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

  13. International comparative study of childhood malignancy comparative study of pediatric malignancy between Kurume and Karachi (K-K Project 1991).

    PubMed

    Shakoor, A; Murakami, T; Yamashita, F

    1991-01-01

    A study was undertaken to compare Pediatric Malignancy at Kurume (Japan) and Karachi (Pakistan) with reference to international data collected over the years, in order to identify essential differences between developed and developing conditions and factors influencing the etio-pathogenesis of pediatric cancer. The study was retrospective encompassing all types of cancer in children over a period of three years i-e 1988-1990. Essential factors related to present study were: 1. The population of Karachi is about 10 million while that of Kurume is only half a million. 2. Socio-economic conditions: The average socio-economic condition of people in Karachi is poor while in Kurume it appears to be good. 3. Educational status: Only 25% people in Karachi are educated beyond middle class while Kurume reveals a 100% education up to high school level. 4. Environmental conditions: The environmental conditions of Kurume and surrounding areas are very clean and free from pollution, sewage problems and traffic hazards. Karachi and its surroundings on the other hand pose very serious air and water industries! It was concluded that whereas genetic predisposition predominates, the environmental conditions, educational and socio-economic status of a society immensely influence the pattern and trends of pediatric carcinogenesis.

  14. Implementing a public-private mix model for tuberculosis treatment in urban Pakistan: lessons and experiences.

    PubMed

    Naqvi, S A; Naseer, M; Kazi, A; Pethani, A; Naeem, I; Zainab, S; Fatmi, Z

    2012-06-01

    Six towns of Karachi, Pakistan. 1) To strengthen the capacity of general practitioners (GPs) in providing tuberculosis (TB) treatment through DOTS; and 2) to enhance collaboration between the public and private sectors in TB management and case reporting. A quasi-experimental study design was adopted to ensure enrolment of TB patients through trained GPs with the support of laboratory networks and to improve the case detection rate. The following challenges were faced during implementation of the model in urban settings: no systematic list of GPs was available; the majority of the GPs were untrained health practitioners working in squatter settlements, where formally trained GPs are most needed; the motivation of GPs with high patient loads is very low; and access to a laboratory is difficult. Of 35 patients enrolled in the first quarter (third quarter 2009), 87% completed their treatment successfully. Public-private mix (PPM) DOTS is feasible in the cities of Pakistan. However, the cost, time and effort required to establish the programme is higher than in many other developing countries.

  15. Social support intervention to promote resilience and quality of life in women living in Karachi, Pakistan: a randomized controlled trial.

    PubMed

    Hirani, Saima S; Norris, Colleen M; Van Vliet, K Jessica; Van Zanten, Sander Veldhuyzen; Karmaliani, Rozina; Lasiuk, Gerri

    2018-04-21

    This study tested the efficacy of a 6-week social support intervention for enhancing resilience and quality of life among women living in low socioeconomic areas of Karachi, Pakistan. One hundred and twenty women were randomly allocated to the intervention (n = 60) or control group (n = 60). Women in the intervention group attended a 6-week social support program, while those in the control group attended a single mental health awareness session. Outcome variables were measured via the resilience scale-14 item (RS-14), the resilience scale for adults (RSA), and World Health Organization quality of life brief scale (WHOQOL-BREF). Compared to participants in the control group, women in the intervention group reported improvements in resilience measured by RS-14 (p = 0.022) and the structured style subscale of the RSA (p = 0.043). A medium effect size was also measured on the structured style subscale (d = 0.6, 95% CI = 0.62874, 2.57126). No significant findings were noted on QOL scores. Community-based social support interventions are a gender-sensitive-, culturally appropriate-, and resource-sparing approach to promote women's resilience and improve their mental health.

  16. Pattern of external injuries sustained during bomb blast attacks in Karachi, Pakistan from 2000 to 2007.

    PubMed

    Surani, Arif Anwar; Ali, Salman; Surani, Asif; Zahid, Sohaib; Shoukat, Akber; Varon, Joseph; Surani, Salim

    2015-07-01

    To evaluate patterns of external injury resulting from bomb blasts in Karachi, and compare the injury profile resulting from explosions in open versus semi-confined blast environments. The retrospective, cross-sectional study was conducted in Karachi and comprised relevant data from January 2000 to October 2007. Casualty medical records and medico-legal certificates of the victims presented to three large public-sector hospitals were evaluated using a self-designed proforma. SPSS 17 was used for statistical analysis. Of the 1146 victims, data of 481(42%) represented the final study sample. Of these, 306(63.6%) were injured in open spaces and 175(36.4%) in semi-confined spaces. Of the 896 recorded injuries, lacerations were encountered as external injury in 427(47.7%) cases, followed by penetrating wounds in 137(15.3%). Lower and upper extremities were injured in 348(38.8%) and 170(19%) victims respectively. Open and semi-confined blast environments produced specific injury pattern and profile (p<0.001). External injuries sustained during bomb blast attacks in Karachi demonstrated specific injury patterns and profiles. Further studies are required to account for internal injuries and classification of injuries based on standardised scoring systems.

  17. An Attempt to Design a Naturally Ventilated Tower in Subtropical Climate of the Developing Country; Pakistan

    NASA Astrophysics Data System (ADS)

    Sohail, Maha

    2017-12-01

    A large proportion of the world's population resides in developing countries where there is a lack of rigorous studies in designing energy efficient buildings. This study is a step in designing a naturally ventilated high rise residential building in a tropical climatic context of the developing country, Pakistan. Karachi, the largest city of Pakistan, lies in the subtropical hot desert region with constant high temperature of average 32 °C throughout the summer and no particular winter season. The Design Builder software package is used to design a 25 storey high rise residential building relying primarily on natural ventilation. A final conceptual design is proposed after optimization of massing, geometry, orientation, and improved building envelope design including extensive shading devices in the form of trees. It has been observed that a reduction of 8 °C in indoor ambient temperature is possible to achieve with passive measures and use of night time ventilation. A fully naturally ventilated building can reduce the energy consumption for cooling and heating by 96 % compared to a building using air conditioning systems.

  18. Stress Faced by Pakistani Mothers of Children with Intellectual Disabilities and Its Impact on Their Family Life

    ERIC Educational Resources Information Center

    Sajjad, Shahida

    2011-01-01

    This exploratory study was designed to examine the stress faced by mothers of children with intellectual disabilities in Pakistan and the impact of the stress on their family life. One hundred mothers of children with intellectual disabilities in Karachi city, which is in Sindh region of Pakistan, were invited and interviewed. The results indicate…

  19. New records and a new species of chewing lice (Phthiraptera, Amblycera, Ischnocera) found on Columbidae (Columbiformes) in Pakistan

    PubMed Central

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

    2012-01-01

    Abstract The chewing lice (Phthiraptera) of Columbidae (Columbiformes) from Pakistan are studied. Six species of chewing lice with new host records are recorded and one new species of the genus Colpocephalum is described from Columba livia in the Karachi region. All the columbid chewing lice from Pakistan are keyed out and the new species is illustrated and compared with the closest allied species. PMID:22451786

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

    PubMed

    Dawani, Narendar; Nisar, Nighat; Khan, Nazeer; Syed, Shahbano; Tanweer, Navara

    2012-12-27

    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. 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. 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 < 0.029, RR = 1.248, 95% Bias corrected CI 0.029-0.437) and 5-years (p-value < 0.009, RR = 1.545, 95% Bias corrected CI 0.047-0.739), presence of dental plaque (p-value < 0.003, RR = 0.744, 95% Bias corrected CI (-0.433)-(-0.169)), poor oral hygiene (p-value < 0.000, RR = 0.661, 95% Bias corrected CI (-0.532)-(-0.284)), as well as consumption of non-sweetened milk (p-value < 0.049, RR = 1.232, 95% Bias corrected CI 0.061-0.367). 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.

  1. 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. © The Author(s) 2016.

  2. Abuse among school going adolescents in three major cities of Pakistan: is it associated with school performances and mood disorders?

    PubMed

    Khawaja, Saleem; Khoja, Adeel Akbar; Motwani, Komal

    2015-02-01

    To assess the proportion of various types of abuses and their association with school performances and psychological stress among adolescents from three major cities of Pakistan. The cross-sectional school survey was conducted from March to September 2009, comprising adolescent students at six schools in Karachi, Lahore and Quetta. Data was collected using a self-administered and pre-tested questionnaire by trained medical students. SPSS 16 was used for statistical analysis. Of the 414 subjects in the study, there were 223 (54%) boys and 191 (46%) girls with an overall mean age of 14.36 ± 1.08 years. In all, 140 (33.7%) participants were physically abused and 236 (57%) participants were verbally abused in the preceding 12 months. Besides, 245 (59.2%) were involved in physical fight and 195 (47.1%) had suffered injury during the preceding year. There were 171 (41.4%) subjects having suffered bullying during the same period. Verbal abuse (p = 0.05), physical fight (p = 0.05) and bullying (p < 0.001) were significantly associated with poor school performances among adolescents. Physical abuse (p = 0.05), verbal abuse (p = 0.003), injury (p = 0.02) and bullying (p < 0.001) were significantly associated with psychological stress. Various types of abuse were quite prevalent in adolescents that were significantly associated with poor school performance and poor mental health.

  3. An Evaluation of Systematic Tuberculosis Screening at Private Facilities in Karachi, Pakistan

    PubMed Central

    Creswell, Jacob; Khowaja, Saira; Codlin, Andrew; Hashmi, Rabia; Rasheed, Erum; Khan, Mubashir; Durab, Irfan; Mergenthaler, Christina; Hussain, Owais; Khan, Faisal; Khan, Aamir J.

    2014-01-01

    Background In Pakistan, like many Asian countries, a large proportion of healthcare is provided through the private sector. We evaluated a systematic screening strategy to identify people with tuberculosis in private facilities in Karachi and assessed the approaches' ability to diagnose patients earlier in their disease progression. Methods and Findings Lay workers at 89 private clinics and a large hospital outpatient department screened all attendees for tuberculosis using a mobile phone-based questionnaire during one year. The number needed to screen to detect a case of tuberculosis was calculated. To evaluate early diagnosis, we tested for differences in cough duration and smear grading by screening facility. 529,447 people were screened, 1,010 smear-positive tuberculosis cases were detected and 942 (93.3%) started treatment, representing 58.7% of all smear-positive cases notified in the intervention area. The number needed to screen to detect a smear-positive case was 124 (prevalence 806/100,000) at the hospital and 763 (prevalence 131/100,000) at the clinics; however, ten times the number of individuals were screened in clinics. People with smear-positive TB detected at the hospital were less likely to report cough lasting 2–3 weeks (RR 0.66 95%CI [0.49–0.90]) and more likely to report cough duration >3 weeks (RR 1.10 95%CI [1.03–1.18]). Smear-positive cases at the clinics were less likely to have a +3 grade (RR 0.76 95%CI [0.63–0.92]) and more likely to have +1 smear grade (RR 1.24 95%CI [1.02–1.51]). Conclusions Tuberculosis screening at private facilities is acceptable and can yield large numbers of previously undiagnosed cases. Screening at general practitioner clinics may find cases earlier than at hospitals although more people must be screened to identify a case of tuberculosis. Limitations include lack of culture testing, therefore underestimating true TB prevalence. Using more sensitive and specific screening and diagnostic tests such as

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

    PubMed

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

    2015-01-01

    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. 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. 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. 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 cost-reduction measures are needed to reduce

  5. 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

  6. Knowledge and perceptions of polio and polio immunization in polio high-risk areas of Pakistan.

    PubMed

    Habib, Muhammad Atif; Soofi, Sajid Bashir; Ali, Noshad; Hussain, Imtiaz; Tabassum, Farhana; Suhag, Zamir; Anwar, Saeed; Ahmed, Imran; Bhutta, Zulfiqar Ahmed

    2017-02-01

    Pakistan and Afghanistan remain the only countries where polio is endemic, and Pakistan reports the most cases in the world. Although the rate is lower than in previous years, the situation remains alarming. We conducted a mixed methods study in high-risk areas of Pakistan to identify knowledge, attitudes, and practices of target populations about polio vaccine and its eradication, and to estimate coverage of routine immunization and oral polio vaccine. We surveyed 10,685 households in Karachi, 2522 in Pishin, and 2005 in Bajaur. Some knowledge of polio is universal, but important misconceptions persist. The findings of this study carry strategic importance for program direction and implementation.

  7. JPRS Report, Near East & South Asia, Pakistan

    DTIC Science & Technology

    1991-08-09

    more specifically so long as it is well planned and well implemented; and Karachi’s and Hyderabad’s) cancerous eruptions of is preceded by reliable...is it rest of Pakistan. Unless we start to cure it, the cancer of a very distinctive or rare quality in this country. social violence shall spread...are numerous reports of smugglers operating in bail by the High Court on medical grounds. He was connivance with the FC, Customs, Levys and the PNCB

  8. Association between intensive handwashing promotion and child development in Karachi, Pakistan: a cluster randomized controlled trial.

    PubMed

    Bowen, Anna; Agboatwalla, Mubina; Luby, Stephen; Tobery, Timothy; Ayers, Tracy; Hoekstra, R M

    2012-11-01

    To evaluate associations between handwashing promotion and child growth and development. Cluster randomized controlled trial. Informal settlements in Karachi, Pakistan. A total of 461 children who were enrolled in a trial of household-level handwashing promotion in 2003 and were younger than 8 years at reassessment in 2009. In 2003, neighborhoods were randomized to control (n = 9), handwashing promotion (n = 9), or handwashing promotion and drinking water treatment (n = 10); intervention households received free soap and weekly handwashing promotion for 9 months. Anthropometrics and developmental quotients measured with the Battelle Developmental Inventory II at 5 to 7 years of age. Overall, 24.9% (95% CI, 20.0%-30.6%) and 22.1% (95% CI, 18.0%-26.8%) of children had z scores that were more than 2 SDs below the expected z scores for height and body mass index for age, respectively; anthropometrics did not differ significantly across study groups. Global developmental quotients averaged 104.4 (95% CI, 101.9-107.0) among intervention children and 98.3 (95% CI, 93.1-103.4) among control children (P = .04). Differences of similar magnitude were measured across adaptive, personal-social, communication, cognitive, and motor domains. Although growth was similar across groups, children randomized to the handwashing promotion during their first 30 months of age attained global developmental quotients 0.4 SDs greater than those of control children at 5 to 7 years of age. These gains are comparable to those of at-risk children enrolled in publicly funded preschools in the United States and suggest that handwashing promotion could improve child well-being and societal productivity. clinicaltrials.gov Identifier: NCT01538953.

  9. Why do Families of Sick Newborns Accept Hospital Care? A Community-Based Cohort Study in Karachi, Pakistan

    PubMed Central

    Owais, Aatekah; Sultana, Shazia; Stein, Aryeh D.; Bashir, Nasira H.; Awaldad, Razia; Zaidi, Anita K M

    2011-01-01

    Objective Sick young infants are at high risk of mortality in developing countries but families often decline hospital referral. Our objective was to identify the predictors of acceptance of referral for hospital care among families of severely ill newborns and infants <59 days old in three low-income communities of Karachi, Pakistan. Study design A cohort of 541 newborns and infants referred from home by community health workers doing household surveillance, and diagnosed with a serious illness at local community clinics between January 1 and December 31, 2007, was followed-up within 1 month of referral to the public hospital. Results Only 24% of families accepted hospital referral. Major reasons for refusal were financial difficulties (67%) and father/elder denying permission (65%). Religious/cultural beliefs were cited by 20% of families. Referral acceptance was higher with recognition of severity of the illness by mother (OR=12.7; 95% CI=4.6–35.2), family’s ability to speak the dominant language at hospital (OR=2.0; 95% CI=1.3–3.1), presence of grunting in the infant (OR=3.3; 95% CI=1.2–9.0), and infant temperature <35.5°C (OR=4.1; 95% CI=2.3–7.4). No gender differential was observed. Conclusion Refusal of hospital referral for sick young infants is very common. Interventions that encourage appropriate care seeking, as well as community-based management of young infant illnesses when referral is not feasible are needed to improve neonatal survival in low-income countries. PMID:21273989

  10. 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

  11. Improving Practices in Early Childhood Classrooms in Pakistan: Issues and Challenges from the Field

    ERIC Educational Resources Information Center

    Juma, Audrey

    2004-01-01

    This article focuses on an early childhood programme that has been initiated by the Institute for Educational Development at the Aga Khan University in Karachi, Pakistan. The programme is a Certificate in Education and involves training teachers so as to enable them to understand early childhood education and development, and to become effective…

  12. Assessing reasons for school/college dropout among young adults and implications for awareness about STDs and HIV/AIDS: findings from a population-based study in Karachi, Pakistan.

    PubMed

    Farid-ul-Hasnain, Syed; Krantz, Gunilla

    2011-06-01

    Dropping out of school/college not only impedes economic prosperity but may also result in poor knowledge and awareness about sexually transmitted diseases (STDs). This study investigated, among young adults in Karachi, Pakistan, the risk factors associated with involuntary school/college dropout and the implications for awareness about HIV/AIDS and STDs. A population-based, cross-sectional study of 1,650 young males and females, aged 17-21 years and living in Karachi, was conducted using a structured questionnaire. Bivariate and multivariate analyses were performed separately for males and females. Females were twice as likely to drop out of school/college as males. Furthermore, migrant residential status, living in an extended family and lower socio-economic status were identified as risk factors for school/college dropout both for males and females. In the total sample, only 17% of males and 13% of females had heard of STDs (p = 0.020). Furthermore, 26.8% of males and 20.5% of females had not heard of HIV/AIDS (p = 0.003). The females exhibited a higher level of awareness on these matters than the males, irrespective of whether they had dropped out of school or not. While the males who dropped out were considerably less aware than those who remained at school, there was no such difference among females. Young adults from poor families are at increased risk of dropping out of school/college. Among the dropouts, males were clearly at risk of ignorance about STDs while females were somewhat better informed.

  13. 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

  14. An insight into frequency and predictors leading psychiatric patients to visit faith healers: A hospital-based cross-sectional survey, Karachi, Pakistan.

    PubMed

    Khoso, Aneeta; Soomro, Rafiq Ahmed; Quraishy, Ayesha Muquim; Khan, Hammad Ali; Ismail, Saba; Nazaz, Mehrunnisa; Younus, Sana; Zainab, Saima

    2018-05-01

    Psychiatric illnesses have recently escalated in numbers, with patients resorting to various forms of healthcare providers, including faith healers. This delays early psychiatric treatment, resulting in further mental health deterioration of the patient. Various factors impact the mode of treatment preferred by psychiatric patients. To determine the frequency of psychiatric patients visiting faith healers, presenting at the outpatient department of Liaquat National Hospital, Karachi, Pakistan, and to explore the predictors that direct them toward visiting faith healers. This cross-sectional survey was conducted using a semi-structured pre-tested questionnaire, employing a total of 219 male and female psychiatric patients. Patients were recruited through non-random consecutive sampling technique. SPSS 18 was used for statistical analysis. About 32% of the patients had visited a faith healer in their lifetime. Frequency of current visitors declined; the most frequent reason being stated was no relief from their treatment. Students, patients of upper middle class and those coming for initial visit to a psychiatrist were more likely to visit a faith healer. Patients who knew of someone previously visiting a faith healer were less likely to have visited a faith healer. This study highlights the importance of a multisectoral approach to dealing with psychiatric patients to help in bridging the treatment gap in mental health.

  15. ASSESSING THE KNOWLEDGE, ATTITUDES AND PRACTICES OF SCHOOL TEACHERS REGARDING DYSLEXIA, ATTENTION-DEFICIT/ HYPERACTIVITY AND AUTISTIC SPECTRUM DISORDERS IN KARACHI, PAKISTAN.

    PubMed

    Lodhi, Shaia Kan; Thaver, Danyal; Akhtar, Irfan Nake; Javaid, Hina; Masoor, Maman; Bano, Shah; Malik, Fatima Noor; Iqbal, Mehreen Rizwana; Hashmi, Hassan Raza; Siddiqullah, Syed; Saleem, Sarah

    2016-01-01

    Learning impairments in children consist of a spectrum of disorders that are under diagnosed in Pakistan. Most learning disorders have long term consequences for a child and early detection is thus imperative. Teachers may be able to play a key role in such identification. The objective of our study was to survey knowledge, attitudes and practices of school teachers regarding dyslexia, Attention-deficit/hyperactivity disorder (ADHD) and autistic spectrum disorder, and assess their ability to identify learning disabilities. A cross-sectional study was conducted with 233 primary school teachers from Karachi using a self-administered questionnaire. Mean scores for the knowledge test and the ability to identify learning- impaired children were 58.8% and 53.3%, respectively. Better qualified teachers scored significantly more on the knowledge and ability to identify learning impairments sections. Most teachers believed that these students should study in mainstream schools with special educators. Majority of the teachers belonged to schools where children with learning disabilities were detected using teachers' judgment. Most teachers manage these children by involving them in discussions, seating them at the front of the class, and giving them extra time. Knowledge about learning disabilities is very low amongst school teachers, which may limit their ability to identify learning impairments.

  16. Association of tobacco use and other determinants with pregnancy outcomes: a multicentre hospital-based case-control study in Karachi, Pakistan.

    PubMed

    Rozi, Shafquat; Butt, Zahid Ahmad; Zahid, Nida; Wasim, Saba; Shafique, Kashif

    2016-09-20

    The study aimed to identify the effects of maternal tobacco consumption during pregnancy and other factors on birth outcomes and obstetric complications in Karachi, Pakistan. A multicentre hospital-based case-control study. Four leading maternity hospitals of Karachi. A random sample of 1275 women coming to the gynaecology and obstetric department of selected hospitals for delivery was interviewed within 48 hours of delivery from wards. Cases were women with adverse birth outcomes and obstetric complications, while controls were women who had normal uncomplicated delivery. Adverse birth outcomes (preterm delivery, low birth weight, stillbirth, low Apgar score) and obstetric complications (antepartum haemorrhage, caesarean section, etc). Final multiple logistic regression analysis revealed that with every 1 year increase in age the odds of being a case was 1.03 times as compared with being a control. Tobacco use (adjusted OR (aOR): 2.24; 95% CI 1.56 to 3.23), having no slits in the kitchen (proxy indicator for indoor air pollution) (aOR=1.90; 95% CI 1.05 to 3.43), gravidity (aOR=0.83; 95% CI 0.73 to 0.93), non-booked hospital cases (aOR=1.87; 95% CI 1.38 to 2.74), history of stillbirth (aOR=4.06; 95% CI 2.36 to 6.97), miscarriages (aOR=1.91; 95% CI 1.27 to 2.85) and preterm delivery (aOR=6.04; 95% CI 2.52 to 14.48) were significantly associated with being a case as compared with control. This study suggests that women who had adverse pregnancy outcomes were more likely to have exposure to tobacco, previous history of adverse birth outcomes and were non-booked cases. Engagement of stakeholders in tobacco control for providing health education, incorporating tobacco use in women in the tobacco control policy and designing interventions for tobacco use cessation is warranted. Prenatal care and health education might help in preventing such adverse events. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  17. 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

  18. Diabetes related knowledge among residents and nurses: a multicenter study in Karachi, Pakistan.

    PubMed

    Ahmed, Asma; Jabbar, Abdul; Zuberi, Lubna; Islam, Muhammad; Shamim, Khusro

    2012-09-11

    Assessment of knowledge among resident trainees and nurses is very important since majority of patients admitted in hospital have underlying diabetes which could lead to adverse clinical outcomes if not managed efficiently. Therefore, the purpose of this study was to evaluate and compare the knowledge related to the management of diabetes among registered nurses (RN) and trainee residents of internal medicine (IMR), family medicine (FMR) and surgery (SR) at tertiary care hospitals of Karachi, Pakistan. A validated questionnaire consisting of 21 open ended questions related to diabetes awareness was acquired through a study done at Thomas Jefferson University Hospital, Philadelphia with the permission of primary author. 169 IMR, 27 FMR, 86 SR and 99 RN completed a questionnaire that assessed the knowledge related to different aspects of management of diabetes. The results were further stratified by participant's specialty and level of training. The percentage of knowledge based questions answered correctly was found to be low. The overall mean correct percentage among all the participants was 50% +/- 21. There was no statistical difference in terms of knowledge between IMR & FMR residents (64% +/- 14 vs. 60% +/- 16, p = 0.47) respectively. The total scores of SR and RN were quite low (40% +/- 16 & 31% +/- 15 respectively).SR and RN were found to have profound deficit in both inpatient and outpatient knowledge of diabetes. We did not observe any improvement in level of knowledge of FMR & SR with increase in duration of their training (p = 0.47 & 0.80 respectively). In contrast, improvement in the level of knowledge of IMR was observed from first to second year of their training (p = 0.03) with no further improvement thereafter. RN's didn't respond correctly on most of the items related to in-patient management of diabetes (Mean score 40% +/- 20). As there are no prior studies in our setting evaluating knowledge related to diabetes management among

  19. A quality of care issue: appropriate use and efficacy knowledge of five contraceptive methods: views of men and women living in low socioeconomic settlements of Karachi, Pakistan.

    PubMed

    Fikree, Fariyal F; Saleem, Sarah; Sami, Neelofar

    2005-09-01

    To assess knowledge regarding availability, affordability, appropriate use and efficacy for five non-permanent contraceptive methods. Married Muslim women and men (500 each) were randomly selected from two low socioeconomic settlements in Karachi, Pakistan. Interviews to assess their knowledge on a range of contraceptive and abortion themes were conducted. Four hundred men and 357 women were selected from this larger sample based on their knowledge of condoms, withdrawal, oral pills, injectables and IUDs. Nearly half of the sampled men (56%) and women (48%) were contraceptive users. Knowledge regarding contraception, a specific method, its availability and affordability was high. Appropriate use knowledge for condoms was 73% among men (users 78%, non-users 60%; p-value < or = 0.001 ) and 5% among women. Efficacy knowledge was generally poor. Low knowledge levels regarding appropriate use and efficacy even among contraceptive users suggests, that quality of family planning services should not be limited to service delivery issues but extend to appropriate use and efficacy knowledge levels among clients.

  20. Critical evaluation of the claims made by pharmaceutical companies in drug promotional material in Pakistan.

    PubMed

    Rohra, Dileep Kumar; Gilani, Anwarul Hassan; Memon, Ismail Kamal; Perven, Ghazala; Khan, Muhammad Talha; Zafar, Hina; Kumar, Rakesh

    2006-01-01

    In Pakistan, there is no mechanism to monitor the drug promotional campaign by pharmaceutical industry despite the fact that there is enough evidence that irrational pharmacotherapy is increasingly encountered even in the developed countries due to unethical practices of pharmaceutical promotion. Objectives. To audit the drug promotional claims made by the pharmaceutical companies in Pakistan. Drug promotional pamphlets and brochures containing claims for the drugs, which were circulated by the pharmaceutical representatives were collected from 122 general practitioners (GPs) from Karachi and Larkana cities of the Sindh Province. The claims were critically analyzed and audited with the help of currently available evidence in the medical literature. 345 distinct advertisements covering 182 drugs from different manufacturers were critically analyzed for information content. Sixty two out of 345 (18%) of the reviewed advertisements were adjudged to be misleading / unjustifiable, which were again classified as, exaggerated (32%), ambiguous (21%), false (26%), and controversial (21%). The primary source of information (approximately 78%) about the newly launched drugs for the GPs was found to be the pharmaceutical representatives followed by hospital doctors (5%) and colleagues (5%). Furthermore, 110 (90%) GPs were of the view that the drug promotion has definitely an influence on their prescribing pattern. Since GPs in Pakistan rate pharmaceutical companies as their primary source of information regarding drugs, it can be anticipated that inappropriate advertisement claims would lead to irrational prescribing if physicians had no any other information to follow.

  1. 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

  2. Gender differences in nonfatal suicidal behavior in Pakistan: significance of sociocultural factors.

    PubMed

    Khan, M M; Reza, H

    1998-01-01

    Suicidal behavior is an understudied subject in Pakistan. A variety of social, legal, and religious factors make reporting and data collection on suicide and nonfatal suicidal behavior difficult. To study the problem, a retrospective case-note analysis was carried out in which the sociodemographic and clinical characteristics of 262 female and 185 male suicidal individuals admitted to a university hospital in Karachi, Pakistan, are compared. Three quarters of the suicidal persons were under the age of 30 years. Compared to men, women were younger and more often married. Both women and men tended to use self-poisoning with benzodiazepines, but more women used organophosphate insecticides. In Pakistani society, legal, social, and economic discrimination predisposes women to psychological distress and subsequent suicidal behavior. The study highlights the need for culture-specific research on suicidal behavior in Pakistan.

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

    USDA-ARS?s Scientific Manuscript database

    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 ...

  4. Self-perceived health among school going adolescents in Pakistan: influence of individual, parental and life style factors?

    PubMed

    Afridi, Asad Ali Khan; Motwani, Komal; Khawaja, Saleem; Khoja, Adeel A; Fatmi, Zafar; Azam, Iqbal; Kadir, Muhammad Masood

    2013-04-06

    Adolescents are at substantial risk of acquiring behaviors which might influence their health status. This study was aimed to assess the proportion of school going adolescents (both males and females) with poor self-perceived health and its associated factors. A cross-sectional study was conducted in three major cities of Pakistan i.e. Karachi, Lahore and Quetta. From each city, six (6) secondary schools were randomly selected (3 public and 3 private). Pre-tested, self-administered questionnaire was distributed to students. Binary logistic regression analysis was conducted to determine independent factors associated with poor self-perceived health. Approximately 29% adolescents (119/414) reported poor self-perceived health. Individual and parental factors significantly associated with poor self-perceived health were being male (AOR = 1.75, 95% CI: 1.09 - 2.79), living in extended family (AOR = 2.65, 95% CI: 1.66 - 4.22), unskilled employment of father (AOR = 2.17, 95% CI: 1.35 - 3.48), lack of parental-child communication (AOR = 1.74, 95% CI: 1.03 - 2.91) and unfair treatment by parents (AOR = 1.80, 95% CI: 1.09 - 2.96). Life style factors such as use of smokeless tobacco (AOR = 2.14, 95% CI: 1.26 - 3.96) and unhealthy diet (AOR = 3.60, 95% CI: 1.76 - 7.33) were associated with poor self-perceived health. Better employment opportunities for father, parental counseling and increase awareness for adolescents about healthy diet are recommended to improve adolescent self-perceived health in Pakistan.

  5. Frequency of tetanus toxoid immunization among college/university female students of Karachi.

    PubMed

    Qadir, Murad; Murad, Rafat; Mumtaz, Seema; Azmi, Abdul Azim; Rehman, Rehana; Omm-E-Hani; Aziz, Nasir

    2010-01-01

    Tetanus is a deadly infectious disease for which immunisation is available in EPI at both infant level and for females of reproductive age. More than 95% of patients who develop tetanus have not been previously immunised. Objectives of the study were to determine the frequency of tetanus vaccination and to access the awareness of immunisation among females studying in 11 girls' colleges of Karachi and University of Karachi. A cross sectional study was conducted among 1,407 females studying in colleges and University of Karachi from April to August 2007 using a prescribed questionnaire. Among 1,407 female students who were interviewed for the study, 232 (16.48%) were not aware about tetanus immunisation program for females of reproductive age. Only 560 students (39.80%) received at least 1 of 5 recommended doses. Only 41 female students (2.91%) received complete course of 5 doses. Coverage of tetanus immunisation among literate females in most populous city of the country is far behind satisfactory. There is need for awareness and crash programs of tetanus immunisation.

  6. 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

  7. 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).

  8. Prevailing trends of climatic extremes across Indus-Delta of Sindh-Pakistan

    NASA Astrophysics Data System (ADS)

    Abbas, Farhat; Rehman, Iqra; Adrees, Muhammad; Ibrahim, Muhammad; Saleem, Farhan; Ali, Shafaqat; Rizwan, Muhammad; Salik, Muhammad Raza

    2018-02-01

    This study examines the variability and change in the patterns of climatic extremes experienced in Indus-Delta of Sindh province of Pakistan, comprising regions of Karachi, Badin, Mohenjodaro, and Rohri. The homogenized daily minimum and maximum temperature and precipitation data for a 36-year period were used to calculate 13 and 11 indices of temperature and precipitation extremes with the help of RClimDex, a program written in the statistical software package R. A non-parametric Mann-Kendall test and Sen's slope estimates were used to determine the statistical significance and magnitude of the calculated trend. Temperatures of summer days and tropical nights increased in the region with overall significant warming trends for monthly maximum temperature as well as for warm days and nights reflecting dry conditions in the study area. The warm extremes and nighttime temperature indices showed greater trends than cold extremes and daytime indices depicting an overall warming trends in the Delta. Historic decrease in the acreage of major crops and over 33% decrease in agriculture credit for Sindh are the indicators of adverse impacts of warmer and drier weather on Sindh agriculture. Trends reported for Karachi and Badin are expected to decrease rice cultivation, hatching of fisheries, and mangroves forest surrounding these cities. Increase in the prevailing temperature trends will lead to increasingly hotter and drier summers resulting to constraints on cotton, wheat, and rice yield in Rohri and Mohenjodaro areas due to increased crop water requirements that may be met with additional groundwater pumping; nonetheless, the depleted groundwater resources would have a direct impact on the region's economy.

  9. ASTER Maps Continued Pakistan Flooding

    NASA Image and Video Library

    2010-09-07

    On Sept. 3, 2010, when NASA Terra spacecraft captured this image strip over the Indus River in Pakistan, severe flooding was still causing a major humanitarian crisis in Pakistan. The city of Hyderabad is near the middle of the image.

  10. Frequency and determinants of vaginal infection in postpartum period: a cross-sectional survey from low socioeconomic settlements, Karachi, Pakistan.

    PubMed

    Ali, Tazeen Saeed; Fikree, Fariyal F; Rahbar, Mohammad H; Mahmud, Sadia

    2006-03-01

    To determine the frequency and factors associated with perceived vaginal infections among married women in their postpartum period. A cross-sectional study was conducted from July 2000 to October 2000 in five squatter settlements of Karachi, Pakistan. These squatter settlements were selected on the basis of an existing surveillance system run by female community health workers for maternal and child healthcare which identified women who had delivered 42-56 days prior to the date of interview. Vaginal infection was considered present when a mother perceived foul smelling vaginal discharge during the postpartum period. Mothers were interviewed to gain insight into socioeconomic and demographic variables, materials used to staunch lochia, duration of labour, personal and perineal hygiene and past obstetric history. A total of 525 women were interviewed. The estimated prevalence of perceived vaginal infection was 5.1%. Factors associated with perceived vaginal infections included, delivery conducted by a non-medical personnel (AOR 3.5, CI 1.3-9.5) and use of unhygienic cloth or cotton for staunch of lochia (AOR 2.7, CI 1.1-6.2). Among women who reported perceived vaginal infection, a higher proportion were delivered by non-medical personnel, and used unhygienic material (cloth or cotton) for staunch of lochia as compared to women who did not perceive vaginal infection. We recommend deliveries to be conducted by trained personnel and provision of health education for persons who conduct delivery and women to use hygienic material for staunch of lochia during post partum period.

  11. Impact of postpartum anxiety and depression on child's mental development from two peri-urban communities of Karachi, Pakistan: a quasi-experimental study.

    PubMed

    Ali, Niloufer Sultan; Mahmud, Sadia; Khan, Asia; Ali, Badar Sabir

    2013-10-22

    Postpartum anxiety and depression has detrimental effects on the overall mental development of children. This study aims to assess the impact of postpartum anxiety and depression on children's mental development on all sub-scales in a Pakistani population. A quasi-experimental study was conducted in two peri-urban communities of Karachi, a mega city of Pakistan, to assess the impact of postpartum anxiety and depression on children's growth and mental development. A total of 420 women were enrolled, who had given consent out of 651 pregnant women identified, during February 2004 to December 2005. Data for socio-demographic, home environment and family relationship variables were collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother's levels of anxiety and depression were assessed at 1, 2, 6, 12, 18, 24, and 30 months of childbirth. 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. Children's growth and development was monitored in the same sequence using an Early Childhood Development tool that consists of five subscales; socio emotional, language, cognitive, gross motor and fine motor development. Physical growth was monitored by measuring height and weight of the child. Data was analyzed using SAS 9.2. Multivariable Generalized Estimating Equations (GEE) logistic regression was conducted to identify association of postpartum anxiety and depression with each early childhood development indicator, adjusting for parental and child factors. A significant association of postpartum anxiety and depression with delayed development on all five subscales of children's mental development was found in our study. Interestingly, our study found that higher maternal age had adverse effects on child's emotional whereas positive impact on child's cognitive development. Children's stunting had an adverse

  12. Workers' 9/11 in Pakistan: neglected sparks causing conflagration.

    PubMed

    Mirza, Muhammad Zeeshan; Bashir, Sajid

    2015-01-01

    A deadly factory fire in Karachi, Pakistan caused the death of 289 workers on September 11, 2012. The havoc played by fire could have been avoided if the concerned authorities had better fire safety measures and strategy. This article presents an exploratory study designed to obtain first-hand information about this issue in which data were collected from 135 organizations within various industries of Pakistan. The results of this study are alarming because most of the organizations are not even equipped with basic fire safety equipment and are devoid of fire exit paths. Incompetence and negligence on the part of government agencies and many stakeholders frequently allows fire to play havoc with the lives of workers in Pakistani organizations, confirming the famous saying 'Parva saepe scintilla contempta magnum excitavit incendium' (A spark neglected has often raised a conflagration).

  13. 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

    2016-07-06

    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. © The American Society of Tropical Medicine and Hygiene.

  14. 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

  15. Pakistan and Afghanistan Librarianship.

    ERIC Educational Resources Information Center

    Harvey, John F.

    In March and April 1968, the author was a guest of the U.S. Information Service on a two week trip to Pakistan and Afghanistan. During this stay, 30 libraries in five cities were visited. This paper describes this trip and relates the library happenings in these countries. It was obvious that Pakistan librarianship had advanced beyond the…

  16. Self-Perceived Health among School Going Adolescents in Pakistan: Influence of Individual, Parental and Life Style Factors?

    PubMed Central

    Afridi, Asad Ali Khan; Motwani, Komal; Khawaja, Saleem; Khoja, Adeel A; Fatmi, Zafar; Azam, Iqbal; Kadir, Muhammad Masood

    2013-01-01

    Background: Adolescents are at substantial risk of acquiring behaviors which might influence their health status. This study was aimed to assess the proportion of school going adolescents (both males and females) with poor self-perceived health and its associated factors. Methodology: A cross-sectional study was conducted in three major cities of Pakistan i.e. Karachi, Lahore and Quetta. From each city, six (6) secondary schools were randomly selected (3 public and 3 private). Pre-tested, self-administered questionnaire was distributed to students. Binary logistic regression analysis was conducted to determine independent factors associated with poor self-perceived health. Results: Approximately 29% adolescents (119/414) reported poor self-perceived health. Individual and parental factors significantly associated with poor self-perceived health were being male (AOR = 1.75, 95% CI: 1.09 – 2.79), living in extended family (AOR = 2.65, 95% CI: 1.66 – 4.22), unskilled employment of father (AOR = 2.17, 95% CI: 1.35 – 3.48), lack of parental-child communication (AOR = 1.74, 95% CI: 1.03 – 2.91) and unfair treatment by parents (AOR = 1.80, 95% CI: 1.09 – 2.96). Life style factors such as use of smokeless tobacco (AOR = 2.14, 95% CI: 1.26 – 3.96) and unhealthy diet (AOR = 3.60, 95% CI: 1.76 – 7.33) were associated with poor self-perceived health. Conclusion: Better employment opportunities for father, parental counseling and increase awareness for adolescents about healthy diet are recommended to improve adolescent self-perceived health in Pakistan. PMID:23777723

  17. Impact of postpartum anxiety and depression on child’s mental development from two peri-urban communities of Karachi, Pakistan: a quasi-experimental study

    PubMed Central

    2013-01-01

    Background Postpartum anxiety and depression has detrimental effects on the overall mental development of children. This study aims to assess the impact of postpartum anxiety and depression on children’s mental development on all sub-scales in a Pakistani population. Methods A quasi-experimental study was conducted in two peri-urban communities of Karachi, a mega city of Pakistan, to assess the impact of postpartum anxiety and depression on children’s growth and mental development. A total of 420 women were enrolled, who had given consent out of 651 pregnant women identified, during February 2004 to December 2005. Data for socio-demographic, home environment and family relationship variables were collected between 36 weeks of pregnancy and within 10 days of childbirth. Mother’s levels of anxiety and depression were assessed at 1, 2, 6, 12, 18, 24, and 30 months of childbirth. 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. Children’s growth and development was monitored in the same sequence using an Early Childhood Development tool that consists of five subscales; socio emotional, language, cognitive, gross motor and fine motor development. Physical growth was monitored by measuring height and weight of the child. Data was analyzed using SAS 9.2. Multivariable Generalized Estimating Equations (GEE) logistic regression was conducted to identify association of postpartum anxiety and depression with each early childhood development indicator, adjusting for parental and child factors. Results A significant association of postpartum anxiety and depression with delayed development on all five subscales of children’s mental development was found in our study. Interestingly, our study found that higher maternal age had adverse effects on child’s emotional whereas positive impact on child’s cognitive

  18. Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi

    PubMed Central

    Almas, Aysha; Ghouse, Ayaz; Iftikhar, Ahmed Raza; Khursheed, Munawwar

    2014-01-01

    Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi. Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included. Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) were the most commonly administered medication in the ER. The mean (SD) drop in SBP in patients with hypertensive crisis on intravenous treatment was 53.1 (29) mm Hg and on per oral treatment was 43 (27) mm Hg. The maximum mean (SD) drop in blood pressure was seen by intravenous sodium nitroprusside; 80 (51) mm Hg in SBP. Acute renal failure was the most common complication with a prevalence of 11.5% (24). Conclusion. The prevalence of hypertensive crisis is high. Per oral calcium channel blocker and intravenous nitrate are the most commonly administered medications in our setup. PMID:26464857

  19. Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi.

    PubMed

    Almas, Aysha; Ghouse, Ayaz; Iftikhar, Ahmed Raza; Khursheed, Munawwar

    2014-01-01

    Objectives. Hypertension, if uncontrolled, can lead to hypertensive crisis. We aim to determine the prevalence of hypertensive crisis, its management, and outcome in patients presenting to a tertiary care center in Karachi. Methods. This was a cross-sectional study conducted at the Aga Khan University, Karachi, Pakistan. Adult inpatients (>18 yrs) presenting to the ER who were known hypertensive and had uncontrolled hypertension were included. Results. Out of 1336 patients, 28.6% (387) had uncontrolled hypertension. The prevalence of hypertensive crisis among uncontrolled hypertensive was 56.3% (218). Per oral calcium channel blocker; 35.4% (137) and intravenous nitrate; 22.7% (88) were the most commonly administered medication in the ER. The mean (SD) drop in SBP in patients with hypertensive crisis on intravenous treatment was 53.1 (29) mm Hg and on per oral treatment was 43 (27) mm Hg. The maximum mean (SD) drop in blood pressure was seen by intravenous sodium nitroprusside; 80 (51) mm Hg in SBP. Acute renal failure was the most common complication with a prevalence of 11.5% (24). Conclusion. The prevalence of hypertensive crisis is high. Per oral calcium channel blocker and intravenous nitrate are the most commonly administered medications in our setup.

  20. Comparing risk factors of HIV among hijra sex workers in Larkana and other cities of Pakistan: an analytical cross sectional study.

    PubMed

    Altaf, Arshad; Zahidie, Aysha; Agha, Ajmal

    2012-04-10

    In 2005, Pakistan was first labeled as a country with concentrated epidemic of Human Immunodeficiency Virus (HIV). This was revealed through second generation surveillance conducted by HIV/AIDS Surveillance Project (HASP). While injection drug users (IDUs) were driving the epidemic, subsequent surveys showed that Hijra (transgender) sex workers (HSWs) were emerging as the second most vulnerable group with an average national prevalence of 6.4%. An exceptionally high prevalence (27.6%) was found in Larkana, which is a small town on the right bank of river Indus near the ruins of Mohenjo-Daro in the province of Sindh. This paper presents the risk factors associated with high prevalence of HIV among HSWs in Larkana as compared to other cities of the country. Data were extracted for secondary analysis from 2008 Integrated behavioral and biological survey (IBBS) to compare HSWs living in Larkana with those living in other cities including Karachi and Hyderabad in Sindh; Lahore and Faisalabad in Punjab; and Peshawar in Khyber Pakhtunkhwa provinces. After descriptive analysis, univariate and multivariate analyses were performed to identify risk factors. P value of 0.25 or less was used to include factors in multivariate analysis. We compared 199 HSWs from Larkana with 420 HSWs from other cities. The average age of HSWs in Larkana was 26.42 (±5.4) years. Majority were Sindhi speaking (80%), uneducated (68%) and unmarried (97%). In univariate analysis, factors associated with higher prevalence of HIV in Larkana included younger age i.e. 20-24 years (OR: 5.8, CI: 2.809-12.15), being unmarried (OR: 2.4, CI: 1.0-5.7), sex work as the only mode of income (OR: 5.5, CI: 3.70-8.2) and longer duration of being involved in sex work 5-10 years (OR: 3.3, CI: 1.7-6.12). In multivariate logistic regression the HSWs from Larkana were more likely to lack knowledge regarding preventive measures against HIV (OR 11.9, CI: 3.4-41.08) and were more prone to use of alcohol during anal

  1. Assessing the effect of dietary calcium intake and 25 OHD status on bone turnover in women in Pakistan.

    PubMed

    Khan, Aysha Habib; Naureen, Ghazala; Iqbal, Romaina; Dar, Farhan Javed

    2013-01-01

    Bone health assessed in three towns of Karachi, Pakistan in females showed poor calcium intake, vitamin D deficiency, secondary hyperparathyroidism, and high bone turnover. Correlates of high bone turnover included females residing in Saddar Town, underweight females less than 30 years of age from low socio-economic status, and secondary hyperparathyroidism. To assess bone health and association of dietary calcium and 25 hydroxy vitamin D with bone turnover in the community-dwelling females of Karachi. Bone health was assessed in three randomly selected towns of Karachi, Pakistan. One premenopausal female fulfilling the inclusion criteria from each household was included in the study. Dietary calcium was assessed through a food frequency questionnaire and biochemical markers including calcium, phosphates, albumin, magnesium, creatinine, and SGPT, intact parathyroid hormone, 25 hydroxy vitamin D, and N-telopeptide of type I collagen were measured to assess the bone health. Three hundred and five females were included from three towns. Overall, 90.5% of females had vitamin D deficiency with 42.6 and 23.3% having secondary hyperparathyroidism and high bone turn over respectively. Prevalence of vitamin D deficiency, secondary hyperparathyroidism, and high bone turnover was significantly different among towns. Mean vitamin D levels were significantly low and iPTH levels significantly high in females with high bone turnover. Calcium intake was not significantly different among females with normal, high, and low bone turnover. Correlates of high bone turnover included females residing in Saddar Town, underweight females less than 30 years of age belonging to low socio-economic status, and secondary hyperparathyroidism. Compromised bone health is seen in community-dwelling females of Karachi. There is a need to perform large-scale community-based studies in all age groups to understand the interplay of markers in our population to understand the impact of these variables

  2. Comparison of Knowledge, Attitudes, and Practices of Educated and Uneducated Adults Regarding Human Immunodeficiency Virus in Karachi, Pakistan

    PubMed Central

    Ahmad, Zainab; Asghar, Mariam; Khan, Alizay Rashid; Arif, Omer; Shah, Syed Hamza; Nadeem, Shahrukh; Waseem, Yamna; Aibani, Rafi; Syed, Ammar salman; Mustafa, Rabia M; Abdulrahman, Zainab; Fatima, Kaneez

    2017-01-01

    Background Despite the high prevalence of human immunodeficiency virus (HIV) in Pakistan, no prior work has been done to specifically highlight the importance of education as a social vaccine against HIV. Therefore, our study focuses on differences in knowledge and practices regarding HIV and acquired immunodeficiency syndrome (AIDS) among educated and uneducated adults. Methodology A cross-sectional study was carried out in which data was collected from all over Karachi. An individual was designated as educated if he had received education above primary school level. Individuals who had studied till primary school or less were considered uneducated. The questionnaire was split into four sections that assessed respondents' demographics, knowledge, attitudes, and practices regarding HIV/AIDS. Chi square test was used as the primary statistical test. Results Out of the 446 adult participants, 235 (52.7%) were educated and 211 (47.3%) were uneducated. Educated participants were significantly more likely to have heard about HIV (183 vs. 39, p < 0.001) and had better knowledge about the symptoms of HIV/AIDS (p < 0.001). Among the participants who knew about AIDS, a greater percentage of uneducated (n = 28, 53%) than educated individuals (n = 68, 37%) believed that people suffering from AIDS should be isolated (p = o.o16) and that HIV can spread through water (40% vs 20% respectively, p < 0.001). Both educated (n = 49, 27%) and uneducated (n = 46, 89%) adults believed that awareness would help prevent the spread of HIV (p = 0.978) and were willing to educate their children about it (p = 0.696). Conclusion Our study revealed a gap in the knowledge about HIV/AIDS between educated and uneducated adults. There is an urgent need for awareness programs that especially reach out to the uneducated masses that are otherwise uninformed about HIV and are under high risk of acquiring HIV. PMID:28706763

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

    PubMed Central

    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

  4. Post-traumatic stress disorder and its predictors in emergency medical service personnel: a cross-sectional study from Karachi, Pakistan.

    PubMed

    Kerai, Salima Mansoor; Khan, Uzma Rahim; Islam, Muhammad; Asad, Nargis; Razzak, Junaid; Pasha, Omrana

    2017-08-29

    Emergency medical service (EMS) personnel who work to provide emergency medical care at the scene and during transportation are exposed to various kinds of stressors and are particularly susceptible to developing stress-reactions. This study assesses symptoms of post-traumatic stress disorder and its predictors among the personnel of a selected EMS in Karachi, Pakistan. Data were gathered from 518 personnel working in an EMS setting from February to May 2014. Participants were screened for post-traumatic stress symptoms using the Impact of Event Scale-Revised (IES-R). Demographic and work-related characteristics, coping styles and the social support systems of the participants were assessed. Linear regression was used on the IES-R to identify predictors of post-traumatic stress symptoms. The mean score of the IES-R was 23.9 ± 12.1. EMS personnel with a dysfunctional coping style (β = 0.67 CI 0.39 - 0.95), anxiety, and depression (β = 0.64 CI 0.52 - 0.75) were more likely to have increased severity of post-traumatic stress symptoms. Age was found to have an inverse relationship with stress symptoms (β = -0.17 CI 0.33 - -0.023), indicating the susceptibility of younger EMS personnel to stress. The EMS personnel in this setting were found to have a moderate level of post-traumatic stress symptoms. The significant predictors of post-traumatic stress symptoms in this EMS population were age, coping style, and levels of anxiety and depression. These predicting factors can be a potential avenue for interventions to improve the mental health of these frontline workers.

  5. A university-sponsored home health nursing program in Karachi, Pakistan.

    PubMed

    Smego, Raymond A; Khan, Mohammad Aslam; Khowaja, Khurshid; Rafique, Rozina; Datoo, Farida

    2005-11-01

    This article describes a university-sponsored home health nursing program in a large urban center in Pakistan and details the essential elements needed in implementing such a program in a developing country. Compared to in-hospital treatment, home healthcare reduced hospital stay from 12.8 days to 3.9 days, and resulted in a net savings of Pakistani rupees (PRs) 5,374,135 (USD 89,569). A cost-effective home treatment program in a resource-limited country can be successfully implemented by using the hospital pharmacy as the central point for the preparation and distribution of medications and specialty nursing services.

  6. A multi-criteria decision-making approach to rank supplier selection criteria for hospital waste management: A case from Pakistan.

    PubMed

    Ishtiaq, Palvisha; Khan, Sharfuddin Ahmed; Haq, Moiz-Ul

    2018-04-01

    To address environmental issues and cost effectiveness, waste management is necessary for healthcare facilities. Most importantly, segregation of hazardous and non-hazardous waste must be done as in many developing countries; disposal of both types of healthcare waste is done together, which is an unsafe practice. Waste generated in hospitals needs proper management to minimise hazards for patient and healthcare workers. At the same time, it is quite difficult for hospitals to find a systematic way to select appropriate suppliers for hospital waste management. Therefore, the purpose of this article is to identify, validate, and rank criteria that are essential for hospital waste management suppliers' selection. The analytical hierarchal process approach has been used and a survey from Pakistan's largest city (Karachi) has been considered to rank the most appropriate criteria that is necessary to select the supplier, especially in a developing country like Pakistan. Results show that waste management cost (45.5%) and suppliers' details (31.5%) are the top two main criteria for supplier selection; and storage cost (15.7%), waste handling cost (14.7%), and qualification of the suppliers (10.9%) are the top three most important overall sub-criteria for supplier selection for hospital waste management.

  7. 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

    2013-05-27

    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.

  8. Risk assessment of dissolved trace metals in drinking water of Karachi, Pakistan.

    PubMed

    Karim, Zahida

    2011-06-01

    Health risk caused by the exposure to trace metals in water through different exposure pathways was investigated. Graphite furnace atomic absorption spectrometry was used for the determination of trace metals (nickel, copper, chromium, lead, cobalt, manganese and iron) in drinking water samples. The concentration of metals was compared with the world health organization (WHO) drinking water quality guideline values. Risk of metals on human health was evaluated using Hazard Quotient (HQ). Hazard quotients of all metals through oral ingestion and dermal absorption are found in the range of 1.11 × 10⁻² to 1.35 × 10⁻¹ and 8.52 × 10⁻⁵ to 9.75 × 10⁻², respectively. The results of the present study reflect the unlikely potential for adverse health effects to the inhabitants of Karachi due to the oral ingestion and dermal absorption of water containing these metals.

  9. ASTER Captures New Image of Pakistan Flooding

    NASA Image and Video Library

    2010-08-20

    NASA Terra spacecraft captured this cloud-free image over the city of Sukkur, Pakistan, on Aug. 18, 2010. Sukkur, located in southeastern Pakistan Sindh Province, is visible as the grey, urbanized area in the lower left center of the image.

  10. 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.

  11. 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

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

    PubMed

    Khan, Irum; Khan, Nadeem; Naeem, Rubaba; Kerai, Salima; Allen, Kate; Zia, Nukhba; Shahbaz, Sana; Afridi, Shiraz; Siddiqui, Emaduddin; Khan, Uzma; Hyder, Adnan A; Razzak, Junaid A

    2015-01-01

    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. 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. 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. 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.

  13. Patho-epidemiology of Cancer Cervix in Karachi South.

    PubMed

    Bhurgri, Yasmin; Nazir, Kauser; Shaheen, Yasmeen; Usman, Ahmed; Faridi, Naveen; Bhurgri, Hadi; Malik, Jawaid; Bashir, Imtiaz; Bhurgri, Asif; Kayani, Naila; Pervez, Shahid; Hasan, Sheema H; Setna, Faridoon; Zaidi, S M H

    2007-01-01

    The present study was conducted with the objective of examining descriptive epidemiological and pathological characteristics of cancer cervix in Karachi South, an all urban district population of Karachi, Pakistan. A total of 74 cases of cancer cervix, ICD-10 (International Classification of Diseases 10th Revision) category C53 were registered at the Karachi Cancer Registry, for Karachi South, during a 3 year period, 1st January, 1995 to 31st December 1997. The age standardized incidence rate (ASR) world and crude incidence rate (CIR) per 100,000 were 6.81 (5.2, 8.43) and 3.22 (2.49 to 3.96). Cancer cervix accounted for approximately 3.6% of all cancers in females and was the sixth malignancy in hierarchy. The mean age of the cancer cases was 53.27 years [standard deviation (SD) 11.6; 95% confidence interval (CI) 50.58, 55.96; range (R) 32-85 years)]. The distribution by religion was Muslims (90.5%), Christians (8.1%) and Hindus (1.4%). There were no cases reported in Parsees. The frequency distribution by ethnicity was Urdu speaking Mohajirs (20.3%), Punjabis (17.6%), Gujrati speaking Mohajirs (4.1%), memon Mohajirs (8.1%), Sindhis (10.8%), Baluchs (8.1%), Pathans (5.4%) and Afghan migrants (2.7%). The ethnicity was not known in approximately a fourth (23.0%) of the cases. The socio-economic distribution was 27.0% financially deprived class, 24.4% lower middle class and 48.7% upper middle and affluent classes. The majority of the women were married (86.5%); a smaller number were unmarried (2.7%) or widows (10.8%). The age-specific curves showed a gradual increase in risk from the fourth up till the seventh decade, followed by an actual apparent decrease in risk after 64 years of age. The peak incidence was observed in the 60-64 year age group. The morphological categorization was squamous cell carcinoma (86.5%), adenocarcinoma (10.9%) and adenosquamous carcinoma (2.6%). The majority of cases presented with moderately differentiated or grade 2 lesions (45

  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. Concentration of heavy metals in drinking water of different localities in district east Karachi.

    PubMed

    Jaleel, M A; Noreen, R; Baseer, A

    2001-01-01

    Several heavy metals are present in drinking water that play important roles in the body provided their level remains within the specified range recommended by WHO. But now due to the industrialization and rapid urbanization, the problems of pollution have surfaced. This study was designed to ascertain the contents of some heavy metals and then their variations if any in drinking water in different localities of district East of Karachi, Pakistan. Drinking water samples were collected from different sources and localities of district East of Karachi. The concentration of the heavy metals i.e. Lead, Arsenic, Copper, Iron, Mercury, Chromium, Manganese, Nickel, Cadmium and Zinc were determined by Atomic Absorption Spectrophotometry. PH was estimated by pH meter. Total dissolved solids (TDS) were calculated by formula. These concentrations of heavy metals, pH and TDS were compared with the standards set by WHO. Concentrations of lead and nickel were found to be significantly elevated as compared to WHO recommended levels in all the three sources of water (Piped water, Hand pump water and Tanker water supply). Chromium was found to be raised in hand pump water. Arsenic and Mercury were not detected in any source of water. Copper, iron, manganese, cadmium and zinc were found to be within the safe limits in all the three sources of water. pH was found to be within the range of WHO recommended level in all the three sources of water. TDS was found to be elevated in hand pump water and tanker water. Concentrations of lead and nickel were found to be significantly elevated as compared to WHO recommended levels in all the three sources of water in district East of Karachi.

  16. Presentations and Outcome of Thyroiditis from a Tertiary Care Hospital of Karachi.

    PubMed

    Mahar, Saeed Ahmed; Shahid, Muhammad; Sarfaraz, Aqiba; Shaikh, Zuhaib-u-Ddin; Shaikh, Shiraz; Shahid, Nadia

    2015-10-01

    To assess the clinical presentations and short-term outcomes of patients with thyroiditis presenting to a tertiary care hospital in Karachi, Pakistan. Case series. Department of Endocrinology, Liaquat National Hospital, Karachi, from June 2014 to February 2015. Patients between 18 and 70 years of age with acute onset of thyroiditis confirmed on thyroid scan or clinical judgment presenting to the outpatient services were included in the study. Pregnant females, psychiatric patients and patients having other chronic illnesses were excluded from the study. A total of 26 patients with thyroiditis attended the endocrine clinic. Mean age of patients was 41.2 ± 11.12 years. There were 18 (69.2%) females. Clinical presentations were fever (65.4%), tender neck (23.1%), goiter (19.2%), localized tenderness in neck and palpable lymph nodes (26.9%). Major symptoms reported were: sore throat (69.2%), weight loss (38.5%), upper respiratory tract infection, thyroid pain, tremor, sweating and fever of unknown origin in 26.9% cases. All the patients had raised Erythrocyte Sedimentation Rate (ESR). Low Thyroid Stimulating Hormone (TSH) < 0.4 mlU/L was seen in 88.5% and 57.7% had raised Free T4 > 1.8 ng/dL. Complete recovery was seen in 88.5% patients while 11.5% had early hypothyroidism. Fever and sore throat were the main presenting features of thyroiditis patients. ESR was raised in all patients. A majority of patients had complete recovery with appropriate management; however, few cases developed hypothyroidism.

  17. 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

  18. First ever Evaluation of Atmospheric Lightning Activity in Pakistan

    NASA Astrophysics Data System (ADS)

    Shahzad, M. I.; Qaiser, S.; Campbell, J. R.; Mahmud, S.

    2016-12-01

    In Pakistan, most of the atmospheric lightning occurs in monsoon and pre-monsoon seasons. To prevent or at least minimize the unforeseen property damages and human casuality, we need to identify the vulnerable locations to lightning in Pakistan. However, unfortunately, there has not been any study regarding the lightning hazards to date for Pakistan. In this study satellite based datasets of location and Time of Occurrence (TOA) along with ground data for subset of thunderstorms are used to identify lightning-prone locations in Pakistan for the years 2001-2014. This is the first study to compute climatologies for lighting activity, identifying locations that are susceptible to high, moderate and low lightning activities regionally. Results of the study indicate that lightning activity is comparatively higher over the mountain and sub-mountain regions in the Punjab, Federally Administered Tribal Areas (FATA) and Khyber Pakhtoon Khwa (KPK) provinces. Overall, there is a significant increase in lighting activity in Pakistan from 2001-2014 with more than a 138 % increase near Islamabad and Karachi, indicating the development a lightening dipole. Interestingly, lightning data shows a strong correlation between flashes-per-year and El Niño and La Niña conditions. Atmospheric lightning in Pakistan shows a seasonal pattern, with significant dependencies on Convective Available Potential Energy (CAPE), Aerosol Optical Depth (AOD), Total Cloud Cover, Convective Precipitation, Soil Temperature and Total Column Ozone. Extreme lighting events are found significantly dependant on high surface temperatures, high CAPE and AOD values between 0-0.4 in pre monsoon and monsoon seasons that contribute to overall staggering high mean intra-seasonal value of 66832 flashes. The results surely demand urgent attention of the stakeholders and policy makers for proposing mitigation and adaptation strategies.

  19. 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…

  20. Comparative analysis of three prehospital emergency medical services organizations in India and Pakistan.

    PubMed

    Sriram, V; Gururaj, G; Razzak, J A; Naseer, R; Hyder, A A

    2016-08-01

    Strengthened emergency medical services (EMS) are urgently required in South Asia to reduce needless death and disability. Several EMS models have been introduced in India and Pakistan, and research on these models can facilitate improvements to EMS in the region. Our objective was to conduct a cross-case comparative analysis of three EMS organizations in India and Pakistan - GVK EMRI, Aman Foundation and Rescue 1122 - in order to draw out similarities and differences in their models. Case study methodology was used to systematically explore the organizational models of GVK EMRI (Karnataka, India), Aman Foundation (Karachi, Pakistan), and Rescue 1122 (Punjab, Pakistan). Qualitative methods - interviews, document review and non-participant observation - were utilized, and using a process of constant comparison, data were analysed across cases according to the WHO health system 'building blocks'. Emergent themes under each health system 'building block' of service delivery, health workforce, medical products and technology, health information systems, leadership and governance, and financing were described. Cross-cutting issues not applicable to any single building block were further identified. This cross-case comparison, the first of its kind in low- and middle-income countries, highlights key innovations and lessons, and areas of further research across EMS organizations in India, Pakistan and other resource-poor settings. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  1. Adherence to the European Society of Cardiology (ESC) guidelines for chronic heart failure - A national survey of the cardiologists in Pakistan

    PubMed Central

    2011-01-01

    Background The aims of this study were to evaluate the awareness of and attitudes towards the 2005 European Society of Cardiology (ESC) guidelines for Heart Failure (HF) of the cardiologists in Pakistan and assess barriers to adherence to guidelines. Methods A cross-sectional survey was conducted in person from March to July 2009 to all cardiologists practicing in 4 major cities in Pakistan (Karachi, Lahore, Quetta and Peshawar). A validated, semi-structured questionnaire assessing ESC 2005 Guidelines for HF was used to obtain information from cardiologists. It included questions about awareness and relevance of HF guidelines (See Additional File 1). Respondents' management choices were compared with those of an expert panel based on the guidelines for three fictitious patient cases. Cardiologists were also asked about major barriers to adherence to guidelines. Results A total of 372 cardiologists were approached; 305 consented to participate (overall response rate, 82.0%). The survey showed a very high awareness of CHF guidelines; 97.4% aware of any guideline. About 13.8% considered ESC guidelines as relevant or very relevant for guiding treatment decisions while 92.8% chose AHA guidelines in relevance. 87.2% of respondents perceived that they adhered to the HF guidelines. For the patient cases, the proportions of respondents who made recommendations that completely matched those of the guidelines were 7% (Scenario 1), 0% (Scenario 2) and 20% (Scenario 3). Respondents considered patient compliance (59%) and cost/health economics (50%) as major barriers to guideline implementation. Conclusion We found important self reported departures from recommended HF management guidelines among cardiologists of Pakistan. PMID:22093082

  2. A low-cost intervention for cleaner drinking water in Karachi, Pakistan.

    PubMed

    Luby, S; Agboatwalla, M; Raza, A; Sobel, J; Mintz, E; Baier, K; Rahbar, M; Qureshi, S; Hassan, R; Ghouri, F; Hoekstra, R M; Gangarosa, E

    2001-01-01

    To pilot test an inexpensive, home-based water decontamination and storage system in a low-income neighborhood of Karachi. Fifty households received a 20-L plastic water storage vessel with a high-quality spout and a regular supply of diluted hypochlorite solution. Twenty-five control households were recruited. Water samples were collected at baseline and during unannounced follow-up visits 1, 3, 6, and 10 weeks later. Baseline drinking water samples among intervention households were contaminated with a mean 9397 colony-forming units (cfu)/100 mL of thermotolerant coliforms compared with a mean 10,990 cfu/100 mL from controls. After intervention the mean concentration of thermotolerant coliforms decreased by 99.8% among the intervention households compared with an 8% reduction among controls. Two years after vessel distribution, 34 (68%) of the families were still using the vessel. Thirteen of the households had stopped using their vessel because it had broken after more than 6 months of use, a pattern most consistent with ultraviolet radiation-induced degradation of the plastic. In a highly contaminated environment, a specifically designed water storage container and in-home water chlorination was acceptable and markedly improved water quality. Where plastic water vessels will be exposed to substantial sunlight, ultraviolet light stabilizers should be incorporated into the plastic.

  3. Assessment of medication adherence among type 2 diabetic patients in Quetta city, Pakistan.

    PubMed

    Iqbal, Qaiser; Bashir, Sajid; Iqbal, Javeid; Iftikhar, Shehla; Godman, Brian

    2017-08-01

    Type 2 diabetes (T2DM) is a growing burden among all countries including Pakistan, with medication adherence very important to improve care. However, little is known about medication adherence in Pakistan and potential predictors among T2DM patients to provide future guidance. This needs to be addressed. Consequently, the present study sought to assess medication adherence among type 2 diabetic patients in Quetta city, Pakistan. Questionnaire based, descriptive study among 300 Pakistani patients attending public and private hospitals aged 18 years and above, having a confirmed diagnosis of T2DM, without additional co-morbidities were targeted. Descriptive statistics were used to describe demographic and disease characteristics. The association between socio-demographic data and study variables was compared through the Mann Whitney/Kruskal Wallis test (where applicable). The factors that were significantly associated with medication adherence were further assessed by logistic regression analysis. 55.6% of patients had high adherence although overall patients reported moderate adherence. Age, gender, education, diabetes-related knowledge and treatment satisfaction were significantly associated with medication adherence. Older males with only primary education and with poor diabetes-related knowledge had the lowest adherence. This study presents a model that is associated with medication adherence among T2DM patients, with disease-related knowledge as a significant predictor of likely adherence. Results of the current study revealed that improved diabetes related knowledge plays a significant role in improving medication adherence. Healthcare practitioners and the system should formalize and acknowledge patient education as a key component to treat patients with T2DM. This should include a greater role for pharmacists and other professionals.

  4. 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

  5. Reducing length of stay in hospital for very low birthweight infants by involving mothers in a stepdown unit: an experience from Karachi (Pakistan).

    PubMed

    Bhutta, Zulfiqar A; Khan, Iqtidar; Salat, Suhail; Raza, Farukh; Ara, Husan

    2004-11-13

    Clinical care of infants with a very low birth weight (less than 1500 g) in developing countries can be labour intensive and is often associated with a prolonged stay in hospital. The Aga Khan University Medical Center in Karachi, Pakistan, established a neonatal intensive care unit in 1987. By 1993-4, very low birthweight infants remained in hospital for 18-21 days. A stepdown unit was established in September 1994, with mothers providing all basic nursing care for their infants before being discharged under supervision. We analysed neonatal outcomes for the time periods before and after the stepdown unit was created (1987-94 and 1995-2001). We compared these two time periods for survival after birth until discharge, morbidity patterns during hospitalisation, length of stay in hospital, and readmission rates to hospital in the four weeks after discharge. Of 509 consecutive, very low birthweight infants, 494 (97%) preterm and 140 (28%) weighing < 1000 g at birth), 391 (76%) survived to discharge from the hospital. The length of hospitalisation fell significantly from 1987-90, when it was 34 (SD 18) days, to 16 (SD 14) days in 1999-2001 (P < 0.001). Readmission rates to hospital did not rise, nor did adverse outcomes at 12 months of age. Our results indicate that it is possible to involve mothers in the active care of their very low birthweight infants before discharge. This may translate into earlier discharge from hospital to home settings without any increase in short term complications and readmissions.

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

    PubMed

    Khan, Amad N; Khalid, Salema; Khan, Hussain I; Jabeen, Mehnaz

    2011-05-24

    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. 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. 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). Our study confirmed the tendency of the media to have an overall negative effect on individuals' body image. A striking

  7. Comparison of Ramadan-specific education level in patients with diabetes seen at a Primary and a Tertiary care center of Karachi-Pakistan.

    PubMed

    Masood, Shabeen Naz; Alvi, Syed Faraz Danish; Ahmedani, Muhammad Yakoob; Kiran, Shazia; Zeeshan, Nimra Fatima; Basit, Abdul; Shera, A Samad

    2014-01-01

    To compare Ramadan-specific education level in fasting patients with diabetes at a Primary and a Tertiary care center. An observational study was conducted in the Outpatient departments of a Primary care center and a Tertiary care center in Karachi-Pakistan. Recruitment of patients started at the end of Ramadan 2011 and continued till three months after Ramadan 2011. All patients with diabetes who observed fast during the month of Ramadan 2011 were included in the study. In Primary care center, patients were attended by physicians only, while at Tertiary care center patients were seen by physicians, diabetes educator and dietician. For data collection, standardized questionnaire based interview was conducted on one to one basis by trained healthcare professionals. Same questionnaire was used at both the centers. A total of 392 and 199 patients with diabetes recruited at Primary and Tertiary care centers, respectively. Ramadan-specific diabetes education received by 213 (55%) and 123 (61.80%) patients with diabetes at Primary and Tertiary care centers, respectively. Compared to Primary care center, patients at Tertiary care centers were more aware about components of Ramadan-specific diabetes education such as signs and symptoms of hypoglycemia and hyperglycemia, dose of medicines/insulin during Ramadan fasting, dose of medicines/insulin when not fasting, self-monitoring of blood glucose, dietary modifications, physical activity, adequate nutrition and adequate hydration during Ramadan (p<0.05). It was observed that Ramadan-specific education level of patients at Tertiary care center was significantly better compared to patients at Primary care center. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  8. Polyester projects for India, Pakistan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    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 supportmore » 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.« less

  9. Associations of Sleep Duration and Disturbances With Hypertension in Metropolitan Cities of Delhi, Chennai, and Karachi in South Asia: Cross-Sectional Analysis of the CARRS Study.

    PubMed

    Shivashankar, Roopa; Kondal, Dimple; Ali, Mohammed K; Gupta, Ruby; Pradeepa, Rajendra; Mohan, Viswanathan; Kadir, Muhammad Masood; Narayan, K M Venkat; Tandon, Nikhil; Prabhakaran, Dorairaj; Peasey, Anne

    2017-09-01

    Sleep duration and disturbances may be risk factors for hypertension. Despite the high burden of hypertension in South Asia, little is known about this relationship in this region. We analyzed population-level cross-sectional data from the Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) study that recruited representative samples of adults ≥ 20 years from three cities-Delhi, Chennai (India), and Karachi (Pakistan) during 2010-2011. We defined hypertension as self-reported treatment or measured blood pressure (BP) ≥140/90 mm Hg. Data on usual duration of sleep, insomnia, and snoring were collected using "The Sleep Habits Questionnaire" and excessive daytime sleepiness (EDS) using Epworth Sleepiness Score. Logistic and linear regression were done with hypertension and BP as outcome variables, respectively. Age, gender, education, wealth index, family history, and body mass index (BMI) were included as covariates. We used multiple imputation to account for missing variables. Prevalence of hypertension was 30.1%. The mean (SD) sleep duration was 7.3 (1.2) hours. Insomnia, snoring, and EDS were present in 13.6%, 28.7%, and 4.6%, respectively. Moderate and habitual snoring were associated with increased odds of hypertension (odds ratio [OR] = 1.18, 95% confidence interval [CI] [1.04 to 1.33] and 1.47 [1.29 to 1.67], respectively), after adjusting for covariates. Rare, occasional, and frequent insomnia were associated with increased hypertension (OR 1.41 [1.12 to 1.77], 1.39 [1.16 to 1.67], and 1.34 [1.09 to 1.65], respectively). Sleep duration and EDS were not associated with hypertension. Self-reported snoring and insomnia were associated with hypertension in South Asia. This relationship needs further exploration through robust longitudinal studies in this region. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  10. Intussusception among children less than 2years of age: Findings from pre-vaccine introduction surveillance in Pakistan.

    PubMed

    Yousafzai, Mohammad Tahir; Thobani, Rozina; Qazi, Saqib Hamid; Saddal, Nasir; Yen, Catherine; Aliabadi, Negar; Ali, Syed Asad

    2017-07-11

    Rotavirus vaccination introduction in routine immunization is under consideration in Pakistan. Data on the baseline epidemiology of intussusception will inform surveillance strategies for intussusception after rotavirus vaccine introduction in Pakistan. We describe the epidemiology of intussusception-associated hospitalizations among children <2years of age in Karachi, Pakistan. We conducted a retrospective chart review for July 01, 2012 through June 30, 2015 at the National Institute of Child Health (NICH) and Aga Khan University Hospital (AKUH) Karachi. At AKUH, the International Classification of Disease, ninth revision, code 560.0 for intussusception was used to retrieve intussusception case records. At NICH, daily Operation Theater, Emergency Room, and surgical daycare log sheets and surgical ward census sheets were used to identify cases. Records of children who fulfilled eligibility criteria and the Brighton Collaboration level one case definition of intussusception were selected for data analysis. We used structured case report forms to extract data for the descriptive analysis. We identified 158 cases of confirmed intussusception; 30 cases (19%) were from AKUH. More than half (53%) of the cases occurred in children aged 6-12months, followed by 35% among those aged <6months. Two-thirds (106/158) of the cases were male. The most common presenting complaints were vomiting and bloody stool. At NICH, almost all (93%) were managed surgically, while at AKUH, ∼57% of the cases were managed with enemas. Three deaths occurred, all from NICH. Cases occurred without any seasonality. At NICH, 4% (128/3618) of surgical admissions among children aged <2years were attributed to intussusception, while that for AKUH was 2% (30/1702). In this chart review, intussusception predominantly affected children 0-6months of age and occurred more commonly in males. This information on the baseline epidemiology of intussusception will inform post-vaccine introduction adverse event

  11. Clinical Spectrum of Chikungunya in Pakistan.

    PubMed

    Naqvi, Syeda; Bashir, Shehroz; Rupareliya, Chintan; Shams, Abdullah; Giyanwani, Pirthvi Raj; Ali, Zeeshan; Qamar, Faiza; Kumar, Vijesh; Talib, Vikash

    2017-07-06

    Background Chikungunya fever is a pandemic disease caused by an arthropod-borne chikungunya virus (CHIKV). The virus spreads through mosquitoes. This mosquito induced viral illness is clinically suspected on symptoms from fever and severe polyarthralgia. The recent outbreak of chikungunya was reported in November 2016 in the metropolitan city Karachi, Pakistan. We emphasis on the awareness of the etiology and vector control to prevent serious consequences. Method A total number of 1275 patients were included in this cross-sectional study. These patients were enrolled based on clinical findings described by Centers for Disease Control and Prevention (CDC). Our exclusion criteria were patients with missing data or having co-infection with dengue or malaria. The patients were tested for chikungunya antibodies, malaria, and dengue. The patients were followed for three months. Results Out of 1275 consenting patients from the emergency department, 564 tested positive for chikungunya antibodies and out of these 564 patients 365 had co-infection of dengue and malaria. So based on exclusion criteria, 199 patients had isolated chikungunya infection and were studied for the frequency of clinical symptoms. The most common finding was joint pain and fever on presentation and joint pain was the only chronic finding which persisted. Conclusion Our study demonstrated the frequency of clinical findings in chikungunya infection. It also signifies the importance of testing for antibodies because it helped in excluding patients with false positive clinical findings and differentiating co-infection with malaria and dengue. It also gauged patient's view about the cause of this disease.

  12. Clinical Spectrum of Chikungunya in Pakistan

    PubMed Central

    Bashir, Shehroz; Rupareliya, Chintan; Shams, Abdullah; Giyanwani, Pirthvi Raj; Ali, Zeeshan; Qamar, Faiza; Kumar, Vijesh; Talib, Vikash

    2017-01-01

    Background Chikungunya fever is a pandemic disease caused by an arthropod-borne chikungunya virus (CHIKV). The virus spreads through mosquitoes. This mosquito induced viral illness is clinically suspected on symptoms from fever and severe polyarthralgia. The recent outbreak of chikungunya was reported in November 2016 in the metropolitan city Karachi, Pakistan. We emphasis on the awareness of the etiology and vector control to prevent serious consequences. Method A total number of 1275 patients were included in this cross-sectional study. These patients were enrolled based on clinical findings described by Centers for Disease Control and Prevention (CDC). Our exclusion criteria were patients with missing data or having co-infection with dengue or malaria. The patients were tested for chikungunya antibodies, malaria, and dengue. The patients were followed for three months. Results Out of 1275 consenting patients from the emergency department, 564 tested positive for chikungunya antibodies and out of these 564 patients 365 had co-infection of dengue and malaria. So based on exclusion criteria, 199 patients had isolated chikungunya infection and were studied for the frequency of clinical symptoms. The most common finding was joint pain and fever on presentation and joint pain was the only chronic finding which persisted. Conclusion Our study demonstrated the frequency of clinical findings in chikungunya infection. It also signifies the importance of testing for antibodies because it helped in excluding patients with false positive clinical findings and differentiating co-infection with malaria and dengue. It also gauged patient's view about the cause of this disease.  PMID:28924518

  13. 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…

  14. 77 FR 29755 - Additional Designations, Foreign Narcotics Kingpin Designation Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ..., Fisherman Colony Mahim, Mumbai, India; House No. C-201, Extension-A, Karachi Development Scheme, Karachi, Pakistan; DOB 24 Nov 1960; POB Mumbai (Bombay), India; nationality India; Passport AA762402 (Pakistan); alt... Manzil, 78 Temkar Street, Nagpada, Mumbai, India; DOB 31 Dec 1955; alt. DOB 1960; POB Mumbai (Bombay...

  15. Retrospective study of cancer types in different ethnic groups and genders at Karachi.

    PubMed

    Khaliq, Sheikh Abdul; Naqvi, Syed Baqir; Fatima, Anab

    2013-12-01

    Retrospective study of Cancer types in different ethnic groups & genders determines the pattern of cancers in different ethnic groups & genders during the last eight years reported in Oncology wards of hospitals of Karachi, Pakistan. Every single one male & female case with histologically and cytologically established cancer was enrolled from January 2003 to December 2010. Data for all patients were collected retrospectively by patient's file & charts, which represents the population of Karachi, Interior Sindh & Balochistan. 5134 patients (Male = 2432 / Female = 2702) investigated for their diagnosis of cancer type, ethnicity, age & gender. Classification of malignancy was done according to the International Classification of Disease coding system by W.H.O (ICD-10). The statistical analysis was performed for mean, standard error & proportions for ethnic groups & genders. Proportionately 47.37% males and among which major ethnic groups 17% Sindhi, 17% Immigrant, 4% Baloch, 3% Pukhtoon, ≈ 4% Punjabi, 1% Siraiki, 2% Minorities and 52.62% females, in which 16% Sindhi, 21% Immigrant, 4% Baloch 3% Pukhtoon, 5% Punjabi, 1% Siraiki, 3% Minorities. Mean age of males = 45.75 years, SE ± 0.227 and for females = 44.07, SE ± 0.183. The three most occurring tumors in all cancers of male were found Head & Neck, Adenoma/Carcinoma of Glands & Body cavity membranes, GIT, and females Breast, Head & Neck, Adenoma/Carcinoma of Glands & Body cavity membranes, GIT. The analysis of data indicates Head & Neck is most common cancer among male, in the similar way Breast cancer is the most common malignancy among female.

  16. Flooding in Pakistan August 4, 2010

    NASA Image and Video Library

    2017-12-08

    NASA image acquired August 4, 2010 Though many areas in northwest Pakistan were bracing for heavy rain and additional flash flooding on August 4, 2010, the city of Kheshgi, in northwest Pakistan, had clear skies. This image, taken by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA’s Terra satellite reveals a city awash in flood water. Thick with mud, the Kabul River is pale green in this false color image. Clearer water is dark blue. The river flows through its usual channel, but in places, water seeps over the channel and across the landscape. The buildings and roads of Kheshgi are silver. Spots of turquoise blue—shallow, muddy water or water-logged ground—covers several sections of the city. On the south side of the Kabul River, water flows down the hills, washing over neighborhoods. The bare ground in the hills is brown and tan. Plant-covered land, red in this image, is divided into long, narrow rectangles, pointing to agriculture. Geometric shapes under the water near the river are probably submerged fields of crops. Thousands of acres of crops had been lost in floods throughout Pakistan, said the United Nations. Kheshgi is in the Nowshera district in the Khyber Pakhutnkhwa province. As of August 2, Khyber Pakhutnkhwa was the hardest hit province in Pakistan, said the United Nations, and Nowshera was the most impacted district in the province. Nowshera reported 500,000 people displaced with 161 dead, said the Government of Khuber Pakhtunkhwa. The floods affected communities throughout Pakistan. More than 1,100 people had died, 15,000 homes were damaged or destroyed, and at least one million people were in need of emergency assistance throughout Pakistan, said the United Nations on August 2. The floods occurred as unusually heavy monsoon rains fell over Pakistan. NASA image courtesy NASA/GSFC/MITI/ERSDAC/JAROS, and U.S./Japan ASTER Science Team. Caption by Holli Riebeek. Instrument: Terra - ASTER Credit: NASA’s Earth

  17. Molecular and epidemiological characterisation of clinical isolates of carbapenem-resistant Acinetobacter baumannii from public and private sector intensive care units in Karachi, Pakistan.

    PubMed

    Irfan, S; Turton, J F; Mehraj, J; Siddiqui, S Z; Haider, S; Zafar, A; Memon, B; Afzal, O; Hasan, R

    2011-06-01

    The purpose of this study was to identify molecular and epidemiological characteristics of hospital-acquired carbapenem-resistant Acinetobacter baumannii (CRAB) from two different intensive care unit (ICU) settings in Karachi, Pakistan. A cross-sectional study was performed in the adult ICUs of a private sector tertiary care hospital (PS-ICU) and of a government sector hospital (GS-ICU) between November 2007 and August 2008. Deduplicated CRAB isolates from clinical specimens were examined for carbapenemase and class 1 integrase genes. Isolates were typed using sequence-based multiplex polymerase chain reaction, pulsed-field gel electrophoresis (PFGE) and variable number tandem repeat (VNTR). A total of 50 patients (33 from PS-ICU and 17 from GS-ICU) were recruited. There were statistically significant differences between patients in the two ICUs in terms of mean age, comorbidities, the presence of central venous pressure lines, urinary catheters, and average length of stay. bla(OxA-23-like) acquired-oxacillinase genes were found in 47/50 isolates. Class 1 integrase genes were found in 50% (25/50) of the organisms. The majority of isolates belonged to strains of European clones I and II. PFGE typing grouped the isolates into eight distinct clusters, three of which were found in both hospitals. Most of the isolates within each PFGE cluster shared identical or highly similar VNTR profiles, suggesting close epidemiological association. Irrespective of differences in risk factors and infection control policies and practices, the extent of clonality among CRAB isolates was very similar in both ICU settings. Copyright © 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  18. Male hypogonadism at a tertiary care hospital in Karachi, Pakistan.

    PubMed

    Ram, Nanik; Asghar, Ali; Hashmi, Fauzan; Islam, Najmul

    2012-01-01

    Male hypogonadism is defined as 'inadequate gonadal function, manifested by deficiency in gametogenesis and/or secretion of gonadal hormones'. Signs and symptoms of hypogonadism depend primarily on the age of onset. It can be classified according to the site primarily involved: the gonads, the hypothalamus, or the pituitary gland. The objective this study was to determine the presentation and aetiology of male hypogonadism seen in a tertiary care hospital. This cross-sectional study was conducted at Endocrine Clinics, Aga Khan University Hospital Karachi. Data of male patients with hypogonadism who attended clinics during January 2009 to August 2011 were reviewed. All male patients with clinical and biochemical evidence of hypogonadism were included in the study. Patients with Diabetes Mellitus, Metabolic Syndrome, Andropause, AIDS, Chronic Renal Failure, and Cirrhosis were excluded. Mean +/- SD were computed for quantitative variables. Frequency and percentages were computed for qualitative variables. Aetiology of male hypogonadism was categorised as primary and secondary hypogonadism. A total of 85 patients with male hypogonadism attended the endocrine clinic. Mean age of patients was 25 +/- 10 years. Clinical presentations were small genitalia (65%), absent secondary sexual characteristics (53%), not attained puberty (47%), infertility (53%), erectile dysfunction (41%) and loss of libido (29%). Seventy-three (86%) patients had hypogonadotrophic hypogonadism (secondary hypogonadism) and 12 (14%) patients had hypergonadotrophic hypogonadism (primary hypogonadism). Among the patients with hypogonadotrophic hypogonadism 38 had idiopathic hypogonadotrophic hypogonadsim, 7 had pituitary adenoma, 6 had empty sella syndrome, 3 had Kallman's syndrome, and 1 patient had haemosiderosis due to thalassaemia major; 18 patients did not undergo brain imaging. Small genitalia, absent secondary sexual characteristics and infertility were the main presenting features of hypogonad

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

    PubMed Central

    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

  20. 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

  1. Introduction and development of NCP using ICNP in Pakistan.

    PubMed

    Rukanuddin, R J

    2005-12-01

    Traditionally, nursing care has been described as performing nursing tasks and often focused on nurses carrying out doctors' orders. In many countries of the world, including Pakistan, nurses do not document care in a standardized manner. Because of this limitation many health administrators, policy makers, and consumers make inadequate assumptions about nursing work, often regarding nurses as any other 'health care technician' who can be easily replaced by more economical health care workers. To overcome this problem, standardized documentation is being introduced into the Aga Khan University School of Nursing and hospital, Aga Khan Health Services, Public Health School in Karachi, and government colleges of nursing, using the International Classification for Nursing Practice (ICNP). The purpose of this paper is to highlight the process of introducing and developing standardized nursing care plans (NCP) using ICNP in Pakistan. The process for introducing ICNP consists of four components, including administrative planning, development, teaching and training, and testing. Subsets of the ICNP for (i) maternity: antenatal, postnatal and natal care; and (ii) cardiology were developed using standardized NCPs. The subsets were developed by nurse experts and introduced at the testing sites. The testing will be conducted as a pilot project. Findings from the pilot will be used to continue and expand standardized nursing documentation using the ICNP across Pakistan. Through this project, nurses, midwives and lady health visitors (midwives, vaccinator and health educators) will test standardization of documentation and begin to evaluate efficiency and effectiveness of clinical practice.

  2. 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.

  3. Dengue fever virus in Pakistan: effects of seasonal pattern and temperature change on distribution of vector and virus.

    PubMed

    Bostan, Nazish; Javed, Sundus; Nabgha-E-Amen; Eqani, Syed Ali Musstjab Akber Shah; Tahir, Faheem; Bokhari, Habib

    2017-01-01

    Dengue fever is regarded as one of the most prominent emerging arboviral infections in Pakistan since its first epidemic almost 2 decades ago. Interplay between potential vectors, susceptible host, and lax environmental conditions may promote the infection, leading to an epidemic. These factors may indeed have played a major role in the spread of the disease in the country, which was limited to Karachi till 2006. With recent natural disasters such as the earthquake in 2005 and flooding in 2010, 2011 and 2012, numbers of vector-borne diseases and outbreaks including dengue fever are on the rise in Pakistan. Therefore, it is a major concern for health sector workers and of utmost importance to have some understanding of the factors affecting disease outbreak for better risk assessment in the region. In the following report we review the climatic as well as host- and vector-associated factors involved in the outbreak of dengue epidemics in Pakistan and highlight high-risk zones in the country. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Interorganizational collaboration for health care between nongovernmental organizations (NGOs) in Pakistan.

    PubMed

    Gulzar, Laila; Henry, Beverly

    2005-11-01

    The complexity and cost of health systems requires innovative forms of organization to provide accessible health services of an acceptable quality and at an acceptable cost. Interorganizational collaboration (IoC) is an innovation to increase the availability of organizational resources, improve service effectiveness, and improve access to health care. In Pakistan, a weak health system and little collaboration limit access, especially of women and children, to health services. Many nongovernmental organizations (NGOs) provide primary health care to the very poor, and some appear to collaborate to varying degrees; however, this has not been systematically analyzed. The purpose of this qualitative research, the first scientific study of collaboration between NGOs providing health services in Pakistan, was to describe collaboration between three pairs of NGOs providing community-based health services to women in Karachi. A long-term goal is to build a basis for future research linking IoC to access to health care and health outcomes. Findings indicated that collaboration was strongest when there was willingness to cooperate, a need for expertise and funds, and adaptive efficiency. In Pakistan's complex social environment, collaboration tended to be stronger when there was fairly high organizational formalization. Broader IoC appears to be positively associated with women's access to health care. Recommendations are made for future research, education, and management.

  5. Son preference, fertility desire and contraceptive use in two largest cities of Pakistan.

    PubMed

    Farooqui, M N

    1990-01-01

    The preference for sons in deeprooted in Pakistan and the growth rate is 3.1%/year, which has long term implications for the Population Welfare Program. In this study, the relationship between living sons and contraceptive use is examined among 1243 currently married industrial workers and 307 control group workers from 13 sample industries in Karachi and Lahore, Pakistan. The Family Welfare Education for Workers' Project has been operating in these industries. Questions were asked about the number of living children by sex, desired number of children by sex, and ideal family size by sex. The ideal number of children was 4 (3.7) with an average of 2.2 sons and 1.5 daughters, which indicates son preference. Average desired children (living plus additional wanted) is 5.0 (4.7) with an average of 2.6 for sons and 2.1 for daughters. All workers with an ideal of 1 wanted a son. 90% of those wanting an ideal of 2 children desired 1 son and 1 daughter. 95% with an ideal of 3 children wanted 2 sons and 1 daughter. 83% with an ideal of 4 children desired 2 sons and 2 daughters, and 16% wanted 3 sons and 1 daughter. 85% with an ideal of 5 children wanted 3 sons and 2 daughters. Further evidence for son preference occurs with total desired number of children; i.e., 79% of those desiring 2 children preferred 1 of each sex, and 21%, 2 sons. This pattern was repeated for each increase in child desired. The desire for children was also examined in terms of existing children. Workers who have more sons were less likely to desire another child; however, those with 2 living daughters desired 1.63 more children and those with 1 of each desired .85 more children. Those with 2 sons desired .67 more children. The number of additional children desired decreases with the increasing number of living children, and with increasing numbers of living sons. Desiring no more children tends to increase with an increase in number of living children, and with an increase in the number of living

  6. 75 FR 69742 - Designation of Three Individuals and One Entity Pursuant to Executive Order 13224

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ..., Pakistan; Office 22, Third Floor, al Fatah Plaza, Commerical Market, Rawalpindi, Pakistan; Room No. 22, 3rd Floor, al-Fateh Plaza, Commerical Market Road, Chandi Chowk, Rawalpindi, Pakistan; Karachi, Pakistan; Nelam Road, Bandi Chehza, Muzaffarabad, Pakistan; Balakot, Besyan Chouk, Pakistan; Rajana Road, Srah...

  7. Spatiotemporal assessment of CO2 emissions and its satellite remote sensing over Pakistan and neighboring regions

    NASA Astrophysics Data System (ADS)

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

    2017-01-01

    For the first time, anthropogenic CO2 emissions and spatiotemporal variability of mid-tropospheric CO2 has been discussed using EDGAR database and Atmospheric Infrared Sounder (AIRS) onboard Aqua satellite observations. The EDGAR data indicate an increase of 147% in anthropogenic CO2 emissions from 66,101 to 163,737 Gg for Pakistan during the period of 1990-2008. Dera Ghazi Khan (Pakistan) is found with the highest increase of 260% of anthropogenic CO2 emissions followed by Delhi (India) 153%, Karachi (Pakistan) 66% and Lahore (Pakistan) 59% whereas a decreasing trend of -53% is observed for Kabul (Afghanistan) during 1990-2008. Industrial activities, road transportation, open field crop-waste burning, and energy production have been identified as major anthropogenic emission sources of CO2 in the studied region. AIRS CO2 retrievals over Pakistan and adjoining areas of India and Afghanistan show an averaged CO2 to be 383±5 ppm with a positive trend of 5.05% during December 2002 to February 2012. An elevated value of CO2 has been observed over northern mountainous and high human settlement regions. The seasonal analysis shows a spring maximum 385±5 ppm with a secondary peak in late autumn, and the highest increasing trend of 5.5% associated with winter. May and August showed maximum and minimum mean monthly values of 385±5 ppm and 382±5 ppm respectively. HYSPLIT trajectories of air masses movement have been drawn to track CO2 transport.

  8. Rising threat of terrorist bomb blasts in Karachi--a 5-year study.

    PubMed

    Mirza, Farhat Hussain; Parhyar, Hamid Ali; Tirmizi, Syed Zubair Ahmed

    2013-08-01

    This study aims to determine the frequency of injuries and fatalities associated with terrorist bomb explosions in the city of Karachi from 1 January 2007 to 31 December 2011. Moreover, this study is aimed to determine age and sex vulnerability among the victims of blast explosion. A descriptive cross-sectional study was conducted. The study was carried out at mortuaries and medicolegal sections at Jinnah Postgraduate Medical Center, Civil Hospital and Abbasi-Shaheed Hospital Karachi, the three main hospitals, which cater to all these cases of Karachi. The study included all bomb blast victims examined and autopsied from January 2007 to December 2011 at Jinnah Postgraduate Medical Center, Civil Hospital and Abbassi Shaheed Hospital Karachi. Details of 1142 cases were collected for those medicolegal deaths and injured persons, identified to be the victims of bomb blasts from January 2007 to December 2011. Data were collected on a preformed proforma from the mortuaries and medicolegal sections of these three public sector hospitals. The variables investigated include age, gender, year-wise distribution of the injured and the dead along with the cause of death and body parts injured in survivors. Out of the total 11,109 autopsies during the study period, 249 (2.24%) were carried out on deaths due to bomb blasts. Similarly, 135,065 injury cases were reported during the study period out of which 893 (0.66%) cases were due to bomb blasts. An initial peak in the year 2007, followed by a decline in 2008 and since then a steady rise of bomb blast incidences with casualties and fatalities, has been observed. The highest numbers of injured victims were reported in the year 2010 and fatalities in 2007. Among 1142 cases, 95.18% were male and 4.82% female with a male to female ratio of 19.76:1. Persons of ages between 15 and 45 years were chiefly involved. Shock due to multiple injuries was the leading cause of death, followed by head injury with or without haemorrhage. The

  9. Stressors affecting nursing students in Pakistan.

    PubMed

    Watson, R; Rehman, S; Ali, P A

    2017-12-01

    To determine factors contributing to stress experienced by preregistration nursing students in Pakistan, using the Stressors in Nursing Students scale. The aim was to explore the psychometric properties of this instrument and to investigate the effect of a range of demographic variables on the perception of stressors in nursing students. Nursing is a stressful profession, and nursing students may experience more stress due to competing demands and challenges of nursing education, assessment, placements and worries about employment prospects. In this cross-sectional survey, data from 726 nursing students from 11 schools of nursing in Karachi, Pakistan, were collected using a questionnaire. Data were analysed using descriptive as well inferential statistics. An exploratory factor analysis was also conducted. There was no apparent factor structure to the Stressors in Nursing Students scale, unlike in previous studies. The total score on the Stressors in Nursing Students scale was related to gender with males scoring higher. The score generally increased over 4 years of the programme, and students in private schools of nursing scored higher than those in public schools of nursing. Nursing students in Pakistan do not appear to differentiate between different stressors, and this may be due to cultural differences in the students and to the structure of the programme and the articulation between the academic and clinical aspects. Likewise, cultural reasons may account for differences between stress experienced by male and female students. The fact that scores on the Stressors in Nursing Students scale increased over 4 years of the programme and males scored higher than females should alert nursing schools and policymakers related to nursing education and workforce to pay attention to prevent attrition from nursing programmes. © 2017 International Council of Nurses.

  10. 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.

  11. 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

  12. 75 FR 21151 - Designation of Two Individuals Pursuant to Executive Order 13224

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-22

    ..., Pakistan; DOB 5 Oct 1951; POB Azamgarh, Uttar Pradesh, India; nationality Pakistan; Passport KZ 550207 (Pakistan); alt. Passport G154297 (Pakistan); alt. Passport KC550207 (Pakistan) (individual) [SDGT]. 2...; a.k.a. ``USTAAD SHEHEB''), Karachi, Pakistan; DOB circa 1955; alt. DOB circa 1964; POB Sarghoda...

  13. Frequency and associated risk factors for neck pain among software engineers in Karachi, Pakistan.

    PubMed

    Rasim Ul Hasanat, Mohammad; Ali, Syed Shahzad; Rasheed, Abdur; Khan, Muhammad

    2017-07-01

    To determine the frequency of neck pain and its association with risk factors among software engineers. This descriptive, cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, from February to March 2016, and comprised software engineers from 19 different locations. Non-probability purposive sampling technique was used to select individuals spending at least 6 hours in front of computer screens every day and having a work experience of at least 6 months. Data were collected using a self-administrable questionnaire. SPSS 21 was used for data analysis. Of the 185 participants, 49(26.5%) had neck pain at the time of data-gathering, while 136(73.5%) reported no pain. However, 119(64.32%) participants had a previous history of neck pain. Other factors like smoking, physical inactivity, history of any muscular pain and neck pain, uncomfortable workstation, and work-related mental stress and insufficient sleep at night, were found to be significantly associated with current neck pain (p<0.05 each). Intensive computer users are likely to experience at least one episode of computer-associated neck pain.

  14. Clothing-related motorcycle injuries in Pakistan: findings from a surveillance study.

    PubMed

    Khan, Uzma R; Bhatti, Junaid A; Shamim, M Shahzad; Zia, Nukhba; Razzak, Junaid A; Jooma, Rashid

    2015-01-01

    This study aims to assess the burden and patterns of clothing-related motorcycle injuries in Karachi, Pakistan. Data were extracted from an ongoing traffic injury surveillance system. In three years (2007-2009), out of 99155 road traffic injury cases there were 986 (0.9%) cases of clothing-related motorcycle injuries. Most cases were females (73.9%) and pillion riders (80.6%). The crashes involving clothing-related injuries were mostly single vehicle (98.5%), and largely resulted in injuries to the external body (60.3%), limbs (51.0%), head (41.5%) and face (35.9%). One-third of injuries were either moderate (26.7%) or severe (10.2%) while 10 (1.01%) deaths were reported. Female gender (11.4%), age ≥ 45 years (19.4%), pillion riding (11.3%) and crashes occurring at intersections (12.3%) were more likely to result in moderate or severe injury as compared to other users (P < 0.001). Injuries due to entanglement of loose fitting clothing in motorcycles are not uncommon in Karachi. Awareness campaigns for prevention of such injuries may involve promotion of appropriate dressing for motorcycle riding including close wrapping of clothes and encouraging installations of covers on the rear wheels and drive chains.

  15. Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience.

    PubMed

    Afridi, Shahida Parveen; Malik, Faiza; Ur-Rahman, Shafiq; Shamim, Shahid; Samo, Khursheed A

    2008-11-08

    Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world as well in Pakistan. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counter part. This study was conducted at Dow University of health sciences and Civil Hospital Karachi (DUHS & CHK) Pakistan, designed to highlight the spectrum of perforation peritonitis in the East and to improve its outcome. A prospective study includes three hundred consecutive patients of perforation peritonitis studied in terms of clinical presentations, Causes, site of perforation, surgical treatment, post operative complications and mortality, at (DUHS&CHK) Pakistan, from 1st September 2005 - 1st March 2008, over a period of two and half years. All patients were resuscitated underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. The most common cause of perforation peritonitis noticed in our series was acid peptic disease 45%, perforated duodenal ulcer (43.6%) and gastric ulcer 1.3%. followed by small bowel tuberculosis (21%) and typhoid (17%). large bowel perforation due to tuberculosis 5%, malignancy 2.6% and volvulus 0.3%. Perforation due to acute appendicitis (5%). Highest number of perforations has seen in the duodenum 43.6%, ileum37.6%, and colon 8%, appendix 5%, jejunum 3.3%, and stomach 2.3%. Overall mortality was (10.6%). The spectrum of perforation peritonitis in Pakistan continuously differs from western country. Highest number of perforations noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. Most common cause of perforation peritonitis is perforated duodenal ulcer, followed by small bowel tuberculosis and typhoid perforation. Majority of the large bowel perforations are also tubercular. Malignant perforations are least common in our setup.

  16. 76 FR 61776 - Designation of Five Individuals Pursuant to Executive Order 13224

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ...''), Boghra Road, Miralzei Village, Chaman, Baluchistan Province, Pakistan; DOB 1966; alt. DOB 1961; alt. DOB.... YAMIN, Abdur Rehman Muhammad; a.k.a. ``ABDULLAH SINDHI''), Karachi, Pakistan; DOB 3 Oct 1965; POB Mirpur Khas, Pakistan; nationality Pakistan; National ID No. 44103- 5251752-5 (Pakistan); Passport CV9157521...

  17. Prevalence of High risk Human Papillomavirus in cervical dysplasia and cancer samples from twin cities in Pakistan.

    PubMed

    Gul, Sana; Murad, Sheeba; Javed, Aneela

    2015-05-01

    Human Papilloma Virus (HPV) is small DNA virus mostly infecting mucosa and cutaneous keratinocytes. So far, more than 200 Human papillomaviruses are known. HPV have been divided into high- and low-risk on the basis of their oncogenic potential. High risk HPV is considered to be the main etiological cause for cervical cancer. The current study was designed to screen the local cervical cancer patients from the twin cities of Pakistan for the occurance of high risk HPV. A total of 67 formalin fixed paraffin-embedded samples of cervical cancer biopsies were obtained from the government hospitals in Islamabad and Rawalpindi. Cervical cancer biopsies were examined for the presence of HPV DNA. Polymerase chain reaction (PCR) was used for the amplification of a region in the HPV-L1 gene for the general detection of the Papilloma virus and for the genotype specific detection of high risk HPV 16 and 18 using the GP5/GP6 primers and genotype specific primers, respectively. HPV DNA was detected in 59 out of 67 samples analyzed. 30 samples showed the presence of HPV16 while 22 samples were positive for HPV18. HPV subtype could not be determined in 7 samples. Our results show a strong association between HPV infection and cervical cancer among women in twin cities of Pakistan. One way to minimize the disease burden in relation to HPV infection in Pakistani population is the use of prophylactic vaccines and routine screening. An early diagnosis of HPV infection will allow better health management to reduce the risk of developing cervical cancer. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Using SERVQUAL for assessing and improving patient satisfaction at a rural health facility in Pakistan.

    PubMed

    Shaikh, B T; Mobeen, N; Azam, S I; Rabbani, F

    2008-01-01

    A cross-sectional study of patient satisfaction with care was conducted over a period of 1 year from March 2004 to March 2005 in a secondary-level hospital in a peri-urban area of Karachi, Pakistan. Using the SERVQUAL tool and exit interviews, data were collected quarterly from a total of 1533 patients. Results sharing and capacity-building workshops were arranged during the 4 phases of the survey to sensitize the staff of the hospital to work towards improving patient satisfaction. The level of satisfaction of the patients with the outpatient health services provided showed a gradual increase from 34.4% to 82.0% over the 1-year period.

  19. Histopathological spectrum of childhood nephrotic syndrome in Pakistan.

    PubMed

    Mubarak, Muhammed; Lanewala, Ali; Kazi, Javed Iqbal; Akhter, Fazal; Sher, Atika; Fayyaz, Amir; Bhatti, Sajid

    2009-12-01

    There is no information in international literature on the pattern of glomerulopathies in children with idiopathic nephrotic syndrome (INS) in Pakistan. We undertook this study to determine the pattern of glomerulopathies based on renal biopsies studied by light (LM), immunofluorescence (IF), and electron microscopy (EM). The study was conducted at Sindh Institute of Urology and Transplantation (SIUT), Karachi over 12 years (1996-2008). All children (Pakistan.

  20. 78 FR 52823 - Designation of 1 Individual and 1 Entity Pursuant to Executive Order 13224 of September 23, 2001...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-26

    .... UMAR, Muhammad), Karachi, Pakistan; Miram Shah, North Waziristan Agency, Federally Administered Tribal Areas, Pakistan; DOB 1977; POB Saudi Arabia; nationality Pakistan; National ID No. 466-77-221879 (Pakistan); alt. National ID No. 42201-015024707-7 (individual) [SDGT]. Entity 1. JAMIA TALEEM-UL-QURAN-WAL...

  1. Humid free efficient solar panel

    NASA Astrophysics Data System (ADS)

    Panjwani, Manoj Kumar; Panjwani, Suresh Kumar; Mangi, Fareed Hussain; Khan, Danish; Meicheng, Li

    2017-09-01

    The paper examines the impact of the humidity on the Solar panels which makes a space for the drastic variation in the power generated and makes the device less efficient. Humidity readily affects the efficiency of the solar cells and creates a minimal layer of water on its surface. It also decreases the efficiency by 10-20% of the total power output produced. Moreover, to handle this issue, all around characterized measures are required to be taken to guarantee the smooth working of the solar panels utilized in humid areas. In connection with this issue, Karachi, the biggest city of Pakistan which is located near the costal line touching Arabian Sea, was taken as a reference city to measure the humidity range. In Karachi, the average humidity lies between 25-70% (as per Pakistan Meteorological Department PMD), that indirectly leads in decreasing power acquired from a Solar Panel and develops various complexities for the solar system. The system on average experiences stability issues, such as those of power fluctuations etc., due to which, the whole solar system installed observes abnormal variations in acquired power. Silica Gel was used as a desiccant material in order to assure dryness over the solar panel. More than four experiments were conducted with the usage of water absorbent to improve the efficiency and to make system more power efficient.

  2. Experiences of young smokers in quitting smoking in twin cities of Pakistan: a phenomenological study.

    PubMed

    Shaheen, Kanwal; Oyebode, Oyinlola; Masud, Haleema

    2018-04-10

    Smoking is highly prevalent in Pakistan claiming the lives of over 100,000 individuals every year. A significant proportion of smokers (24.7%) make an attempt to quit each year but 97.4% fail to quit successfully. Little is known about the reasons for, and experiences of, failed quit attempts. This study was carried out to explore the experiences of young male smokers in quitting smoking in the twin cities of Pakistan METHOD: A qualitative study was carried out using a phenomenological approach in Rawalpindi and Islamabad. A total of 11 participants were interviewed. All study participants were male and had made at least one quit attempt. Study participants were a mix of smokers who failed to quit smoking, intermittent smokers and successful quitters. Streubert's (1991) method of phenomenology was followed during data analysis. The experiences of smokers while smoking "the smoking phase" have major effects on their journey towards quitting smoking. The smoking phase consists of three major stages: contact with initial smoking stimuli, the journey from first puff to enjoying smoking and then finally smoking becoming part of life. However, the journey towards quitting smoking is not as simple as the journey towards becoming a smoker. Instead, smokers get trapped in three overlapping cycles of smoking and quit attempts: smoking & forced quitting, smoking & intentional quitting, and smoking & intermittent smoking before successful quitting. Breaking the cycle is not easy in the presence of trapping factors (addiction, high availability, easy affordability, conducive social setup and low perceived risks of smoking). Three factors play a major role in breaking these cycles which are strong will power, continuous peer support and avoidance of smokers' company. A young smoker, during his experience of quitting smoking gets entrapped in several overlapping cycles of smoking & quit attempts before successful quitting. There are known entrapping factors as well as factors

  3. 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. © 2015 Elsevier Ltd All rights reserved.

  4. Exploring environmental literacy in low-literate communities of Pakistan: A descriptive study to recommend strategies for planning environmental education programs

    NASA Astrophysics Data System (ADS)

    Daudi, Sabiha Shafique

    2000-10-01

    The widely accepted definition of environmental education as stated by The Tbilisi Declaration of 1978 focuses on developing an environmentally literate citizenry which is capable of working "...individually and collectively toward solutions of current [environmental] problems and the prevention of new ones". The two basic tenets of environmental literacy are further defined in this study as the ability to understand environmental problems and the ability to address those environmental problems in a responsible manner. Acquisition of knowledge has also been considered an important element when developing environmental literacy programs. However, a large sector of the world population is non- or low-literate and communication is through channels other than the written word. The challenge for environmental educators is to reach the low-literate learners who have not had many opportunities to participate in formal education activities through established institutions. The purpose of this study was to describe levels of environmental literacy in communities with varying levels of formal literacy in two cities, Karachi and Islamabad, Pakistan to determine the role formal literacy plays in enhancing environmental literacy and decision making in relation to age, sex, location, number of years spent in formal education, and the socio-economic status (SES) of adult learners. Based on the outcomes, recommendations were made for designing effective programs to ensure involvement of low-literate communities in established decision-making processes through relevant program planning. This study suggested strategies to program planners and environmental educators for designing programs that reach low-literate communities, highlight local environmental concerns, and empower these communities in addressing local environmental issues. A purposive sample was identified from the constituencies of five non-governmental organizations in Karachi and Islamabad, Pakistan. Two instruments

  5. Paediatric innovation in Pakistan: our experience and a call to action.

    PubMed

    Farooqi, Walid; Subhani, Faysal; Mian, Asad

    2017-10-01

    Standardisation in paediatric medicine may have the unintended effect of stifling innovation. Thinking outside the box becomes even more important in low-income to middle-income countries like Pakistan, where a large paediatric population requires healthcare. In addition, there is always a lack of funds, making an innovative, low-cost and high impact solution all the more necessary. While regulation and formal research is an integral part of the process, the local synthesis of a solution must start with a creative idea. To address the dearth of avenues promoting lateral thinking relevant to biomedicine and healthcare among students and faculty, the Critical Creative Innovative Thinking forum was formed at the Aga Khan University in Karachi, Pakistan, by a group consisting of students and faculty in 2014. The primary objective of the forum was to provide an arena conducive to lateral thinking and to equip biomedical professionals with the skill set to enable and promote creativity and innovation. This paper seeks to outline those efforts and discuss their potential impact on paediatric care for resource-limited settings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Prevalence and associated factors of perceived stress among adolescent girls in Nawabshahi City, Pakistan.

    PubMed

    Parpio, Yasmin

    2013-01-01

    The aim of this study was to determine the prevalence and associated factors of perceived stress among female adolescent in Nawabshah City, Pakistan. This study was a sub-analysis of a parent research. Analytical cross-sectional design was used to achieve the study objectives. The study population comprised of school-going female adolescents aged 10-16 years resident of Nawabshah City. Perceived Stress Scale (PSS) and structured questionnaire were employed to measure the prevalence and associated factors of stress respectively. Multiple linear regressions were done to determine the predictors contributing to stress among female adolescents by using SPSS-17. The mean (+/- SD) of perceived stress score of the respondents was 27.84 +/- 2.84 with median 28 and the values were ranging from 19-37 scores for female participants. The final model indicated that among adolescents whose fathers are unemployed, the estimated mean score of stress was 0.734 +/- 0.493 higher than adolescents whose fathers are employed. As the number of rooms in the house increased by one, the estimated mean stress score decreases by 0.213 +/- 0.082. Among adolescents whose parents quarrelled, the estimated mean score of stress was 0.158 +/- 0.051 higher than adolescents whom parents did not quarrel. Almost every second female adolescent (58%) reported stress symptoms. The father's unemployment, number of rooms and parental quarrel is associated with risk of stress among female adolescents.

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

    PubMed

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

    2014-01-01

    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). 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 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. 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%).

  8. Genetic diversity of Plasmodium vivax clinical isolates from southern Pakistan using pvcsp and pvmsp1 genetic markers

    PubMed Central

    2013-01-01

    Background Plasmodium vivax is the prevalent malarial species accounting for 70% of malaria burden in Pakistan; however, there is no baseline data on the circulating genotypes. Studies have shown that polymorphic loci of gene encoding antigens pvcsp and pvmsp1 can be used reliably for conducting molecular epidemiological studies. Therefore, this study aimed to bridge the existing knowledge gap on population structure on P. vivax from Pakistan using these two polymorphic genes. Methods During the period January 2008 to May 2009, a total of 250 blood 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/RFLP was performed, using pvcsp and pvmsp1 markers to detect the extent of genetic diversity in clinical isolates of P. vivax from southern Pakistan. Results A total of 227/250 (91%) isolates were included in the analysis while the remainder were excluded due to negative PCR outcome for P.vivax. Pvcsp analysis showed that both VK 210 (85.5%, 194/227) and VK 247 type (14.5%, 33/227) were found to be circulating in P. vivax isolates from southern Pakistan. A total of sixteen and eighty-seven genotypes of pvcsp and pvmsp-1 were detected respectively. Conclusion This is the first report from southern Pakistan on characterization of P. vivax isolates confirming that extensively diverse pvcsp and pvmsp1 variants are present within this region. Results from this study provide valuable data on genetic diversity of P. vivax that will be helpful for further epidemiological studies. PMID:23311628

  9. Comparison between Greulich-Pyle and Girdany-Golden methods for estimating skeletal age of children in Pakistan.

    PubMed

    Awais, Muhammad; Nadeem, Naila; Husen, Yousuf; Rehman, Abdul; Beg, Madiha; Khattak, Yasir Jamil

    2014-12-01

    To compare Greulich-Pyle (GP) and Girdany-Golden (GG) methods for estimation of Skeletal Age (SA) in children referred to a tertiary care hospital in Karachi, Pakistan. Cross-sectional study. Department of Radiology, The Aga Khan University Hospital, Karachi, Pakistan, from July 2010 to June 2012. Children up to the age of 18 years, who had undergone X-ray for the evaluation of trauma were included. Each X-ray was interpreted using both methods by two consultant paediatric radiologists having at least 10 years experience, who were blinded to the actual Chronologic Age (CA) of children. A total of 283 children were included. No significant difference was noted in mean SA estimated by GP method and mean CA for female children (p=0.695). However, a significant difference was noted between mean CA and mean SA by GG method for females (p=0.011). For males, there was a significant difference between mean CA and mean SA estimated by both GP and GG methods. A stronger correlation was found between CA and SA estimated by GP method (r=0.943 for girls, r=0.915 for boys) as compared to GG method (r=0.909 for girls, r=0.865 for boys) respectively. Bland- Altman analysis also revealed that the two methods cannot be used interchangeably. Excellent correlation was seen between the two readers for both GP and GG methods. There was no additional benefit of using GP and GG methods simultaneously over using GP method alone. Moreover, although GP was reliable in estimating SA in girls, it was unable to accurately assess SA in boys. Therefore, it would be ideal to develop indigenous standards of bone age estimation based on a representative sample of healthy native children.

  10. 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

  11. Medical students' perspectives on gender and smoking: a mixed methodology investigation in Karachi, Pakistan.

    PubMed

    Mubeen, Syed Muhammad; Morrow, Martha; Barraclough, Simon

    2011-08-01

    To explore the gender dimensions on influences of tobacco uptake on medical students using both qualitative and quantitative methods. A phased mixed-method study design was used with in-depth interviews followed by a survey questionnaire in a 'smoke-free' medical college campus in a private university of Karachi. Eight in-depth interviews were conducted to under-pin themes that were further used for developing the questionnaire. Tabulation and analysis of the quantitative data was done using SPSS software version 12. All the ethical issues for the research were taken into consideration. One hundred and sixty-five (72 male, 93 female) students participated in the study. Mean age was 21.57 +/- 1.66 years. The survey results reported perceived reasons for male smoking as stress relief (74%), image (62%), companionship (54%), leisurely independence (46%) and male power and masculinity (44%). Among reasons for women for not smoking by the majority was that it was frowned upon (87%) while the reasons for smoking clustered around concepts of images (65%), western culture (66%), stress relief (51%) and advertising (36%). A large proportion (55%) of students felt bad and bothered by male and female smoking. Despite being medical students, the anti-tobacco future role models, traditional concepts of gender were frequently involved that explains smoking and non-smoking gendered behaviours.

  12. Microbial and chemical analysis of illicit drugs samples confiscated from different areas of PakistanMicrobial and chemical analysis of illicit drugs samples confiscated from different areas of Pakistan.

    PubMed

    Hussain, Shahzad; Khattak, Zainab; Mahmood, Sidra; Malik, Farnaz; Riaz, Humayun; Raza, Syed Atif; Khan, Samiullah

    2016-09-01

    The microbial and chemical analysis of illicit drug samples from different areas of Pakistan i.e. Quetta, Karachi, Lahore and Islamabad was conducted in a cross-sectional study at National Institute of Health, Islamabad. The drug samples were confiscated by Anti Narcotics Force (ANF), Pakistan. Microbial analysis was done by estimating bioburden which revealed the presence of gram negative and positive bacteria's, fungus, Streptococcus, Staphylococcus species. Trypton soya agar was used for total aerobic count, MacConkey agar for gram-negative bacteria, Sabouraud dextrose agar for fungus and Vogel-Johnson agar for Streptococcus and Staphylococcus species. Colour tests were applied to identify the drug samples. Qualitative and quantitative analysis of suspected samples of Heroin, morphine, cocaine and acetic anhydride was made by employing different chromatographic techniques i.e. Thin-layer chromatography (TLC) and High-performance liquid chromatography (HPLC). The samples were found to be adulterated with paracetamol, diazepam and Dextromethorphen. Acetic anhydride was adulterated with hydrochloric acid (HCl). There is lack of information providing structured advice on responses to the consequences of illicit drug adulteration. Robust and rehearsed interventions and communication strategies would provide a basis for response for a wide variety of organisations. Research into the usefulness of media warnings about adulteration of illicit drugs is required.

  13. Assessment of sea water inundation along Daboo creek area in Indus Delta Region, Pakistan

    NASA Astrophysics Data System (ADS)

    Zia, Ibrahim; Zafar, Hina; Shahzad, Muhammad I.; Meraj, Mohsin; Kazmi, Jamil H.

    2017-12-01

    Indus Deltaic Region (IDR) in Pakistan is an erosion vulnerable coast due to the high deep water wave energy. Livelihood of millions of people depends on the fisheries and mangrove forests in IDR. IDR consists of many creeks where Daboo is a major creek located at southeast of the largest city of Pakistan, Karachi. Unfortunately, there has been no detailed study to analyze the damages of sea water intrusion at a large temporal and spatial scale. Therefore, this study is designed to estimate the effects of sea water inundation based on changing sea water surface salinity and sea surface temperature (SST). Sea surface salinity and SST data from two different surveys in Daboo creek during 1986 and 2010 are analyzed to estimate the damages and extent of sea water intrusion. Mean salinity has increased 33.33% whereas mean SST decreased 13.79% from 1987 to 2010. Spatio-temporal analysis of creek area using LANDSAT 5 Thematic mapper (TM) data for the years 1987 and 2010 shows significant amount of erosion at macro scale. Creek area has increased approximately 9.93% (260.86 m2 per year) which is roughly equal to 60 extensive sized shrimp farms. Further Land Use Land Cover (LULC) analyses for years 2001 and 2014 using LANDSAT 7 Enhanced Thematic Mapper Plus (ETM+) has indicated 42.3% decrease in cultivated land. Wet mud flats have spread out at the inner mouth of creek with enormous increase of 123.3%. Significant sea water intrusion has increased the area of barren land by 37.9%. This also resulted in overall decrease of 6.7% in area covered by mangroves. Therefore, this study recorded a significant evidence of sea water intrusion in IDR that has caused serious damages to community living in the area, economical losses. Additionally, it has also changed the environment by reducing creek biological productivity as reported by earlier studies over other regions of the world.

  14. Are our people health conscious? Results of a patients survey in Karachi, Pakistan.

    PubMed

    Qidwai, Waris; Saleheen, Danish; Saleem, Sadia; Andrades, Marie; Azam, Syed Iqbal

    2003-01-01

    Life style is known to influence health and may be responsible for certain diseases. There is a need to document the life style on health among the Pakistani population. The study was conducted on patients visiting the Family Practice Center, the Aga Khan University, Karachi. A questionnaire was used to collect information on the demographic profile, and the life style on health. The ethical requirements for conducting the study were met. 393 patients were surveyed. The majority were young married men, in either private or government service. Preference for consumption of fats/oils, sweets, spicy foods, salt, fruits/vegetables, tea, coffee, cola drinks and alcohol was found among 103 (26%), 84 (22%), 86 (22%), 110 (28%), 239 (61%), 319 (81%), 117 (30%), 253 (64%) and 13 (03%) respondents respectively. Hand washing after defecation, before eating food and after work was seen among 341 (87%), 296 (75%) and 256 (65%) respondents respectively. Brushing of teeth after eating food, before breakfast and bedtime was seen in 56 (14%), 346 (88%) and 176 (45%) respondents respectively. Preventive dental check-up was practiced by 102 (26%) of the respondents. Sleep of less than 6 hours per day among 74 (19%), water consumption of less than 1 liter daily among 84 (21%) and fish consumption on once a week basis among 173 (44%) respondents was found. Tobacco and betel nuts use was found among 69 (17%) and 79 (20%) respondents. We have documented a clear need to raise public awareness on the issue of life style on health. There is a need and we strongly recommend debate and further research, along with interventional strategies in line with the available evidence on healthy life style.

  15. Variability of Aerosol and its Impact on Cloud Properties Over Different Cities of Pakistan

    NASA Astrophysics Data System (ADS)

    Alam, Khan

    Interaction between aerosols and clouds is the subject of considerable scientific research, due to the importance of clouds in controlling climate. Aerosols vary in time in space and can lead to variations in cloud microphysics. This paper is a pilot study to examine the temporal and spatial variation of aerosol particles and their impact on different cloud optical properties in the territory of Pakistan using the Moderate resolution Imaging Spectroradiometer (MODIS) on board NASA's Terra satellite data and Multi-angle Imaging Spectroradiometer (MISR) data. We also use Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model for trajectory analysis to obtain origin of air masses in order to understand the spatial and temporal variability of aerosol concentrations. We validate data of MODIS and MISR by using linear correlation and regression analysis, which shows that there is an excellent agreement between data of these instruments. Seasonal study of Aerosol Optical Depth (AOD) shows that maximum value is found in monsoon season (June-August) over all study areas. We analyze the relationships between aerosol optical depth (AOD) and some cloud parameters like water vapor (WV), cloud fraction (CF), cloud top temperature (CTT) and cloud top pressure (CTP). We construct the regional correlation maps and time series plots for aerosol and cloud parameters mandatory for the better understanding of aerosol-cloud interaction. Our analyses show that there is a strong positive correlation between AOD and water vapor in all cities. The correlation between AOD and CF is positive for the cities where the air masses are moist while the correlation is negative for cities where air masses are relatively dry and with lower aerosol abundance. It shows that these correlations depend on meteorological conditions. Similarly as AOD increases Cloud Top Pressure (CTP) is decreasing while Cloud Top Temperature (CTT) is increasing. Key Words: MODIS, MISR, HYSPLIT, AOD, CF, CTP

  16. Report on drilling activities in the Thar Desert, Sindh Province, Pakistan

    USGS Publications Warehouse

    Thomas, Roger E.; Fassett, James E.; Warwick, Peter D.; Wardlaw, Bruce R.; Shah, Abas A.; Khan, Shafique Ahmed; Tagar, Mohammad A.; Memon, Abdul R.; Lashari, Ghulam S.; Khan, Zameer M.; Khan, Muhammad D.; Chandio, Altaf H.; Anwar, Mohammad; Nizamani, Mohammad A.; Ahmad, Mujeeb; Ur-Raman, Mehtab-

    1994-01-01

    Coal test drilling in the Thar Desert of southeast Pakistan was conducted as part of the Coal Exploration and Assessment Program (COALREAP) involving the United States Agency for International Development (USAID), the Geological Survey of Pakistan (GSP), and the U.S. Geological Survey. Drilling was performed in the Thar Desert, or Great Indian Desert, approximately 175 km northeast of Karachi. Twenty five exploration holes were drilled between January 1992 and May 1994. Drill core was described by geologists of the Pakistan Geological Survey and coal samples were analyzed in both the United States and Pakistan. U.S. Geological Survey geologists offered technical assistance, trained GSP personnel, and managed the drilling program according to an agreement with USAID under the Energy Planning and Development Project.Drilling was performed by the Geological Survey of Pakistan. During drilling, the first 50 m was rotary drilled and cuttings collected every 2 m for examination. Average depth for all coal beds is 214 m with a total average thickness of 10 m of coal per drill hole. Core was described, boxed, and stored at the Geological Survey of Pakistan core library at Sonda, near Hyderabad. Approximately 6,412 m of Paleocene to Eocene rock was drilled of which 3,990 m was cored and 1,113 m was rotary drilled.There was 1,309 m of core loss. Geophysical logging of each drill hole permitted detailed thicknesses of coal to be determined. Analysis of the coal indicated a rank of lignite B with an as-received heating value over 5,000 Btu.This report presents data collected at the drill sites and should be used inconjunction with the published interpretive report (Fassett and Durrani, 1994) and the USGS Open-File Report 94-167, which contains analysis of the coal samples. Tables provide quick reference to numeric data and results. Detailed index maps and specific data, for each drill hole are included. This report covers drill holes TP-5 to TP-31. Drill holes TP-16, 17, 21

  17. Spatial variance and assessment of nitrogen dioxide pollution in major cities of Pakistan along N5-Highway.

    PubMed

    Shabbir, Yasir; Khokhar, Muhammad Fahim; Shaiganfar, Reza; Wagner, Thomas

    2016-05-01

    This paper discusses the findings of the first car MAX-DOAS (multi-axis differential optical absorption spectroscopy) field campaign (300km long) along the National Highway-05 (N5-Highway) of Pakistan conducted on 13 and 14 November, 2012. The main objective of the field campaign was to assess the spatial distribution of tropospheric nitrogen dioxide (NO2) columns and corresponding concentrations along the N5-Highway from Islamabad to Lahore. Source identification of NO2 revealed that the concentrations were higher within major cities along the highway. The highest NO2 vertical column densities (NO2 VCDs) were found around two major cities of Rawalpindi and Lahore. This study also presents a comparison of NO2 VCDs measured by the ozone monitoring instrument (OMI) and car MAX-DOAS observations. The comparison revealed similar spatial distribution of the NO2 columns with both car MAX-DOAS and satellite observations, but the car MAX-DOAS observations show much more spatial details. Maximum NO2 VCD retrieved from car MAX-DOAS observations was up to an order of magnitude larger than the OMI observations in urban areas. Copyright © 2015. Published by Elsevier B.V.

  18. The Islamic Republic of Pakistan: country profile.

    PubMed

    Newcomb, L

    1986-07-01

    This discussion of Pakistan covers the following: regions and cities; the dominant Islamic sect; ethnicity and language; population growth; housing; households and families; the labor force; and information sources. Currently, Pakistan is in a period of transition. In 1985 Pakistan was ruled under martial law. On December 30, 1985, martial law was lifted, and a modified version of the 1973 constitution was adopted, restoring fundamental rights of Pakistanis and powers of the judiciary. Pakistan is divided into 4 provinces. The last census recorded the 1981 population at 84.3 million, nearly double the 1961 figure of 42.9 million. By 1983, the population had tripled to nearly 93 million, making Pakistan the world's 9th most populous country, although in area it ranked 34th. Its 3% annual growth rate placed it among the world's fastest growing countries. Although created as a sanctuary for followers of Islam, Pakistan suffers from periodic disputes between the members of Islam's various sects. Generally, ethnic groups and the use of their native languages divide along provincial boundaries. Punjabi, the native tongue of Pakistan's predominant group, is spoken in 48% of all Pakistani households and in about 80% of Punjab and Islamabad Federal Territory households. Pakistan's sixth 5-year plan recognizes the need for an additional 1.4 million dwellings to adequately house the current population. In 1980, Pakistan's 12.6 million housing units averaged nearly 7 people per unit. The ideal Pakistani household is an extended family consisting of a married couple, their sons, and their sons' wives and children. At the death of the patriarch, each son establishes a separate household. Marriage solidifes all social relationships. Single adults have little place in society. Women, although protected by law, often are deprived of their legal rights where marriage is concerned. Only 23% of the population aged 10 or older has completed primary school. Fewer than 1% hold university

  19. View of Pakistan Atomic Energy Commission towards SMPR's in the light of KANUPP performance

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Huseini, S.D.

    1985-01-01

    The developing countries in general do not have grid capacities adequate enough to incorporate standard size, economic but rather large nuclear power plants for maximum advantage. Therefore, small and medium size reactors (SMPR) have been and still are, of particular interest to the developing countries in spite of certain known problems with these reactors. Pakistan Atomic Energy Commission (PAEC) has been operating a CANDU type of a small PHWR plant since 1971 when it was connected to the local Karachi grid. This paper describes PAEC's view in the light of KANUPP performance with respect to such factors associated with SMPR'smore » as selection of suitable reactor size and type, its operation in a grid of small capacity, flexibility of operation and its role as a reliable source of electrical power.« less

  20. Genomic Surveillance Elucidates Persistent Wild Poliovirus Transmission During 2013-2015 in Major Reservoir Areas of Pakistan.

    PubMed

    Alam, Muhammad Masroor; Sharif, Salmaan; Shaukat, Shahzad; Angez, Mehar; Khurshid, Adnan; Rehman, Lubna; Zaidi, Syed Sohail Zahoor

    2016-01-15

    Despite tremendous efforts in the fight against polio, Pakistan bears the highest proportion of poliomyelitis cases among the 3 endemic countries including Afghanistan and Nigeria. Apart from insecurity and inaccessibility challenges, the substantial shift of unimmunized children from North Waziristan due to recent military operations was presumed to favor the widespread poliovirus infection in Pakistan. To better understand the current epidemiological situation, we analyzed the virologic data of wild poliovirus type 1 (WPV1) strains detected in Pakistan during 2013-2015. Five genetic clusters (A-E) were identified with at least 5% nucleotide divergence in the viral protein 1 (VP1) coding region. Peshawar, Quetta, and Karachi were found to be the major endemic foci where multiple discrete genetic lineages of WPV1 were detected. Phylogenetic analysis suggests that wild poliovirus strains from endemic regions were genetically distant (with 5%-15% VP1 nucleotide divergence) from those detected in North Waziristan cases, excluding the possibility of a recent progenitor of WPV1 instigating single-source transmission across the country. Orphan lineages detected in Rawalpindi, Lahore, Hyderabad, Sukkur, and Jacobabad revealed silent transmission and the need for vigilant surveillance. Sustenance of analogous genetic lineages over a period of 3 years highlights multiple unimmunized foci present to maintain viral genetic diversity. Our findings are inconsistent with the hypothesis that impoverished populations from North Waziristan serve as a possible determinant of widespread poliomyelitis infection in Pakistan and further emphasize the need to scale-up clinical and environmental surveillance as well as immunization activities. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  1. 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

  2. Integration of mental health into primary healthcare: perceptions of stakeholders in Pakistan.

    PubMed

    Hussain, Syed S; Khan, Murad; Gul, Raisa; Asad, Nargis

    2018-05-03

    In Pakistan, there is high prevalence of mental health disorders, but mental health services to address these are not well developed. To provide effective mental health services, the World Health Organization emphasizes the integration of mental health into primary health care (PHC). This study aimed to assess the views of key stakeholders about integration of mental health into PHC in Karachi, Pakistan. A qualitative, exploratory study was conducted between June and September 2013 among 15 decision-making (from the Department of Health) and implementation-level stakeholders (mental health and public health professionals and primary care staff) from both the public and private sectors. Face-to-face, in-depth interviews were conducted using a semi-structured interview guide. Data were collected until theoretical saturation was achieved and conventional content analysis was carried out. Although there was general support among all the stakeholders for integration of mental health services within PHC, there were also a number of reservations. First was the perceived lack of support within the system in terms of resource allocation and acceptance from the community. Second was the lack of human resources in the field of mental health. In addition, resistance at the PHC level is likely as staff are already burdened with other preventive care services. The study suggests that strong political commitment, adequate human and financial resources, and strong advocacy are needed for the integration of mental health into PHC in Pakistan. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

  3. 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. © The Author(s) 2015.

  4. Pandemic influenza A(H1N1)pdm09: An unrecognized cause of mortality in children in Pakistan

    PubMed Central

    ALI, SYED ASAD; AZIZ, FATIMA; AKHTAR, NIDA; QURESHI, SHAHIDA; EDWARDS, KATHRYN; ZAIDI, ANITA

    2016-01-01

    The role of influenza virus as a cause of child mortality in South Asia is under-recognized. We aimed to determine the incidence and case fatality rate of influenza A(H1N1)pdm09 infections in hospitalized children in Karachi, Pakistan. Children less than 5 y old admitted with respiratory illnesses to the Aga Khan University Hospital, Karachi, from 17 August 2009 to 16 September 2011, were tested for influenza A(H1N1)pdm09 using a real-time reverse transcriptase polymerase chain reaction. Out of 2650 children less than 5 y old admitted with a respiratory illness during the study period, 812 (31%) were enrolled. Influenza A(H1N1)pdm09 virus was detected in 27 (3.3%) children. There were 4 deaths in children who tested positive for influenza A(H1N1)pdm09 (case fatality rate of 15%). Children with influenza A(H1N1)pdm09 were 5 times more likely to be admitted or transferred to the intensive care unit, 5.5 times more likely to be intubated, and 12.9 times more likely to die as compared to children testing negative for influenza A(H1N1)pdm09. PMID:23826795

  5. Environmental impact assessment (EIA): an overlooked instrument for sustainable development in Pakistan.

    PubMed

    Saeed, Rashid; Sattar, Ayesha; Iqbal, Zafar; Imran, Muhammad; Nadeem, Raziya

    2012-04-01

    Environmental impact assessment (EIA) is a policy tool used for evaluating a project proposal from physical and socioeconomic environmental perspectives. Its aim is to reduce the impact of development on environment, hence, ensuring environmental sustainability. It is mandatory to submit an Environmental Impact Statement before starting a mega project as required by Environmental Protection Act of 1997 and Environmental Policy of Pakistan. Public consultation plays a key role in an EIA system, identifying the likely aspects and impacts of a development activity. This aspect has been ignored in effective enactment of environmental legislation in Pakistan. Sufficient legislative instruments are there to support EIA system in the country but the agencies responsible for the enforcement of environmental regulations have failed to do so. The current research gives an insight into the actual status of EIA system in Pakistan along with the feedback of EIA specialists and university teachers of the concerned departments. A new index has been devised on the basis of questionnaire response to work out the overall performance of EIA system in Pakistan or any other country. The weaknesses and deficiencies of each EIA stage have been worked out for Pakistan and elaborated with the help of the controversial Zero point Interchange Project in the capital city of Pakistan.

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

    PubMed

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

    2011-01-01

    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. 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. 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. 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. 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.

  7. Second-hand smoke in indoor hospitality venues in Pakistan.

    PubMed

    Zaidi, S M A; Moin, O; Khan, J A

    2011-07-01

    Second-hand smoke (SHS) constitutes a significant public health threat in countries with a high smoking prevalence. However, data assessing the quality of indoor air at public venues in Pakistan are limited. To measure mean concentrations of PM(2.5) (particulate matter ≤2.5 microns in diameter), a sensitive indicator of SHS, in hospitality venues in Pakistan. Data were collected discreetly from 39 indoor venues such as cafes, restaurants and shisha (water-pipe) bars from three major cities in Pakistan. Data were recorded using a portable air quality monitoring device. The overall mean PM(2.5) value for the visited venues was 846 μg/m(3) (95%CI 484-1205). The mean PM(2.5) value was 101 μg/m(3) (95%CI 69-135 μg/m(3)) for non-smoking venues, 689 μg/m(3) (95%CI 241-1138) for cigarette smoking venues and 1745 μg/m(3) (95%CI 925-2565) for shisha smoking venues. The significant levels of SHS recorded in this study, in particular from shisha smoking venues, could represent a major public health burden in Pakistan. Appropriate legislation needs to be enforced to protect the health of those exposed to the hazards of second-hand tobacco smoke.

  8. 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

  9. Pakistan: A Nation at War with Itself

    DTIC Science & Technology

    2010-12-01

    boundaries in India.13 As a recent Rand Corporation report argued, “the Use of militant groups, including the Taliban, has remained an important instrument...government at Dhaka in East Pakistan. Pakistan’s experiments with democracy have been marked by a “multi- layered trajectory of contrasts and...protect the city by destroying a large number of bridges on the canal that surrounded it. The Indian strategy of expanding the war beyond Kashmir was

  10. Swine Flu: Knowledge, Attitude, and Practices Survey of Medical and Dental Students of Karachi.

    PubMed

    Hasan, Fariha; Khan, Mohammad O; Ali, Mukarram

    2018-01-09

    Introduction Pakistan is extremely susceptible to an influenza outbreak, as it shares borders with the most affected countries, namely China and India. The medical and dental students come into direct contact with the affected population and should be aware of the risk factors and signs and symptoms pertaining to swine influenza virus (SIV). Hence, this survey was conducted to assess the knowledge, perceptions and self-care practices of the medical and dental students with regards to this pandemic. Methods A descriptive, cross-sectional study was conducted to evaluate the swine flu-related knowledge, attitudes and practices of the medical and dental students at various institutions in Karachi, Pakistan. We approached 613 students that were available on the dates of this survey, keeping a medical to dental student ratio of 75:25. All students from first to final year comprised of the study population, and no internists or medical personnel were included. The questionnaire was divided into three sections, namely knowledge, attitudes and, practices. All questions were based on a multiple choice format. The data were entered and interpreted using the IBM Statistical Package for the Social Sciences 23.0 (IBM Corp., Armonk, New York). Results The majority of the students were aware that the swine flu is a transmittable disease (n=485, 80.8%). Most students identified the signs and symptoms correctly; however, diarrhea (15.5%) and vomiting (32.2%) were the least correct answers (n=93, n=193 respectively). Most of the preventative measures were reported accurately by the participants. Despite this, only 15.5% students (n=93) reported the use of a facemask when suffering from fever, cough and a runny nose. Conclusion There is a dire need for the routine integration of the awareness and management programs in the medical and dental schools. There exists a gap between the policy and practice, and it is high time we bridge the divide. The students should also be vaccinated

  11. Swine Flu: Knowledge, Attitude, and Practices Survey of Medical and Dental Students of Karachi

    PubMed Central

    Khan, Mohammad O; Ali, Mukarram

    2018-01-01

    Introduction Pakistan is extremely susceptible to an influenza outbreak, as it shares borders with the most affected countries, namely China and India. The medical and dental students come into direct contact with the affected population and should be aware of the risk factors and signs and symptoms pertaining to swine influenza virus (SIV). Hence, this survey was conducted to assess the knowledge, perceptions and self-care practices of the medical and dental students with regards to this pandemic. Methods A descriptive, cross-sectional study was conducted to evaluate the swine flu-related knowledge, attitudes and practices of the medical and dental students at various institutions in Karachi, Pakistan. We approached 613 students that were available on the dates of this survey, keeping a medical to dental student ratio of 75:25. All students from first to final year comprised of the study population, and no internists or medical personnel were included. The questionnaire was divided into three sections, namely knowledge, attitudes and, practices. All questions were based on a multiple choice format. The data were entered and interpreted using the IBM Statistical Package for the Social Sciences 23.0 (IBM Corp., Armonk, New York). Results The majority of the students were aware that the swine flu is a transmittable disease (n=485, 80.8%). Most students identified the signs and symptoms correctly; however, diarrhea (15.5%) and vomiting (32.2%) were the least correct answers (n=93, n=193 respectively). Most of the preventative measures were reported accurately by the participants. Despite this, only 15.5% students (n=93) reported the use of a facemask when suffering from fever, cough and a runny nose. Conclusion There is a dire need for the routine integration of the awareness and management programs in the medical and dental schools. There exists a gap between the policy and practice, and it is high time we bridge the divide. The students should also be vaccinated

  12. Audit of custodial deaths in Karachi--an autopsy-based study.

    PubMed

    Mirza, Farhat Hussain; Memon, Akhtar Amin; Adil, Syeda Ezz-e-Rukhshan; Paryar, Hamid Ali

    2012-08-01

    To assess the causes and manner of custodial deaths in Karachi, and to determine the factor of negligence on the part of the custodians behind such deaths. The cross-sectional study involved the deaths in custody undergoing autopsy at Civil Hospital, Karachi, from January 2005 to December 2010. Autopsy was followed by histological examination, X-ray or CT scan wherever required. A proforma was also filled as per the standard autopsy protocol. There were 61 custodial deaths in Karachi during the six-year study period which met the inclusion criterion. There were 58 (95.1%) males and 3 (9.4%) females. Natural causes accounted for a majority of deaths (n = 36; 59%), the most common disease being coronary artery disease (n = 13; 21.3%). Unnatural causes accounted for 25 (41%) deaths, comprising 13 (21.3%) homicidal, 7 (11.5%) suicidal and 5 (8.2%) accidental. Deaths were more frequent in the age group ranging from 30-39 years (34.4%), while the overall age-range was from 19 to 75 years. Measures need to be taken to provide a wholesome environment for the prisoners. Code of conduct for the prisoners should be followed and judicial procedures shall be conducted at a quick pace. Torture should be avoided under all circumstances, and proper vigilance shall be kept to prompt suicidal deaths.

  13. Musculoskeletal pain and its associated risk factors among medical students of a public sector University in Karachi, Pakistan.

    PubMed

    Haroon, Husna; Mehmood, Safia; Imtiaz, Fauzia; Ali, Syed Arif; Sarfraz, Mohammad

    2018-04-01

    To assess the frequency and anatomical distribution of musculoskeletal pain and its related risk factors. This cross-sectional study was conducted at the Dow Medical College, Karachi, from September to November 2016, and comprised medical students. A self-administered questionnaire was filled out by the participants. Data was analysed using SPSS 17. Of the 360 participants, 268(74.4%)and 140(38.9%)students reported having musculoskeletal pain in at least one of the body sites in the past 12 months and in the past seven days, respectively. Self-reported mental stress (p=0.01) and history of trauma in the neck, shoulder or lower back (p=0.002) were the most significant predictors of musculoskeletal pain during the past seven days. Age, body mass index, gender, academic year, family history of musculoskeletal disorders, hours of clinical practice per day, hours of study per day, smoking and exercise had no significant relation with musculoskeletal pain in neck, shoulder or lower back (p>0.05 each). The use of computer/laptop for more than three hours per day had an increased occurrence of neck pain (p=0.03).. There was a significant risk of musculoskeletal pain for medical students.

  14. 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

  15. Heterogeneity Among Sex Workers in Overlapping HIV Risk Interactions With People Who Inject Drugs: A Cross-Sectional Study From 8 Major Cities in Pakistan

    PubMed Central

    Melesse, Dessalegn Y.; Shafer, Leigh Anne; Shaw, Souradet Y.; Thompson, Laura H.; Achakzai, Baser K.; Furqan, Sofia; Reza, Tahira; Emmanuel, Faran; Blanchard, James F.

    2016-01-01

    Abstract Concerns remain regarding the heterogeneity in overlapping human immunodeficiency virus (HIV) risk behaviors among sex workers (SWs) in Pakistan; specifically, the degree to which SWs interact with people who inject drugs (PWID) through sex and/or needle sharing. Following an in-depth mapping performed in 2011 to determine the size and distribution of key populations at highest risk of HIV acquisition in Pakistan, a cross-sectional biological and behavioral survey was conducted among PWID, female (FSWs), male (MSWs), and hijra/transgender (HSWs) sex workers, and data from 8 major cities were used for analyses. Logistic regression was used to identify factors, including city of residence and mode of SW-client solicitation, contributing to the overlapping risks of drug injection and sexual interaction with PWID. The study comprised 8483 SWs (34.5% FSWs, 32.4% HSWs, and 33.1% MSWs). Among SWs who had sex with PWID, HSWs were 2.61 (95% confidence interval [CI], 1.19–5.74) and 1.99 (95% CI, 0.94–4.22) times more likely to inject drugs than MSWs and FSWs, respectively. There was up to a 3-fold difference in drug injecting probability, dependent on where and/or how the SW solicited clients. Compared with SWs in Larkana, the highest likelihood of drug injection use was among SWs in Multan (OR = 4.52; 95% CI: 3.27–6.26), followed by those in Lahore, Quetta, and Faisalabad. Heterogeneity exists in the overlapping patterns of HIV risk behaviors of SWs. The risk of drug injection among SWs also varies by city. Some means of sexual client solicitation may be along the pathway to overlapping HIV risk vulnerability due to increased likelihood of drug injection among SWs. There is a need to closely to monitor the mixing patterns between SWs and PWID and underlying structural factors, such as means of sexual client solicitation, that mediate HIV risk, and implement prevention programs customized to local subepidemics. PMID:27015178

  16. Heterogeneity Among Sex Workers in Overlapping HIV Risk Interactions With People Who Inject Drugs: A Cross-Sectional Study From 8 Major Cities in Pakistan.

    PubMed

    Melesse, Dessalegn Y; Shafer, Leigh Anne; Shaw, Souradet Y; Thompson, Laura H; Achakzai, Baser K; Furqan, Sofia; Reza, Tahira; Emmanuel, Faran; Blanchard, James F

    2016-03-01

    Concerns remain regarding the heterogeneity in overlapping human immunodeficiency virus (HIV) risk behaviors among sex workers (SWs) in Pakistan; specifically, the degree to which SWs interact with people who inject drugs (PWID) through sex and/or needle sharing.Following an in-depth mapping performed in 2011 to determine the size and distribution of key populations at highest risk of HIV acquisition in Pakistan, a cross-sectional biological and behavioral survey was conducted among PWID, female (FSWs), male (MSWs), and hijra/transgender (HSWs) sex workers, and data from 8 major cities were used for analyses. Logistic regression was used to identify factors, including city of residence and mode of SW-client solicitation, contributing to the overlapping risks of drug injection and sexual interaction with PWID.The study comprised 8483 SWs (34.5% FSWs, 32.4% HSWs, and 33.1% MSWs). Among SWs who had sex with PWID, HSWs were 2.61 (95% confidence interval [CI], 1.19-5.74) and 1.99 (95% CI, 0.94-4.22) times more likely to inject drugs than MSWs and FSWs, respectively. There was up to a 3-fold difference in drug injecting probability, dependent on where and/or how the SW solicited clients. Compared with SWs in Larkana, the highest likelihood of drug injection use was among SWs in Multan (OR = 4.52; 95% CI: 3.27-6.26), followed by those in Lahore, Quetta, and Faisalabad.Heterogeneity exists in the overlapping patterns of HIV risk behaviors of SWs. The risk of drug injection among SWs also varies by city. Some means of sexual client solicitation may be along the pathway to overlapping HIV risk vulnerability due to increased likelihood of drug injection among SWs. There is a need to closely to monitor the mixing patterns between SWs and PWID and underlying structural factors, such as means of sexual client solicitation, that mediate HIV risk, and implement prevention programs customized to local subepidemics.

  17. Traditional Healing Practices Sought by Muslim Psychiatric Patients in Lahore, Pakistan

    ERIC Educational Resources Information Center

    Farooqi, Yasmin Nilofer

    2006-01-01

    This research explored the type of traditional healing practices sought by Muslim psychiatric patients treated at public hospitals of Lahore city, Pakistan. The sample comprised 87 adult psychiatric patients (38% male and 62% female). The patients self-reported on the Case History Interview Schedule that they had sought diverse traditional healing…

  18. Attitudes to School Science Held by Primary Children in Pakistan

    ERIC Educational Resources Information Center

    Iqbal, Hafiz Muhammad; Nageen, Tabassum; Pell, Anthony William

    2008-01-01

    Attitudes to science scales developed earlier in England have been used in and around a Pakistan city with children in Primary/Elementary Grades 4-8. The limitations of a "transferred scale" in a culturally different context are apparent in a failure to reproduce the English factor patterns, but items are identified to serve as a base…

  19. Intellectual wellness in medical university teachers: Gender based comparison.

    PubMed

    Syed, Sadiqa; Rehman, Rehana; Hussain, Mehwish; Shaikh, Saifullah

    2017-05-01

    A cross section, questionnaire based study was carried out from January 2012 till December 2014 to compare intellectual wellness (IW) awareness on the basis of gender in teachers of basic sciences at medical universities of Karachi, Pakistan. Data was collected from 3 public and 5 private medical universities of Karachi, Pakistan. Questionnaire was tailored from "Wellness Wheel" and responses were aggregated for eight questions in the dimension of IW to obtain aggregate IW score. Reliability of the questionnaire was measured using Cronbach's alpha. The average intellectual score was 24.99 ± 3.93 with a minimum score of 8 and maximum 32.The frequency of keeping informed about research updates was significantly higher in males (p = 0.043) that emphasized significantly better IW awareness of male medical teachers involved in teaching of medical sciences in both public and private medical universities of Pakistan.

  20. 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

  1. Exploring the impact of gender inequities on the promotion of cardiovascular health of women in Pakistan.

    PubMed

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

    2017-01-01

    Cardiovascular disease exerts an enormous burden on women's health. The intake of a healthy diet may reduce this burden. However, social norms and economic constraints are often factors that restrain women from paying attention to their diet. Underpinned by critical realism, this study explores how gender/sex influences decision-making regarding food consumption among women of low socioeconomic status (SES). The study was carried out at two cardiac facilities in Karachi, Pakistan, on 24 participants (male and female from different ethnic backgrounds), who had received health education. Using an interpretive descriptive approach, the study identified major barriers to a healthy diet: proscribed gender roles and lack of women's autonomy, power, male domination, and abusive behaviours. Cardiovascular risk and disease outcomes for the Pakistani women of low SES are likely to further escalate if individual and structural barriers are not reduced using multifactorial approaches. © 2016 John Wiley & Sons Ltd.

  2. Dengue viral infections in Pakistan and other Asian countries: a comprehensive review.

    PubMed

    Zubair, Muhammad; Ashraf, Muhammad; Ahsan, Aitezaz; Nazir, Noor-Ul-Ain; Hanif, Hina; Khan, Haider Ali

    2016-07-01

    Infections due to Dengue virus are widespread throughout the world. Disease starts with mild flu like sickness to a severe intricate condition which results in the death of the patient. Dengue illness has high morbidity and mortality in Pakistan as well as in other Asian countries. The Review article is a discourse analysis that explores the facts about the history, emergence and impact of dengue in Pakistan and other Asian countries. Data was collected from internet sources, mainly using Science Direct and PubMed. The final literature was reviewed and summarised. About 150 articles were identified and 47 articles were shortlisted for final review. Aedesaegypti was found to be a major vector for the transmission and spread of dengue illness. Treatment comprises supportive therapy as no specific treatment was available. During the last couple of years, the incidence of dengue fever was extraordinary in metropolitan cities of Pakistan.

  3. Dietary modification, body mass index (BMI), blood pressure (BP) and cardiovascular risk in medical students of a government medical college of Karachi.

    PubMed

    Raza, Sajjad; Sheikh, Muhammad Adil; Hussain, Muhammad Fawwad Ahmed; Siddiqui, Saad Ebrahim; Muhammad, Rabia; Aziz, Sina; Qamar, Salima; Saleem, Mohammad Azfar; Waki, Nida; Faruqi, Hina; Zia, Aisha

    2010-11-01

    To determine the prevalence of major risk factors including dietary modification, Body Mass Index (BMI), Blood Pressure (BP) and physical activity in medical students of government teaching hospitals of Karachi. A cross sectional study was conducted on students of Dow Medical College, Karachi, Pakistan through a structured pre-tested questionnaire. Non-probability purposive sampling was used. Smoking, hypertension, family history of cardiovascular disease (CVD), overweight and low physical activity levels are risk factors the presence of which can lead to development of CVD. Prevalence of these risk factors was determined by asking appropriate questions and through measurement of BMI and blood pressure for overweight and hypertension respectively. Awareness of risk factors was determined through knowledge of the effect of various food substances on development of CVD and of adoption of dietary changes keeping in mind the risk of developing CVD. SPSS 16.0 was used for statistical analysis. A total of 132 medical students were included in the study of which 57 (43.2%) and 75 (56.8%) were male and female respectively with mean age of 20.85 +/- 1.21 years. About 15.9% of students had elevated blood pressure i.e. > or = 140/90 mmHg. Twenty eight percent of the total students were found to be underweight and 17.4% were overweight, 5% had some history of CVD, 56.8% had family history of CVD, 9.4% were smokers and 29.5% had high physical activity level. About 87.1% had modified their diet for preventing CVD. Most of the students had adequate knowledge about the cardiovascular risk factors Majority of students were not overweight. A high prevalence of cardiovascular risk factors; family history and elevated blood pressure was present. Awareness in terms of knowledge was satisfactory but implementation in terms of diet modification and adequate physical activity was lacking.

  4. Feasibility of conducting intradermal vaccination campaign with inactivated poliovirus vaccine using Tropis intradermal needle free injection system, Karachi, Pakistan.

    PubMed

    Yousafzai, Mohammad Tahir; Saleem, Ali Faisal; Mach, Ondrej; Baig, Attaullah; Sutter, Roland W; Zaidi, Anita K M

    2017-08-01

    Administration of intradermal fractional dose of inactivated poliovirus vaccine (fIPV) has proven to be safe and immunogenic; however, its intradermal application using needle and syringe is technically difficult and requires trained personnel. We assessed feasibility of conducting an intradermal fIPV campaign in polio high risk neighborhood of Karachi using Tropis needle-free injector. During the one-day fIPV campaign, we measured average "application time" to administer fIPV with Tropis, collected ergonomic information and measured vaccine wastage. Eleven vaccinator teams, after two-day training, immunized 582 children between 4 months and 5 years of age. Average "application time" ranged from 35-75 seconds; the "application time" decreased with the number of children vaccinated from 68 to 38 seconds between 1st and 30th child. 10/11 (91%) vaccinator teams found no ergonomic issues; 1/11 (9%) assessed that it was not easy to remove air bubbles when filling the device. There was 0% vaccine loss reported. No adverse events following immunizations were reported. We demonstrated that it is feasible, safe and efficient to use Tropis for the administration of fIPV in a campaign setting.

  5. Assessment of disease management of insomnia at community pharmacies through simulated visits in Pakistan.

    PubMed

    Hussain, Azhar; Ibrahim, Mohamed Izham; Malik, Madeeha

    2013-10-01

    The study aimed to document the state of insomnia management at community pharmacies in Pakistan. A cross-sectional study was conducted at randomly selected 371 pharmacies in three cities of Pakistan. Simulated patient visits were performed to collect information on case management of insomnia in terms of history taking and patient counseling at community pharmacies. The data was coded, entered and analyzed by using SPSS Version 16. Kruskal-Wallis and Mann Whitney tests (p<0.05) were performed to find out differences. The patients were mainly handled by salesman 83.8% (n=311), by pharmacist 3.5% (n=13) and pharmacy assistants 12.7% (n=47). The mean dispensing time was 1.11 minutes (SD=5.61) with the range of 0.5 - 6 minutes. Of the 371 simulated patients who visited the pharmacies, 72.8% (n=270) subjects were given medicines and 24.3% (n=90) subjects were referred to the doctor for treatment of insomnia. 61.8% (n=193) of the subjects were given benzodiazepines, 35.6% (n=111) antihistamines and 2.6% (n=8) NSAIDs at community pharmacies in the three cities. The mean cost of treatment in case of insomnia was PKR12.7 (SD=10.13, median=10). The disease management of insomnia by community pharmacies in Pakistan is not appropriate. The overall process of history taking, medication counselling and referral practices at community pharmacies either located in rural or urban setting and irrespective of the provider type and location of pharmacies, in the three cities is limited.

  6. Estimation of GFR in South Asians: A Study From the General Population in Pakistan

    PubMed Central

    Jessani, Saleem; Levey, Andrew S.; Bux, Rasool; Inker, Lesley A.; Islam, Muhammad; Chaturvedi, Nish; Mariat, Christophe; Schmid, Christopher H.; Jafar, Tazeen H.

    2015-01-01

    Background South Asians are at high risk for chronic kidney disease. However, unlike those in the United States and United Kingdom, laboratories in South Asian countries do not routinely report estimated glomerular filtration rate (eGFR) when serum creatinine is measured. The objectives of the study were to: (1) evaluate the performance of existing GFR estimating equations in South Asians, and (2) modify the existing equations or develop a new equation for use in this population. Study Design Cross-sectional population-based study. Setting & Participants 581 participants 40 years or older were enrolled from 10 randomly selected communities and renal clinics in Karachi. Predictors eGFR, age, sex, serum creatinine level. Outcomes Bias (the median difference between measured GFR [mGFR] and eGFR), precision (the IQR of the difference), accuracy (P30; percentage of participants with eGFR within 30% of mGFR), and the root mean squared error reported as cross-validated estimates along with bootstrapped 95% CIs based on 1,000 replications. Results The CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) creatinine equation performed better than the MDRD (Modification of Diet in Renal Disease) Study equation in terms of greater accuracy at P30 (76.1% [95% CI, 72.7%–79.5%] vs 68.0% [95% CI, 64.3%–71.7%]; P <0.001) and improved precision (IQR, 22.6 [95% CI, 19.9–25.3] vs 28.6 [95% CI, 25.8–31.5] mL/min/1.73 m2; P < 0.001). However, both equations overestimated mGFR. Applying modification factors for slope and intercept to the CKD-EPI equation to create a CKD-EPI Pakistan equation (such that eGFRCKD-EPI(PK) = 0.686 × eGFRCKD-EPI1.059) in order to eliminate bias improved accuracy (P30, 81.6% [95% CI, 78.4%–84.8%]; P < 0.001) comparably to new estimating equations developed using creatinine level and additional variables. Limitations Lack of external validation data set and few participants with low GFR. Conclusions The CKD-EPI creatinine equation is more

  7. Spectrum of glomerulonephritides in adults with nephrotic syndrome in Pakistan.

    PubMed

    Kazi, Javed Iqbal; Mubarak, Muhammed; Ahmed, Ejaz; Akhter, Fazal; Naqvi, Syed Ali Anwer; Rizvi, Syed Adeebul Hassan

    2009-02-01

    There is currently little information in literature about the pattern of glomerulonephritides (GN) in adults with nephrotic syndrome in this part of the world, particularly that involving the use of immunofluorescence (IMF) and electron microscopy (EM). A few studies reported are based on light microscopic study alone and hence do not reflect the true pattern of GN underlying nephrotic syndrome. We carried out this study in the Department of Histopathology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan to determine, for the first time, the true pattern of GN in adult nephrotic patients from Pakistan. SIUT is a tertiary care center for renal and urologic disease in Pakistan. The Histopathology Laboratory of SIUT is equipped with all the modalities, including EM, required for precise diagnosis of glomerular disease. This is a retrospective clinicopathologic study involving retrieval of clinical and pathological data from a review of original renal biopsy reports of adult patients with nephrotic syndrome who presented at the adult nephrology clinic of SIUT from July 1996 till July 2006. Two cores of renal tissue were routinely obtained. One core was fixed in 10% buffered formalin and processed for light microscopy; the other core was divided into two halves, for EM and the IMF study. A total of 316 adult patients were included. Of these, 201 (63.6%) were male and 115 (36.4%) were female. Mean age was 28.4 +/- 10.51 years with a range of 16-78 years. The spectrum of pathological lesions in the adult nephrotic population was wide and comprised focal segmental glomerulosclerosis (FSGS) (39.87%), followed by membranous GN (MGN) (26.58%), minimal change disease (MCD) (14.82%), mesangiocapillary GN (4.3%), mesangioproliferative GN (4.11%), post-infectious GN (2.84%), IgA nephropathy (2.53%), and other rare lesions. Results from this study indicate that FSGS is the single most common cause of nephrotic syndrome in adult nephrotic patients, followed

  8. Sexual abuse, social stigma and HIV vulnerability among young feminised men in Lahore and Karachi, Pakistan.

    PubMed

    de Lind van Wijngaarden, Jan W; Schunter, Bettina T; Iqbal, Qasim

    2013-01-01

    This study describes the experiences of 10 young feminised men in Pakistan. They face high levels of stigma, violence and sexual abuse. The average age of first sex was 11 years old and all reported having been been raped during childhood and early adolescence, often several times. While some mothers and siblings were quietly supportive, young feminised men often end up running away from home, finding support as a member of a hijra dera, a 'pseudo-household' led by an older feminised man or guru, in which they find employment as dancers or sex workers. After their entry into sex work there is little or no opportunity to use condoms. The hijra dera offer an important entry point for improved social support and sexual health programmes, including efforts to ensure young feminised men postpone their sexual debut and/or improve their sexual health, retain access to education, explore alternative forms of employment and improve access to health care.

  9. Mobile phone intervention to improve diabetes care in rural areas of Pakistan: a randomized controlled trial.

    PubMed

    Shahid, Muhammad; Mahar, Saeed Ahmed; Shaikh, Shiraz; Shaikh, Zuhaib-u-ddin

    2015-03-01

    To determine the effect of mobile phone intervention on HbA1c in type-2 Diabetes Mellitus (DM) patients living in rural areas of Pakistan. Randomized controlled trial. Department of Endocrinology, Liaquat National Hospital, Karachi, from December 2013 to June 2014. A total of 440 patients in intervention and control groups were enrolled. All patients between 18 - 70 years of age, residing in rural areas of Pakistan, HbA1c ³ 8.0% and having personal functional mobile phone were included. The intervention group patients were called directly on mobile phone after every 15 days for a period of 4 months. They were asked about the self-monitoring blood glucose, intake of medications, physical activity, healthy eating and were physically examined after 4 months. However, the control group was examined initially and after 4 months physically in the clinic and there were no mobile phone contacts with these patients. Patients in intervention group showed improvement (p < 0.001) in following diet plan from 17.3% at baseline to 43.6% at endline, however, the control group showed insignificant increase (p=0.522) from 13.6% at baseline to 15.9% at endline. Intervention group (RR = 2.71, 95% CI = 1.18 - 6.40) showed significant positive association with normalization of HbA1c levels. The relationship was adjusted for age, gender, socio-economic status, ethnicity, education, hypertension, medication, BMI, diet, LDL levels and physical activity. Dietary restriction and low LDL levels also showed significant associations with reduced HbA1c levels on multivariate analysis. Mobile phone technology in rural areas of Pakistan was helpful in lowering HbA1c levels in intervention group through direct communication with the diabetic patients. Lowering LDL and following diabetic diet plan can reduce HbA1c in these patients and help in preventing future complications.

  10. The constant threat of terrorism: stress levels and coping strategies amongst university students of Karachi.

    PubMed

    Ahmed, Ayesha Ejaz; Masood, Komal; Dean, Sohni Vicky; Shakir, Tanzila; Kardar, Ahmed Abdul Hafeez; Barlass, Usman; Imam, Syed Haider; Mohmand, Mohammad Ghawar Khan; Ibrahim, Hussain; Khan, Imad Saeed; Akram, Usman; Hasnain, Farid

    2011-04-01

    To assess the levels of stress in the face of terrorism and the adopted coping strategies, amongst the student population of universities in Karachi. A descriptive, cross sectional study was conducted on undergraduate students from four universities of Karachi. Self-administered questionnaires were filled out by 291 students. Pearson Chi-Square test was used to assess associations between stress levels and different variables at a level of significance of 0.05%. A total of 65.8% of the students had mild stress levels, 91.5% of university students were exposed to terrorism through television, while only 26.5% students reported personal exposure to terrorism. 67.4% students were forbidden by their parents to go out (p = 0.002). Most of those who had self exposure to an attack were the ones whose parents forbade them from going out (p = 0.00). Most commonly used coping strategy was increased faith in religion. Irritability was the most common stress symptom. A majority of students studying in universities of Karachi had mild stress levels due to the constant threat of terrorism whereas a minority had severe stress levels. Possible reasons for resilience and only mild stress levels could be the history of Karachi's internal conflicts and its prolonged duration of being exposed to terrorism. These students who are positive for stress need to be targeted for counseling either through the media or through their universities. More extensive research is needed in this area.

  11. Genetic analysis and epidemiology of Crimean Congo hemorrhagic fever viruses in Baluchistan province of Pakistan

    PubMed Central

    2013-01-01

    Background Pakistan is considered as an endemic country for Crimean-Congo Hemorrhagic fever with numerous outbreaks and sporadic cases reported during the past two decades. Majority of cases are reported from Baluchistan province with subsequent transmissions to non-endemic regions mainly through infected animals directly or via infested ticks. We hereby describe the molecular investigations of CCHF cases reported during 2008 in Quetta city of Baluchistan province. Methods Serum Samples from 44 patients, with clinical signs of hemorrhagic fever attending a tertiary care hospital in Quetta city, were collected and tested for CCHF virus antigen and genomic RNA, using capture IgM EIA kit and standard RT-PCR assay, respectively. The partial S-gene fragments were directly sequenced to get information related to the prevailing CCHFV genotypes and their molecular epidemiology in Pakistan. Results Out of the total forty four, sixteen (36%) samples were found positive for CCHF IgM. Similarly, viral RNA was detected in six (16%) samples. Phylogenetic analysis revealed that all study viruses belong to genotype Asia-1 with closest similarity (99-100%) to the previously reported strains from Pakistan, Afghanistan and Iran. Conclusion We conclude that CCHF virus remains endemic within Baluchistan and its neighboring regions of Afghanistan warranting a need of incessant surveillance activities. PMID:23641865

  12. Genetic analysis and epidemiology of Crimean Congo Hemorrhagic fever viruses in Baluchistan province of Pakistan.

    PubMed

    Alam, Muhammad Masroor; Khurshid, Adnan; Sharif, Salmaan; Shaukat, Shahzad; Rana, Muhammad Suleman; Angez, Mehar; Zaidi, Syed Sohail Zahoor

    2013-05-04

    Pakistan is considered as an endemic country for Crimean-Congo Hemorrhagic fever with numerous outbreaks and sporadic cases reported during the past two decades. Majority of cases are reported from Baluchistan province with subsequent transmissions to non-endemic regions mainly through infected animals directly or via infested ticks. We hereby describe the molecular investigations of CCHF cases reported during 2008 in Quetta city of Baluchistan province. Serum Samples from 44 patients, with clinical signs of hemorrhagic fever attending a tertiary care hospital in Quetta city, were collected and tested for CCHF virus antigen and genomic RNA, using capture IgM EIA kit and standard RT-PCR assay, respectively. The partial S-gene fragments were directly sequenced to get information related to the prevailing CCHFV genotypes and their molecular epidemiology in Pakistan. Out of the total forty four, sixteen (36%) samples were found positive for CCHF IgM. Similarly, viral RNA was detected in six (16%) samples. Phylogenetic analysis revealed that all study viruses belong to genotype Asia-1 with closest similarity (99-100%) to the previously reported strains from Pakistan, Afghanistan and Iran. We conclude that CCHF virus remains endemic within Baluchistan and its neighboring regions of Afghanistan warranting a need of incessant surveillance activities.

  13. Becoming Teacher Educators in Pakistan: Voices from the Government Colleges of Education

    ERIC Educational Resources Information Center

    Khan, Haji Karim

    2011-01-01

    Little is known of the identities and practices of teacher educators in Pakistan. This paper aims to contribute towards redressing that situation. It draws on part of a larger scale study to explore the lives of two teacher educators in one of the largest cities in the country, discussing what influences individuals as they develop their…

  14. An Ethnolinguistic and Genetic Perspective on the Origins of the Dravidian-Speaking Brahui in Pakistan

    PubMed Central

    Pagani, Luca; Colonna, Vincenza; Tyler-Smith, Chris; Ayub, Qasim

    2017-01-01

    Pakistan is a part of South Asia that modern humans encountered soon after they left Africa ~50 – 70,000 years ago. Approximately 9,000 years ago they began establishing cities that eventually expanded to represent the Harappan culture, rivalling the early city states of Mesopotamia. The modern state constitutes the north western land mass of the Indian sub-continent and is now the abode of almost 200 million humans representing many ethnicities and linguistic groups. Studies utilising autosomal, Y chromosomal and mitochondrial DNA markers in selected Pakistani populations revealed a mixture of Western Eurasian-, South- and East Asian-specific lineages, some of which were unequivocally associated with past migrations. Overall in Pakistan, genetic relationships are generally predicted more accurately by geographic proximity than linguistic origin. The Dravidian-speaking Brahui population are a prime example of this. They currently reside in south-western Pakistan, surrounded by Indo-Europeans speakers with whom they share a common genetic origin. In contrast, the Hazara share the highest affinity with East Asians, despite their Indo-European linguistic affiliation. In this report we reexamine the genetic origins of the Brahuis, and compare them with diverse populations from India, including several Dravidian-speaking groups, and present a genetic perspective on ethnolinguistic groups in present-day Pakistan. Given the high affinity of Brahui to the other Indo-European Pakistani populations and the absence of population admixture with any of the examined Indian Dravidian groups, we conclude that Brahui are an example of cultural (linguistic) retention following a major population replacement. PMID:28381901

  15. An Ethnolinguistic and Genetic Perspective on the Origins of the Dravidian-Speaking Brahui in Pakistan.

    PubMed

    Pagani, Luca; Colonna, Vincenza; Tyler-Smith, Chris; Ayub, Qasim

    2017-01-01

    Pakistan is a part of South Asia that modern humans encountered soon after they left Africa ~50 - 70,000 years ago. Approximately 9,000 years ago they began establishing cities that eventually expanded to represent the Harappan culture, rivalling the early city states of Mesopotamia. The modern state constitutes the north western land mass of the Indian sub-continent and is now the abode of almost 200 million humans representing many ethnicities and linguistic groups. Studies utilising autosomal, Y chromosomal and mitochondrial DNA markers in selected Pakistani populations revealed a mixture of Western Eurasian-, South- and East Asian-specific lineages, some of which were unequivocally associated with past migrations. Overall in Pakistan, genetic relationships are generally predicted more accurately by geographic proximity than linguistic origin. The Dravidian-speaking Brahui population are a prime example of this. They currently reside in south-western Pakistan, surrounded by Indo-Europeans speakers with whom they share a common genetic origin. In contrast, the Hazara share the highest affinity with East Asians, despite their Indo-European linguistic affiliation. In this report we reexamine the genetic origins of the Brahuis, and compare them with diverse populations from India, including several Dravidian-speaking groups, and present a genetic perspective on ethnolinguistic groups in present-day Pakistan. Given the high affinity of Brahui to the other Indo-European Pakistani populations and the absence of population admixture with any of the examined Indian Dravidian groups, we conclude that Brahui are an example of cultural (linguistic) retention following a major population replacement.

  16. Drinking water contamination by chromium and lead in industrial lands of Karachi.

    PubMed

    Nadeem-ul-Haq; Arain, Mubashir Aslam; Haque, Zeba; Badar, Nasira; Mughal, Noman

    2009-05-01

    To identify and quantify chromium and lead as contaminant in water sources of Karachi. This water assessment survey was conducted from June 2007 to February 2008 in all the 18 towns of Karachi. In total 216 water samples were collected from ground (n=108) and surface water sources (n = 108). Water samples were collected in a liter polyethylene acid resistant bottle with extreme care to prevent contamination and concentrations of heavy metals (chromium and lead). Metallic ion contents were estimated by Atomic Absorption Spectrophotometer. Statistical analysis was done by applying T-test and chi-square for continuous and categorical variables respectively at 95% confidence level; Pearson correlation was also determined between chromium and lead concentrations. A total of 187 water samples had lead concentration higher than the maximum acceptable concentration (MAC) in drinking water, established by WHO (10 PPB) and lead contaminated sources were in significantly higher proportion than chromium contaminated water samples (n = 49) [chi2 = 128; P- < 0.001]. Mean chromium concentration in ground water was (micro = 49; SE = 3.8) was significantly higher than mean chromium concentration (micro = 33, SE = 3.5) in surface water (P = 0.003). There was a significant and positive correlation between chromium and lead concentrations in ground water (P = 0.04) however Pearson correlation was not significant for surface water (P = 0.6). Industrial towns (Korangi, Landhi and SITE) had significantly higher concentration of chromium (micro = 82.4; SE = 8.9) in their ground and tap water as compared to the mean chromium concentration (micro = 33; SE = 2.2) in the water samples of rest of the towns of Karachi (P < 0.001). Chromium and Lead levels are high in almost all ground water sources, however extremely high concentrations were found in industrial areas. Presence of any one of the heavy metal contamination necessitate the need for the estimation of other heavy metals as

  17. Prevalence and distribution of human Plasmodium infection in Pakistan.

    PubMed

    Khattak, Aamer A; Venkatesan, Meera; Nadeem, Muhammad F; Satti, Humayoon S; Yaqoob, Adnan; Strauss, Kathy; Khatoon, Lubna; Malik, Salman A; Plowe, Christopher V

    2013-08-28

    Both Plasmodium vivax and Plasmodium falciparum are prevalent in Pakistan, yet up-to-date data on the epidemiology of malaria in Pakistan are not available. This study was undertaken to determine the current prevalence and distribution of Plasmodium species across the country. A malariometric population survey was conducted in 2011 using blood samples collected from 801 febrile patients of all ages in four provinces and the capital city of Islamabad. Microscopically confirmed Plasmodium-positive blood samples were reconfirmed by polymerase chain reaction (PCR). Confirmed parasite-positive samples were subjected to species-specific PCR capable of detecting four species of human malaria. Of the 707 PCR-positive samples, 128 (18%) were P. falciparum, 536 (76%) were P. vivax, and 43 (6%) were mixed P. falciparum and P. vivax. Ninety-four microscopy-positive samples were PCR-negative, and Plasmodium malariae and Plasmodium ovale were not detected. Prevalence of P. vivax ranged from 2.4% in Punjab Province to 10.8% in Sindh Province and prevalence of P. falciparum ranged from 0.1% in Islamabad to 3.8% in Balochistan. Plasmodium infections in Pakistan are largely attributed to P. vivax but P. falciparum and mixed species infections are also prevalent. In addition, regional variation in the prevalence and species composition of malaria is high.

  18. Patient communication in radiology: current status of breaking bad news among radiologists and radiology trainees in Pakistan.

    PubMed

    Ali Khawaja, Ranish Deedar; Akhtar, Waseem; Khawaja, Ali; Irfan, Hira; Naeem, Mohammad; Memon, Mukhtiar

    2013-10-01

    Breaking bad news can be an intimidating task for any physician. The aim of this study was to record the practices of breaking bad news to the patients by Pakistani radiologists and trainees. The radiologists and trainees attending the 26th National Radiological Conference in October 2010 in Karachi, Pakistan, were surveyed. The response rate was 76%. The respondents included residents (51%), private practicing radiologists (28%), academic radiologists (13%), and other trainees (8%). Most of the academic radiologists communicated with their patients. The daily frequency of breaking bad news by residents was noted, which was highest in the public teaching hospitals (71%). For severe abnormalities such as malignancy, 50% residents, 55% of the academic radiologists and 74% of the private practicing radiologists were very uncomfortable in disclosure of results. Differences in frequency of communication with patients were noticed with both different training levels, and different settings of practice in a developing country.

  19. 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…

  20. Physician migration at its roots: a study on the factors contributing towards a career choice abroad among students at a medical school in Pakistan.

    PubMed

    Sheikh, Asfandyar; Naqvi, Syed Hassan Abbas; Sheikh, Kainat; Naqvi, Syed Hassan Shiraz; Bandukda, Muhammad Yasin

    2012-12-15

    Physician migration, also known as "brain drain," results from a combination of a gap in the supply and demand in developed countries and a lack of job satisfaction in developing countries. Many push and pull factors are responsible for this effect, with media and internet playing their parts. Large-scale physician migration can pose problems for both the donor and the recipient countries, with a resulting reinforcement in the economic divide between developed and developing countries. The main objectives of our study were to determine the prevalence of migration intentions in medical undergraduates, to elucidate the factors responsible and to analyze the attitudes and practices related to these intentions. This was a cross-sectional, observational, questionnaire-based study, conducted at Dow Medical College of Dow University of Health Sciences, Karachi, between January, 2012 and May, 2012. A total of 323 students responded completely. The questionnaire consisted of 3 sections, and was aimed at collecting demographic details, determining students' migratory intentions, evaluating reasons for and against migration and assessing attitudes and practices of students related to these intentions. Out of 323 respondents, 195 wanted to pursue their careers abroad, giving a prevalence rate of 60.4% in our sample. United States was the most frequently reported recipient country. The most common reasons given by students who wished to migrate, in descending order, were: lucrative salary abroad followed by quality of training, job satisfaction, better way of life, relatives, more opportunities, better working environment, terrorism in Pakistan, harassment of doctors in Pakistan, desire to settle abroad, more competition in Pakistan, better management, peer pressure, longer working hours in Pakistan, religious reasons, parent pressure, political reasons and favoritism in Pakistan. A considerable number of respondents had already started studying for licensing examinations, and

  1. Why women go to medical college but fail to practise medicine: perspectives from the Islamic Republic of Pakistan.

    PubMed

    Moazam, Farhat; Shekhani, Sualeha

    2018-07-01

    Female medical students outnumber men in countries such as Saudi Arabia, India and Pakistan, yet many fail to practise medicine following graduation. In Pakistan, 70% of medical students are women, yet it is estimated that half of them will not pursue medicine following graduation. This is considered a major reason for physician shortages in the country. We conducted a qualitative study drawing upon the 'role strain' theory to explore the views of final-year medical students from four medical colleges in Karachi, Pakistan, on female graduates not entering the medical field. Data were obtained through 20 individual in-depth interviews and two focus group discussions. Themes were developed inductively from the data using the constant comparison method. Pakistani parents actively channel daughters into medical education, considering medicine to be the most 'respectable' field. However, in a patrilocal society with norms of early, arranged marriages for daughters, there is a significant influence of in-laws and a husband on a woman's professional future. Parents perceive the medical degree as a 'safety net' should something go wrong with the marriage, rather than a step toward a medical career. Female respondents experience significant role conflict between their socially rooted gender roles as homemakers and mothers and their careers in medicine. Postgraduate training systems that are unfriendly to women provide further deterrents for women wishing to work. Contrary to popular belief, women not practising medicine is not the sole contributor to physician shortages. A significant factor appears to be male graduates migrating abroad for better training and financial prospects. Acceptance of traditional cultural values, including entrenched gender roles in society, deters women from practising medicine. To enable greater participation of women in the medical field, steps are required that will allow women to better manage family and work conflicts. © 2018 John Wiley

  2. Lead Exposure Assessment among Pregnant Women, Newborns, and Children: Case Study from Karachi, Pakistan.

    PubMed

    Fatmi, Zafar; Sahito, Ambreen; Ikegami, Akihiko; Mizuno, Atsuko; Cui, Xiaoyi; Mise, Nathan; Takagi, Mai; Kobayashi, Yayoi; Kayama, Fujio

    2017-04-13

    Lead (Pb) in petrol has been banned in developed countries. Despite the control of Pb in petrol since 2001, high levels were reported in the blood of pregnant women and children in Pakistan. However, the identification of sources of Pb has been elusive due to its pervasiveness. In this study, we assessed the lead intake of pregnant women and one- to three-year-old children from food, water, house dust, respirable dust, and soil. In addition, we completed the fingerprinting of the Pb isotopic ratios (LIR) of petrol and secondary sources (food, house-dust, respirable dust, soil, surma (eye cosmetics)) of exposure within the blood of pregnant women, newborns, and children. Eight families, with high (~50 μg/dL), medium (~20 μg/dL), and low blood levels (~10 μg/dL), were selected from 60 families. The main sources of exposure to lead for children were food and house-dust, and those for pregnant women were soil, respirable dust, and food. LIR was determined by inductively coupled plasma quadrupole mass spectrometry (ICP-QMS) with a two sigma uncertainty of ±0.03%. The LIR of mothers and newborns was similar. In contrast, surma , and to a larger extent petrol, exhibited a negligible contribution to both the child's and mother's blood Pb. Household wet-mopping could be effective in reducing Pb exposure. This intake assessment could be replicated for other developing countries to identify sources of lead and the burden of lead exposure in the population.

  3. Lead Exposure Assessment among Pregnant Women, Newborns, and Children: Case Study from Karachi, Pakistan

    PubMed Central

    Fatmi, Zafar; Sahito, Ambreen; Ikegami, Akihiko; Mizuno, Atsuko; Cui, Xiaoyi; Mise, Nathan; Takagi, Mai; Kobayashi, Yayoi; Kayama, Fujio

    2017-01-01

    Lead (Pb) in petrol has been banned in developed countries. Despite the control of Pb in petrol since 2001, high levels were reported in the blood of pregnant women and children in Pakistan. However, the identification of sources of Pb has been elusive due to its pervasiveness. In this study, we assessed the lead intake of pregnant women and one- to three-year-old children from food, water, house dust, respirable dust, and soil. In addition, we completed the fingerprinting of the Pb isotopic ratios (LIR) of petrol and secondary sources (food, house-dust, respirable dust, soil, surma (eye cosmetics)) of exposure within the blood of pregnant women, newborns, and children. Eight families, with high (~50 μg/dL), medium (~20 μg/dL), and low blood levels (~10 μg/dL), were selected from 60 families. The main sources of exposure to lead for children were food and house-dust, and those for pregnant women were soil, respirable dust, and food. LIR was determined by inductively coupled plasma quadrupole mass spectrometry (ICP-QMS) with a two sigma uncertainty of ±0.03%. The LIR of mothers and newborns was similar. In contrast, surma, and to a larger extent petrol, exhibited a negligible contribution to both the child’s and mother’s blood Pb. Household wet-mopping could be effective in reducing Pb exposure. This intake assessment could be replicated for other developing countries to identify sources of lead and the burden of lead exposure in the population. PMID:28406467

  4. 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 ...

  5. Healthcare-associated infections among pediatric oncology patients in Pakistan: risk factors and outcome.

    PubMed

    Siddiqui, Naveed-ur-Rehman; Wali, Rabia; Haque, Anwar-ul; Fadoo, Zehra

    2012-05-14

    Pediatric oncology patients are at increased risk of contracting healthcare-associated infections (HAIs), which are responsible for increased morbidity and mortality rates as well as treatment costs.  This study aimed to identify the frequency of HAIs among pediatric oncology patients and their outcome. Pediatric oncology patients admitted between January 2009 and June 2010 in a pediatric ward at Aga Khan University Hospital, Karachi, Pakistan, who developed HAIs, were analyzed. A total of 90 HAIs were identified in 32 patients in 70 admissions. The HAI rate among pediatric oncology patients was 3.1/100 admission episodes. Bloodstream infections (63 episodes, 90.0%) were the most common, followed by urinary tract infection (two episodes, 2.9%). Gram-positive infections were seen in 54 (60%) patients, followed by Gram-negative infection in 34 (37.8%), and fungi in 2 (2.8%) cases. Coagulase negative staphylococci was the most common Gram-positive and Escherichia coli and Pseudomonas aeruginosa were most common Gram-negative infections. Mortality rate among pediatric oncology patients who developed HAIs was 12.5% (4/32). Total parental nutrition use and length of stay longer than 30 days were the identified risk factors associated with increased mortality among pediatric oncology patients who developed HAIs. We report an HAI rate among pediatric oncology patients of 3.1/100 admission episodes with a mortality rate of 12.5% in Pakistan. Further studies should be done, especially in the developing world, to identify the risk factors associated with increased mortality among pediatric oncology patients so that adequate measures can be taken to reduce the mortality among these patients.

  6. 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

  7. Educational status and awareness among tuberculosis patients of Karachi.

    PubMed

    Miandad, Muhammad; Nawaz-Ul-Huda, Syed; Burke, Farkhunda; Hamza, Salma; Azam, Muhammad

    2016-03-01

    To investigate and analyse patients' educational status and awareness regarding tuberculosis in the context of demographic distribution. The survey-based study was conducted at Tuberculosis Diagnostic Centres in Karachi from March to October 2013. A predesigned questionnaire was used as the data collection tool. It was filled through face-to-face interviews. Data was anylsed using SPSS 20. Of the 1260 respondents, 646(51.2%) were women and 614(48.7%) were men. Women were more affected by extra pulmonary tuberculosis (65%; n=123) compared to men (35%; n=65), while the reverse was the case for pulmonary tuberculosis, with men accounting for 52% (n=557) and women 48% (n=514). Pulmonary tuberculosis was prevalent in all age groups of both genders, but was most notable in the 11-30 years age group. Educational status of tuberculosis patients indicated men as being more educated with 52% (n=91) and 55% (n=258) for above and below secondary school certificate level or education respectively. The level of awareness and pursuance of precautionary measures was higher among literate males (58%; n=108 and 54%; n=347) compared to females at 42% (n=77) and 46% (n=296) respectively. The findings may prove helpful in convincing the educated tuberculosis patients to reform their lifestyles in order to improve their living environments to prevent the spread of the infectious disease, thereby improving the quality of life in the city.

  8. 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

  9. Current Status and Future Suggestions for Improving the Pharm. D Curriculum towards Clinical Pharmacy Practice in Pakistan

    PubMed Central

    Malhi, Saima Mahmood; Ajmal, Kiran; Shamim, Sumbul; Ata, Saniya; Farooq, Salman; Sharib, Syed Muhammad; Muntaha, Sidrat-ul

    2017-01-01

    Objectives & Background: Good curriculum is reflected as the backbone for standard universities to develop competitive professionals having great potential. Pharmacy education in Pakistan has gone through the same developmental stages as in other countries, but is still striving for improvement. In the present study, we want (i) to know the opinion on whether the current pharmacy curriculum requires any improvement in order to meet the training needs of pharmacy professionals regarding clinical knowledge and pharmacy practice; and (ii) to present some humble suggestions to decision-making authorities in order to improve it with respect to patient-focused programs (PFP). Methods: The study was conducted in two sessions. In first session, a questionnaire was distributed to pharmacy students of eight public/private sector universities of Karachi (N = 354) offering Pharm. D degrees. The second session dealt with the pharmacy teachers, deans, and practicing pharmacists in health care facilities (who are in any ways also related to academia), in order to take their opinions on and suggestions for the development of a better Pharm. D curriculum (N = 135). Results: Our results showed that 75.2% of respondents agree that the Pharm. D curriculum does not meet the international standards of practice, and 88.4% of respondents support the addition of more clinical aspects than industrial ones, as Pharm. D could be both clinically and industrially oriented, according to the needs of the Pakistani people. Furthermore, 80.2% of respondents are of the view that an apprenticeship should be included in last two years, while 88.4% demand a ‘paid residency program’ to facilitate the hospital, clinical and compounding areas of pharmacy. In addition, we also received a number of verbal suggestions for improving the Pharm. D curriculum being followed in Pakistan. Discussion & Conclusions: We conclude that our Pharm. D curriculum needs additions in terms of clinical practice by

  10. Automated Versus Manual Blood Pressure Measurement: A Randomized Crossover Trial in the Emergency Department of a Tertiary Care Hospital in Karachi, Pakistan: Are Third World Countries Ready for the Change?

    PubMed

    Mansoor, Kanaan; Shahnawaz, Saba; Rasool, Mariam; Chaudhry, Huwad; Ahuja, Gul; Shahnawaz, Sara

    2016-09-15

    Hypertension has proven to be a strong liability with 13.5% of all mortality worldwide being attributed to elevated blood pressures in 2001. An accurate blood pressure measurement lies at the crux of an appropriate diagnosis. Despite the mercury sphygmomanometer being the gold standard, the ongoing deliberation as to whether mercury sphygmomanometers should be replaced with the automated oscillometric devices stems from the risk mercury poses to the environment. This study was performed to check the validity of automated oscillometric blood pressure measurements as compared to the manual blood pressure measurements in Karachi, Pakistan. Blood pressure was recorded in 200 individuals aged 15 and above using both, an automated oscillometric blood pressure device (Dinamap Procare 100) and a manual mercury sphygmomanometer concomitantly. Two nurses were assigned to each patient and the device, arm for taking the reading and nurses were randomly determined. SPSS version 20 was used for analysis. Mean and standard deviation of the systolic and diastolic measurements from each modality were compared to each other and P values of 0.05 or less were considered to be significant. Validation criteria of British Hypertension Society (BHS) and the US Association for the Advancement of Medical Instrumentation (AAMI) were used. Two hundred patients were included. The mean of the difference of systolic was 8.54 ± 9.38 while the mean of the difference of diastolic was 4.21 ± 7.88. Patients were further divided into three groups of different systolic blood pressure <= 120, > 120 to = 150 and > 150, their means were 6.27 ± 8.39 (p-value 0.175), 8.91 ± 8.96 (p-value 0.004) and 10.98 ± 10.49 (p-value 0.001) respectively. In our study 89 patients were previously diagnosed with hypertension; their difference of mean systolic was 9.43 ± 9.89 (p-value 0.000) and difference of mean diastolic was 4.26 ± 7.35 (p-value 0.000). Systolic readings from a previously validated device are not

  11. Reasons for failure to quit: a cross-sectional survey of tobacco use in major cities in Pakistan.

    PubMed

    Irfan, M; Haque, A S; Shahzad, H; Samani, Z A; Awan, S; Khan, J A

    2016-05-01

    Tobacco dependence has been defined as a chronic relapsing disease. Around 5 million annual tobacco-related deaths have been reported worldwide. The majority of smokers want to quit but are not successful. To screen our population for tobacco use, gauge the baseline demographics of tobacco users and assess factors associated with failed attempts to quit. Free health camps supervised by a physician were held across two major cities of Pakistan. All consenting participants were administered a questionnaire and had their exhaled carbon monoxide (CO) levels measured. Of 12 969 participants successfully enrolled, the mean age was 31.4 ± 10.0 years. More than three quarters were aged 20-40 years (n = 10 168, 78.4%). The overall average CO level was 12.0 ± 8.0 ppm. The majority of the participants wanted to quit, and nearly everyone had received advice about quitting. The majority had tried smoking cessation pharmacotherapy. Friends/peer pressure (n = 1554, 12%), anxiety (n = 681, 5.3%), tobacco dependence (n = 1965, 15.2%) and stress/mood changes (n = 390, 3.0%) were the most widely observed reasons for failure to quit in study participants. The information provided by this study can guide the development of more targeted intervention programmes for smokers who wish to quit.

  12. Prevalence and distribution of human Plasmodium infection in Pakistan

    PubMed Central

    2013-01-01

    Background Both Plasmodium vivax and Plasmodium falciparum are prevalent in Pakistan, yet up-to-date data on the epidemiology of malaria in Pakistan are not available. This study was undertaken to determine the current prevalence and distribution of Plasmodium species across the country. Methods A malariometric population survey was conducted in 2011 using blood samples collected from 801 febrile patients of all ages in four provinces and the capital city of Islamabad. Microscopically confirmed Plasmodium-positive blood samples were reconfirmed by polymerase chain reaction (PCR). Confirmed parasite-positive samples were subjected to species-specific PCR capable of detecting four species of human malaria. Results Of the 707 PCR-positive samples, 128 (18%) were P. falciparum, 536 (76%) were P. vivax, and 43 (6%) were mixed P. falciparum and P. vivax. Ninety-four microscopy-positive samples were PCR-negative, and Plasmodium malariae and Plasmodium ovale were not detected. Prevalence of P. vivax ranged from 2.4% in Punjab Province to 10.8% in Sindh Province and prevalence of P. falciparum ranged from 0.1% in Islamabad to 3.8% in Balochistan. Conclusions Plasmodium infections in Pakistan are largely attributed to P. vivax but P. falciparum and mixed species infections are also prevalent. In addition, regional variation in the prevalence and species composition of malaria is high. PMID:23984968

  13. Health-seeking behaviour of people living with HIV/AIDS and their satisfaction with health services provided at a tertiary care hospital, Karachi, Pakistan.

    PubMed

    Bhutto, Abdul-Qadir; Nisar, Nighat

    2017-02-21

    Appropriate health-seeking behaviour is important as it allows prompt treatment for a condition and this can reduce complications and improve quality of life. This study aimed to assess the health-seeking behaviour and satisfaction with health care services of people living with HIV/AIDS attending the HIV/AIDS clinic of the Civil Hospital in Karachi. A total of 182 patients were interviewed using a pretested semi-structured questionnaire. Mean age of the participants was 32.31 (SD 7.91) years, 76.9% were male, 81.3% had no education and 75.8% were employed. Only 23.6% showed positive health-seeking behaviour and 57.7% were satisfied with the health care services. In logistic regression analysis, the cost of treatment per visit < US$ 5 and duration of HIV infection < 2 years were significantly associated with health-seeking behaviour. Efforts are needed to improve the health-seeking behaviour of people living with HIV/AIDS at the clinic and the health services offered.

  14. Heterogeneity of BCR-ABL rearrangement in patients with chronic myeloid leukemia in Pakistan.

    PubMed

    Tabassum, Najia; Saboor, Mohammad; Ghani, Rubina; Moinuddin, Moinuddin

    2014-07-01

    Breakpoint cluster region-Abelson (BCR-ABL) rearrangement or Philadelphia (Ph) chromosome in Chronic Myeloid Leukemia (CML) is derived from a reciprocal chromosomal translocation between ABL gene on chromosome 9 and BCR gene on chromosome 22. This chimeric protein has various sizes and therefore different clinical behaviour. The purpose of this study was to determine the heterogeneity of BCR-ABL rearrangement in patients with Ph(+)CML in Pakistan. The study was conducted at Civil Hospital and Baqai Institute of Hematology (BIH) Karachi. Blood samples from 25 patients with CML were collected. Multiplex reverse transcription polymerase chain reaction (RT-PCR) was performed to identify various BCR-ABL transcripts. All 25 samples showed BCR-ABL rearrangements. Out of these, 24 (96%) patients expressed p210 BCR-ABL rearrangements i.e. 60% (n=15) had b3a2 and 32% (n=8) had b2a2 rearrangements. Co-expression of b3a2 /b2a2 rearrangement and p190 (e1a3) rearrangement was also identified in two patients. It is apparent that majority of the patients had p210 BCR-ABL rearrangements. Frequency of co-expression and rare fusion transcripts was very low.

  15. The status of women in Pakistan. [Extracts from the Report of the Pakistan Commission on the Status of Women, December 1984].

    PubMed

    1988-01-01

    Extracts from the Report of the Pakistan Commission on the Status of Women, December 1984, are quoted under the headings of demographic, health, educational and economic status, followed by recommendations on health, education and employment. Pakistan's current Five Year Plan includes women in national development, yet in reality, women are only valued as mothers of sons or family servants. Demographically, females in Pakistan constitute 47.5% of the population, reflecting general neglect of girls and women. Women have a 54-year life expectancy, compared to 55 for men. Women are subject to poorer nutrition, hard physical labor, greater disability and maternal mortality of 6-8/1000. School enrollment is relatively lower for girls than boys than in India, apparently because people prefer gender-segregated primary schools, and few women are trained as teachers. Official labor statistics do not reflect the high participation rates of women in family, farm, and informal sector work. None of these workplaces afford good pay, working conditions, upward mobility or respect. Consequently women work harder and longer than men: 16 hours daily in rural areas, and as laborers and helpers rather than skilled workers in cities. Some of the recommendations are nutrition supplements, sanitation, clean nearby drinking water, appropriate technology, maternal-child health care, literacy programs, primary classes for girls, quotas for females in professional training, and a list of suggestions to improve women's self respect, safety in public, and equal employment opportunity.

  16. Regional variation in identified cancer care needs of early-career oncologists in China, India, and Pakistan.

    PubMed

    Lyerly, H Kim; Fawzy, Maria R; Aziz, Zeba; Nair, Reena; Pramesh, C S; Parmar, Vani; Parikh, Purvish M; Jamal, Rozmin; Irumnaz, Azizunissa; Ren, Jun; Stockler, Martin R; Abernethy, Amy P

    2015-05-01

    Cancer incidence and mortality is increasing in the developing world. Inequities between low-, middle-, and high-income countries affect disease burden and the infrastructure needs in response to cancer. We surveyed early-career oncologists attending workshops in clinical research in three countries with emerging economies about their perception of the evolving cancer burden. A cross-sectional survey questionnaire was distributed at clinical trial concept development workshops held in Beijing, Lahore, Karachi, and Mumbai at major hospitals to acquire information regarding home-country health conditions and needs. A total of 100 respondents participated in the workshops held at major hospitals in the region (India = 29, China = 25, Pakistan = 42, and other = 4). Expected consensus on many issues (e.g., emergence of cancer as a significant health issue) was balanced with significant variation in priorities, opportunities, and challenges. Chinese respondents prioritized improvements in cancer-specific care and palliative care, Indian respondents favored improved cancer detection and advancing research in cancer care, and Pakistani respondents prioritized awareness of cancer and improvements in disease detection and cancer care research. For all, the most frequently cited opportunity was help in improving professional cancer education and training. Predominantly early-career oncologists attending clinical research workshops (in China, India, and Pakistan) identified needs for increasing clinical cancer research, professional education, and public awareness of cancer. Decision makers supporting efforts to reduce the burden of cancer worldwide will need to factor the specific needs and aspirations of health care providers in their country in prioritizing health policies and budgets. ©AlphaMed Press.

  17. 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%.

  18. Characterization of ambient aerosol at a remote site and twin cities of Pakistan

    NASA Astrophysics Data System (ADS)

    Ghauri, B.; Lodhi, A.

    The pollution controls have significantly decreased pollutant concentrations in the industrialized nations in the west while the concentrations are expected to grow in developing countries. In this study the concentrations of major ions i.e SO4 2 -, NO3 -, NO2 -, Cl- , NH4 + and trace metals i.e. Al, V, Cr, Mn, Cu, As, Se, Cd, Sb, Ba, Ti and Pb were determined in aerosols at a remote site of Northern Pakistan in July 1996. Later in May 1998, a comparative study of aerosols in two size fractions (bulk &PM10) at 14 sites enabled to understand the anomalous distribution of several constituents present in the ambient air of the twin cities, Islamabad / Rawalpindi 90 km from South East of earlier site. The suspended particulate matter concentrations (bulk and PM10) were 475 ug/m3, 175 ug/m3 respectively. For urban areas Pb, Cd, Zn and Ni are obviously contributed by steel and other allied industries besides vehicle's contribution of lead and cadmium. In Northern area concentrations of Al, K, Ca, and Fe exceeded 1000 ng/m3. The SO2 concentrations varied from 0.03 to 1.2 ppb. Mean SO4 2- and NO3 - concentrations were 5.2 ug/m3 and 3.6 ug/m3 respectively. Concentrations of Se, Ti, Pb, Cd, Sb, Zn and As in all aerosol samples were highly enriched relative to average crustal abundances indicating significant anthropogenic contributions. As the dominant flow pattern from the Arabian Sea through India (monsoon air pattern) this may transport pollution derived aerosol and moisture from distant sources in China or India. Key word index: Aerosol, trace metals , enrichment, anions, air pollution, Islamabad/Rawalpindi, remote site.

  19. Epidemiology of Hepatitis C Infection in Pakistan: Current Estimate and Major Risk Factors.

    PubMed

    Arshad, Aiman; Ashfaq, Usman Ali

    2017-01-01

    In Pakistan, hepatitis C virus (HCV) is a major healthcare problem, with acute and chronic infections responsible for liver damage, cirrhosis, and hepatocellular carcinoma. Under the Human Development Index of the United Nations, Pakistan is ranked 134th of 174 countries due to its poor educational and health standards. This study was designed to study HCV and its genotype prevalence in different cities and provinces of Pakistan and describe the major routes of HCV transmission. Literature searches were performed in PubMed, Mendeley, and Google Scholar. Ninety different studies were screened for this review, ranging from those published during the years 2000 to 2013. By calculating the mean average of all studies, it was clear that HCV percentage prevalence in the adult population was 11.55%, blood donors 10.10%, pregnant women 4.65%, children 1.6%, patients with different diseases 24.97%, and injecting drug users had the highest prevalence at 51.0%. HCV genotype 3a prevalence was found to be 63.45%, the highest of all genotypes. The percentage prevalence of HCV found for all of the provinces was Punjab: 5.46%, Sindh: 2.55%, Khyber Pakhtoonkhaw: 6.07%, Balochistan: 25.77%, and federally administrated tribal areas: 3.37%. This study shows that the overall prevalence of HCV in the provinces of Pakistan is 8.64% and suggests that the major routes of HCV transmission are reuse of syringes and needles and unchecked blood transfusions. Awareness and economic growth are required to help decrease HCV infection and improve health standards in Pakistan.

  20. Development and validation of sunlight exposure measurement questionnaire (SEM-Q) for use in adult population residing in Pakistan.

    PubMed

    Humayun, Quratulain; Iqbal, Romaina; Azam, Iqbal; Khan, Aysha Habib; Siddiqui, Amna Rehana; Baig-Ansari, Naila

    2012-06-08

    Vitamin D deficiency has been identified as a major public health problem worldwide. Sunlight is the main source of vitamin D and its measurement using dosimeters is expensive and difficult for use in population-based studies. Hence, the aim of this study was to develop and validate questionnaires to assess sunlight exposure in healthy individuals residing in Karachi, Pakistan. Two questionnaires with seven important items for sunlight exposure assessment were developed. Fifty four healthy adults were enrolled based on their reported sunlight exposure (high = 17, moderate = 18, low = 19) from Aga Khan University, Karachi. Over four days, study participants were asked to wear a dosimeter between sunrise and sunset and report time spent and activities undertaken in the sun for questionnaire validation. Algorithm for item weightage was created as an average score based on ultraviolet B percentage received. Blood samples were obtained for serum vitamin D. The mean time (minutes) spent in sun over 4 days (±SD) was 69.5 (±32) for low, 83.5 (±29.7) for moderate and 329 (±115) for high exposure group. The correlation between average time (minutes) spent in sun over 4 days and mean change in absorbance of UV dosimeters for 4 days was 0.60 (p < 0.01). Correlation between average score and vitamin D levels was found to be 0.36 (p = 0.01) for short term questionnaire score, 0.43 (p = 0.01) for long term questionnaire score in summers and 0.48 (p = 0.01) in winters. The sunlight exposure measurement questionnaires were valid tools for use in large epidemiological studies to quantify sunlight exposure.

  1. High burden of prediabetes and diabetes in three large cities in South Asia: The Center for Cardio-metabolic Risk Reduction in South Asia (CARRS) Study

    PubMed Central

    Deepa, Mohan; Grace, Mundu; Binukumar, Bhaskarapillai; Pradeepa, Rajendra; Roopa, Shivashankar; Khan, Hassan M; Fatmi, Zafar; Kadir, Muhammad M.; Naeem, Imran; Ajay, Vamadevan S; Anjana, Ranjit Mohan; Ali, Mohammed K; Prabhakaran, Dorairaj; Tandon, Nikhil; Mohan, Viswanathan; Venkat Narayan, KM

    2016-01-01

    Aim To estimate the prevalence of, and assess factors associated with, diabetes and prediabetes in three South Asian cities. Methods Using a multi-stage cluster random sample representative of each city, 16,288 subjects aged ≥20 years (Chennai: 6906, Delhi: 5365 and Karachi: 4017) were recruited to the Centre for cArdiometabolic Risk Reduction in South-Asia (CARRS) Study. Fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) were measured in 13720 subjects. Prediabetes was defined as FPG 100-125mg/dl (5.6-6.9 mmol/l) and/or HbA1c 5.7-6.4% (39-46mmol/mol) and diabetes as self-report and/or drug treatment for diabetes and/or FPG ≥126 mg/dl (≥7.0mmol/l) and/or HbA1c ≥6.5% (48mmol/mol). We assessed factors associated with diabetes and prediabetes using polytomous logistic regression models. Results Overall 47.3-73.1% of the population had either diabetes or prediabetes: Chennai 60.7% [95%CI: 59.0-62.4%] (diabetes-22.8% [21.5-24.1%], prediabetes-37.9% [36.1-39.7%]); Delhi 72.7% [70.6-74.9%] (diabetes-25.2% [23.6-26.8%], prediabetes-47.6% [45.6-49.5%]); and Karachi 47.4% [45.7-49.1%]; (diabetes-16.3% [15.2-17.3%], prediabetes-31.1% [29.5-32.8%], respectively). Proportions of self-reported diabetes were 55.1%, 39.0%, and 48.0% in Chennai, Delhi, and Karachi, respectively. City, age, family history of diabetes, generalized obesity, abdominal obesity, body fat, high cholesterol, high triglyceride, and low HDL cholesterol levels were each independently associated with prediabetes, while the same factors plus waist-to-height ratio and hypertension were associated with diabetes. Conclusion Six in ten adults in large South Asian cities have either diabetes or prediabetes. These data call for urgent action to prevent diabetes in South Asia. PMID:26432412

  2. Attitude of teaching faculty towards statistics at a medical university in Karachi, Pakistan.

    PubMed

    Khan, Nazeer; Mumtaz, Yasmin

    2009-01-01

    Statistics is mainly used in biological research to verify the clinicians and researchers findings and feelings, and gives scientific validity for their inferences. In Pakistan, the educational curriculum is developed in such a way that the students who are interested in entering in the field of biological sciences do not study mathematics after grade 10. Therefore, due to their fragile background of mathematical skills, the Pakistani medical professionals feel that they do not have adequate base to understand the basic concepts of statistical techniques when they try to use it in their research or read a scientific article. The aim of the study was to assess the attitude of medical faculty towards statistics. A questionnaire containing 42 close-ended and 4 open-ended questions, related to the attitude and knowledge of statistics, was distributed among the teaching faculty of Dow University of Health Sciences (DUHS). One hundred and sixty-seven filled questionnaires were returned from 374 faculty members (response rate 44.7%). Forty-three percent of the respondents claimed that they had 'introductive' level of statistics courses, 63% of the respondents strongly agreed that a good researcher must have some training in statistics, 82% of the faculty was in favour (strongly agreed or agreed) that statistics was really useful for research. Only 17% correctly stated that statistics is the science of uncertainty. Half of the respondents accepted that they have problem of writing the statistical section of the article. 64% of the subjects indicated that statistical teaching methods were the main reasons for the impression of its difficulties. 53% of the faculty indicated that the co-authorship of the statistician should depend upon his/her contribution in the study. Gender did not show any significant difference among the responses. However, senior faculty showed higher level of the importance for the use of statistics and difficulties of writing result section of

  3. The vespid fauna of Pakistan.

    PubMed

    Rafi, Muhammad Ather; Carpenter, James M; Qasim, Muhammad; Shehzad, Anjum; Zia, Ahmed; Khan, Muhammad Rafique; Mastoi, Muhammad Ishaque; Naz, Falak; Ilyas, Muhammad; Shah, Mazafar; Bhatti, Abdul Rauf

    2017-12-04

    This study provides the first annotated check list of the Vespidae of Pakistan. It is based on the National Insect Museum collection and various studies in Pakistan. Among 105 identified taxa, 77 species and 28 subspecies are recorded in the four subfamilies Eumeninae, Masarinae, Polistinae and Vespinae. Three new records for the fauna of Pakistan are added, namely Anterhynchium mellyi, Antepipona ovalis and Eumenes coronatus coronatus. Among the total, 12 species/subspecies are endemic to Pakistan, namely Ancistrocerus pakistanus, Antepipona luteipes, Antodynerus flavescens karachiensis, Celonites nursei, Cyrtolabulus karachiensis, Eustenancistrocerus (Parastenancistrocerus) baluchistanensis, Katamenes dimidiatus watsoni, Knemodynerus lahorensis, Leptochilus (Neoleptochilus) hina, Leptochilus (Neoleptochilus) mirificus, Leptochilus (Neoleptochilus) umerolatus and Tachyancistrocerus pakistanus. Antepipona varentzowi (Morawitz, 1896) and Polistes rothneyi quatei van der Vecht, 1968 were incorrectly reported from Pakistan.

  4. Region Hit by Large Pakistan Quake as Shown by NASA Spacecraft

    NASA Image and Video Library

    2017-12-08

    On September 24 at 11:29 GMT, a magnitude 7.7 earthquake struck in south-central Pakistan at a relatively shallow depth of 20 kilometers. The earthquake occurred as the result of oblique strike-slip motion, consistent with rupture within the Eurasian tectonic plate. Tremors were felt as far away as New Delhi as well as Karachi in Pakistan. Even though the immediate area to the epicenter is sparsely populated, the majority of houses are of mud brick construction and damage is expected to be extensive. The perspective view, looking to the east, shows the location of the epicenter in Pakistan's Makran fold belt. The image is centered near 27 degrees north latitude, 65.5 degrees east longitude, and was acquired December 13, 2012. With its 14 spectral bands from the visible to the thermal infrared wavelength region and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet. ASTER is one of five Earth-observing instruments launched Dec. 18, 1999, on Terra. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and data products. The broad spectral coverage and high spectral resolution of ASTER provides scientists in numerous disciplines with critical information for surface mapping and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats; monitoring potentially active volcanoes; identifying crop stress; determining cloud morphology and physical properties; wetlands evaluation; thermal pollution monitoring; coral reef degradation; surface temperature mapping of soils and geology; and measuring surface heat balance. The U.S. science team is located at NASA's Jet Propulsion Laboratory, Pasadena, Calif. The Terra mission is part of NASA's Science Mission Directorate, Washington, D.C. More information

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

    PubMed

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

    2015-02-24

    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. 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. 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. 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.

  6. 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

  7. Severity of burn and its related factors: A study from the developing country Pakistan.

    PubMed

    Adil, Syed Omair; Nisar, Nighat; Ehmer-Al-Ibran; Shafique, Kashif; Baig-Ansari, Naila

    2016-06-01

    Burns are leading cause of fatal injuries and major cause of morbidity and mortality in developing countries. The major obstacle in controlling severity is factors related to burn. This study determines frequency of burns and the factors related to it in Karachi, Pakistan. A cross-sectional study was conducted and 384 hospitalized adult patients with burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile, intent of burn, severity of burn, health hazards, physical and psychological characteristics. TBSA burn of >15% was considered as higher severity of burn. Higher severity of burns was found in 76.3% patients. Multivariate analysis showed that higher severity of burns were significantly associated with age less than 25 years (OR 2.7, 95% CI 1.5-4.9), never had been to school (OR 3.1, 95% CI 1.7-5.9) and intentional burn (OR 20.6, 95% CI 5.0-84.9). Majority of patients had higher severity of burn. The intent of injury was intentional, age less than 25 years and no schooling were found significantly associated with higher severity of burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  8. Pattern of unintentional burns: A hospital based study from Pakistan.

    PubMed

    Adil, Syed Omair; Ibran, Ehmer-Al; Nisar, Nighat; Shafique, Kashif

    2016-09-01

    Burns are major cause of morbidity and mortality in developing countries. Better understanding of the nature and extent of injury remains the major and only available way to halt the occurrence of the event. The present study was conducted to determine the prevalence of by self and by other unintentional burn, their comparison and the possible mode of acquisition by obtaining the history of exposure to known risk factors. A cross-sectional questionnaire based survey was conducted in Burns Centre of Civil Hospital Karachi, Pakistan and 324 hospitalized adult patients with unintentional burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile. The source of burn, affected body part and place of injury acquisition in terms of home, outside or work were also noted. Logistic regression model was conducted using SPSS software. Out of 324 patients, 295 (91%) had unintentional burn by self and 29 (9%) had unintentional burn by others. Male gender were 2.37 times and no schooling were 1.75 times more likely to have self-inflicted unintentional burn. Lower limb and head and neck were less likely to involve in unintentional burn by self. The burden of unintentional burn by self was considerably higher. Male gender and no schooling were found more at risk to have unintentional burn by self. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  9. Physician migration at its roots: a study on the factors contributing towards a career choice abroad among students at a medical school in Pakistan

    PubMed Central

    2012-01-01

    Background Physician migration, also known as “brain drain,” results from a combination of a gap in the supply and demand in developed countries and a lack of job satisfaction in developing countries. Many push and pull factors are responsible for this effect, with media and internet playing their parts. Large-scale physician migration can pose problems for both the donor and the recipient countries, with a resulting reinforcement in the economic divide between developed and developing countries. The main objectives of our study were to determine the prevalence of migration intentions in medical undergraduates, to elucidate the factors responsible and to analyze the attitudes and practices related to these intentions. Methods This was a cross-sectional, observational, questionnaire-based study, conducted at Dow Medical College of Dow University of Health Sciences, Karachi, between January, 2012 and May, 2012. A total of 323 students responded completely. The questionnaire consisted of 3 sections, and was aimed at collecting demographic details, determining students’ migratory intentions, evaluating reasons for and against migration and assessing attitudes and practices of students related to these intentions. Results Out of 323 respondents, 195 wanted to pursue their careers abroad, giving a prevalence rate of 60.4% in our sample. United States was the most frequently reported recipient country. The most common reasons given by students who wished to migrate, in descending order, were: lucrative salary abroad followed by quality of training, job satisfaction, better way of life, relatives, more opportunities, better working environment, terrorism in Pakistan, harassment of doctors in Pakistan, desire to settle abroad, more competition in Pakistan, better management, peer pressure, longer working hours in Pakistan, religious reasons, parent pressure, political reasons and favoritism in Pakistan. A considerable number of respondents had already started studying

  10. Frequency and predictors of anxiety and depression among pregnant women attending tertiary healthcare institutes of Quetta City, Pakistan.

    PubMed

    Ghaffar, Rahila; Iqbal, Qaiser; Khalid, Adnan; Saleem, Fahad; Hassali, Mohamed Azmi; Baloch, Nosheen Sikandar; Ahmad, Fiaz Ud Din; Bashir, Sajid; Haider, Sajjad; Bashaar, Mohammad

    2017-07-25

    Anxiety and depression (A&D) are commonly reported among pregnant women from all over the world; however, there is a paucity of workable data from the developing countries including Pakistan. The current study, therefore, aims to find out the frequency and predictors of A&D among pregnant women attending a tertiary healthcare institutes in the city of Quetta, in the Balochistan province, Pakistan. A questionnaire based, cross-sectional survey was conducted. The pre-validated Hospital Anxiety and Depression Scale (HADS) were used to assess the frequency of A&D among study respondents. Anxiety and depression scores were calculated via standard scoring procedures while logistic regression was used to identify the predictors of A&D. SPSS v. 20 was used for data analysis and p < 0.05 was taken as significant. Seven hundred and fifty pregnant women responded to the survey. The majority of the respondents belonged to age group of 26-35 year (424, 56.4%) and had no formal education (283, 37.6%). Furthermore, 612 (81.4%) of the respondents were unemployed and had urban residencies (651, 86.6%). The mean anxiety score was 10.08 ± 2.52; the mean depression score was 9.51 ± 2.55 and the total HADS score was 19.23 ± 3.91 indicating moderate A&D among the current cohort. Logistic regression analysis reported significant goodness of fit (Chi square = 17.63, p = 0.030, DF = 3), indicating that the model was advisable. Among all variables, age had a significant association when compared with HADS scores [adjusted OR (odds ratios) = 1.23, 95% CI = 1.13-1.62, p < 0.001]. Moderate A&D was reported among the study respondents. Furthermore, age was highlighted as a predictor of A&D. The evidence from this study provides a motion of support programs for anxious and depressed pregnant women. The benefits of implementing good mental health in antenatal care have long-lasting benefits for both mother and infant. Therefore, there is a need to incorporate

  11. Terrorist attacks in the largest metropolitan city of Pakistan: Profile of soft tissue and skeletal injuries from a single trauma center.

    PubMed

    Khan, Muhammad Shahid; Waheed, Shahan; Ali, Arif; Mumtaz, Narjis; Feroze, Asher; Noordin, Shahryar

    2015-01-01

    Pakistan has been hugely struck with massive bomb explosions (car and suicide bombs) resulting in multiple casualties in the past few years. The aim of this study is to present the patterns of skeletal and soft tissue injuries and to review the outcome of the victims who presented to our hospital. This is a retrospective chart review from January 2008 to December 2012. The medical record numbers of patients were obtained from the hospital Health Information and Management Sciences (HIMS) as per the ICD-9 coding. During the study period, more than 100 suicide and implanted bomb blast attacks took place in the public proceedings, government offices, residential areas and other places of the city. Altogether 262 patients were enrolled in the study. The mean age of the patients was 31±14 years. The shrapnel inflicted wounds were present on to the upper limb in 24 patients and the lower limb in 50. Long bone fractures were the most common skeletal injuries. The fractures were complicated by penetrating fragments and nails which result in post operative infections and prolonged hospital stay.

  12. Impact of city effluents on water quality of Indus River: assessment of temporal and spatial variations in the southern region of Khyber Pakhtunkhwa, Pakistan.

    PubMed

    Khan, Ilham; Khan, Azim; Khan, Muhammad Sohail; Zafar, Shabnam; Hameed, Asma; Badshah, Shakeel; Rehman, Shafiq Ur; Ullah, Hidayat; Yasmeen, Ghazala

    2018-04-04

    The impact of city effluents on water quality of Indus River was assessed in the southern region of Khyber Pakhtunkhwa, Pakistan. Water samples were collected in dry (DS) and wet (WS) seasons from seven sampling zones along Indus River and the physical, bacteriological, and chemical parameters determining water quality were quantified. There were marked temporal and spatial variations in the water quality of Indus River. The magnitude of pollution was high in WS compared with DS. The quality of water varied across the sampling zones, and it greatly depended upon the nature of effluents entering the river. Water samples exceeded the WHO permissible limits for pH, EC, TDS, TS, TSS, TH, DO, BOD, COD, total coliforms, Escherichia coli, Ca 2+ , Mg 2+ , NO 3 - , and PO 4 2- . Piper analysis indicated that water across the seven sampling zones along Indus River was alkaline in nature. Correlation analyses indicated that EC, TDS, TS, TH, DO, BOD, and COD may be considered as key physical parameters, while Na + , K + , Ca 2+ , Mg 2+ , Cl - , F - , NO 3 - , PO 4 2- , and SO 4 2- as key chemical parameters determining water quality, because they were strongly correlated (r > 0.70) with most of the parameters studied. Cluster analysis indicated that discharge point at Shami Road is the major source of pollution impairing water quality of Indus River. Wastewater treatment plants must be installed at all discharge points along Indus River for protecting the quality of water of this rich freshwater resource in Pakistan.

  13. Association of depression with treatment outcomes in Type 2 Diabetes Mellitus: a cross-sectional study from Karachi, Pakistan.

    PubMed

    Zuberi, Saman I; Syed, Ehsan U; Bhatti, Junaid A

    2011-02-15

    To assess the associations of depression with glycemic control and compliance to self-care activities in adult patients with Type 2 Diabetes Mellitus This cross-sectional study was conducted at a tertiary-care hospital in Karachi (Aga Khan University Hospital). Equal numbers of depressed and non-depressed patients were consecutively recruited from the diabetic clinic. Information on demographic and clinical characteristics was collected in face-to-face interviews and from medical records. Hospital Anxiety Depression Scale (HADS) was used to measure depression. Associations of depressed status (HADS ≥ 8) with poor glycemic control (Hemoglobin A1c level ≥ 7%) and compliance to self-care activities were assessed by logistic regression analyses. A total of 286 patients were included in this study with a male-female ratio of 1.2:1. Mean age was 52 years and in 64.7% of them, the duration of diabetes was more than 3 years. Depressed patients were more likely to be female (adjusted odds ratio [OR] = 1.88; 95% confidence interval [95%CI] = 1.07-3.31), had a family history of diabetes (OR = 2.64; 95%CI = 1.26-5.55), and poor glycemic control (OR = 5.57; 95%CI = 2.88-10.76) compared with non-depressed patients. Depression was also associated with low compliance to self-care activities such as taking dose as advised (OR = 0.32; 95%CI = 0.14-0.73), dietary restrictions (OR = 0.45; 95%CI = 0.26-0.79) and foot care (OR = 0.38; 95%CI = 0.18-0.83). Adult patients with Type 2 Diabetes who have depression were more likely to have poor glycemic control and lower compliance to self-care activities, and they might need particular attention during follow-up visits.

  14. Teaching children road safety through storybooks: an approach to child health literacy in Pakistan.

    PubMed

    Ahmad, Haris; Naeem, Rubaba; Feroze, Asher; Zia, Nukhba; Shakoor, Amarah; Khan, Uzma Rahim; Mian, Asad Iqbal

    2018-02-07

    Road traffic injuries (RTIs) commonly affect the younger population in low- and-middle-income countries. School children may be educated about road safety using storybooks with colorful pictures, which tends to increase the child's interest in the text. Therefore, this study assessed the use of bilingual pictorial storybooks to improve RTI prevention knowledge among school children. This pretest-posttest study was conducted in eight public and nine private schools of Karachi, Pakistan, between February to May 2015. Children in grades four and five were enrolled at baseline (n = 410). The intervention was an interactive discussion about RTI prevention using a bilingual (Urdu and English) pictorial storybook. A baseline test was conducted to assess children's pre-existing knowledge about RTI prevention followed by administration of the intervention. Two posttests were conducted: first immediately after the intervention, and second after 2 months. Test scores were analyzed using McNemar test and paired sample t-test. There were 57% girls and 55% public school students; age range 8-16 years. Compared to the overall baseline score (5.1 ± 1.4), the number of correct answers increased in both subsequent tests (5.9 ± 1.2 and 6.1 ± 1.1 respectively, p-value < 0.001). Statistically significant improvement in mean scores was observed based on gender, grades and school type over time (p-value < 0.001). Discussions using bilingual pictorial storybooks helped primary school children in Pakistan grasp knowledge of RTI prevention. RTI education sessions may be incorporated into school curricula using storybooks as teaching tools. Potential exists to create similar models for other developing countries by translating the storybooks into local languages.

  15. A qualitative study exploring perceptions and attitudes of community pharmacists about extended pharmacy services in Lahore, Pakistan.

    PubMed

    Hashmi, Furqan K; Hassali, Mohamed Azmi; Khalid, Adnan; Saleem, Fahad; Aljadhey, Hisham; Babar, Zaheer Ud Din; Bashaar, Mohammad

    2017-07-19

    In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan. A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings. Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan.

  16. Frequency of JAK2 V617F mutation in patients with Philadelphia positive Chronic Myeloid Leukemia in Pakistan.

    PubMed

    Tabassum, Najia; Saboor, Mohammed; Ghani, Rubina; Moinuddin, Moinuddin

    2014-01-01

    Co-existence of myeloproliferative disorders (MPD) and Janus associated kinase 2 mutation (JAK2 V617F) is a well-established fact. Only few case reports are available showing presence of JAK2 V617F mutation in chronic myeloid leukemia (CML). Purpose of this study was to determine the frequency of JAK2 V617F mutation in Philadelphia Chromosome positive (Ph (+)) CML patients in Pakistan. The study was conducted from August 2009 to July 2010 at Civil Hospital and Baqai Institute of Hematology (BIH) Karachi. Blood samples from 25 patients with CML were collected. Multiplex reverse transcription polymerase chain reaction (RT-PCR) was performed for Breakpoint Cluster Region - Abelson (BCR-ABL) rearrangement. Conventional PCR was performed for JAK2 V617F mutation on BCR-ABL positive samples. All 25 samples showed BCR-ABL rearrangement. Out of these 11 samples (44%) had JAK2 V617F mutation; the remaining 14 (56%) cases showed JAK2 617V wild type. It is concluded that the co-existence of Ph (+)CML and JAK2 V617F mutation is possible.

  17. Perceived stress and stressors among house officers.

    PubMed

    Hassan, Maroof; Hussain, Talal; Ahmed, Syed Mustajab; Fraz, Tayyab Raza; Rehmat, Zoha

    2014-01-01

    House officers training has always been regarded as a highly stressful environment to doctors. The objectives of our study were to assess perceived stress and sources of stress among house officers. A cross-sectional questionnaire-based survey was carried out among house officers working in Civil Hospital, Karachi, Pakistan, and Jinnah Postgraduate Medical Centre, Karachi, Pakistan, during November and December, 2013. Perceived stress was assessed using perceived stress scale. A 15-item questionnaire was used to assess sources of stress and was graded by Likert scale (1 = very low, 5 = very high). To calculate the difference of mean for stressors by gender of house officers, t-test with 95% confidence interval was used. The overall response rate was 81.5% (269 out of 330). One hundred twenty-nine (47.9%) were found to be under stress of whom 32 (24.8%) were males and 97 (75.2%) were females. Top five stressors reported by house officers were night calls, workload, time pressure, working alone, and coping with diagnostic uncertainty. Significant differences for stressors by gender were found for night calls (P < 0.05), unrealistically high expectation by others (P < 0.05), financial issues (P < 0.05), and lack of senior support (P < 0.05). Majority of house officers working in Civil Hospital, Karachi, and Jinnah Postgraduate Medical Centre, Karachi, were under high level of stress. Therefore, immediate steps should be taken for control of stress and its management.

  18. Changing trend of viral hepatitis--"A twenty one year report from Pakistan Medical Research Council Research Centre, Jinnah Postgraduate Medical Centre, Karachi".

    PubMed

    Ahmed, Waquaruddin; Qureshi, Huma; Arif, Ambreen; Alam, Syed Ejaz

    2010-02-01

    To determine the frequency and pattern of Hepatitis B and C over the past twenty one years, in a liver research unit of Karachi. Retrospective analysis of the records of PMRC, Research Centre, Jinnah Postgraduate Medical Centre, Karachi, from 1987 to 2007 were reviewed. A special flow sheet was made where information of all patients with viral liver disease was entered. Patients having complete information of viral markers were included in the analysis. Cases with HBsAg, Anti HBc IgM positive and raised ALT were considered as acute Hepatitis B. HBs Ag/Anti HBc IgG positive were considered as chronic Hepatitis B. Delta antibody positive with or without HBsAg were considered as Delta Hepatitis. Anti HCV positive and raised ALT more than ten times for less than 6 months were considered as acute Hepatitis C, whereas Anti HCV and HCV-RNA positive with or without raised ALT for more than six months were considered as chronic Hepatitis C. Anti HEV IgM and Anti HAV IgM positive were considered as acute Hepatitis E and A respectively. A total of 5193 cases fulfilling all criteria of viral hepatitis were seen in the past 21 years. Of the total 3247 (62.5%) were males and 1946 (37.5%) females giving a male to female ratio of 1.7 : 1. Hepatitis C was the most common infection seen in 2896 cases (55.8%), followed by Hepatitis B in 1691 cases (32.6%). Seventy five percent cases of Hepatitis B were males and 25% females while 55% Hepatitis C cases were males and 45% females. Hepatitis B was seen a decade earlier in different age groups than hepatitis C. Overall, out of the total 5193 cases, 2294 (44.2%) were of chronic hepatitis, 1430 (27.5%) cirrhosis, 1083 (20.8%) carriers and 346 (6.7%) had acute hepatitis (hepatitis B; 214 (61.8%), hepatitis C; 21 (6.0%). While hepatitis B and hepatitis C both were present in 3 (1.3%). Hepatitis E was 70 (20.2%), hepatitis A 12 (3.5%) and all markers were negative in 26 (7.5%) cases). Forty cases (0.8%) were of Hepatocellular carcinoma. Year

  19. Development and validation of sunlight exposure measurement questionnaire (SEM-Q) for use in adult population residing in Pakistan

    PubMed Central

    2012-01-01

    Background Vitamin D deficiency has been identified as a major public health problem worldwide. Sunlight is the main source of vitamin D and its measurement using dosimeters is expensive and difficult for use in population-based studies. Hence, the aim of this study was to develop and validate questionnaires to assess sunlight exposure in healthy individuals residing in Karachi, Pakistan. Methods Two questionnaires with seven important items for sunlight exposure assessment were developed. Fifty four healthy adults were enrolled based on their reported sunlight exposure (high = 17, moderate = 18, low = 19) from Aga Khan University, Karachi. Over four days, study participants were asked to wear a dosimeter between sunrise and sunset and report time spent and activities undertaken in the sun for questionnaire validation. Algorithm for item weightage was created as an average score based on ultraviolet B percentage received. Blood samples were obtained for serum vitamin D. Results The mean time (minutes) spent in sun over 4 days (±SD) was 69.5 (±32) for low, 83.5 (±29.7) for moderate and 329 (±115) for high exposure group. The correlation between average time (minutes) spent in sun over 4 days and mean change in absorbance of UV dosimeters for 4 days was 0.60 (p < 0.01). Correlation between average score and vitamin D levels was found to be 0.36 (p = 0.01) for short term questionnaire score, 0.43 (p = 0.01) for long term questionnaire score in summers and 0.48 (p = 0.01) in winters. Conclusions The sunlight exposure measurement questionnaires were valid tools for use in large epidemiological studies to quantify sunlight exposure. PMID:22682277

  20. A review of global outlook on fluoride contamination in groundwater with prominence on the Pakistan current situation.

    PubMed

    Rasool, Atta; Farooqi, Abida; Xiao, Tangfu; Ali, Waqar; Noor, Sifat; Abiola, Oyebamiji; Ali, Salar; Nasim, Wajid

    2017-12-19

    Several million people are exposed to fluoride (F - ) via drinking water in the world. Current review emphasized the elevated level of fluoride concentrations in the groundwater and associated potential health risk globally with a special focus on Pakistan. Millions of people are deeply dependent on groundwater from different countries of the world encompassing with an elevated level of fluoride. The latest estimates suggest that around 200 million people, from among 25 nations the world over, are under the dreadful fate of fluorosis. India and China, the two most populous countries of the world, are the worst affected. In Pakistan, fluoride data of 29 major cities are reviewed and 34% of the cities show fluoride levels with a mean value greater than 1.5 mg/L where Lahore, Quetta and Tehsil Mailsi are having the maximum values of 23.60, 24.48, > 5.5 mg/L, respectively. In recent years, however, other countries have minimized, even eliminated its use due to health issues. High concentration of fluoride for extended time period causes adverse effects of health such as skin lesions, discoloration, cardiovascular disorders, dental fluorosis and crippling skeletal fluorosis. This review deliberates comprehensive strategy of drinking water quality in the global scenario of fluoride contamination, especially in Pakistan with prominence on major pollutants, mitigation technologies, sources of pollution and ensuing health problems. Considering these verities, health authorities urgently need to establish alternative means of water decontamination in order to prevent associated health problems.

  1. Monitoring the distribution of tropospheric ozone concentration over Pakistan by using OMI/MLS satellite observations

    NASA Astrophysics Data System (ADS)

    Noreen, Asma; Fahim Khokhar, Muhammad; Murtaza, Rabbia; Zeb, Naila

    2016-07-01

    Pakistan is a semi-arid, agricultural country located in Indian Sub-continent, Asia. Due to exponential population growth, poor control and regulatory measures and practices in industries, it is facing a major problem of air pollution. The concentration of greenhouse gases and aerosols are showing an increasing trend in general. One of these greenhouse gases is tropospheric ozone, one of the criteria pollutant, which has a radiative forcing (RF) of about 0.4 ± 0.2 Wm-2, contributing about 14% of the present total RF. Spatial distribution and temporal evolution of tropospheric ozone concentration over Pakistan during 2004 to 2014 was studied by using combined OMI/MLS product, which was derived by tropospheric ozone residual (TOR) method. Results showed an overall increase of 3.2 ± 2.2 DU in tropospheric ozone concentration over Pakistan since October 2004. The mean spatial distribution showed high concentrations of ozone in the Punjab and southern Sindh where there is high population densities along with rapid urbanization and enhanced anthropogenic activities. The seasonal variations were observed in the provinces of the country and TO3 VCDs were found to be high during summer while minimum during winter. The statistical analysis by using seasonal Mann Kendal test also showed strong positive trends over the four provinces as well as in major cities of Pakistan. These variations were driven by various factors such as seasonality in UV-B fluxes, seasonality in ozone precursor gases such as NOx and VOCs and agricultural fire activities in Pakistan. A strong correlation of 97% was found between fire events and tropospheric ozone concentration over the country. The results also depicted the influence of UV-B radiations on the tropospheric ozone concentration over different regions of Pakistan especially in Baluchistan and Sindh provinces.

  2. Maritime Strategy in Pakistan

    DTIC Science & Technology

    2004-12-01

    69 Shamim Ahmed Rizvi, “New Measures in the Shipping Policy,” Pakistan and Gulf Economist (22- 28 April, 2002) http...2003. Rizvi, Shamim Ahmed. “New Measures in the Shipping Policy,” Pakistan and Gulf Economist (22-28 April, 2002) http

  3. Hydrometeorological Variability Over Pakistan

    NASA Astrophysics Data System (ADS)

    Bashir, Furrukh

    Pakistan, as an agriculture based economy, is vulnerable to various hydrometeorological hazards ranging from tropical cyclones, thunderstorms, tornadoes, drought, rain, hail, snow, lightning, fog, wind, temperature extremes, air pollution, and climatic change. However, three of the most pressing challenges in terms of water resource availability, that are different in nature, but are inter-linked to each other are discussed over here. We begin with the Karakoram Anomaly that is considered as one of the most mysterious and most speculated phenomena on Planet Earth. Though, it is confined to the glaciers in the eastern Hindukush, western Karakoram and northwestern Himalayan mountain ranges of Northern Pakistan that are not responding to global warming in the same manner as their counterparts elsewhere, because, their retreat rates are less than the global average, and some are either stable or growing. However, the Karakoram Anomaly has baffled scientific society for more than a decade since its earliest discovery in the year 2005. The reasons of the Karakoram anomaly were mainly associated to physiography of the area and role of climate was considered marginal till now, as climate is influencing glaciers differently all over the globe. Here, for the first time, we present a hydro-meteorological perspective based on five decades of synoptic weather observations collected by the meteorological network of Pakistan. Analysis of this unique data set indicates that increased regional scale humidity, cloud cover, and precipitation, along with decreased net radiation, near-surface wind speed, potential evapotranspiration and river flow, especially during the summer season, represent a substantial change in the energy, mass and momentum fluxes that are facilitating the establishment of the Karakoram Anomaly. In turn, it is influencing the availability of glacier melt in River Indus in summer season. Secondly, we developed a hydrometeorological data sets for Pakistan as they

  4. Heterogeneity of BCR-ABL rearrangement in patients with chronic myeloid leukemia in Pakistan

    PubMed Central

    Tabassum, Najia; Saboor, Mohammad; Ghani, Rubina; Moinuddin, Moinuddin

    2014-01-01

    Background and Objective: Breakpoint cluster region-Abelson (BCR-ABL) rearrangement or Philadelphia (Ph) chromosome in Chronic Myeloid Leukemia (CML) is derived from a reciprocal chromosomal translocation between ABL gene on chromosome 9 and BCR gene on chromosome 22. This chimeric protein has various sizes and therefore different clinical behaviour. The purpose of this study was to determine the heterogeneity of BCR-ABL rearrangement in patients with Ph+CML in Pakistan. Methods: The study was conducted at Civil Hospital and Baqai Institute of Hematology (BIH) Karachi. Blood samples from 25 patients with CML were collected. Multiplex reverse transcription polymerase chain reaction (RT-PCR) was performed to identify various BCR-ABL transcripts. Results: All 25 samples showed BCR-ABL rearrangements. Out of these, 24 (96%) patients expressed p210 BCR-ABL rearrangements i.e. 60% (n=15) had b3a2 and 32% (n=8) had b2a2 rearrangements. Co-expression of b3a2 /b2a2 rearrangement and p190 (e1a3) rearrangement was also identified in two patients. Conclusion: It is apparent that majority of the patients had p210 BCR-ABL rearrangements. Frequency of co-expression and rare fusion transcripts was very low. PMID:25097530

  5. Circulating serotypes of dengue virus and their incursion into non-endemic areas of Pakistan; a serious threat.

    PubMed

    Ali, Amjad; Ahmad, Habib; Idrees, Muhammad; Zahir, Fazli; Ali, Ijaz

    2016-08-26

    Dengue virus is circulating in Pakistan since 1994, which causes major and minor outbreaks in many areas of the country. The incidence of dengue in Pakistan in past years mainly restricted to parts of Sindh and Punjab provinces. As such, a severe dengue outbreak appeared in Pakistan in 2011, particularly in Punjab province with Lahore as the most hit city (290 deaths). In 2013, for the first time in the history of Pakistan, dengue outbreak erupted in Swat District, Khyber Pakhtunkhwa, which claimed more than 57 lives. Hence this study was conducted to document circulating serotypes of dengue virus in Pakistan in 2011 and 2013 dengue outbreaks in two different territories/areas of the country. In total, 1340 blood samples from people having dengue (ELISA positive) and/or dengue like symptoms from various cities/areas of Punjab and Swat, Khyber Pakhtunkhwa (KP) were collected and analyzed by reverse transcription polymerase chain reaction (RT-PCR) using serotype specific primers. The results indicated that all the four dengue virus serotypes were circulating in Punjab Province with highest frequency of DENV-2 (41.64 %) and DENV-3 (41.05 %). Similarly, DENV-2 (41.66 %) and DENV-3 (35.0 %) were dominant serotypes detected in KP-based people lived in Punjab. On the other hand only DENV-2 (40.0 %) and DENV-3 (60.0 %) were detected in Swat District. Furthermore an important observation noted in this study was mixed infection of DENV-2 and DENV-3 in Punjab in 2011 (3.81 %) and in people from KP infected in Punjab (8.33 %) which may account for the high mortality and morbidity rates as compared to previous outbreaks. Over all male population was mostly infected as compared to females and people in the age group between 15 to 45 was the highest infected group. The findings of this study indicate that all four serotypes of dengue virus are circulating in Punjab whereas serotypes 2 and 3 introduced for the first time into Swat, KP in 2013; about 600 km away from Lahore

  6. 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.

  7. Building research capacity in developing countries: cost-effectiveness of an epidemiology course taught by traditional and video-teleconferencing methods in Pakistan.

    PubMed

    Dodani, Sunita; Songer, Thomas; Ahmed, Zakiuddin; Laporte, Ronald E

    2012-10-01

    Building research capacity in developing countries using cost-effective methods has been recognized as an important pillar for the production of a sound evidence base for decision-making in policy and practice. We assessed the effectiveness and cost-effectiveness of a research training course conducted using traditional methods as well as the video-teleconferencing (VTC) method in Pakistan. A 9-day epidemiology research training course was offered to physicians in Pakistan (92%) and Bangladesh (8%). The course was taught using (1) a traditional classroom face-to face (F2F) method at the Aga Khan University, Karachi, Pakistan, and (2) the VTC method at two medical institutions within Pakistan. In total, 40 participants were selected for the F2F group and 46 for the VTC group. Outcome parameters were assessed pre- and post-course (short-term) as well as after 1 year (long-term). Costs of conducting the training by both methods were also identified using cost-effectiveness analysis. The total study sample included 56 participants (F2F n =38, VTC n=18) for the short-term and 49 participants for the long-term assessment. After the end of the course (Day 9), mean post-test 1 scores showed significant improvement in both groups: 15.08 ± 1.75 in F2F (p=0.001) versus 13.122 ± 1.87 in VTC (p=0.001). Mean scores 1 year after the course (post-test 2) were lower than mean post-test 1 scores in both groups (13.42 ± 2.61 in F2F versus 12.31 ± 2.08 in VTC) but were higher than the baseline pretest scores. The total incremental cost per score gained was higher for the VTC group for both short-term (VTC incremental cost was $166/score gained) and long-term (VTC incremental cost was $458/ score gained) course effectiveness. The use of e-technologies in developing countries proves to be an effective way of building capacity and reducing the problems of brain drain. This initial study provides a foundation from which larger studies may be developed.

  8. China Pakistan Economic Corridor (CPEC): Benefits For Pakistan And Comparison With Suez And Panama Canals

    DTIC Science & Technology

    2017-12-01

    ECONOMIC CORRIDOR (CPEC): BENEFITS FOR PAKISTAN AND COMPARISON WITH SUEZ AND PANAMA CANALS by Hanif Ullah Khan December 2017 Thesis...DATE December 2017 3. REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE CHINA PAKISTAN ECONOMIC CORRIDOR (CPEC): BENEFITS FOR...The China Pakistan Economic Corridor (CPEC) is part of China’s “One Belt, One Road” initiative and joins two major economic corridors: The Silk Road

  9. 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

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

    PubMed

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

    2016-01-01

    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. 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. 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. 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.

  11. Suicidal Ideation, Depression, Anxiety, Stress, And Life Satisfaction Of Medical, Engineering, And Social Sciences Students.

    PubMed

    Naseem, Sabahat; Munaf, Seema

    2017-01-01

    Pursuing higher education is not an easy task as it requires hard work, dedication, and motivation. Although there are many rewards involved in growing up academically, nevertheless, it contains a few hazards too. For instance, suicidal ideation is associated with presence of depression, anxiety, and stress with low level of satisfaction with life in students finding difficulty in handling educational demands of higher education. Therefore, the present study focused on the query that whether there is any difference or not among medical, engineering, and social sciences students of city of Karachi, Pakistan in the level of suicidal ideation, depression, anxiety, stress, and life satisfaction. Using comparative group design, total 300 students (150 males and 150 females) with age range of 19-26 were selected from faculties of medical, engineering, and social sciences of different universities of Karachi, Pakistan, through purposive sampling. Respondent Profile Form, The Suicide Behaviours Questionnaire-Revised, Depression Anxiety Stress Scale-21, and Satisfaction with Life Scale were administered to assess suicidal ideation; depression, anxiety, stress; and life satisfaction, respectively, of the students. Scores were analysed through ANOVA and Post Hoc (Tukey's HSD) test using SPSS. Social sciences and engineering students were significantly higher on depression, anxiety, and stress than medical students [F (2, 297) =8.701, p=.000] whereas insignificant differences in the level of suicidal ideation [F (2, 297) =1.914, p=.149] and life satisfaction [F (2, 297) = .726, p = .485] among these students were found. With the help of these findings, it would be easier to counsel students of different disciplines in time on the lines of suggested preventive measures.

  12. Gastroenteritis: A Grass Root Approach.

    ERIC Educational Resources Information Center

    Dure-Samin, Akram; Mubina, Agboatwalla

    1992-01-01

    In Karachi, Pakistan, 4 resource personnel disseminated information about sanitation and breastfeeding in the prevention of gastroenteritis to 100 households. Compared to 100 that did not receive health information, the intervention group had less incidence of diarrhea and better use of oral rehydration salt. (SK)

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

    PubMed

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

    2015-01-01

    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. 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. 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. 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.

  14. Detection of multiple cocirculating wild poliovirus type 1 lineages through environmental surveillance: impact and progress during 2011-2013 in Pakistan.

    PubMed

    Alam, Muhammad Masroor; Shaukat, Shahzad; Sharif, Salmaan; Angez, Mehar; Khurshid, Adnan; Malik, Farzana; Rehman, Lubna; Zaidi, Syed Sohail Zahoor

    2014-11-01

    The environmental surveillance has proven to be a useful tool to identify poliovirus circulation in different countries and was started in Pakistan during July 2009 to support the acute flaccid paralysis (AFP) surveillance system. Sewage samples were collected from 27 environmental sampling (ENV) sites and processed for poliovirus isolation through 2-phase separation method. Poliovirus isolates were identified as Sabin-like or wild type through real-time polymerase chain reaction (PCR). Wild-type strains were subjected to VP1 gene sequencing and phylogenetic analysis performed using MEGA 5.0. During 2011-2013, a total of 668 samples were collected from 4 provinces that resulted in 40% of samples positive for wild poliovirus type-1 (WPV-1). None of the samples were positive for WPV-3. The areas with high frequency of WPV-1 detection were Karachi-Gadap (69%), Peshawar (82%), and Rawalpindi (65%), whereas the samples from Quetta and Sukkur remained negative for WPV during 2013. Phylogenetic analysis revealed 3 major clusters with multiple poliovirus lineages circulating across different country areas as well as in bordering areas of Afghanistan. Environmental surveillance in Pakistan has been proven to be a powerful tool to detect WPV circulation in the absence of poliomyelitis cases in many communities. Our findings emphasize the need to continue and expand such surveillance activities to other high-risk areas in the country. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  15. Fourth-generation spinal instrumentation: experience with adolescent idiopathic scoliosis at a tertiary care hospital in Pakistan

    PubMed Central

    Fazal, Akil; Lakdawala, Riaz H

    2012-01-01

    Objective To evaluate the radiological and functional outcome of surgical treatment of adolescent idiopathic scoliosis using fourth-generation posterior spinal instrumentation at The Aga Khan University, Karachi, Pakistan. Design Case series. Place and duration of study The Aga Khan University Hospital after a minimum of 2 years postoperatively. Patients and methods A total of 20 patients with adolescent idiopathic scoliosis were recruited into the study and evaluated for radiological and functional outcome. The study period was from 2000 to 2005. Radiological outcome was assessed using Cobb angle measurement pre and postoperatively, hence assessing percentage correction. The lower instrumented vertebra was taken as the neutral vertebra and the level was recorded. Functional outcome was determined using the Scoliosis Research Society patient administered questionnaire. All patients were called to the clinic and asked to fill in the form. Those patients who were out of the city were mailed the forms and requested via telephone to complete and return. Results Of the 20 patients operated on, twelve were female and eight were male. The average age at operation was 12.7 years. The mean Cobb angle was 69° preoperatively and 20° postoperatively, representing a percentage correction of 71%. The average duration of follow-up was 3.6 years. There was one major complication involving neurological injury post-op and two minor complications involving wound infection. The average Scoliosis Research Society score (on a scale of 1–5, with 5 being best) for pain was 4.5, self-image was 4.2, functional status was 4.1, mental status was 3.8, and satisfaction was 4.4. There was no relationship between the percentage correction of scoliosis and the functional outcome. Those patients with a high preoperative Cobb angle tended to have a better outcome for functional and mental status postoperatively. There was no relation between the lower instrumented vertebra and functional outcome

  16. Fourth-generation spinal instrumentation: experience with adolescent idiopathic scoliosis at a tertiary care hospital in Pakistan.

    PubMed

    Fazal, Akil; Lakdawala, Riaz H

    2012-01-01

    To evaluate the radiological and functional outcome of surgical treatment of adolescent idiopathic scoliosis using fourth-generation posterior spinal instrumentation at The Aga Khan University, Karachi, Pakistan. Case series. The Aga Khan University Hospital after a minimum of 2 years postoperatively. A total of 20 patients with adolescent idiopathic scoliosis were recruited into the study and evaluated for radiological and functional outcome. The study period was from 2000 to 2005. Radiological outcome was assessed using Cobb angle measurement pre and postoperatively, hence assessing percentage correction. The lower instrumented vertebra was taken as the neutral vertebra and the level was recorded. Functional outcome was determined using the Scoliosis Research Society patient administered questionnaire. All patients were called to the clinic and asked to fill in the form. Those patients who were out of the city were mailed the forms and requested via telephone to complete and return. Of the 20 patients operated on, twelve were female and eight were male. The average age at operation was 12.7 years. The mean Cobb angle was 69° preoperatively and 20° postoperatively, representing a percentage correction of 71%. The average duration of follow-up was 3.6 years. There was one major complication involving neurological injury post-op and two minor complications involving wound infection. The average Scoliosis Research Society score (on a scale of 1-5, with 5 being best) for pain was 4.5, self-image was 4.2, functional status was 4.1, mental status was 3.8, and satisfaction was 4.4. There was no relationship between the percentage correction of scoliosis and the functional outcome. Those patients with a high preoperative Cobb angle tended to have a better outcome for functional and mental status postoperatively. There was no relation between the lower instrumented vertebra and functional outcome. In the correct indications, fourth-generation posterior instrumentation

  17. The determinants of infant mortality in Pakistan.

    PubMed

    Agha, S

    2000-07-01

    This study examines factors associated with infant survival in Pakistan. It uses data from the Pakistan Integrated Household Survey 1991, a nationally representative sample survey of the Government of Pakistan, funded by the World Bank. The infant mortality rate was still very high in Pakistan until the early 1990s, at 100 deaths per 1000 live births. The study shows that there is no evidence of a secular decline in infant mortality during the 1980s. Large differentials in infant survival by socio-economic factors and access to water and sanitation indicate that social and gender inequities are the underlying cause of the stagnation of infant mortality in Pakistan. Economic and social policies of earlier decades have resulted in tremendous disparities in wealth and access to resources in Pakistan. The low social, economic and legal status of women is intimately tied to the well-being of their children. Health interventions in Pakistan should be designed to reach the most under-served: women and children. Systematic evaluations of health interventions will be necessary to make informed decisions about health investments in the future.

  18. Hope or Despair? Learning in Pakistan's Primary Schools.

    ERIC Educational Resources Information Center

    Warwick, Donald P.; Reimers, Fernando

    This book reports on the research findings of the Pakistan Study, a collaboration between the Harvard Institute for International Development and other organizations in Pakistan. The focus is primarily on what affects student learning in Pakistan's government-sponsored primary schools. Chapter 1 discusses primary schools in Pakistan and the…

  19. Terrorist attacks in the largest metropolitan city of Pakistan: Profile of soft tissue and skeletal injuries from a single trauma center

    PubMed Central

    Khan, Muhammad Shahid; Waheed, Shahan; Ali, Arif; Mumtaz, Narjis; Feroze, Asher; Noordin, Shahryar

    2015-01-01

    BACKGROUND: Pakistan has been hugely struck with massive bomb explosions (car and suicide bombs) resulting in multiple casualties in the past few years. The aim of this study is to present the patterns of skeletal and soft tissue injuries and to review the outcome of the victims who presented to our hospital. METHODS: This is a retrospective chart review from January 2008 to December 2012. The medical record numbers of patients were obtained from the hospital Health Information and Management Sciences (HIMS) as per the ICD-9 coding. RESULTS: During the study period, more than 100 suicide and implanted bomb blast attacks took place in the public proceedings, government offices, residential areas and other places of the city. Altogether 262 patients were enrolled in the study. The mean age of the patients was 31±14 years. The shrapnel inflicted wounds were present on to the upper limb in 24 patients and the lower limb in 50. CONCLUSION: Long bone fractures were the most common skeletal injuries. The fractures were complicated by penetrating fragments and nails which result in post operative infections and prolonged hospital stay. PMID:26401184

  20. Drug resistance profile and biofilm forming potential of Pseudomonas aeruginosa isolated from contact lenses in Karachi-Pakistan

    PubMed Central

    2013-01-01

    Background The contaminated contact lens provides Pseudomonas aeruginosa an ideal site for attachment and biofilm production. Continuous contact of the eye to the biofilm-infested lens can lead to serious ocular diseases, such as keratitis (corneal ulcers). The biofilms also prevent effective penetration of the antibiotics, which increase the chances of antibiotic resistance. Methods For this study, 22 Pseudomonas aeruginosa isolates were obtained from 36 contact lenses and 14 contact lens protective fluid samples. These isolates were tested against eight commonly used antibiotics using Kirby-Bauer disk diffusion method. The biofilm forming potential of these isolates was also evaluated using various qualitative and quantitative techniques. Finally, a relationship between biofilm formation and antibiotic resistance was also examined. Results The isolates of Pseudomonas aeruginosa tested were found resistant to most of the antibiotics tested. Qualitative and quantitative biofilm analysis revealed that most of the isolates exhibited strong biofilm production. The biofilm production was significantly higher in isolates that were multi-drug resistant (p < 0.0001). Conclusion Our study indicates that multi-drug resistant, biofilm forming Pseudomonas aeruginosa isolates are mainly involved in contact lens associated infections. This appears to be the first report from Pakistan, which analyzes both antibiotic resistance profile and biofilm forming potential of Pseudomonas aeruginosa isolates from contact lens of the patients with contact lens associated infections. PMID:24134792

  1. Exploring the China-Pakistan Relationship. Roundtable Report

    DTIC Science & Technology

    2010-06-01

    Gwadar deep sea port, in Pakistan’s Balochistan province along Pakistan’s southwest coast (see figure 2), was built...Duddhar lead-zinc mining project in Lasbela district, Balochistan . As roundtable participants suggested, Pakistan seems to be the biggest beneficiary

  2. Isolation of potentially pathogenic fungi from selected pigeons' feeding sites in Karachi: A new dimension to health hazard.

    PubMed

    Naz, Sehar Afshan; Yaseen, Muhammad; Jabeen, Nusrat; Shafique, Maryam

    2017-06-01

    To determine the presence of pathogenic fungal strains in areas where pigeons are present in a large number. This study was conducted at the Federal Urdu University of Arts, Science and Technology, Karachi, from February 2015 to March2016, and comprised samples of soil contaminated with pigeons' excreta. The samples were collected from 20 different pigeon-feeding places in the city. These samples were processed for the isolation and identification of fungi by using standard conventional methods. The fungal strains isolated were also tested for their susceptibility to commonly used antifungal agents by disc diffusion technique. There were 105 samples. A wide variety of fungal strains belonging to different genera of Aspergillus, Rhizopus, Penicillium, Fusarium and Candida were isolated and identified by using conventional methods. The antifungal resistance pattern of these strains also depicts emergence of resistance against commonly used antifungal agents such as amphotericin B and fluconazole. The soil and air of places densely populated with pigeons were found to be loaded with fungal spores and many of them were potential pathogens.

  3. Assessment of knowledge about childhood autism among medical students from private and public universities in Karachi.

    PubMed

    Shaukat, Farah; Fatima, Ambreen; Zehra, Nosheen; Hussein, Mohammed Amirali Ghulam; Ismail, Ozair

    2014-11-01

    To assess the knowledge about childhood autism among fourth year medical students in public and private medical universities of a metropolitan city. The cross-sectional descriptive study was conducted in Karachi from January to August 2012. Two medical universities--one each from public and private sectors--were selected using non-probability convenience sampling technique. Fourth year medical students present at the time of data collection were included in the study. Data collection was done by Knowledge About Childhood Autism Among Health Worker questionnaire from fourth year medical students. Data was analysed using SPSS 20. Of the 157 students in the study, 62(39.6%) were males and 95(60.4%) were females; 84(43.5%) were from public medical university and 73(46.5%) were from private university. Total mean score obtained out of the maximum 25 was 12.30±4.71. The mean score obtained by public medical students was 12.40±4.69 and 12.1±4.76 by those of private university. The scores reflected shortcoming in knowledge about childhood autism among the study population. In order to bridge knowledge deficit, awareness-generation activities must be held more frequently.

  4. Knowledge, perceptions and myths regarding infertility among selected adult population in Pakistan: a cross-sectional study

    PubMed Central

    2011-01-01

    Background The reported prevalence of infertility in Pakistan is approximately 22% with 4% primary and 18% secondary infertility. Infertility is not only a medical but also a social problem in our society as cultural customs and perceived religious dictums may equate infertility with failure on a personal, interpersonal, or social level. It is imperative that people have adequate knowledge about infertility so couples can seek timely medical care and misconceptions can be rectified. We aim to assess the knowledge, perception and myths regarding infertility and suggest ways to improve it. Methods A cross-sectional survey was carried out by interviewing a sample of 447 adults who were accompanying the patients at two tertiary care hospitals in Karachi, Pakistan. They were interviewed one-on-one with the help of a pretested questionnaire drafted by the team after a thorough literature review and in consultation with infertility specialists. Results The correct knowledge of infertility was found to be limited amongst the participants. Only 25% correctly identified when infertility is pathological and only 46% knew about the fertile period in women's cycle. People are misinformed that use of IUCD (53%) and OCPs (61%) may cause infertility. Beliefs in evil forces and supernatural powers as a cause of infertility are still prevalent especially amongst people with lower level of education. Seeking alternative treatment for infertility remains a popular option for 28% of the participant as a primary preference and 75% as a secondary preference. IVF remains an unfamiliar (78%) and an unacceptable option (55%). Conclusions Knowledge about infertility is limited in the population and a lot of misconceptions and myths are prevalent in the society. Alternative medicine is a popular option for seeking infertility treatment. The cultural and religious perspective about assisted reproductive technologies is unclear, which has resulted in its reduced acceptability. PMID:21970548

  5. Knowledge, perceptions and myths regarding infertility among selected adult population in Pakistan: a cross-sectional study.

    PubMed

    Ali, Sumera; Sophie, Raafay; Imam, Ayesha M; Khan, Faisal I; Ali, Syed F; Shaikh, Annum; Farid-ul-Hasnain, Syed

    2011-10-04

    The reported prevalence of infertility in Pakistan is approximately 22% with 4% primary and 18% secondary infertility. Infertility is not only a medical but also a social problem in our society as cultural customs and perceived religious dictums may equate infertility with failure on a personal, interpersonal, or social level. It is imperative that people have adequate knowledge about infertility so couples can seek timely medical care and misconceptions can be rectified. We aim to assess the knowledge, perception and myths regarding infertility and suggest ways to improve it. A cross-sectional survey was carried out by interviewing a sample of 447 adults who were accompanying the patients at two tertiary care hospitals in Karachi, Pakistan. They were interviewed one-on-one with the help of a pretested questionnaire drafted by the team after a thorough literature review and in consultation with infertility specialists. The correct knowledge of infertility was found to be limited amongst the participants. Only 25% correctly identified when infertility is pathological and only 46% knew about the fertile period in women's cycle. People are misinformed that use of IUCD (53%) and OCPs (61%) may cause infertility. Beliefs in evil forces and supernatural powers as a cause of infertility are still prevalent especially amongst people with lower level of education. Seeking alternative treatment for infertility remains a popular option for 28% of the participant as a primary preference and 75% as a secondary preference. IVF remains an unfamiliar (78%) and an unacceptable option (55%). Knowledge about infertility is limited in the population and a lot of misconceptions and myths are prevalent in the society. Alternative medicine is a popular option for seeking infertility treatment. The cultural and religious perspective about assisted reproductive technologies is unclear, which has resulted in its reduced acceptability.

  6. Application of solar disinfection for treatment of contaminated public water supply in a developing country: field observations.

    PubMed

    Mustafa, Atif; Scholz, Miklas; Khan, Sadia; Ghaffar, Abdul

    2013-03-01

    A sustainable and low-cost point-of-use household drinking water solar disinfection (SODIS) technology was successfully applied to treat microbiologically contaminated water. Field experiments were conducted to determine the efficiency of SODIS and evaluate the potential benefits and limitations of SODIS under local climatic conditions in Karachi, Pakistan. In order to enhance the efficiency of SODIS, the application of physical interventions were also investigated. Twenty per cent of the total samples met drinking water guidelines under strong sunlight weather conditions, showing that SODIS is effective for complete disinfection under specific conditions. Physical interventions, including black-backed and reflecting rear surfaces in the batch reactors, enhanced SODIS performance. Microbial regrowth was also investigated and found to be more controlled in reactors with reflective and black-backed surfaces. The transfer of plasticizer di(2-ethylhexyl)phthalate (DEHP) released from the bottle material polyethylene terephthalate (PET) under SODIS conditions was also investigated. The maximum DEHP concentration in SODIS-treated water was 0.38 μg/L less than the value of 0.71 μg/L reported in a previous study and well below the WHO drinking-quality guideline value. Thus SODIS-treated water can successfully be used by the people living in squatter settlements of mega-cities, such as Karachi, with some limitations.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    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 andmore » 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.« less

  8. Head Teachers and Teachers as Pioneers in Facilitating Dyslexic Children in Primary Mainstream Schools

    ERIC Educational Resources Information Center

    Jaka, Fahima Salman

    2015-01-01

    This study explores the perceptions of school heads and teachers in facilitating young dyslexic children in primary mainstream schools of Pakistan. Through purposive sampling, the researcher selected eight participants: Four primary school heads and four primary teachers from elite schools of Karachi. The research instrument selected for this…

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    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 gasmore » 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.« less

  10. Identification of measles virus genotype B3 associated with outbreaks in Islamabad, Pakistan, 2013-2015.

    PubMed

    Zaidi, Syed Sohail Zahoor; Hameed, Abdul; Suleman Rana, Muhammad; Alam, Muhammad Masroor; Umair, Massab; Aamir, Uzma Bashir; Hussain, Maqbool; Sharif, Salmaan; Shaukat, Shahzad; Angez, Mehar; Khurshid, Adnan

    2017-11-09

    Measles virus infection remains a significant cause of childhood mortality and morbidity despite continued global efforts and the availability of a safe and effective vaccine. Molecular analysis of indigenous measles viruses could provide critical information on outbreak linkages and transmission pathways that can aid the implementation of appropriate control programs in Pakistan. Blood samples and throat swabs were collected from subjects suspected with measles in Islamabad, Pakistan from 2013 to 2015. Serum samples were tested for the presence of measles immunoglobulin M (IgM) antibodies using enzyme-linked immunosorbent assay (ELISA) while throat swabs were used for the isolation (Vero/SLAM cell line) and subsequent characterization and phylogenetic analysis of measles strains. Of 373 blood samples, 66% tested positive for measles IgM. Male subjects were more often infected (58%) than female (42%) with the highest frequency of positive cases (63%) in the 0-5-years age group. Among the positive cases, only 13% had received one or two doses of the measles vaccine, while 87% were unvaccinated. Of 80 throat swabs, 29 (36%) showed a measles virus-specific cytopathic effect (CPE) and were characterized as genotype B3 through partial sequencing of the nucleoprotein (N) gene. Phylogenetic analysis revealed the Pakistani B3 strains to be closely related to strains from neighboring countries (Iran and Afghanistan) as well as with B3 viruses from the USA, Germany, and the UK. The study results showed that despite the availability of an effective vaccine, the burden of measles infections is very high in Pakistan due to poor routine immunization coverage even in major cities, including the capital city of Islamabad. It is imperative that national health authorities take urgent strategic steps to improve routine immunization and implement adequate molecular identification methods to tackle future measles outbreaks. Copyright © 2017 The Authors. Published by Elsevier Ltd

  11. Islamic Republic of Pakistan: A Study of the Educational System of Pakistan and a Guide to the Academic Placement of Students from Pakistan in Educational Institutions of the United States.

    ERIC Educational Resources Information Center

    Sweeney, Leo J.

    Written as a guide to be used in the admission and placement of students from Pakistan in U.S. institutions of higher education, this study discusses the education system of Pakistan. The first four chapters contain a summary of the development of Pakistan. These are followed by guidelines and suggestions for admissions officers and admissions and…

  12. Frequency of JAK2 V617F mutation in patients with Philadelphia positive Chronic Myeloid Leukemia in Pakistan

    PubMed Central

    Tabassum, Najia; Saboor, Mohammed; Ghani, Rubina; Moinuddin, Moinuddin

    2014-01-01

    Background and Objective: Co-existence of myeloproliferative disorders (MPD) and Janus associated kinase 2 mutation (JAK2 V617F) is a well-established fact. Only few case reports are available showing presence of JAK2 V617F mutation in chronic myeloid leukemia (CML). Purpose of this study was to determine the frequency of JAK2 V617F mutation in Philadelphia Chromosome positive (Ph +) CML patients in Pakistan. Methods: The study was conducted from August 2009 to July 2010 at Civil Hospital and Baqai Institute of Hematology (BIH) Karachi. Blood samples from 25 patients with CML were collected. Multiplex reverse transcription polymerase chain reaction (RT-PCR) was performed for Breakpoint Cluster Region – Abelson (BCR-ABL) rearrangement. Conventional PCR was performed for JAK2 V617F mutation on BCR-ABL positive samples. Results: All 25 samples showed BCR-ABL rearrangement. Out of these 11 samples (44%) had JAK2 V617F mutation; the remaining 14 (56%) cases showed JAK2 617V wild type. Conclusion: It is concluded that the co-existence of Ph +CML and JAK2 V617F mutation is possible. PMID:24639858

  13. Panel Analyzes Pakistan's Internal Water Concerns

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2013-06-01

    Although transboundary water issues between Pakistan and neighboring countries may be exciting and interesting, Pakistan's real water and security nexus is at the local level, according to Daanish Mustafa, coauthor of a new report, "Understanding Pakistan's Water-Security Nexus." Mustafa, a reader in politics and environment at King's College, London, U.K., was a panelist at a 30 May forum in Washington, D. C., sponsored by the United States Institute of Peace, which published the report.

  14. Identifying Core Vocabulary for Urdu Language Speakers Using Augmentative Alternative Communication

    ERIC Educational Resources Information Center

    Mukati, Abdul Samad

    2013-01-01

    The purpose of this research is to identify a core set of vocabulary used by native Urdu language (UL) speakers during dyadic conversation for social interaction and relationship building. This study was conducted in Karachi, Pakistan at an institution of higher education. This research seeks to distinguish between general (nonspecific…

  15. Language Ideologies in a Business Institute: A Case Study of Linguistic and Socio-Cultural Realities

    ERIC Educational Resources Information Center

    Sikandar, Aliya; Hussain, Nasreen

    2014-01-01

    This case study explored the English language related ideologies of different management groups and student representatives at a business school of Karachi, Pakistan. The study tried to bring an insider's perspective to the causes of certain language ideologies prevalent in the business school's social structure, and the role language played in…

  16. Studies on battery repair and recycling workers occupationally exposed to lead in Karachi.

    PubMed

    Haider, Muhammad Jamal; Qureshi, Naeemullah

    2013-01-01

    OBJECTIVE. The present study was carried out to investigate the effects of occupational lead exposure on the hematological and biochemical parameters in occupationally exposed and non exposed inhabitants of Karachi. MATERIAL AND METHODS. In 100 lead exposed subjects recruited from automobile workshops, lead battery repair and recycling units located in Karachi and in 100 control subjects the general health status, hematological parameters and exposure markers for lead were measured. RESULTS. Results indicated that the mean values of blood lead level and delta-aminolevulinic acid were significantly higher (P<0.05) while the activity of delta-aminolevulinic acid dehydratase were significantly decreased (P<0.05) among battery repair and recycling workers as compared to controls. The abnormalities in the blood lead level, delta-aminolevulinic acid and delta-aminolevulinic acid dehydratase were more frequent in lead exposed battery repair workers when compared with control subjects. The blood lead levels and deltaaminolevulinic acid were positively correlated while delta-aminolevulinic acid dehydratase was found to be negatively correlated with age, years of exposure and years of employment. Blood lead level was positively correlated with hemoglobin and RBC count while delta-aminolevulinic acid dehydratase was negatively correlated with hemoglobin concentration. The work related symptoms, droopiness, nasal symptoms and muscular pain were more frequent among battery repair workers as compared to control group. The findings of present study confirmed that occupational exposure to lead is associated with deviation in important hematological parameters and biological markers of exposure to lead among lead exposed workers, and also confirms the impact of lead exposure in the development of adverse effects among lead exposed workers. The study provides the data for risk assessment in lead battery repair workers of Karachi and suggests the need for preventive measures for

  17. Schools as potential vaccination venue for vaccines outside regular EPI schedule: results from a school census in Pakistan.

    PubMed

    Soofi, Sajid Bashir; Haq, Inam-Ul; Khan, M Imran; Siddiqui, Muhammad Bilal; Mirani, Mushtaq; Tahir, Rehman; Hussain, Imtiaz; Puri, Mahesh K; Suhag, Zamir Hussain; Khowaja, Asif R; Lasi, Abdul Razzaq; Clemens, John D; Favorov, Michael; Ochiai, R Leon; Bhutta, Zulfiqar A

    2012-01-06

    Vaccines are the most effective public health intervention. Expanded Program on Immunization (EPI) provides routine vaccination in developing countries. However, vaccines that cannot be given in EPI schedule such as typhoid fever vaccine need alternative venues. In areas where school enrolment is high, schools provide a cost effective opportunity for vaccination. Prior to start of a school-based typhoid vaccination program, interviews were conducted with staff of educational institutions in two townships of Karachi, Pakistan to collect baseline information about the school system and to plan a typhoid vaccination program. Data collection teams administered a structured questionnaire to all schools in the two townships. The administrative staff was requested information on school fee, class enrolment, past history of involvement and willingness of parents to participate in a vaccination campaign. A total of 304,836 students were enrolled in 1,096 public, private, and religious schools (Madrasahs) of the two towns. Five percent of schools refused to participate in the school census. Twenty-five percent of schools had a total enrolment of less than 100 students whereas 3% had more than 1,000 students. Health education programs were available in less than 8% of public schools, 17% of private schools, and 14% of Madrasahs. One-quarter of public schools, 41% of private schools, and 43% of Madrasahs had previously participated in a school-based vaccination campaign. The most common vaccination campaign in which schools participated was Polio eradication program. Cost of the vaccine, side effects, and parents' lack of information were highlighted as important limiting factors by school administration for school-based immunization programs. Permission from parents, appropriateness of vaccine-related information, and involvement of teachers were considered as important factors to improve participation. Health education programs are not part of the regular school curriculum

  18. Intellectual wellness awareness: a neglected area in medical universities of Pakistan.

    PubMed

    Naz, Ayesha Saba; Rehman, Rehana; Katpar, Shah Jahan; Hussain, Mehwish

    2014-09-01

    To compare the presence of intellectual wellness awareness in students of public and private sector medical colleges in a metropolitan city. The cross-sectional questionnaire-based survey was conducted from March to November 2011 at Bahria University Medical and Dental College, Karachi, and overall covered five private and 3 public sector medical colleges of the city.The study randomly selected 800 medical students.The responses - never, sometimes, mostly and always (numbered 0-4)--were analysed in terms of frequency, proportion and percentages using Predictive Analysis Software version 18. Of the 800 forms distributed, 736 (92%) completed forms were analysed. Among the respondents, 526 (71.5%) were females. Besides, 450 (61%) belonged to private medical colleges and 236 (39) were from public medical colleges. The participants of private medical colleges had taken part in intellectual discussions actively compared to those from public colleges (p < 0.001). Habit of reading books to acquire knowledge was found in 126 (44%) private college students compared to 149 (33%) in public colleges (p < 0.004). The importance of creative mental activities (p = 0.954) and current information about local and international affairs (p < 0.564) was deficient in both sets of students. Students of private medical colleges were better in terms of presence of intellectual wellness awareness, took active participation in class discussions, had good reading habits and carefully selected television programmes and movies.

  19. Pakistan needs to speed up its human immunodeficiency virus control strategy to achieve targets in fast-track acquired immune deficiency syndrome response.

    PubMed

    Waheed, Yasir; Waheed, Hasnain

    2017-05-12

    In last fifteen years remarkable success in the fight against human immunodeficiency virus (HIV) is achieved globally. The number of HIV infections has decreased and the number of people on antiretroviral therapy is increased. This all is possible by strong political commitments and heavy investments in the fight against HIV. Pakistan is among few Asian countries in which HIV cases are increasing year by year since 1990. There are 94000 cases of HIV in Pakistan and only 14000 are registered with government. The main source of HIV infection in Pakistan is the use of contaminated injection equipment among people who inject drugs (PWID). The overall prevalence of HIV among PWID in Pakistan is 27.2%. There are five cities in Pakistan in which HIV prevalence is above 40% in PWIDs. In June 2016, United Nations political declaration on acquired immune deficiency syndrome (AIDS) provided a global mandate to fast-track the AIDS response over the next five years to achieve the targets in Sustainable Development Goals. To achieve the targets in fast-track AIDS response, the global leaders showed strong commitments to invest $ 26 billion per year by 2020. Pakistan needs to speed up its HIV control program. There is a dire need to locate all HIV positive people and enroll them in the treatment program. Pakistan also needs to calculate exact number of people living with HIV, increase HIV treatment centers and increase HIV awareness. Recently, Global Fund invested handsome money in the fight against HIV. Let's hope the country will have effective HIV control strategy to achieve the HIV elimination target by 2030.

  20. Depression in the elderly: Does family system play a role? A cross-sectional study

    PubMed Central

    Taqui, Ather M; Itrat, Ahmed; Qidwai, Waris; Qadri, Zeeshan

    2007-01-01

    Background The most common geriatric psychiatric disorder is depression. The role of family systems in depression among the elderly has not been studied extensively. It has been suggested that urbanization promotes nucleation of family systems and a decrease in care and support for the elderly. We conducted this study in Karachi, a large urban city of Pakistan, to determine the relationship between the type of family system and depression. We also determined the prevalence of depression in the elderly, as well as correlation of depression with other important socio-demographic variables. Methods A cross-sectional study was carried out in the premises of a tertiary care hospital in Karachi, Pakistan. Questionnaire based interviews were conducted among the elderly people visiting the hospital. Depression was assessed using the 15-item Geriatric Depression Scale. Results Four hundred subjects aged 65 and above were interviewed. The age of majority of the subjects ranged from 65 to 74 years. Seventy eight percent of the subjects were male. The prevalence of depression was found to be 19.8%. Multiple logistic regression analysis revealed that the following were significant (p < 0.05) independent predictors of depression: nuclear family system, female sex, being single or divorced/widowed, unemployment and having a low level of education. The elderly living in a nuclear family system were 4.3 times more likely to suffer from depression than those living in a joint family system (AOR = 4.3 [95% CI = 2.4–7.6]). Conclusion The present study found that residing in a nuclear family system is a strong independent predictor of depression in the elderly. The prevalence of depression in the elderly population in our study was moderately high and a cause of concern. The transition in family systems towards nucleation may have a major deleterious effect on the physical and mental health of the elderly. PMID:17961255

  1. Serious fungal infections in Pakistan.

    PubMed

    Jabeen, K; Farooqi, J; Mirza, S; Denning, D; Zafar, A

    2017-06-01

    The true burden of fungal infection in Pakistan is unknown. High-risk populations for fungal infections [tuberculosis (TB), diabetes, chronic respiratory diseases, asthma, cancer, transplant and human immunodeficiency virus (HIV) infection] are numerous. Here, we estimate the burden of fungal infections to highlight their public health significance. Whole and at-risk population estimates were obtained from the WHO (TB), BREATHE study (COPD), UNAIDS (HIV), GLOBOCAN (cancer) and Heartfile (diabetes). Published data from Pakistan reporting fungal infections rates in general and specific populations were reviewed and used when applicable. Estimates were made for the whole population or specific populations at risk, as previously described in the LIFE methodology. Of the 184,500,000 people in Pakistan, an estimated 3,280,549 (1.78%) are affected by a serious fungal infection, omitting all cutaneous infection, oral candidiasis and allergic fungal sinusitis, which we could not estimate. Compared with other countries, the rates of candidaemia (21/100,000) and mucormycosis (14/100,000) are estimated to be very high, and are based on data from India. Chronic pulmonary aspergillosis rates are estimated to be high (39/100,000) because of the high TB burden. Invasive aspergillosis was estimated to be around 5.9/100,000. Fungal keratitis is also problematic in Pakistan, with an estimated rate of 44/100,000. Pakistan probably has a high rate of certain life- or sight-threatening fungal infections.

  2. A Pragmatic LDI Operational Network Model for Pakistan

    NASA Astrophysics Data System (ADS)

    Sheikh, Roshan; Mirza, Zahir Abbas

    2008-10-01

    This paper describes some common components of contemporary designs for the Long Distance & International (LDI) License in Pakistan and identifies critical aspects needed to implement a commercial LDI network in any developing country like Pakistan. An extensive study is carried out to evaluate various methods through which a carrier can receive and transmit voice traffic and identify their respective merits and demerits. Deficiencies which can harm the growth of telecom market in Pakistan and which require redress by the Pakistan Telecommunication Authority (PTA) are highlighted. A pragmatic model is proposed which takes into consideration, the constraints of Pakistan Telecommunication market. The paper concludes that the proposed model be incorporated with specific suggestions and economic justifications.

  3. Roundtable. Women's magazines under the guise of being frank about sexual problems are sensationalizing them to boost readership.

    PubMed

    Khawar, H

    1995-01-01

    Women's magazines in Pakistan edit their content to avoid matters related to female sexuality. Instead, they focus on fashion, child care, general health, and social problems. Only a few stories have emerged about sex clinics in Karachi, the covert homosexual culture, and exploits of well-known people. This reticence makes the dissemination of information about contraception and AIDS difficult. Even the cover models on the magazines must appear clothed in a manner deemed proper. Foreign magazines are available in Pakistan, but they cost more than the local publications.

  4. Determination of gamma-emitting radionuclides in the inter-tidal sediments off Balochistan (Pakistan) Coast, Arabian Sea.

    PubMed

    Akram, M; Qureshi, Riffat M; Ahmad, Nasir; Solaija, Tariq Jamal

    2007-01-01

    Natural radionuclide contents of 226Ra, 228Ra and (40)K were studied for inter-tidal sediments collected from selected locations off the745 km long Balochistan Coast using HPGe detector based gamma-spectrometry system. The sampling zone extends from the beaches of Sonmiani (near Karachi metropolis) through Jiwani (close to the border of Iran). The natural radioactivity levels detected in various sediment samples range from 14.4 +/- 2.5 to 36.6 +/- 3.8 Bq kg(-1) for 226Ra, 9.8 +/- 1.2 to 35.2 +/- 2.0 Bq kg(-1) for (228)Ra and 144.6 +/- 9.4 to 610.5 +/- 23.9 Bq kg(-1) for (40)K. No artificial radionuclide was detected in any of the marine coastal sediment samples. 137Cs, (60)Co, 106Ru and 144Ce contents in sediment samples were below the limit of detection. The measured radioactivity levels are compared with those reported in the literature for coastal sediments in other parts of the world. The information presented in this paper will serve as the first ever local radioactivity database for the Balochistan/Makran Coastal belt of Pakistan. The presented data will also contribute to the IAEA's, Asia-Pacific Marine Radioactivity Database (ASPAMARD) and the Global Marine Radioactivity Database (GLOMARD).

  5. Religious Extremism in Pakistan

    DTIC Science & Technology

    2014-12-01

    selected ROs in Pakistan have adopted extreme views due to the political and social context in the country. They then use this socio-economic link to...political and social context in the country. They then use this socio-economic link to indoctrinate citizens with extremist ideologies, thus creating a...Pakistan Support to Recovery and Rehabilitation of Basic Social Services for the Earthquake-Affected Population 2007‒2008,” UNICEF, 1 September 2007

  6. Human Resource Management Strategies and Teacher's Efficiency within Schools: A Co-Relational Study

    ERIC Educational Resources Information Center

    Hashmi, Kiran

    2014-01-01

    The aim of the paper is to study Human Resource Management and Development (HRMD) strategies and their effect on teachers' efficiency within the Catholic Board of Education (CBE) schools of Pakistan whose teachers are graduates in educational leadership courses from a private teacher education institutes in Karachi. The study endeavored to build a…

  7. Eradication of dracunculiasis from Pakistan.

    PubMed

    Hopkins, D R; Azam, M; Ruiz-Tiben, E; Kappus, K D

    1995-09-02

    In 1986 the World Health Organization targeted dracunculiasis (Guinea-worm disease), which seriously impairs socioeconomic development in 16 African countries, India, Pakistan, and Yemen, to be eradicated globally. The target date for eradication by the end of 1995 was established in 1991. Pakistan eradicated dracunculiasis from the country in October, 1993, after a national campaign which began in 1987 with a nationwide village-by-village search for cases. The infection, which is transmitted by drinking water from ponds containing infected water fleas, was eradicated by using health education, cloth filters, and the cyclopsicide, temephos; and in the later stages, by case containment. Methods pioneered in Pakistan's National Guinea Worm Eradication Program are now being applied in remaining endemic countries.

  8. Socio-demographic correlates of exhaled breath carbon monoxide in Karachi's adult population.

    PubMed

    Shafiq, Majid; Khan, Sumera; Khawaja, M Rizwanulhaq; Haque, Suleman; Khan, Javaid A

    2008-02-01

    To examine the relationship between CO levels and putative factors including smoking status among residents of Karachi, an urban center with very high levels of air pollution. Two hundred and eighteen volunteering subjects were asked to maximally exhale into a Smokerlyzer breath CO analyzer. Each of the volunteers was also asked to reply to a questionnaire-based interview seeking demographic information as well as details of exposure to tobacco, traffic fumes and other air pollutants. Out of the 218 participating subjects, 75% were males and 27% were current or ex-smokers. The mean CO level was 2.92 parts per million (ppm). Cigarette smoking was the only factor found to influence CO levels. Number of cigarettes smoked per day was directly related to CO levels, while time since the last smoke was inversely related. There was no difference in CO levels between ex-smokers and never-been-smokers. Years of residence in Karachi, quantitative exposure to traffic and perception of occupational exposure to air pollutants were not associated with CO levels. Smoking status, number of cigarettes smoked per day and time since last smoke correlated well with exhaled breath CO levels, in spite of high air pollution levels. This tool therefore continues to provide a valid and real-time assessment of a subject's current smoking status.

  9. Sociodemographic factors associated with IgG and IgM seroprevalence for human cytomegalovirus infection in adult populations of Pakistan: a seroprevalence survey.

    PubMed

    Ibrahim, Saira; Siddiqui, Anwar A; Siddiqui, Amna R; Ahmed, Waquaruddin; Moss, Paul A H; Lalani, El-Nasir M A

    2016-10-22

    The seroprevalence of human cytomegalovirus (HCMV) infection ranges from 30 to 90 % in developed countries. Reliable estimates of HCMV seroprevalence are not available for Pakistan. This study determined the seroprevalence and sociodemographic factors associated with HCMV infection in adult populations of Karachi, Pakistan. A seroprevalence survey was conducted on 1000 adults, including residents of two semi-urban communities, and visitors to a government and a private hospital. Questionnaire-based interviews were conducted. Sera were analysed for HCMV-specific IgG and IgM. Chi-square or Fisher's exact test was used for comparing sociodemographic variables against seropositivity of HCMV-IgG or IgM. Multiple logistic regression modeling was performed for IgG seroprevalence and adjusted odds ratios were computed. The seroprevalence of HCMV-IgG and IgM was 93.2 and 4.3 % respectively. 95.3 % of individuals who were IgM seropositive were also seropositive for IgG. Around 6 % (15/250) of women of childbearing age remained uninfected and were therefore susceptible to primary infection. HCMV-IgG seroprevalence was associated with being female (p = 0.001), increasing age (p = 0.002) and crowding index (p = 0.003) and also with lower levels of both education (p < 0.001) and income (p = 0.008). Seroprevalence also differed significantly by marital status (p = 0.008) and sampling location (p < 0.001). A logistic regression model for HCMV-IgG seroprevalence showed associations with being female (OR = 1.89; 95 % CI: 1.10-3.25), increasing age (OR = 3.95; 95 % CI: 1.79-8.71) and decreasing income (OR = 0.72; 95 % CI: 0.54-0.96). A strong association was observed between increased seroprevalence of HCMV-IgM and decreasing household size (p = 0.008). Seroprevalence of HCMV is very high in Pakistan, although 6 % of women of childbearing age remain at risk of primary infection. The IgM seropositivity observed in some individuals

  10. Progress toward poliomyelitis eradication--Afghanistan and Pakistan, 2008.

    PubMed

    2009-03-06

    Afghanistan and Pakistan, two of the four remaining countries where wild poliovirus (WPV) transmission has never been interrupted, represent one epidemiologic reservoir. During 2008, both countries continued to conduct coordinated supplemental immunization activities (SIAs) against type 1 WPV (WPV1) and type 3 WPV (WPV3) using oral polio vaccine (OPV). Much of Afghanistan remained polio-free in 2008, with the exception of the conflict-affected South Region. In Pakistan, however, WPV transmission increased, particularly after WPV1 reintroduction into polio-free areas of Punjab Province. In total, 149 WPV cases (31 in Afghanistan and 118 in Pakistan) were confirmed in 2008, compared with 49 cases in 2007. Serious security problems in areas along the common border limited access by vaccination teams to large numbers of children in the two countries. In Pakistan, continued managerial and operational problems impeded full implementation of SIAs and adversely affected vaccination coverage in areas not affected by security problems. This report updates previous reports and describes polio eradication activities in Afghanistan and Pakistan during January--December 2008. Further progress toward interruption of WPV transmission in Afghanistan and Pakistan will require continued measures to overcome access problems in conflict-affected areas of both countries and improvements in the quality of SIAs and delivery of routine immunization services in Pakistan.

  11. Elucidating the urban levels, sources and health risks of polycyclic aromatic hydrocarbons (PAHs) in Pakistan: Implications for changing energy demand.

    PubMed

    Hamid, Naima; Syed, Jabir Hussain; Junaid, Muhammad; Mahmood, Adeel; Li, Jun; Zhang, Gan; Malik, Riffat Naseem

    2018-04-01

    Due to the severe fuel crisis in terms of natural gas, a paradigm shift in fuel combustion (diesel, gasoline, and biomass) may increase the atmospheric emissions and associated health risks in Pakistan. Present study was aimed to investigate the concentration of fugitive PAHs in the environment (outdoor and indoor settings), associated probabilistic health risk assessment in the exposed population, and possible linkage between fuel consumption patterns and PAHs emissions in twin cities (Rawalpindi and Islamabad) of Pakistan. Results showed that the mean PAHs concentrations (air: 2390pgm -3 ; dust: 167ngg -1 ) in the indoor environment were higher than that of the outdoor environment (air: 2132pgm -3 ; dust: 90.0ngg -1 ). Further, the source apportionment PCA-MLR receptor model identified diesel and gasoline combustion as the primary PAHs sources in the urban and sub-urban settings. Estimated life cancer risk (LCR) potential via inhalation to indoor PAHs was higher with a probability of 2.0 cases per 10,000 inhabitants as compared to outdoor exposure. Incremental lifetime cancer risk (ILCR) model from exposure to dust bound PAHs showed risk in the order of ingestion>dermal>inhalation for various exposure pathways. Likewise, estimated daily intake (EDI) model reflects that PAHs in surface dust enter into the human body mainly through the respiratory system because EDI for breathing was reported higher than that of oral intake. Therefore, adoption of sustainable fuels is recommended to meet the energy requirements and to reduce PAHs emissions and related health risks in the twin cities of Pakistan. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Population and population policy in Pakistan.

    PubMed

    Mauldin, W P

    1963-02-01

    Pakistan is a divided country with different religious groups represented. Since independence in 1941, the Muslim population has increased more rapidly than the Hindu population, the West Pakistan population more rapidly and steadily than the East Pakistan population. In the late 1950s the Pakistan government initiated a family planning program. The program has trained medical and paramedical personnel in family planning, added family planning services to existing medical centers, planned for a National Research Institute of Family Planning, employed mobile units to reach outlying areas, conducted limited clinical studies on some contraceptives, and used mass media advertising. Only India and Japan are doing more with government-sponsored family planning. A weak organizational structure and an inadequate number of trained personnel are the main weakness of the program. It is too early to assess the success of the program. A 10-point reduction in annual birth rates will be considered successful.

  13. Assessment of knowledge, attitudes and practices towards newborn screening for congenital hypothyroidism before and after a health education intervention in pregnant women in a hospital setting in Pakistan.

    PubMed

    Tariq, Batha; Ahmed, Ayesha; Habib, Atif; Turab, Ali; Ali, Noshad; Soofi, Sajid Bashir; Nooruddin, Shanila; Kumar, Rekha J; Tariq, Amin; Shaheen, Fariha; Ariff, Shabina

    2018-03-01

    Most congenital hypothyroidism (CH) is not avertable; however, the adverse effects of CH are preventable with early detection and treatment. It is a common congenital endocrine disorder that affects 1 in 2000-4000 newborns globally. The true incidence in Pakistan is unknown. Data from hospital studies quote an incidence of 1 in 1600-2000. The aim of this study was to uncover existing knowledge of CH and screening for the condition and to assess the impact of health education on mothers' knowledge and attitudes towards having their newborns screened. The study was conducted from January 2012 to August 2013 at a local hospital in Karachi, Pakistan. This was a prospective, interventional cohort study implemented through a pre- and post-cross-sectional knowledge, attitudes and practices (KAP) survey. Interviews were conducted using structured questionnaires on CH. At baseline (pre-intervention survey), 400 participants consented and 355 (88.9%) completed the study. There was a significant increase in awareness among participating women following the intervention (20% to approximately 98%). Similarly, 78.9% agreed to opt for a screening test for their newborns following delivery as compared with 57.7% in the pre-intervention KAP survey (relative risk 1.38, p-value <0.0001). Unfortunately, the majority of mothers were unaware of CH and its implications, leading to less screening and fewer diagnoses. This study underlines the importance of education in screening programmes to create awareness and maximize uptake.

  14. Impact of CNG Crisis on Student's Academic Life

    ERIC Educational Resources Information Center

    Azeem, Kiran; Nadeem, Wajiha; Zia, Afsa; Shehzad, Shiza; Anwar, Zara

    2017-01-01

    The goal of this study is to determine the impact of Compressed Natural Gas (CNG) crisis on Student's Academic Life of Karachi Pakistan. This research helps in observing the behavior of students and their educational progress includes depression and anxiety, rate of absenteeism and undesirable results in exams threatens due to CNG crisis and…

  15. Student Behavior Management: School Leader's Role in the Eyes of the Teachers and Students

    ERIC Educational Resources Information Center

    Nooruddin, Shirin; Baig, Shariffullah

    2014-01-01

    This study explored the perspectives and viewpoints of the teachers and students in relation to the influence of the head teacher and senior leadership team on students' behavior management in the form of policies, procedures and support mechanisms in a secondary school in Karachi Pakistan. Two surveys were developed and employed, one for the…

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Olson, Jarrod; Kurzrok, Andrew J.; Hund, Gretchen

    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 themore » 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.« less

  17. Pakistan combats hidden AIDS menace.

    PubMed

    1996-05-20

    The conservative Islamic society in Pakistan associates human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS) with prostitution, homosexuality, and drug abuse, activities which are prohibited in Pakistan. There are 1000 reported cases of HIV, 55 with advanced AIDS (53 have died) in Pakistan. Birjees Mazhar Kazi, head of the National AIDS Program, believes that, based on the computer model of the World Health Organization (WHO), the number of HIV cases in Pakistan can be 50,000 to 80,000. Prime Minister Benazir Bhutto's government has allocated $2 million for AIDS prevention. Although some officials argue that Islamic strictures and traditional social pressures discourage sexual license, the poor public health and education standards in Pakistan make it vulnerable to AIDS. Drug abuse has risen in the last 20 years; there are an estimated 1.5 million heroin users among an estimated 3 million addicts. According to Health Ministry Director General Naik Muhammad Shaikh, the government has established 30 HIV/AIDS screening centers and is sponsoring a law that would require all blood banks to provide only safe blood and blood products for transfusion. Marvi states that the reuse and poor disposal of needles, a common practice in Pakistan, could be responsible for most of the transmission there of AIDS and hepatitis C. Health experts acknowledge the obstacles placed in the way of AIDS awareness campaigns by sex taboos and religious sensitivities; condoms cannot be mentioned or displayed in shops, or used in electronic or print media campaigns. They can be mentioned in a recorded message on a 24-hr AIDS hotline. Community-based and nongovernmental organizations are being used to reach segments of society who cannot use the hotline. Eunuchs (hijras), who are much in demand as "female" entertainers at weddings, are particularly resistant to safe sex messages, according to Abid Atiq, head of the information and education section of the

  18. Brief psychological intervention after self-harm: randomised controlled trial from Pakistan.

    PubMed

    Husain, Nusrat; Afsar, Salahuddin; Ara, Jamal; Fayyaz, Hina; Rahman, Raza Ur; Tomenson, Barbara; Hamirani, Munir; Chaudhry, Nasim; Fatima, Batool; Husain, Meher; Naeem, Farooq; Chaudhry, Imran B

    2014-06-01

    Self-harm is a major risk factor for completed suicide. To determine the efficacy of a brief psychological intervention - culturally adapted manual-assisted problem-solving training (C-MAP) - delivered following an episode of self-harm compared with treatment as usual (TAU). The study was a randomised controlled assessor-masked clinical trial (trial registration: ClinicalTrials.gov NCT01308151). All patients admitted after an episode of self-harm during the previous 7 days to the participating medical units of three university hospitals in Karachi, Pakistan, were included in the study. A total of 250 patients were screened and 221 were randomly allocated to C-MAP plus treatment as usual (TAU) or to TAU alone. All patients were assessed at baseline, at 3 months (end of intervention) and at 6 months after baseline. The primary outcome measure was reduction in suicidal ideation at 3 months. The secondary outcome measures included hopelessness, depression, coping resources and healthcare utilisation. A total of 108 patients were randomised to the C-MAP group and 113 to the TAU group. Patients in the C-MAP group showed statistically significant improvement on the Beck Scale for Suicide Ideation and Beck Hopelessness Inventory, which was sustained at 3 months after the completion of C-MAP. There was also a significant reduction in symptoms of depression compared with patients receiving TAU. The positive outcomes of this brief psychological intervention in patients attempting self-harm are promising and suggest that C-MAP may have a role in suicide prevention. Royal College of Psychiatrists.

  19. PREFACE: 1st International Conference on Sensing for Industry, Control, Communication & Security Technologies

    NASA Astrophysics Data System (ADS)

    Shuja Syed, Ahmed

    2013-12-01

    The 1st International Conference on Sensing for Industry, Control, Communication & Security Technologies (ICSICCST-2013), took place in Karachi, Pakistan, from 24-26 June 2013. It was organized by Indus University, Karachi, in collaboration with HEJ Research Institute of Chemistry, University of Karachi, Karachi. More than 80 abstracts were submitted to the conference and were double blind-reviewed by an international scientific committee. The topics of the Conference were: Video, Image & Voice Sensing Sensing for Industry, Environment, and Health Automation and Controls Laser Sensors and Systems Displays for Innovative Applications Emerging Technologies Unmanned, Robotic, and Layered Systems Sensing for Defense, Homeland Security, and Law Enforcement The title of the conference, 'Sensing for Industry, Control, Communication & Security Technologies' is very apt in capturing the main issues facing the industry of Pakistan and the world. We believe the sensing industry, particularly in Pakistan, is currently at a critical juncture of its development. The future of the industry will depend on how the industry players choose to respond to the challenge of global competition and opportunities arising from strong growth in the Asian region for which we are pleased to note that the conference covered a comprehensive spectrum of issues with an international perspective. This will certainly assist industry players to make informed decisions in shaping the future of the industry. The conference gathered qualified researchers from developed countries like USA, UK, Sweden, Saudi Arabia, China, South Korea and Malaysia etc whose expertise resulting from the research can be drawn upon to build an exploitable area of new technology that has potential Defense, Homeland Security, and Military applicability. More than 250 researchers/students attended the event and made the event great success as the turnout was 100%. An exceptional line-up of speakers spoke at the occasion. We want

  20. Comparative Analysis of Seasonal Variation in Tropospheric Nitrogen Dioxide over Pakistan and Saudi Arabia

    NASA Astrophysics Data System (ADS)

    Fahim Khokhar, Muhammad; Wagner, Thomas; Jamil, Mohsin

    2016-07-01

    In this study, spatial and temporal distributions of tropospheric NO2 vertical column densities over Pakistan and Saudi Arabia during the time period of 2004-2015 are discussed. Data products from the satellite instrument OMI are used. The results show a large NO2 growth over major cities of both countries, particularly the areas with rapid urbanization. Different seasonal cycles were observed over both countries. Especially, seasonal variation in tropospheric NO2 over Pakistan is largely impacted by the photolysis rate, OH radical and monsoon rains in addition to soil emissions, agriculture fires and other anthropogenic activities. While in the case of Saudi Arabia, the seasonal variation in tropospheric NO2 is completely driven by thermal power generation. Furthermore, different regions of Pakistan exhibited different seasonal trends. In the provinces of Punjab (north-east), Khyber Paktunkhwa (north-west) and Sindh (south-east), NO2 columns are maximum in winter and minimum in summer months while a reversed seasonality was observed in the province of Baluchistan (south-west). We compared the observed Spatio-temporal patterns to existing emission inventories and found that for the most populated provinces the NOx emissions are clearly dominated by anthropogenic sources. In these areas also the strongest positive trends were observed. NOx released from soils and produced by lightning both together contribute about 20% for the provinces of Punjab, Sindh, and Khyber Pakhtunkhwa, while its contribution in Baluchistan is much stronger (~50%). NOx emissions from biomass burning are negligible. This finding can also explain the observed summer maximum in Baluchistan since the highest lightning activity occurs during the Monsoon season. Our comparison also indicates that the inventories of anthropogenic NOx emissions over Pakistan seem to underestimate the true emissions by about a factor of two.

  1. Long term changes of tropospheric Nitrogen Dioxide over Pakistan derived from Ozone Monitoring Instrument (OMI) during the time period of October 2004 to December 2014

    NASA Astrophysics Data System (ADS)

    Murtaza, Rabbia; Fahim Khokhar, Muhammad

    2016-07-01

    Urban air pollution is causing huge number of diseases and deaths annually. Nitrogen dioxide is an important component of urban air pollution and a precursor to particulate matter, ground level ozone, and acid rain. The satellite based measurements of nitrogen dioxide from Ozone Monitoring Instrument (OMI) can help in analyzing spatio temporal variability in ground level concentrations within a large urban area. In this study, the spatial and temporal distributions of tropospheric nitrogen dioxide Vertical Column Densities (VCDs) over Pakistan are presented from 2004 to 2014. The results showed that the winter season is having high nitrogen dioxide levels as compared to summers. The increase can be attributed to the anthropogenic activities especially thermal power generation and traffic count. Punjab is one of the major provinces with high nitrogen dioxide levels followed by Sindh, Khyber Pakhtunkhwa and Balochistan. Six hotspots have been examined in the present study such as Lahore, Islamabad, Karachi, Faisalabad, Okara and Multan. Emissions of nitrogen compounds from thermal power plants and transportation sector represent a significant fraction of the total nitrogen dioxide emissions to the atmosphere.

  2. 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

  3. Spatiotemporal Clustering Analysis of Malaria Infection in Pakistan.

    PubMed

    Umer, Muhammad Farooq; Zofeen, Shumaila; Majeed, Abdul; Hu, Wenbiao; Qi, Xin; Zhuang, Guihua

    2018-06-07

    Despite tremendous progress, malaria remains a serious public health problem in Pakistan. Very few studies have been done on spatiotemporal evaluation of malaria infection in Pakistan. The study aimed to detect the spatiotemporal pattern of malaria infection at the district level in Pakistan, and to identify the clusters of high-risk disease areas in the country. Annual data on malaria for two dominant species ( Plasmodium falciparum , Plasmodium vivax ) and mixed infections from 2011 to 2016 were obtained from the Directorate of Malaria Control Program, Pakistan. Population data were collected from the Pakistan Bureau of Statistics. A geographical information system was used to display the spatial distribution of malaria at the district level throughout Pakistan. Purely spatiotemporal clustering analysis was performed to identify the high-risk areas of malaria infection in Pakistan. A total of 1,593,409 positive cases were included in this study over a period of 6 years (2011⁻2016). The maximum number of P . vivax cases (474,478) were reported in Khyber Pakhtunkhwa (KPK). The highest burden of P . falciparum (145,445) was in Balochistan, while the highest counts of mixed Plasmodium cases were reported in Sindh (22,421) and Balochistan (22,229), respectively. In Balochistan, incidence of all three types of malaria was very high. Cluster analysis showed that primary clusters of P . vivax malaria were in the same districts in 2014, 2015 and 2016 (total 24 districts, 12 in Federally Administered Tribal Areas (FATA), 9 in KPK, 2 in Punjab and 1 in Balochistan); those of P . falciparum malaria were unchanged in 2012 and 2013 (total 18 districts, all in Balochistan), and mixed infections remained the same in 2014 and 2015 (total 7 districts, 6 in Balochistan and 1 in FATA). This study indicated that the transmission cycles of malaria infection vary in different spatiotemporal settings in Pakistan. Efforts in controlling P . vivax malaria in particular need to be

  4. Pakistan's Education Crisis: The Real Story

    ERIC Educational Resources Information Center

    Naviwala, Nadia

    2016-01-01

    Pakistan suffers from an extensive education crisis. Millions of Pakistani children do not attend school, and those that do must deal with absent teachers and poor learning environments, among other challenges. While this crisis is frequently discussed in Pakistan and beyond, it is often misunderstood. This new Wilson Center report, based on…

  5. 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…

  6. Frequency of thyroid incidentalomas in Karachi population.

    PubMed

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

    2014-07-01

    The aim of this study was to determine frequency of thyroid incidentalomas (TI) through ultrasound (US) and its association with age, gender and ethnicities. 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. 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). 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.

  7. Development of agriculture biotechnology in Pakistan.

    PubMed

    Zafar, Yusuf

    2007-01-01

    Agriculture plays an important role in the national economy of Pakistan, where most of the rapidly increasing population resides in rural areas and depends on agriculture for subsistence. Biotechnology has considerable potential for promoting the efficiency of crop improvement, food production, and poverty reduction. Use of modern biotechnology started in Pakistan since 1985. Currently, there are 29 biotech centers/institutes in the country. However, few centers have appropriate physical facilities and trained manpower to develop genetically modified (GM) crops. Most of the activities have been on rice and cotton, which are among the top 5 crops of Pakistan. Biotic (virus/bacterial/insect) and abiotic (salt) resistant and quality (male sterility) genes have already been incorporated in some crop plants. Despite acquiring capacity to produce transgenic plants, no GM crops, either produced locally or imported, have been released in the country. Pakistan is signatory to the World Trade Organization, Convention on Biological Diversity, and Cartagena protocols. Several legislations under the Agreement on Trade-Related Aspects of Intellectual Property Rights have been promulgated in the country. National Biosafety Guidelines have been promulgated in April 2005. The Plant Breeders Rights Act, Amendment in Seed Act-1976, and Geographical Indication for Goods are still passing through discussion, evaluation, and analysis phases. Meanwhile, an illegal GM crop (cotton) has already sneaked into farmer's field. Concerted and coordinated efforts are needed among various ministries for implementation of regulation and capacity building for import/export and local handling of GM crops. Pakistan could easily benefit from the experience of Asian countries, especially China and India, where conditions are similar and the agriculture sector is almost like that of Pakistan. Thus, the exchange of information and experiences is important among these nations.

  8. Child health inequalities and its dimensions in Pakistan

    PubMed Central

    Murtaza, Fowad; Mustafa, Tajammal; Awan, Rabia

    2015-01-01

    Background and Objective: Poverty and inequality in health is pervasive in Pakistan. The provisions and conditions of health are very dismal. A significant proportion of the population (16.34%) of Pakistan is under 5 years, but Pakistan is in the bottom 5% of countries in the world in terms of spending on health and education. It is ranked the lowest in the world with sub-Sahara Africa in terms of child health equality. The objective of this study was to examine child health inequalities in Pakistan. Materials and Methods: We analyzed data from Pakistan Integrated Household Survey/Household Integrated Economic Survey 2001–2002, collected by the Pakistan Bureau of Statistics, Government of Pakistan. Coverage of diarrhea and immunization were used as indicators of child health. Stata 11.0 was used for data analysis. Descriptive statistics including frequency distribution and proportions for categorical variables and mean for continuous variables were computed. Results: Children under 5 years of age account for about 16.34% of the total population, 11.76% (2.5 million) of whom suffered from diarrhea in 1-month. The average duration of a diarrheal episode was 7 days. About 72% of the children who had diarrhea lived in a house without pipe-borne water supply. Around 22% children who had diarrhea had no advice or treatment. More than one-third of the households had no toilet in the house, and only 29% of the households were connected with pipe-borne drinking water. About 7.73% (1.6 million) children had never been immunized. The main reason for nonimmunization was parents’ lack of knowledge and of immunization. Conclusion: Child health inequalities in Pakistan are linked with several factors such as severe poverty, illiteracy, lack of knowledge, and awareness of child healthcare, singularly inadequate provision of health services, and poor infrastructure. PMID:26392798

  9. Child health inequalities and its dimensions in Pakistan.

    PubMed

    Murtaza, Fowad; Mustafa, Tajammal; Awan, Rabia

    2015-01-01

    Poverty and inequality in health is pervasive in Pakistan. The provisions and conditions of health are very dismal. A significant proportion of the population (16.34%) of Pakistan is under 5 years, but Pakistan is in the bottom 5% of countries in the world in terms of spending on health and education. It is ranked the lowest in the world with sub-Sahara Africa in terms of child health equality. The objective of this study was to examine child health inequalities in Pakistan. We analyzed data from Pakistan Integrated Household Survey/Household Integrated Economic Survey 2001-2002, collected by the Pakistan Bureau of Statistics, Government of Pakistan. Coverage of diarrhea and immunization were used as indicators of child health. Stata 11.0 was used for data analysis. Descriptive statistics including frequency distribution and proportions for categorical variables and mean for continuous variables were computed. Children under 5 years of age account for about 16.34% of the total population, 11.76% (2.5 million) of whom suffered from diarrhea in 1-month. The average duration of a diarrheal episode was 7 days. About 72% of the children who had diarrhea lived in a house without pipe-borne water supply. Around 22% children who had diarrhea had no advice or treatment. More than one-third of the households had no toilet in the house, and only 29% of the households were connected with pipe-borne drinking water. About 7.73% (1.6 million) children had never been immunized. The main reason for nonimmunization was parents' lack of knowledge and of immunization. Child health inequalities in Pakistan are linked with several factors such as severe poverty, illiteracy, lack of knowledge, and awareness of child healthcare, singularly inadequate provision of health services, and poor infrastructure.

  10. 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…

  11. Migration and development in Pakistan: some selected issues.

    PubMed

    Irfan, M

    1986-01-01

    Various sources of cross-sectional data were used as a basis for considering some of the interrelationships between migration and development in Pakistan, particularly the effects on the labor-exporting rural areas. The available data yield a range of estimates as to the level of mobility. During the 1970s, around 7-10% of Pakistan's population changed residence. The incidence of migration was higher among females than males. Women's greater propensity to migrate can be attributed primarily to patrilocal marriage customs wherein a significant proportion of females migrate, particularly in the rural areas. According to the 1979 Population, Labor Force and Migration Survey, the share of migrants in the total female population fell from 11.8% to 4.8% when migration for marriage is excluded. In Pakistan, mobility is predominantly local or involves short distances only. Only 19% of the internal migrants crossed provincial boundaries. 29.8% of the flow was from rural to urban areas. The remainder of the volume of internal migration was shared equally by inter-city and urban-to-rural migrants. The coincidence of the timing of marriage and entry into the labor market in individuals' life cycles generated a peak for the 15-24 age group in the age-mobility curve. A positive association exists between education and the propensity to migrate. In terms of origin, the propensity to move exhibited by the higher educational group was higher (33%) in rural areas than in urban areas (10%). 83% of this group from rural areas moved to urban centers; 80% of the same educational background chose another urban center as destination. The data on remittances may suffer both from reporting areas and being unrepresentative. The remittances estimated due to internal migration, on the basis of the PLM survey, amounted to 3 billion rupees in 1978. On average, remittances accounted for 35% of the earnings of the migrants. Average remittances were substantially less than the earnings of

  12. A Review of Pakistan School System

    ERIC Educational Resources Information Center

    Farooq, Muhammad Sabil; Kai, Yuan Tong

    2017-01-01

    It is mandated in the Constitution of Pakistan to enhance adult literacy and quality education at primary level through provide free and compulsory education to all children between the ages of 5-16 years. The year 2015 was the deadline for the participants of Dakar declaration [Education for All (EFA) commitment] including Pakistan but they fail…

  13. Crimean-Congo hemorrhagic fever nosocomial infection in a immunosuppressed patient, Pakistan: case report and virological investigation.

    PubMed

    Hasan, Zahra; Mahmood, Faisal; Jamil, Bushra; Atkinson, Barry; Mohammed, Murtaza; Samreen, Azra; Altaf, Lamia; Moatter, Tariq; Hewson, Roger

    2013-03-01

    Crimean-Congo hemorrhagic fever (CCHF) is endemic in the Baluchistan province, Pakistan. Sporadic outbreaks of CCHF occur throughout the year especially in individuals in contact with infected livestock. Nosocomial transmission remains a risk due to difficulties in the diagnosis of CCHF and limited availability of facilities for the isolation of suspected patients. Rapid diagnosis of CCHF virus infection is required for early management of the disease and to prevent transmission. This study describes the case of a 43-year-old surgeon who contracted CCHF during a surgical procedure in Quetta, Baluchistan and who was transferred to a tertiary care facility at the Aga Khan University Hospital, Karachi within 1 week of contracting the infection. Diagnosis of CCHF was made using a rapid real-time reverse transcription polymerase chain reaction (RT-PCR) assay for CCHF viral RNA. The patient had chronic hepatitis B and hepatitis D infection for which he had previously received a liver transplant. He proceeded to develop classic hemorrhagic manifestations and succumbed to the infection 14 days post-onset of disease. There was no further nosocomial transmission of the CCHF during the hospital treatment of the surgeon. Early diagnosis of CCHF enables rapid engagement of appropriate isolation, barrier nursing and infection control measures thus preventing nosocomial transmission of the virus. Copyright © 2012 Wiley Periodicals, Inc.

  14. Satellite image maps of Pakistan

    USGS Publications Warehouse

    ,

    1997-01-01

    Georeferenced Landsat satellite image maps of Pakistan are now being made available for purchase from the U.S. Geological Survey (USGS). The first maps to be released are a series of Multi-Spectral Scanner (MSS) color image maps compiled from Landsat scenes taken before 1979. The Pakistan image maps were originally developed by USGS as an aid for geologic and general terrain mapping in support of the Coal Resource Exploration and Development Program in Pakistan (COALREAP). COALREAP, a cooperative program between the USGS, the United States Agency for International Development, and the Geological Survey of Pakistan, was in effect from 1985 through 1994. The Pakistan MSS image maps (bands 1, 2, and 4) are available as a full-country mosaic of 72 Landsat scenes at a scale of 1:2,000,000, and in 7 regional sheets covering various portions of the entire country at a scale of 1:500,000. The scenes used to compile the maps were selected from imagery available at the Eros Data Center (EDC), Sioux Falls, S. Dak. Where possible, preference was given to cloud-free and snow-free scenes that displayed similar stages of seasonal vegetation development. The data for the MSS scenes were resampled from the original 80-meter resolution to 50-meter picture elements (pixels) and digitally transformed to a geometrically corrected Lambert conformal conic projection. The cubic convolution algorithm was used during rotation and resampling. The 50-meter pixel size allows for such data to be imaged at a scale of 1:250,000 without degradation; for cost and convenience considerations, however, the maps were printed at 1:500,000 scale. The seven regional sheets have been named according to the main province or area covered. The 50-meter data were averaged to 150-meter pixels to generate the country image on a single sheet at 1:2,000,000 scale

  15. Adaptation of the Recent Life Changes Questionnaire (RLCQ) to measure stressful life events in adults residing in an urban megapolis in Pakistan.

    PubMed

    Artani, Azmina; Bhamani, Shireen Shehzad; Azam, Iqbal; AbdulSultan, Moiz; Khoja, Adeel; Kamal, Ayeesha K

    2017-05-05

    Contextually relevant stressful life events are integral to the quantification of stress. None such measures have been adapted for the Pakistani population. The RLCQ developed by Richard Rahe measures stress of an individual through recording the experience of life changing events. We used qualitative methodology in order to identify contextually relevant stressors in an open ended format, using serial in-depth interviews until thematic saturation of reported stressful life events was achieved. In our next phase of adaptation, our objective was to scale each item on the questionnaire, so as to weigh each of these identified events, in terms of severity of stress. This scaling exercise was performed on 200 random participants residing in the four communities of Karachi namely Kharadar, Dhorajee, Gulshan and Garden. For analysis of the scaled tool, exploratory factor analysis was used to inform structuring. Finally, to complete the process of adaption, content and face validity exercises were performed. Content validity by subject expert review and face validity was performed by translation and back translation of the adapted RLCQ. This yielded our final adapted tool. Stressful life events emerging from the qualitative phase of the study reflect daily life stressors arising from the unstable socio-political environment. Some such events were public harassment, robbery/theft, missed life opportunities due to nepotism, extortion and threats, being a victim of state sponsored brutality, lack of electricity, water, sanitation, fuel, destruction due to natural disasters and direct or media based exposure to suicide bombing in the city. Personal or societal based relevant stressors included male child preference, having an unmarried middle aged daughter, lack of empowerment and respect reported by females. The finally adapted RLCQ incorporated "Environmental Stress" as a new category. The processes of qualitative methodology, in depth interview, community based scaling and

  16. Effectiveness of training on de-escalation of violence and management of aggressive behavior faced by health care providers in a public sector hospital of Karachi

    PubMed Central

    Baig, Lubna; Tanzil, Sana; Shaikh, Shiraz; Hashmi, Ibrahim; Khan, Muhammad Arslan; Polkowski, Maciej

    2018-01-01

    Background & Objective: Considering high burden of violence against healthcare workers in Pakistan APPNA Institute of Public Health developed a training to prevent reactive violence among healthcare providers. The purpose of this training was to equip healthcare providers with skills essential to control aggressive behaviors and prevent verbal and non-verbal violence in workplace settings. This study assesses the effectiveness of training in prevention, de-escalation and management of violence in healthcare settings. Methods: A quasi-experimental study was conducted in October, 2016 using mixed method concurrent embedded design. The study assessed effectiveness of de-escalation trainings among health care providers working in emergency and gynecology and obstetrics departments of two teaching hospitals in Karachi. Quantitative assessment was done through structured interviews and qualitative through Focus Group Discussions. Healthcare providers` confidence in coping with patient aggression was also measured using a standard validated tool”. Results: The overall self-perceived mean score of Confidence in Coping with Patient Aggression Instrument “(CCPAI)” scale was significantly higher in intervention group (Mean= 27.49, SD=3.53) as compared to control group (Mean= 23.92, SD=4.52) (p<0.001). No statistically significant difference was observed between intervention and control groups with regard to frequency of violence faced by HCPs post training and major perpetrators of violence.. Conclusion: De-escalation of violence training was effective in improving confidence of healthcare providers in coping with patient aggression. PMID:29805396

  17. One Step on a New Journey

    ERIC Educational Resources Information Center

    Arwani, Salima Shahzad

    2011-01-01

    During Mathematics Teaching Course-I (MT-I), the author was given the opportunity to teach a primary mathematics class at a Government school in Karachi, Pakistan while on teaching practice. The author was lucky to be able to share the lesson planning with a friend, and they found the sharing of ideas a supportive process. The focus of the lesson…

  18. An overview of poultry industry in Pakistan.

    PubMed

    Hussain, J; Rabbani, I; Aslam, S; Ahmad, H A

    2015-12-01

    The poultry sector is an important and vibrant segment of agriculture in Pakistan with a significant contribution to the national GDP (1.3%). Commercial poultry production in Pakistan started in the 1960's and has been providing a significant portion of daily proteins to the Pakistani population ever since. During its evolution the industry enjoyed promotional policies of the Government, but has faced several challenges such as disease outbreaks and retail price fluctuations. Despite its important role in the country's economy, not a single scientific study is available on its evolutionary history. The data available in this regard are scattered and lack reliability. This review is an effort to encompass the history of the overall growth of the poultry industry in Pakistan, its present status (2012 statistics) and future directions and challenges. This article may serve as the basic source of information on Pakistan's poultry industry achievements. It will also guide poultry experts and policy makers for developing strategic planning for further growth of the industry.

  19. 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

  20. China-Pakistan Economic Corridor.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Boyce, Tucker

    International trade and related economic activities in Central and South Asia are increasing as developing economies, particularly India and Pakistan, grow. China continues to emerge as a major regional and global power and has embarked upon numerous regional economic and political initiatives . A major development is the China - Pakistan Economic Corridor (CPEC), a host of infrastructure and trade projects worth over 40 billion American dollars . This report analyzes CPEC a nd its potential regional effects, including the trade security implications of the port and land infrastructure developments . As trade increase s in the reg ion andmore » the major CPEC infrastructure projects are completed, there will be numerous implications on trade security and geopolitics within South Asia. CPEC projects uniquely intersect numerous regional situations, including territorial disputes in Kashmir, the Afghanistan/Pakistan border, and Chinese foreign policy a mbitions. A nuanced understanding of these effects can influence future policy adjustments in this region . The views expressed in this report are those of the author and do not necessarily reflect the position of Sandia National Laboratories or the author's current and past institutions.« less

  1. Geothermal areas in Pakistan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shuja, T.A.

    1986-01-01

    In this paper an attempt has been made to correlate the tectonic and geologic features with surface manifestations of geothermal activity in Pakistan to delineate prospective areas for exploration and development of geothermal energy. Underthrusting of the Arabian plate beneath the Eurasian plate has resulted in the formation of Chagai volcanic arc which extends into Iran. Quaternary volcanics in this environment, along with the presence of thermal springs, is an important geotectonic feature revealing the possible existence of geothermal fields. Geothermal activity in the northern areas of Pakistan, as evidenced by thermal springs, is the likely result of collision andmore » underthrusting of the Indian plate beneath the Eurasian plate. Numerous hot springs are found along the Main Mantle thrust and the Main Karakorum thrust in Chilas and Hunza areas respectively. The concentration of hot springs in Sind Province is also indicative of geothermal activity. A string of thermal seepages and springs following the alignment of the Syntaxial Bend in Punjab Province is also noteworthy from the geothermal viewpoint. In Baluchistan Province (southwest Pakistan), Hamun-e-Mushkel, a graben structure, also shows geothermal prospects on the basis of aeromagnetic studies.« less

  2. Country watch: Pakistan.

    PubMed

    Toll, K; Agha, S

    1999-01-01

    In Pakistan, which has a high fertility rate, affordable prices of condoms and family planning services attract low-income residents. This was shown by the two projects: the condom distribution scheme and the family planning franchise. A condom social marketing (CSM) program started by Population Services International (PSI) increased contraceptive use in urban areas and sold low-priced condoms. However, in 1991 the price doubled in order to recover the costs, which resulted in a decline in sales. Thus, in 1995 PSI and Social Marketing Pakistan franchised the Green Star project that aimed to raise the quality of private sector family planning clinics serving low-income women and to increase the availability and use of female-controlled contraception. By 1996, the CSM project was selling over 80 million condoms annually.

  3. Girl child marriage and its effect on fertility in Pakistan: findings from Pakistan Demographic and Health Survey, 2006-2007.

    PubMed

    Nasrullah, Muazzam; Muazzam, Sana; Bhutta, Zulfiqar A; Raj, Anita

    2014-04-01

    Child marriage (before 18 years) is prevalent in Pakistan, which disproportionately affects young girls in rural, low income and low education households. Our study aims to determine the association between early marriage and high fertility and poor fertility health indicators among young women in Pakistan beyond those attributed to social vulnerabilities. Nationally representative data from Pakistan Demographic and Health Survey, 2006-2007, a cross-sectional observational survey, were limited to ever-married women aged 20-24 years (n = 1,560; 15% of 10,023) to identify differences in poor fertility outcomes [high fertility (three or more childbirths); rapid repeat childbirth (<24 months between births); unwanted pregnancy (any ever); pregnancy termination (any stillbirth, miscarriage or abortion ever)] by early (<18) versus adult (≥18) age at marriage. Associations between child marriage and fertility outcomes were assessed by calculating adjusted odds ratios (AORs) using logistic regression models after controlling for demographics, social equity indicators (education, wealth index, rural residence), contraception use, marriage duration and culture-specific factors (husband's desire for more children, son preference). Overall, 50% of ever-married women aged 20-24 years in Pakistan were married before the age of 18 years. Girl child marriage was significantly (p < 0.001) associated with low social equity indicators (poverty, rural residence, and no formal education). Adjusted logistic regression models showed that girl child marriage was significantly associated with high fertility (AOR 6.62; 95% CI 3.53-12.43), rapid repeat childbirth (AOR 2.88; 95% CI 1.83-4.54), unwanted pregnancy (AOR 2.90; 95% CI 1.75-4.79), and pregnancy termination (AOR 1.75; 95% CI 1.10-2.78). Girl child marriage affects half of all ever-married women aged 20-24 years in Pakistan, and increases their risk for high fertility and poor fertility health indicators, highlighting the need of

  4. 75 FR 51615 - Establishment of Pakistan and Afghanistan Support Office

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-23

    ... Establishment of Pakistan and Afghanistan Support Office By the authority vested in me as President by the... 3161 of title 5, United States Code, a temporary organization to be known as the Pakistan and... strengthening the governments in Afghanistan and Pakistan, enhancing the capacity of those governments to resist...

  5. 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.

  6. Community programme in Pakistan aimed at preventing and reducing drug abuse.

    PubMed

    Mufti, K A

    1986-01-01

    A voluntary organization called the Green December Movement was established in December 1983 to make better use of the resources available at the community level for the prevention and reduction of drug abuse in the North Western Frontier Province of Pakistan. As a result, two major treatment and rehabilitation centres have been set up, one in Peshawar and another in Mardan, that provide free treatment for drug addicts, including those from other parts of the province. To cope with the recent increase in heroin abuse in the province, the Green December Movement has succeeded in involving both men and women in community efforts to reduce drug abuse. Emphasis has been placed on the involvement of religious leaders in drug abuse prevention activities, particularly in alerting the population to drug problems, as well as in providing spiritual and psychosocial support for detoxified addicts, which helps them to stay away from drugs. The Green December Movement has recently gained national status, and branch offices have been established in Karachi and Quetta. In addition, the Green December Movement provides drug information adapted for various target groups and encourages students, teachers and out-of-school youth to participate in community activities aimed at preventing drug abuse. To this end, the Green December Movement closely co-operates with government agencies and non-governmental organizations concerned with drug problems in the community and has undertaken research on various aspects of the nature and extent of drug abuse, as well as on its prevention and treatment. An evaluation of the Green December Movement activities carried out so far has revealed positive results.

  7. Impact of a maternal health voucher scheme on institutional delivery among low income women in Pakistan.

    PubMed

    Agha, Sohail

    2011-05-03

    Only 39% of deliveries in Pakistan are attended by skilled birth attendants, while Pakistan's target for skilled birth attendance by 2015 is > 90%. A 12-month maternal health voucher intervention was implemented in Dera Ghazi Khan City, located in Southern Punjab, Pakistan in 2009. A pre-test/post-test non-experimental study was conducted to assess the impact of the intervention. Household interviews were conducted with randomly selected women who delivered in 2008 (the year prior to the voucher intervention), and with randomly selected women who delivered in 2009. A strong outreach model was used and voucher booklets valued at $50, containing redeemable coupons for three antenatal care (ANC) visits, a postnatal care (PNC) visit and institutional delivery, were sold for $1.25 to low-income women targeted by project workers. Regression analysis was conducted to determine the impact of the voucher scheme on ANC, PNC, and institutional delivery. Marginal effects estimated from logistic regression analyses were used to assess the magnitude of the impact of the intervention. The women targeted by voucher outreach workers were poorer, less educated, and at higher parity. After adjusting for these differences, women who delivered in 2009 and were sold voucher booklets were significantly more likely than women who delivered in 2008 to make at least three ANC visits, deliver in a health facility, and make a postnatal visit. Purchase of a voucher booklet was associated with a 22 percentage point increase in ANC use, a 22 percentage point increase in institutional delivery, and a 35 percentage point increase in PNC use. A voucher intervention implemented for 12 months was associated with a substantial increase in institutional delivery. A substantial scale-up of maternal health vouchers that focus on institutional delivery is likely to bring Pakistan closer to achieving its 2015 target for institutional delivery.

  8. An AOGCM based assessment of interseasonal variability in Pakistan

    NASA Astrophysics Data System (ADS)

    Asmat, U.; Athar, H.; Nabeel, A.; Latif, M.

    2018-01-01

    The interseasonal variability of two basic climatic parameters (precipitation and temperature) is assessed, over vulnerable and data sparse region of Pakistan (23° to 37°N and 60° to 75°E), for two Coupled Model Intercomparison Project 3 (CMIP3) based Atmospheric-Oceanic General Circulation Model (AOGCM) versions: CM2.0 and CM2.1 by Geophysical Fluid Dynamics Laboratory (GFDL), and two CMIP5 based AOGCM versions: CM2p1 and CM3.0. A recent historical 50-year period (1951-2000) is analyzed and compared with APHRODITE for precipitation and National Centers for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) re-analysis based gridded datasets for temperature for the following four seasons: DJF, MAM, JJA, and SON. The study area is divided into three regions: all Pakistan, northern Pakistan, and southern Pakistan. The interseasonal variability of the precipitation and the temperature are derived from all three (five) runs of CM2.0 (CM2.1) and from all ten (five) runs of CM 2p1 (CM3.0). The bias, root mean square error (RMSE), one-sigma standard deviation (SD) and correlation coefficient (CC) are used as assessing metrics. The following individual runs have positive CC with respect to APHRODITE at ≤1% Confidence Level (CL). On seasonal basis for CMIP5 based GFDL models during DJF: CM2p1R5 (for all Pakistan), CM2p1R5 (for northern Pakistan), and during MAM: CM2p1R5 (for southern Pakistan; this run has the lowest centered RMSE of 0.11 mm/day), whereas on annual basis: CM3.0R3 (for all Pakistan). However, out of these four runs, only CM2p1 (for southern Pakistan) has SD < SDobs (0.08 < 0.12 mm/day). There are 13 other runs for which the positive CC is at ≤5% CL, both relative to observed precipitation or temperature. Out of these 13 runs, only the average of runs of GFDL-CM2.1 in CMIP3 in JJA in southern Pakistan has SD < SDobs (0.56 < 0.59 °C) with a centered RMSE value of 0.65 °C. These characteristics of GFDL-CM2p1 runs are

  9. 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.…

  10. 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…

  11. Factors associated with stress among adolescents in the city of Nawabshah, Pakistan.

    PubMed

    Parpio, Yasmin; Farooq, Salima; Gulzar, Saleema; Tharani, Ambreen; Javed, Fawad; Ali, Tazeen Saeed

    2012-11-01

    To identify the risk factors of stress among school-going adolescents in rural Nawabshah, Pakistan. The cross-sectional study was conducted in 2005, comprising 800 school-going children of 10-16 years of age in Nawabshah, through simple random sampling. Data was collected using a structured questionnaire to assess the potential risk factors of stress. A modified version of Perceived stress scale was utilized to measure stress level. SPSS 12 was used for statistical analysis, while multiple linear regression analysis was run to identify the factors associated with stress in the study population. Of the total, 529 (66%) children belonged to state-run schools while 271 (34%) were studying at private facilities. The mean age was 13.7+/-1.3 years. The level of stress was positively associated with the number of siblings, parental conflicts, the age of the mother and the number of rooms in the household. There was decreased level of stress among female adolescents (n=474; 59.3%) who had prior information about pubertal body changes than the boys (n=326; 40.8%). The study showed that stress among adolescents can be reduced by modifying socio-economic and demographic factors.

  12. Organochlorine pesticides in surface soils from obsolete pesticide dumping ground in Hyderabad City, Pakistan: contamination levels and their potential for air-soil exchange.

    PubMed

    Alamdar, Ambreen; Syed, Jabir Hussain; Malik, Riffat Naseem; Katsoyiannis, Athanasios; Liu, Junwen; Li, Jun; Zhang, Gan; Jones, Kevin C

    2014-02-01

    This study was conducted to examine organochlorine pesticides (OCPs) contamination levels in the surface soil and air samples together with air-soil exchange fluxes at an obsolete pesticide dumping ground and the associated areas from Hyderabad City, Pakistan. Among all the sampling sites, concentrations of OCPs in the soil and air samples were found highest in obsolete pesticide dumping ground, whereas dominant contaminants were dichlorodiphenyltrichloroethane (DDTs) (soil: 77-212,200 ng g(-1); air: 90,700 pg m(-3)) and hexachlorocyclohexane (HCHs) (soil: 43-4,090 ng g(-1); air: 97,400 pg m(-3)) followed by chlordane, heptachlor and hexachlorobenzene (HCB). OCPs diagnostic indicative ratios reflect historical use as well as fresh input in the study area. Moreover, the air and soil fugacity ratios (0.9-1.0) at the dumping ground reflecting a tendency towards net volatilization of OCPs, while at the other sampling sites, the fugacity ratios indicate in some cases deposition and in other cases volatilization. Elevated concentrations of DDTs and HCHs at pesticide dumping ground and its surroundings pose potential exposure risk to biological organisms, to the safety of agricultural products and to the human health. Our study thus emphasizes the need of spatio-temporal monitoring of OCPs at local and regional scale to assess and remediate the future adverse implications. © 2013.

  13. An assessment of the current municipal solid waste management system in Lahore, Pakistan.

    PubMed

    Masood, Maryam; Barlow, Claire Y; Wilson, David C

    2014-09-01

    The current status of solid waste management in Lahore, a metropolitan city of Pakistan, is reviewed in this article using an existing approach, the UN-Habitat city profile. This involves a systematic quantitative and qualitative assessment of physical components and governance features of the current waste management system. A material flow diagram (MFD) is developed, which allows visualisation of the current waste management system with all related inputs and outputs. This study shows that in the current system, waste collection and transportation is the main focus, however the collection coverage is only about 68%. There is no controlled or even semi-controlled waste disposal facility in Lahore. There is no official recycling system in the city. It is estimated that currently ~27% of waste by weight is being recycled through the informal sector. Making use of the organic content of the waste, a composting facility is operative in the city, producing 47,230 tonnes year(-1) of organic compost. Lahore does not perform very well in governance features. Inclusivity of users and providers of the waste management system is low in the city, as not all stakeholders are consulted in the decision making processes. Waste management costs US$20 per tonne of waste, where the main focus is only on waste collection, and the current user fees are much lower than the actual costs. This study recommends that recycling should be promoted by increasing public awareness and integrating the informal sector to make the current system sustainable and financially viable. © The Author(s) 2014.

  14. Insurgency in Greater Baluchistan: A CNA Small Group Discussion, March 29, 2013

    DTIC Science & Technology

    2013-06-01

    Insurgency in Greater Baluchistan A CNA Small Group Discussion March 29, 2013 Cleared for public release DCP-2013-U-004988-Final... Baluchistan , one of the most remote and least developed areas of southwest Asia, stretches north from Karachi in Pakistan, along the arid and... Baluchistan and the implications for U.S. interests and regional stability. Bottom line up front  Successive generations of ethnic Baluch living along

  15. Heavy metal and other residues in feathers of laggar falcon Falco biarmicus jugger from six districts of Pakistan.

    PubMed

    Movalli, P A

    2000-08-01

    This paper presents the levels of metals and other trace elements measured in feathers of laggar falcons, Falco biarmicus jugger, in Pakistan. The laggar falcon is resident or locally migrant throughout the Indian Subcontinent where it is a rare and declining species. Breast feathers from 57 live, recently trapped, adult and juvenile laggar falcons and from five dead birds were collected from Bahawalpur, Bahawalnagar, Mithi, Chachcro, Jacobabad and Karachi districts. Cadmium (Cd), lead (Pb) and mercury (Hg) were analysed by atomic absorption spectrophotometry (AAS), cobalt (Co), selenium (Se), zinc (Zn), scandium (Sc), chromium (Cr), cesium (Cs), lanthanum (La) and bromine (Br) by neutron activation analysis (NAA). Hg levels were below those found in other raptors with reduced reproductive success. No correlation was found between Hg and Se levels. For some metals and elements interpretation of results is difficult as no data exist in the literature. Concentrations did not differ significantly between males and females nor between juveniles and adults, but differed among districts for Pb, Hg, Co, Sc, Cr, La and Br. A significant correlation was found between Pb concentration and occurrence of louse eggs. As the laggar is resident or a partial local migrant, it is probable that the metal burden in adult and juvenile feathers reflects the level of contamination in these particular districts.

  16. Systems for the management of respiratory disease in primary care--an international series: Pakistan.

    PubMed

    Yusuf, Mohammed Osman

    2009-03-01

    Pakistan has a population exceeding 160 million. Communicable diseases remain the most important health problem in Pakistan, with non-communicable diseases and injuries comprising a quarter of all deaths. The government provides a multi-tiered healthcare system, from the Basic Health Unit at the village level, ranging up to the tertiary care teaching hospitals in the larger cities. These facilities are accessible to all, and are usually free or highly subsidised. Patients have the choice to see a private or government GP, a specialist, or an alternative medicine healer. The current National Health Policy focusses mainly on prevention of communicable diseases, as well as improving primary and secondary health care services. Only 6% of 13 to 14 year olds are medically diagnosed as having asthma, and more than half report symptoms of rhinitis. The prevalence of chronic bronchitis in patients over 65 is 14% and 6% in rural females and males, respectively, and 9% (with no sex difference) in urban areas. The higher rates of chronic bronchitis observed in females in rural areas may be attributed to high levels of indoor air pollution due to cooking over smoking fires. It is estimated that 36% of adult males, and 9% of females, smoke, and the cigarette consumption per person per year in Pakistan is among the highest in South Asia. Pakistan is ranked 7th among the 22 highest tuberculosis disease burden countries in the world. In 2006 the number of all TB cases was 76,668 compared to 97,245 in 2004. It is estimated that 70-80,000 people are infected with HIV, but only 3,000 AIDS cases have been reported so far. The incidence of acute respiratory infections in children varies, and is a common cause of morbidity. In adults, it is estimated that pneumonia may affect as many as 2.8 million Pakistanis. Patients usually can access their local GPs or alternative medical practitioners with relative ease. In villages in remote areas, access to government-run health care facilities

  17. Pakistan/USAID to start CSM project.

    PubMed

    1984-01-01

    Pakistan, with the assistance of funds for the US Agency for International Development (USAID), is about to start its novel approach to contraceptive social marketing (CSM). This new effort suggests a marked policy shift on the part of the Pakistan government toward intensifying its family planning activities. The program will be government-operated and supported by AID over the next 5 years with $20 million, more than double the cost of similar CSM projects elswhere. Distribution of a condom on a pilot project basis is expected to begin by December 1984. Sales of a low-dose oral contraceptive (OC) could begin in test market areas by mid-1985, with national launching of both products tentatively scheduled for January 1986. The Pakistan/USAID agreement represents the 1st time since the formation of India's Nirodh project in the late 1960s that a CSM program is being established without the involvement of either an international social marketing contractor or a country's family planning association. The Pakistan CSM program will be managed by a policy board composed of representatives from the government's Ministries of Planning, Health and Education; a resident advisor from USAID; and a local company responsible for product marketing and distribution. The approach has received a skeptical response among international social marketing experts about the program's chances for success. Their doubts extend to 2 other aspects of the proposed design: an official of the Ministry of Planning's Population and Welfare Division expects the CSM program to generate sufficient revenues to cover all operating costs following the 5-year subsidy period, while also providing attractive profit margins for the marketing/distribution company; and the government prohibits mass media advertising of contraceptives. According to AID, the issue of mass media contraceptive advertising has not yet been resolved, and a national survey will be conducted to determine what communication needs are

  18. Surgery, public health, and Pakistan.

    PubMed

    Zafar, Syed Nabeel; McQueen, K A Kelly

    2011-12-01

    Surgical healthcare is rapidly gaining recognition as a major public health issue. Surgical disparities are large, with poorest populations receiving the least amount of emergency and essential surgical care. In light of recent evidence, developing countries, such as Pakistan, must acknowledge surgical disease as a major public health issue and prioritize research and intervention accordingly. We review information from various sources and describe the current situation of surgical health care in Pakistan and highlight areas of neglect. Pakistan suffers an annual deficit of 17 million surgeries. Surgical disease kills more people than infectious diseases inclusive of tuberculosis, HIV/AIDS, diarrheal disease, and childhood infections. The incidence of trauma and maternal mortality ratio are staggeringly high. There is a severe dearth of surgical and anesthesia-related epidemiological data. Important information that would help to drive policy and planning is not available. Corruption and neglect have led to a dilapidated health care infrastructure. Surgical care is largely inaccessible to the poor, especially those living in rural areas. The country faces a dearth of healthcare professionals, especially paramedics, anesthetists, and surgeons. Unsafe surgery and anesthesia poses a significant risk to patients. There is no national policy on surgical illness and the preventive aspects of surgery are nonexistent. Consistent with other underdeveloped countries, surgical care in Pakistan is dismal. Neglecting surgery and safe anesthesia has led to countless deaths and disability. Physicians, researchers, policy makers, and the government health care system must engage and commit to provide access to emergency, essential, and safe surgical care.

  19. Does academic assessment system type affect levels of academic stress in medical students? A cross-sectional study from Pakistan

    PubMed Central

    Ali, Madiha; Asim, Hamna; Edhi, Ahmed Iqbal; Hashmi, Muhammad Daniyal; Khan, Muhammad Shahjahan; Naz, Farah; Qaiser, Kanza Noor; Qureshi, Sidra Masud; Zahid, Mohammad Faizan; Jehan, Imtiaz

    2015-01-01

    Introduction Stress among medical students induced by academic pressures is on the rise among the student population in Pakistan and other parts of the world. Our study examined the relationship between two different systems employed to assess academic performance and the levels of stress among students at two different medical schools in Karachi, Pakistan. Methods A sample consisting of 387 medical students enrolled in pre-clinical years was taken from two universities, one employing the semester examination system with grade point average (GPA) scores (a tiered system) and the other employing an annual examination system with only pass/fail grading. A pre-designed, self-administered questionnaire was distributed. Test anxiety levels were assessed by The Westside Test Anxiety Scale (WTAS). Overall stress was evaluated using the Perceived Stress Scale (PSS). Results There were 82 males and 301 females while four did not respond to the gender question. The mean age of the entire cohort was 19.7±1.0 years. A total of 98 participants were from the pass/fail assessment system while 289 were from the GPA system. There was a higher proportion of females in the GPA system (85% vs. 59%; p<0.01). Students in the pass/fail assessment system had a lower score on the WTAS (2.4±0.8 vs. 2.8±0.7; p=0.01) and the PSS (17.0±6.7 vs. 20.3±6.8; p<0.01), indicating lower levels of test anxiety and overall stress than in students enrolled in the GPA assessment system. More students in the pass/fail system were satisfied with their performance than those in the GPA system. Conclusion Based on the present study, we suggest governing bodies to revise and employ a uniform assessment system for all the medical colleges to improve student academic performance and at the same time reduce stress levels. Our results indicate that the pass/fail assessment system accomplishes these objectives. PMID:26112353

  20. Does academic assessment system type affect levels of academic stress in medical students? A cross-sectional study from Pakistan.

    PubMed

    Ali, Madiha; Asim, Hamna; Edhi, Ahmed Iqbal; Hashmi, Muhammad Daniyal; Khan, Muhammad Shahjahan; Naz, Farah; Qaiser, Kanza Noor; Qureshi, Sidra Masud; Zahid, Mohammad Faizan; Jehan, Imtiaz

    2015-01-01

    Stress among medical students induced by academic pressures is on the rise among the student population in Pakistan and other parts of the world. Our study examined the relationship between two different systems employed to assess academic performance and the levels of stress among students at two different medical schools in Karachi, Pakistan. A sample consisting of 387 medical students enrolled in pre-clinical years was taken from two universities, one employing the semester examination system with grade point average (GPA) scores (a tiered system) and the other employing an annual examination system with only pass/fail grading. A pre-designed, self-administered questionnaire was distributed. Test anxiety levels were assessed by The Westside Test Anxiety Scale (WTAS). Overall stress was evaluated using the Perceived Stress Scale (PSS). There were 82 males and 301 females while four did not respond to the gender question. The mean age of the entire cohort was 19.7 ± 1.0 years. A total of 98 participants were from the pass/fail assessment system while 289 were from the GPA system. There was a higher proportion of females in the GPA system (85% vs. 59%; p < 0.01). Students in the pass/fail assessment system had a lower score on the WTAS (2.4 ± 0.8 vs. 2.8 ± 0.7; p = 0.01) and the PSS (17.0 ± 6.7 vs. 20.3 ± 6.8; p < 0.01), indicating lower levels of test anxiety and overall stress than in students enrolled in the GPA assessment system. More students in the pass/fail system were satisfied with their performance than those in the GPA system. Based on the present study, we suggest governing bodies to revise and employ a uniform assessment system for all the medical colleges to improve student academic performance and at the same time reduce stress levels. Our results indicate that the pass/fail assessment system accomplishes these objectives.

  1. The Global Polio Eradication Initiative (GPEI) in Pakistan.

    PubMed

    Nadeem, Nighat Jahan

    2016-11-01

    The Global Polio Eradication Initiative (GPEI) has significantly reduced the worldwide incidence of poliomyelitis. However, polio remains endemic in Pakistan which poses a threat to the success of the GPEI. Issues faced by Pakistan relate to politics, terrorism, war, natural disasters, funding constraints, misconceptions and inadequate infrastructure. These contribute in hampering the aims of the GPEI and allow the deadly poliovirus to maintain its reservoir in Pakistan. Until polio is completely eradicated, all countries remain at risk of its re-emergence and this is of grave concern as potentially it could reverse the polio-free certified status of a whole World Health Organisation (WHO) region. With the increase in global travel and international migration, even the smallest potential risk should not be taken lightly. Recommendations are made to help to improve the state of polio in Pakistan to make full use of the GPEI investment and move towards a polio-free world.

  2. Impact of Maternal Education about Complementary Feeding on Their Infants' Nutritional Outcomes in Low- and Middle-income Households: A Community-based Randomized Interventional Study in Karachi, Pakistan

    PubMed Central

    Saleem, Ali Faisal; Mahmud, Sadia; Baig-Ansari, Naila

    2014-01-01

    ABSTRACT This cluster-randomized interventional trial at peri-urban settings of Karachi was conducted to evaluate the impact of maternal educational messages regarding appropriate complementary feeding (CF) on the nutritional status of their infants after 30 weeks of educational interventions delivered by trained community health workers. Mothers in the intervention group received three education modules about breastfeeding (BF) and appropriate CF at a baseline visit and two subsequent visits 10 weeks apart. The control group received advice about BF according to national guidelines. Infants' growth [weight, length, and mid-upper arm-circumference (MUAC), stunting, wasting, and underweight] were measured at four time points. At the end of the study, infants in the intervention group had a higher mean weight of 350 g (p=0.001); length of 0.66 cm (p=0.001), and MUAC of 0.46 cm (p=0.002) compared to the controls; proportionate reduction of stunting and underweight were 10% (84% vs 74%; ORadj 8.36 (5.6-12.42) and 5% (25% vs 20%; ORadj 0.75 (0.4-1.79) in the intervention compared to the control group. For relatively food-secure populations, educational interventions about appropriate CF to mothers had a direct positive impact on linear growth of their infants. PMID:25895196

  3. Pakistan [Population education in countries of the region].

    PubMed

    1982-06-01

    The scope of formal population education in Pakistan covers the entire academic system, beginning from the primary level to the university and professional colleges. The government initiated action in 1980 to integrate population education in the formal and nonformal education sectors. General as well as specific behavioral objectives for population education were developed by the National Committee on Population Education. These objectives were further broken down for primary, middle, and lower and higher secondary school levels. The National Committee on Population Education prepared a curriculum for the training of primary, middle, and lower secondary school teachers which was used in training the master trainers. Textbooks in Pakistan were written in 1975 following the concepts and guidelines provided in the new curricula. Curriculum development specialists prepared model lessons on the integration of population education with social studies, Pakistan studies, Urdu, health and physical education, and nursing and general science for the guidance of textbook writers and teachers. The Allama Iqbal Open University has developed a 24-unit course to orientate primary school teachers in the philosophy and content of new curricula provided for in the new education policy of Pakistan. The Population Planning Division of Pakistan and the Family Planning Association of Pakistan periodically develop materials which serve as supplementary readers; an orientation program for teachers began on a limited scale following the inception of population education in Pakistan. Some research and evaluation projects have been undertaken periodically to study the effectiveness of some of the family planning programs. To ensure systematic and comprehensive coverage of population education through the existing formal and nonformal education programs the government is planning to undertake in collaboration with the UN Fund for Population Activities (UNFPA) and other bilateral and

  4. Nuclear programs in India and Pakistan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mian, Zia

    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 formore » 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.« less

  5. 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.

  6. Women's Perspectives of Peace: Unheard Voices from Pakistan

    ERIC Educational Resources Information Center

    Habib, Zehra

    2013-01-01

    Pakistan is currently impacted by rampant terrorism and is simultaneously grappling with intrastate ethnic and sectarian violence. The focus of this dissertation was on examining grassroots Pakistani women's perspectives on peace and women's contributions to peace in Pakistan. The study was centered on grassroots women because their voices remain…

  7. Trajectory of cause of death among brought dead neonates in tertiary care public facilities of Pakistan: A multicenter study.

    PubMed

    Mustufa, Muhammad Ayaz; Sheikh, Munir Ahmed; Taseer, Ijaz-Ul-Haque; Raza, Syed Jamal; Arshad, Muhammad Sohail; Akhter, Tasleem; Arain, Ghazala Mohyuddin; Habibullah, Sultana; Safdar, Sohail; Firdous, Rukhsana; Adnan, Muhammad

    2017-02-01

    Considering the fact that Pakistan is amongst the countries with very high neonatal mortality rates, we conducted a research study to determine the possible causes and characteristics of neonates presenting dead to the emergency department of tertiary public health care facilities of Pakistan using verbal autopsies. A descriptive case series study was conducted in emergency department/pediatrics ward/neonatal ward/nursery unit of ten tertiary care public health facilities, situated in seven major cities of Pakistan from November, 2011 to June, 2013. Precoded verbal autopsy proforma was used to collect information regarding cause of death, family narratives and other associated risks accountable for pathway to mortality. We identified 431 neonates presenting dead to the emergency department (238 males and 193 females). Sepsis (26.7%), birth asphyxia (18.8%) and persistent pulmonary arrest (17.2%) were main primary causes of brought death. Around 72% brought dead neonates were referred from doctors/health care facilities and more than 28% caregivers mentioned that they were not informed about the diagnosis/ailment of their deceased newborn. Findings of our study suggest that infectious disease remains the main primary cause of neonatal mortality. Underweight in newborns (64%) was estimated as a leading associated risk. Delays in referrals to respective health care facility enlightened the concern of sub-standard prerequisites of neonatal care that could be one of the major contributing risk factor of high mortality rates.

  8. Stem cell research in pakistan; past, present and future.

    PubMed

    Zahra, Sayeda Anum; Muzavir, Sayed Raheel; Ashraf, Sadia; Ahmad, Aftab

    2015-05-01

    Stem cells have proved to have great therapeutic potential as stem cell treatment is replacing traditional ways of treatment in different disorders like cancer, aplastic anemia, stroke, heart disorders. The developed and developing countries are investing differently in this area of research so research output and clinical translation of research greatly vary among developed and developing countries. Present study was done to investigate the current status of stem cells research in Pakistan and ways to improve it. Many advanced countries (USA, UK and Canada etc.) are investing heavily in stem cell research and treatment. Different developing countries like Iran, Turkey and India are also following the developed countries and investing a lot in stem cells research. Pakistan is also making efforts in establishing this field to get desired benefits but unfortunately the progress is at very low pace. If Government plays an active role along with private sector, stem cell research in Pakistan can be boosted up. The numbers of publications from Pakistan are very less compared to developed and neighboring countries and Pakistan also has very less number of institutes working in this area of research. Stem cells research is at its initial stages in Pakistan and there is great need to bring Government, academia and industry together so they could make serious efforts to promote research in this very important field. This will help millions of patients suffering from incurable disorders and will also reduce economic loss.

  9. Daughter neglect, women's work, and marriage: Pakistan and Bangladesh compared.

    PubMed

    Miller, B D

    1984-01-01

    This article looks at juvenile sex ratios, juvenile mortality, women's work roles and marriage patterns in Pakistan and bangladesh in order to assess whether patterns previously observed in India, namely, daughter neglect in the northwest and equal juvenile sex ratios in the eastern part of the country, are carried over into the 2 adjacent nations, Pakistan and Bangladesh, respectively. The Indian study indicates that nationwide sex ratio data, sample survey data on childhood mortality, longitudinal population records in several locations and ethonographic evidence all point to inequalities in mortality as the prime cause of unbalanced sex ratios. The juvenile sex ratios of Pakistan and Bangladesh are very different from 1 another. Whereas there are no regional contrasts among juvenile sex ratios within Bangladesh, it is greater within Pakistan. Sex ratio data correspond roughly to what the mortality data indicate in terms of the contrast between Pakistan and Bangladesh. The evidence on juvenile mortality in both countries is too scant to support an airtight argument that juvenile females in Pakistan have much higher mortality rates than boys, while mortality rates are more balanced in Bangladesh. But the existing evidence clearly points to that conclusion. The immediate causes of the greater sex-differential mortality in Pakistan cannot be documented in the available ethnographic literature. Biased allocation of food, medical care, and love might be operating. Looking at the economic and sociocultural complex that promotes much differences between Pakistan and Bangladesh, it is argued that, in both countries, class-based variations in both women's work and marriage patterns exist and are important. It is hypothesized that females in Pakistan are little valued for agricultural labor, and pose an economic liability on their families who need to provide a large dowry with her marriage to compensate for the daughter's low economic utility to the agrucultural workforce

  10. Emergence and diversification of dengue 2 cosmopolitan genotype in Pakistan, 2011.

    PubMed

    Khan, Mohammad A; Ellis, Esther M; Tissera, Hasitha A; Alvi, Mohammad Y; Rahman, Fatima F; Masud, Faisal; Chow, Angelia; Howe, Shiqin; Dhanasekaran, Vijaykrishna; Ellis, Brett R; Gubler, Duane J

    2013-01-01

    Major dengue epidemics have been observed in the Indian subcontinent since the 1980s and have occurred with increased hospitalizations and mortality. In 2011, the first major epidemic of dengue occurred in Lahore, the second largest city in Pakistan, and resulted in 21,685 confirmed cases and 350 deaths. To investigate the possible viral causes for the increased epidemic activity, we determined the predominant serotype and characterized the viruses genetically. Of 50 patients carefully selected as probable dengue fever or dengue hemorrhagic fever, 34 were positive by virologic testing (i.e. PCR and/or virus isolation). DENV-2 was detected in 32 patients and DENV-1 in two. A total of 24 partial and three full DENV genomes were sequenced. Phylogenetic analyses of the capsid (C), pre-membrane (prM), and envelope genes comprising 2500 nucleotides in length indicated that all DENV-2 isolates in Pakistan since 2007 form a monophyletic lineage that is endemic in the country. These viruses were all of the cosmopolitan genotype (IV) and most closely related to viruses isolated in India and Sri Lanka in the past two decades. Phylogenetic analyses of data currently available in GenBank suggest that the Cosmopolitan genotype has diverged into two geographically distinct sub-lineages: sub-lineage IV-a has only been observed in Southeast Asia, China and Oceania, while IV-b is prevalent in the Indian subcontinent. These results highlight the increased diversity of dengue viruses as they spread geographically within the region.

  11. The First Avenue After-School Day Care Center: A Program for Low Income Families in New York City.

    ERIC Educational Resources Information Center

    Jarm, Charles

    This paper provides a very brief overview of an after-school day care center in New York City which cares for a maximum of 65 immigrant children 6 through 12 years of age. The population served consists of families from Hong Kong, China, Latin America, India, Pakistan, Puerto Rico, Korea and Nigeria. As most families served know little English,…

  12. Workplace Violence and Self-reported Psychological Health: Coping with Post-traumatic Stress, Mental Distress, and Burnout among Physicians Working in the Emergency Departments Compared to Other Specialties in Pakistan.

    PubMed

    Zafar, Waleed; Khan, Uzma R; Siddiqui, Shakeel A; Jamali, Seemin; Razzak, Junaid A

    2016-01-01

    Little is known about the mental health impact of workplace violence (WPV) among emergency physicians (EPs) working in emergency departments (EDs) in Pakistan and whether this impact varies across specialties. Our aim was to measure the prevalence of WPV among EPs in 4 of the largest hospitals in Karachi, Pakistan; to measure the association between the experience of WPV and self-report of post-traumatic stress disorder (PTSD), depression, anxiety, and burnout; to compare the same factors across medical specialties; and to explore the coping strategies used by physicians in dealing with job-related stressors. A cross-sectional survey was conducted among 179 physicians from 5 specialties (response rate, 92.2%) using standard questionnaires for WPV, PTSD, burnout, current mental distress, and methods of coping. One in 6 physicians reported experiencing a physical attack and 3 in 5 verbal abuse on the job in the previous 12 months. Pathologists were less likely to report any form of WPV compared to all other specialties. There was, however, no difference in experience of WPV between EPs and internists, surgeons, or pediatricians. One in 6 physicians screened positive for PTSD, and 2 in 5 for current anxiety and depression. There was significant comorbidity of mental distress with PTSD. Those who reported experiencing physical attack were 6.7 times more likely to report PTSD symptoms. We also found high rates of burnout (42.4% emotional exhaustion; 72.9% depersonalization) among physicians. Experience of WPV was not uniform across specialties but was generally high among Pakistani physicians. Prevention of WPV should be a high priority for health care policy makers. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Khyber Pass, Afghanistan-Pakistan

    NASA Image and Video Library

    2010-11-08

    The ASTER instrument onboard NASA Terra spacecraft imaged the Khyber Pass, a mountain pass that links Afghanistan and Pakistan. Throughout its history it has been an important trade route between Central Asia and South Asia.

  14. Rise in childhood obesity with persistently high rates of undernutrition among urban school-aged Indo-Asian children.

    PubMed

    Jafar, T H; Qadri, Z; Islam, M; Hatcher, J; Bhutta, Z A; Chaturvedi, N

    2008-05-01

    Childhood obesity is an emerging global public health challenge. Evidence for the transition in nutrition in Indo-Asian developing countries is lacking. We conducted these analyses to determine the trends in nutritional status of school-aged children in urban Pakistan. Data on the nutritional status of children aged 5 to 14 years from two independent population-based representative surveys, the urban component of the National Health Survey of Pakistan (NHSP; 1990-1994) and the Karachi survey (2004-2005), were analysed. Using normative data from children in the United States as the reference, trends for age- and gender-standardised prevalence (95% CI) of underweight (more than 2 SD below the weight-for-age reference), stunted (more than 2 SD below the height-for-age reference) and overweight and obese (body mass index (BMI) 85(th) percentile or greater) children were compared for the two surveys. The association between physical activity and being overweight or obese was analysed in the Karachi survey using logistical regression analysis. 2074 children were included in the urban NHSP and 1675 in the Karachi survey. The prevalence of underweight children was 29.7% versus 27.3% (p = 0.12), stunting was 16.7% versus 14.3% (p = 0.05), and prevalence of overweight and obese children was 3.0 versus 5.7 (p<0.001) in the NHSP and Karachi surveys, respectively. Physical activity was inversely correlated with being overweight or obese (odds ratio, 95% CI, 0.51, 0.32-0.80 for those who engaged in more than 30 minutes of physical activity versus those engaged in less than 30 minutes' activity). Our study highlights the challenge faced by Pakistani school-aged children. There has been a rapid rise in the number of overweight and obese children despite a persistently high burden of undernutrition. Focus on prevention of obesity in children must include strategies for promoting physical activity.

  15. Rise in childhood obesity with persistently high rates of undernutrition among urban school-aged Indo-Asian children

    PubMed Central

    Jafar, T H; Qadri, Z; Islam, M; Hatcher, J; Bhutta, Z A; Chaturvedi, N

    2008-01-01

    Background: Childhood obesity is an emerging global public health challenge. Evidence for the transition in nutrition in Indo-Asian developing countries is lacking. We conducted these analyses to determine the trends in nutritional status of school-aged children in urban Pakistan. Methods: Data on the nutritional status of children aged 5 to 14 years from two independent population-based representative surveys, the urban component of the National Health Survey of Pakistan (NHSP; 1990–1994) and the Karachi survey (2004–2005), were analysed. Using normative data from children in the United States as the reference, trends for age- and gender-standardised prevalence (95% CI) of underweight (more than 2 SD below the weight-for-age reference), stunted (more than 2 SD below the height-for-age reference) and overweight and obese (body mass index (BMI) 85th percentile or greater) children were compared for the two surveys. The association between physical activity and being overweight or obese was analysed in the Karachi survey using logistical regression analysis. Results: 2074 children were included in the urban NHSP and 1675 in the Karachi survey. The prevalence of underweight children was 29.7% versus 27.3% (p = 0.12), stunting was 16.7% versus 14.3% (p = 0.05), and prevalence of overweight and obese children was 3.0 versus 5.7 (p<0.001) in the NHSP and Karachi surveys, respectively. Physical activity was inversely correlated with being overweight or obese (odds ratio, 95% CI, 0.51, 0.32–0.80 for those who engaged in more than 30 minutes of physical activity versus those engaged in less than 30 minutes’ activity). Conclusions: Our study highlights the challenge faced by Pakistani school-aged children. There has been a rapid rise in the number of overweight and obsese children despite a persistently high burden of undernutrition. Focus on prevention of obesity in children must include strategies for promoting physical activity. PMID:17942586

  16. In Pakistan, the Problems that Money Can Bring

    ERIC Educational Resources Information Center

    Neelakantan, Shailaja

    2007-01-01

    Over the past four years, Pakistan's higher-education budget has increased more than sevenfold, to about $449-million. While that amounts to only 0.5 percent of Pakistan's gross domestic product, it is a big improvement from the days of barely enough to pay "measly salaries and basic bills." But for students, along with many of…

  17. A survey of knowledge, attitude, and practices of private retail pharmacies staff in tuberculosis care: study from Dera Ismail Khan City, Pakistan.

    PubMed

    Mustafa, Tehmina; Shahzad, Yasir; Kiani, Ayyaz

    2018-01-01

    In order to engage pharmacies in tuberculosis (TB) care, a survey was conducted in the Dera Ismail (DI) Khan City of the Khyber Pakhtoon Khwa province, Pakistan. The objectives were to; 1) characterize the retail pharmacies; 2) determine knowledge of the staff on various aspects of pulmonary TB; 3) determine practices related to the sale of anti-TB drugs, and referrals of presumptive TB patient, and willingness to participate in the National Tuberculosis Control Programme's (NTP) Directly Observed Treatment Short-Course (DOTS) strategy. A cross-sectional survey was conducted by using a structured questionnaire to collect data from pharmacy staff at all the private retail pharmacies of the DI khan city. All the interviewed staff ( n  = 82) were males, only 38% had formal training as pharmacist (5%) or as a pharmacy assistant (33%). Pharmacies established for a longer period were better staffed and had high customer load. About 92% of the interviewed staff knew that persistent cough is a symptom for TB, 82% knew that TB is diagnosed by examination of sputum. Almost 66% of the pharmacy staff did not know multi-drug resistance TB as a consequence of improper treatment. Those with formal training and longer experience in retail pharmacy had better knowledge of various aspects of TB as compared to the staff with no formal pharmacy training and lesser experience ( p  < 0.01). Only 57% were aware of NTP while only 30% had heard of the DOTS strategy. All reported sale of first-line TB drugs as fixed dose combinations. The majority (80%) referred presumptive TB patients to chest physicians and no patient was referred to the NTP. Nearly 83% of the interviewed staff was willing to be involved in TB control efforts by getting training and referring patients to the DOTS facility. There was shortage of professionally qualified and female staff in private retail pharmacies. Knowledge of professionally qualified staff about TB seemed sufficient to identify presumptive TB

  18. Pakistan: Ascending a Path through Regional Turmoil

    DTIC Science & Technology

    2013-03-01

    Correspondingly, the US perceives that it is Pakistan’s unwarranted and paranoid fear of India (and mistrust of the reliability of the US) that is causing...For instance, Pakistan has welcomed the Iranian offer to overcome its energy crisis with the building of the Iran-Pakistan-India (IPI) gas pipeline...mitigate its effects. It may have to look both inwards and outwards to overcome this emerging crisis. It will have to carefully develop a viable

  19. Deconstructive Pedagogy and Ideological Demystification in Post-Colonial Pakistan

    ERIC Educational Resources Information Center

    Mansoor, Asma; Malik, Samina

    2016-01-01

    With post-colonial Pakistan inheriting the British colonial ideological and governmental apparatus, the English literature curriculum implemented at the university level in Pakistan carried the interpellatory baggage of its colonial past. Our interdisciplinary exploration focuses on using deconstructive pedagogy to demystify and subvert the…

  20. Regional Studies of the Potwar Plateau Area, Northern Pakistan

    USGS Publications Warehouse

    Warwick, Peter D.; Wardlaw, Bruce R.

    2007-01-01

    The papers in this volume are products of a cooperative program between the Geological Survey of Pakistan (GSP) and the U.S. Geological Survey (USGS), sponsored by the Government of Pakistan and the U.S. Agency for International Development. The focus of the program, the Coal Resources Exploration and Assessment Program (COALREAP), was to explore and assess Pakistan?s indigenous coal resources. As part of COALREAP, GSP and USGS geologists conducted regional geologic studies from 1988 to 1991 of the coal-bearing areas in the Potwar region of northern Pakistan. A reference section was selected from which to obtain faunal and floral analyses. The composite sections at Nammal Pass and Nammal Dam served as the basis for this regional reference. Although this Bulletin 2078 is being released in 2007, the writing and technical reviews were completed in 1993, and the chapters reflect the work done until that time. During the long production process for the Bulletin, which ultimately resulted in the oversize plates being digitized, the scientific content of the chapters was not changed, and most reports published since 1993 were not cited. A change in the age of the Patala Formation is discussed below [in the full preface], but the age discussions and illustrations in the chapters were not updated.

  1. Palliative care in Pakistan.

    PubMed

    Khan, Robyna Irshad

    2017-01-01

    Pakistan is a developing country of South East Asia, with all the incumbent difficulties currently being faced by the region. Insufficient public healthcare facilities, poorly regulated private health sector, low budgetary allocation for health, improper priority setting while allocating limited resources, have resulted essentially in an absence of palliative care from the healthcare scene. Almost 90% of healthcare expenditure is out of the patient's pocket with more than 45% of population living below the poverty line. All these factors have a collective potential to translate into an end-of-life care disaster as a large percentage of population is suffering from chronic debilitating/terminal diseases. So far, such a disaster has not materialised, the reason being a family based culture emphasising the care of the sick and old at home, supported by religious teachings. This culture is not limited to Pakistan but subsists in the entire sub-continent, where looking after the sick/elderly at home is considered to be the duty of the younger generation. With effects of globalisation, more and more older people are living alone and an increasing need for palliative care is being realised. However, there does not seem to be any plan on the part of the public or private sectors to initiate palliative care services. This paper seeks to trace the social and cultural perspectives in Pakistan with regards to accessing palliative care in the context of healthcare facilities available.

  2. Reading Caplan in Karachi.

    PubMed

    Moazam, Farhat

    2018-01-01

    Bioethics education and discussions about ethical dilemmas are being increasingly reduced to teaching students how to balance the four, easily memorised philosophical principles popularised by influential American philosophers Tom Beauchamp and Jim Childress. The reality is that human beings approach and comprehend moral issues in diverse ways shaped by shared histories, cultural norms and values, kinship systems, lived experiences and existing socio-political realities. Therefore, ethical discourse limited to a culturally myopic Principlism that disregards the indigenous landscape can be an abstract and meaningless venture. The different moral lenses through which people can view the same issue is highlighted in this essay. It compares the analyses offered by American bioethicist Arthur Caplan of the blocking of polio vaccination by militants in northern Pakistan and of issues related to posthumous insemination, with the more nuanced, contextualised discussions about both topics offered by Pakistani students of bioethics in our Center. For this discipline to resonate with and make an impact on those we teach, an inclusive, more reflective and socially relevant approach is required. In my opinion, bioethics is a contact sport that should not be transformed into merely an academic exercise.

  3. Big city, small world: density, contact rates, and transmission of dengue across Pakistan.

    PubMed

    Kraemer, M U G; Perkins, T A; Cummings, D A T; Zakar, R; Hay, S I; Smith, D L; Reiner, R C

    2015-10-06

    Macroscopic descriptions of populations commonly assume that encounters between individuals are well mixed; i.e. each individual has an equal chance of coming into contact with any other individual. Relaxing this assumption can be challenging though, due to the difficulty of acquiring detailed knowledge about the non-random nature of encounters. Here, we fitted a mathematical model of dengue virus transmission to spatial time-series data from Pakistan and compared maximum-likelihood estimates of 'mixing parameters' when disaggregating data across an urban-rural gradient. We show that dynamics across this gradient are subject not only to differing transmission intensities but also to differing strengths of nonlinearity due to differences in mixing. Accounting for differences in mobility by incorporating two fine-scale, density-dependent covariate layers eliminates differences in mixing but results in a doubling of the estimated transmission potential of the large urban district of Lahore. We furthermore show that neglecting spatial variation in mixing can lead to substantial underestimates of the level of effort needed to control a pathogen with vaccines or other interventions. We complement this analysis with estimates of the relationships between dengue transmission intensity and other putative environmental drivers thereof. © 2015 The Authors.

  4. The burden of headache disorders in Pakistan: methodology of a population-based nationwide study, and questionnaire validation

    PubMed Central

    2013-01-01

    Background Large geographical gaps in our knowledge of the prevalence and burden of headache disorders include Pakistan, a country with major problems of poverty, illiteracy and security. We report implementation in this country of standard methods developed by Lifting The Burden (LTB) for population-based burden-of-headache studies. Methods We surveyed six locations from the four provinces: Lahore and Multan (Punjab), Karachi and Sukkur (Sindh), Abbottabad (Khyber Pakhtunkhwa) and Gwadar (Baluchistan). We randomly selected rural and urban households in each, which were visited by trained non-medical interviewers from the same locations. One randomly selected adult member (18–65 years) of each household was interviewed using LTB’s structured questionnaire translated into Urdu, the national language. Validation was performed among patients and accompanying attendants in three (urban and rural) medical facilities. After responding to the questionnaire, these participants were re-interviewed and diagnosed by a neurologist (gold standard). Results The survey was completed by 4,223 respondents (1,957 [46.3%] male, 2,266 [53.7%] female, 1,443 [34.2%] urban, 2,780 [65.8%] rural, mean age 34.4 ± 11.0 years). The participation rate was 89.5%. There were 180 participants (46.1% male, 53.9% female, 41.7% urban, 58.3% rural, mean age 39.4 ± 14.2 years) in the validation sample, of whom 147 (81.7%) reported headache in the last year. The questionnaire was 100% sensitive in screening for headache and for headache on ≥15 days/month, and showed good agreement with the gold-standard diagnoses (kappa = 0.77). It was relatively insensitive for TTH. The questionnaire’s default diagnosis of probable MOH when medication overuse accompanied headache on ≥15 days/month was not supported by evidence of causation in most cases seen by the neurologist. In public-health terms, precise diagnosis in these cases matters less than reliably detecting the coexistence of

  5. Vertical and lateral flux on the continental slope off Pakistan: correlation of sediment core and trap results

    NASA Astrophysics Data System (ADS)

    Schulz, H.; von Rad, U.

    2014-06-01

    Due to the lack of bioturbation, the varve-laminated muds from the oxygen minimum zone (OMZ) off Pakistan provide a unique opportunity to precisely determine the vertical and lateral sediment fluxes in the nearshore part of the northeastern Arabian Sea. West of Karachi (Hab area), the results of two sediment trap stations (EPT and WPT) were correlated with 16 short sediment cores on a depth transect crossing the OMZ. The top of a distinct, either reddish- or light-gray silt layer, 210Pb-dated as AD 1905 ± 10, was used as an isochronous stratigraphic marker bed to calculate sediment accumulation rates. In one core, the red and gray layer were separated by a few (5-10) thin laminae. According to our varve model, this contributes < 10 years to the dating uncertainty, assuming that the different layers are almost synchronous. We directly compared the accumulation rates with the flux rates from the sediment traps that collected the settling material within the water column above. All traps on the steep Makran continental slope show exceptionally high, pulsed winter fluxes of up to 5000 mg m-2 d-1. Based on core results, the flux at the seafloor amounts to 4000 mg m-2 d-1 and agrees remarkably well with the bulk winter flux of material, as well as with the flux of the individual bulk components of organic carbon, calcium carbonate and opal. However, due to the extreme mass of remobilized matter, the high winter flux events exceeded the capacity of the shallow traps. Based on our comparisons, we argue that high-flux events must occur regularly during winter within the upper OMZ off Pakistan to explain the high accumulations rates. These show distribution patterns that are a negative function of water depth and distance from the shelf. Some of the sediment fractions show marked shifts in accumulation rates near the lower boundary of the OMZ. For instance, the flux of benthic foraminifera is lowered but stable below ~1200-1300 m. However, flux and sedimentation in the

  6. Comparison of knowledge, attitude and practices of betelnut users in two socio-economic areas of Karachi.

    PubMed

    Khan, Muhammad Shahzeb; Bawany, Faizan Imran; Shah, Syed Raza; Hussain, Mehwish; Arshad, Mohammad Hussham; Nisar, Nighat

    2013-10-01

    To gain an insight on the knowledge, attitude and practices of those who chew betel nut in two different socioeconomic regions of Karachi. The cross-sectional study was conducted in Saddar and Defence areas of Karachi over a five-week period in March-April 2012. Individual interviews following verbal consent were conducted using a pre-coded questionnaire, which was divided into 3 sections to analyse the knowledge, attitude and practices of the chewers. The data was entered and analysed using SPSS v. 16.0. Pearson's chi-square was used as the primary statistical test. A total of 370 subjects, 185 (50%) from each area, comprised the study. Majority of the chewers in Defence had higher educational qualification and income. Most of the participants in both areas acknowledged that betel nut chewing can potentially result in mouth (n = 274; 74.1%) and throat cancers (n = 267; 72.2%). A large part of the sample (n = 299; 80.8%) conceded that betel nut chewing is a bad habit, and almost half the sample was addicted to it (n = 194; 52.4%). Awareness regarding the detrimental effects of betel nut was satisfactory amongst the subjects, but the population was not willing to quit the habit. We recommend a two-pronged approach, offering widespread educational and awareness campaigns to prevent increased consumption of betel nuts, and professional counselling services for those already addicted.

  7. Pakistan embarks on new campaign to reduce fertility.

    PubMed

    1992-01-01

    There was both international and domestic significance in a plea for population stabilization issued by Pakistan's Prime Minister Nawaz Sharif in his address at the recent Earth Summit conference in Rio de Janeiro. Speaking as both a national leader and chairman of the Group of 77, a coalition of developing countries, Sharif said that to eradicate the abject poverty under which more than a billion people in the world live today "developing countries must assume their full responsibility in limiting population growth to manageable levels." Those words may seem odd coming from the leader of a country that has been indifferent about population problems for the past 2 decades. Until Prime Minister Sharif made a public commitment to a population program last July, the last leader of Pakistan to take such action was the late President Ayub Khan in 1969. With an annual 3.1% growth rate, Pakistan's population of 122 million is projected to double in only 23 years. The average Pakistani woman has 6.1 children in her reproductive lifetime. Reduction of population growth was an issue in the October 1990 election campaign. After his Islamic Democratic Alliance won, the government named Syeda Abida Hussain, a prominent and popular politician, to the cabinet post of Minister of Family Welfare. Hussain, who is now Pakistan's Ambassador to the US, recalls that many experts felt that starting a population program would be "an impossible undertaking, "that" attitudes were not conducive to family planning and government would never support it." In a speech on World Population Day in Rio, organized by the Population Institute, she said she soon found that "the problems were managerial, not attitudinal." She maintained that the relatively low acceptance of contraception among the people of Pakistan, Bangladesh and India is not because of religion or ideology "but because they are too poor to have access to birth control." Shortly after Hussain was names Minister of Family Welfare, she

  8. Clinical Presentation and Frequency of Risk Factors in Patients with Breast Carcinoma in Pakistan.

    PubMed

    Memon, Zahid Ali; Qurrat-ul-Ain; Khan, Ruba; Raza, Natasha; Noor, Tooba

    2015-01-01

    Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries .The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was 47.8 ± 12.4 years. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was 5.13 ± 4.8 months, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche <11 years (19%), followed by null parity (16.2%), consumption of high fat diet (15.2%), family history of breast cancer or any other cancer in first degree relatives (9.5% and 13

  9. Retinal Screening Acceptance, Laser Treatment Uptake and Follow-up Response in Diabetics Requiring Laser Therapy in an Urban Diabetes Care Centre.

    PubMed

    Memon, Salah; Ahsan, Shahid; Alvi, Rashid; Fawwad, Asher; Basit, Abdul; Shera, Samad; Sheikh, Sikander Ali; Fahim, Muhammad Faisal

    2015-10-01

    To determine the acceptance of retinal screening, Laser uptake and subsequent follow-up in diabetic patients attending the Diabetes Centre of Diabetic Association of Pakistan (DAP), Karachi. Observational case series. Diabetic Centre of Diabetic Association of Pakistan (DAP), Karachi, from January 2011 to December 2012. All the diabetic patients were screened for Diabetic Retinopathy (DR) with non-Mydriatic Fundus Camera (NMFC). Patients with DR were examined by the ophthalmologist using fundus lens and slit lamp. DR was graded for severity on the basis of modified Airlie House Classification. Patients with Sight Threatening Diabetic Retinopathy (STDR) were advised Laser treatment. Each patient was followed-up for at least 6 months. The records of patients recommended Laser were retrieved, and called for re-examination. Retinal screening was accepted by all of the 8368 registered diabetics attending DAP Centre. On fundus photography, 21.2% (1777) individuals were found to have DR. Seven hundred and five (39.5%) patients were found to have STDR. Laser was advised to 96.4% (680) of STDR patients; amongst whom 70.5% (480) accepted Laser treatment. Out of 480 patients who had Laser treatment, 21.2% (107) turned out for follow-up after 6 months. Acceptance of retinal screening and Laser application was good; but follow-up was suboptional.

  10. Cardiovascular Disease-Related Lifestyle Factors among People with Type 2 Diabetes in Pakistan: A Multicentre Study for the Prevalence, Clustering, and Associated Sociodemographic Determinants

    PubMed Central

    Khuwaja, Ali Khan; Lalani, Saima; Azam, Iqbal Syed; Ali, Badar Sabir; Jabbar, Abdual; Dhanani, Raheem

    2011-01-01

    Background. We evaluated the prevalence and clustering pattern of cardiovascular disease (CVD) related lifestyle factors and their association with CVD among patients with type 2 diabetes. We also examined the association of these factors with various socio-demographic characteristics. Methods. A total of 1000 patients with type 2 diabetes were interviewed in a cross-sectional, multi-center study in out-patient clinics in Karachi, Pakistan. Results. In this study 30.3% study participants had CVD. Majority of the patients were physically inactive and had adverse psychosocial factors. Forty percent of the study participants were exposed to passive smoking while 12.7% were current smokers. Only 8.8% of study subjects had none of the studied lifestyle factor, 27.5% had one, while 63.7% had two or three factors. CVDs were independently associated with physical inactivity, adverse psychosocial factors, passive smoking and clustering of two or three lifestyle factors. Physical inactivity was more prevalent among females and patients with no/less education. Proportion of adverse psychosocial factors were higher among females, elders and patients with no/less education. Clustering of these lifestyle factors was significantly higher among females, elderly and no/less educated patients. Conclusion. These results suggest the need of comprehensive and integrated interventions to reduce the prevalence of lifestyle factors. PMID:21837274

  11. The relative abundance and seasonal distribution correspond with the sources of polycyclic aromatic hydrocarbons (PAHs) in the surface sediments of Chenab River, Pakistan.

    PubMed

    Hussain, Imran; Syed, Jabir Hussain; Kamal, Atif; Iqbal, Mehreen; Eqani, Syed-Ali-Mustjab-Akbar-Shah; Bong, Chui Wei; Taqi, Malik Mumtaz; Reichenauer, Thomas G; Zhang, Gan; Malik, Riffat Naseem

    2016-06-01

    Chenab River is one of the most important rivers of Punjab Province (Pakistan) that receives huge input of industrial effluents and municipal sewage from major cities in the Central Punjab, Pakistan. The current study was designed to evaluate the concentration levels and associated ecological risks of USEPA priority polycyclic aromatic hydrocarbons (PAHs) in the surface sediments of Chenab River. Sampling was performed from eight (n = 24) sampling stations of Chenab River and its tributaries. We observed a relatively high abundance of ∑16PAHs during the summer season (i.e. 554 ng g(-1)) versus that in the winter season (i.e. 361 ng g(-1)), with an overall abundance of two-, five- and six-ring PAH congeners. Results also revealed that the nitrate and phosphate contents in the sediments were closely associated with low molecular weight (LMW) and high molecular weight (HMW) PAHs, respectively. Source apportionment results showed that the combustion of fossil fuels appears to be the key source of PAHs in the study area. The risk quotient (RQ) values indicated that seven PAH congeners (i.e. phenanthrene, anthracene, fluoranthene, pyrene, benzo(a)pyrene, chrysene and benzo(a)anthracene) could pose serious threats to the aquatic life of the riverine ecosystem in Pakistan.

  12. Analysis of misoprostol and chlorhexidine policy gains in Pakistan: the advocacy experience of Mercy Corps Pakistan.

    PubMed

    Sarwar, Zahida; Cutherell, Andrea; Noor, Arif; Naureen, Farah; Norman, Jennifer

    2015-11-25

    While Pakistan has made progress toward achieving Millennium Development Goal 5 for maternal health, it is unlikely to achieve the target; further, it is also not on track for Millennium Development Goal 4 regarding child health. Two low-cost, temperature stable and life-saving drugs, misoprostol and chlorhexidine, can respectively avert maternal and newborn deaths, and are particularly pertinent for poor and marginalized areas which bear the brunt of maternal and newborn deaths in Pakistan. In response, Mercy Corps led focused advocacy efforts to promote changes in policies, protocols, and regulatory environments for misoprostol (2012-2014) and for chlorhexidine (2014). These short-duration advocacy projects facilitated significant policy gains, such as inclusion of misoprostol and chlorhexidine into province-specific essential drug lists, development and endorsement of clinical protocols for the two drugs by provincial health departments, inclusion of misoprostol into pre-service training curriculum for several health cadres, and application for registration of chlorhexidine (at the concentration required for newborn care) by two pharmaceutical companies. These results were achieved by a consultative and evidence-based process which generated feedback from community members, program implementers, and policymakers, and ultimately put the government in the driver's seat to facilitate change. Community Action Dialogue forums were linked with provincial-level Technical Working Groups and Provincial Steering Committees, who passed on endorsed recommendations to the Health Secretary. The key factors which facilitated change were the identification of champions within the provincial health departments, prioritization of relationship building and follow-up, focus on concrete advocacy aims rather than broad objectives, and the use of multi-stakeholder forums to secure an enabling environment for the policy changes to take root. While these advocacy initiatives resulted in

  13. Drinking Water Quality Status and Contamination in Pakistan.

    PubMed

    Daud, M K; Nafees, Muhammad; Ali, Shafaqat; Rizwan, Muhammad; Bajwa, Raees Ahmad; Shakoor, Muhammad Bilal; Arshad, Muhammad Umair; Chatha, Shahzad Ali Shahid; Deeba, Farah; Murad, Waheed; Malook, Ijaz; Zhu, Shui Jin

    2017-01-01

    Due to alarming increase in population and rapid industrialization, drinking water quality is being deteriorated day by day in Pakistan. This review sums up the outcomes of various research studies conducted for drinking water quality status of different areas of Pakistan by taking into account the physicochemical properties of drinking water as well as the presence of various pathogenic microorganisms. About 20% of the whole population of Pakistan has access to safe drinking water. The remaining 80% of population is forced to use unsafe drinking water due to the scarcity of safe and healthy drinking water sources. The primary source of contamination is sewerage (fecal) which is extensively discharged into drinking water system supplies. Secondary source of pollution is the disposal of toxic chemicals from industrial effluents, pesticides, and fertilizers from agriculture sources into the water bodies. Anthropogenic activities cause waterborne diseases that constitute about 80% of all diseases and are responsible for 33% of deaths. This review highlights the drinking water quality, contamination sources, sanitation situation, and effects of unsafe drinking water on humans. There is immediate need to take protective measures and treatment technologies to overcome unhygienic condition of drinking water supplies in different areas of Pakistan.

  14. Pakistan and Water: New Pressures on Global Security and Human Health

    PubMed Central

    2011-01-01

    The Indus River is the major source of water for the more than 180 million people of Pakistan. A rapidly increasing population over the past 60 years has created new pressures on water that was once a plentiful resource for the health and development of the country. Rising tensions between India and Pakistan, which share the Indus flow, may lead to violent confrontation in an already volatile part of the globe. The recent flooding, which affected more than 20 million people, drew attention to poor management of the rivers of Pakistan. Public health has the scientific knowledge and professional capacity to help develop water management practices that could improve population health in Pakistan. PMID:21421956

  15. Malpractice awareness among surgeons at a teaching hospital in Pakistan.

    PubMed

    Sheikh, Asfandyar; Ali, Sajid; Ejaz, Sadaf; Farooqi, Marium; Ahmed, Syed Salman; Jawaid, Imran

    2012-11-06

    The duty of a doctor to take care presumes the person who offers medical advice and treatment to unequivocally possess the skills and knowledge to do so. However, a sense of responsibility cannot be guaranteed in the absence of accountability, which in turn requires a comprehensive medical law system to be in place. Such a system is almost non-existent in Pakistan. Keeping the above in mind, we designed this study to assess the knowledge, attitudes and practices of surgeons regarding malpractice at a tertiary care center in Pakistan. This was an observational, cross-sectional, questionnaire-based study conducted during a three month period from 31st March, 2012 to 30th June, 2012 at Civil Hospital, Karachi. Surgeons who were available during the period of our study and had been working in the hospital for at least 6 months were included. Self-administered questionnaires were distributed after seeking informed, written consent. The specialties included were general surgery, cardiothoracic surgery, neurosurgery, ophthalmology, otolaryngology, plastic surgery, pediatric surgery, orthopedic surgery, oral and maxillofacial surgery and gynecology and obstetrics. The study questionnaire comprised of four sections. The first section was concerned with the demographics of the surgeons. The second section analyzed the knowledge of the respondents regarding professional negligence and malpractice. The third section assessed the attitudes surgeons with regard to malpractice. The last section dealt with the general and specific practices and experiences of surgeons regarding malpractice. Of the 319 surgeons interviewed, 68.7% were oblivious of the complete definition of malpractice. Leaving foreign objects inside the patient (79.6%) was the most commonly agreed upon form of malpractice, whereas failure to break news in entirety (43.9%) was most frequently disagreed. In the event of a medical error, majority (67.7%) were ready to disclose their error to the patient. The most

  16. Malpractice awareness among surgeons at a teaching hospital in Pakistan

    PubMed Central

    2012-01-01

    Background The duty of a doctor to take care presumes the person who offers medical advice and treatment to unequivocally possess the skills and knowledge to do so. However, a sense of responsibility cannot be guaranteed in the absence of accountability, which in turn requires a comprehensive medical law system to be in place. Such a system is almost non-existent in Pakistan. Keeping the above in mind, we designed this study to assess the knowledge, attitudes and practices of surgeons regarding malpractice at a tertiary care center in Pakistan. Methods This was an observational, cross-sectional, questionnaire-based study conducted during a three month period from 31st March, 2012 to 30th June, 2012 at Civil Hospital, Karachi. Surgeons who were available during the period of our study and had been working in the hospital for at least 6 months were included. Self-administered questionnaires were distributed after seeking informed, written consent. The specialties included were general surgery, cardiothoracic surgery, neurosurgery, ophthalmology, otolaryngology, plastic surgery, pediatric surgery, orthopedic surgery, oral and maxillofacial surgery and gynecology and obstetrics. The study questionnaire comprised of four sections. The first section was concerned with the demographics of the surgeons. The second section analyzed the knowledge of the respondents regarding professional negligence and malpractice. The third section assessed the attitudes surgeons with regard to malpractice. The last section dealt with the general and specific practices and experiences of surgeons regarding malpractice. Results Of the 319 surgeons interviewed, 68.7% were oblivious of the complete definition of malpractice. Leaving foreign objects inside the patient (79.6%) was the most commonly agreed upon form of malpractice, whereas failure to break news in entirety (43.9%) was most frequently disagreed. In the event of a medical error, majority (67.7%) were ready to disclose their error

  17. Obesity, An Emerging Epidemic In Pakistan-A Review Of Evidence.

    PubMed

    Tanzil, Sana; Jamali, Tanzil

    2016-01-01

    In Pakistan, the disease pattern is facing a huge changeover from acute and communicable diseases to the non-communicable diseases. Moreover, an emerging epidemic of obesity is still under recognized in Pakistan. A detailed review and dissemination of the existing knowledge to determine the extent of burden of obesity can help understand this important public health issue. A detailed literature review was conducted through PubMed search engines, regarding obesity burden in Pakistan. The original peer reviewed research articles, reports of WHO in English language, non-government organizations reports were included in the review. "Obesity AND Pakistan" were used as a search terms. Pakistan is suffering from epidemic of obesity, affecting all age groups. Urban population, particularly women shows considerable higher burden of obesity as compared to men and women from rural population. However, among children and adolescents there is variation in prevalence of obesity. Girls from all age groups are predominantly more obese as compared to boys. Most of the studies have estimated child obesity among school going children of different age groups and need careful interpretation. Pakistan is currently suffering from an emerging epidemic of obesity. The rising burden of obesity is widespread among adults (man and women) and children. The burden of obesity is higher among females in all age groups as compare to males. Effective interventions are required at population level to prevent and control this emerging public health issue.

  18. Returns to Schooling, Ability and Cognitive Skills in Pakistan

    ERIC Educational Resources Information Center

    Aslam, Monazza; Bari, Faisal; Kingdon, Geeta

    2012-01-01

    This study investigates the economic outcomes of education for wage earners in Pakistan. This is done by analysing the relationship between schooling, cognitive skills and ability, on the one hand, and economic activity, occupation, sectoral choice and earnings, on the other. In Pakistan, an important question remains largely unaddressed: what…

  19. Progress toward poliomyelitis eradication - Afghanistan and Pakistan, 2009.

    PubMed

    2010-03-12

    Afghanistan, Pakistan, India, and Nigeria are the four remaining countries where indigenous wild poliovirus (WPV) transmission has never been interrupted. This report updates previous reports and describes polio eradication activities in Afghanistan and Pakistan during January-December 2009 and proposed activities in 2010 to address challenges. During 2009, both countries continued to conduct coordinated supplemental immunization activities (SIAs) and used multiple strategies to reach previously unreached children. These strategies included 1) use of short interval additional dose (SIAD) SIAs to administer a dose of oral poliovirus vaccine (OPV) within 1-2 weeks after a prior dose during negotiated periods of security; 2) systematic engagement of local leaders; 3) negotiations with conflict parties; and 4) increased engagement of nongovernmental organizations delivering basic health services. However, security problems continued to limit access by vaccination teams to large numbers of children. In Afghanistan, poliovirus transmission during 2009 predominantly occurred in 12 high-risk districts in the conflict-affected South Region; 38 WPV cases were confirmed in 2009, compared with 31 in 2008. In Pakistan, 89 WPV cases were confirmed in 2009, compared with 118 in 2008, but transmission persisted both in security-compromised areas and in accessible areas, where managerial and operational problems continued to affect immunization coverage. Continued efforts to enhance safe access of vaccination teams in insecure areas will be required for further progress toward interruption of WPV transmission in Afghanistan and Pakistan. In addition, substantial improvements in subnational accountability and oversight are needed to improve immunization activities in Pakistan.

  20. Introduction and evolution of dengue virus type 2 in Pakistan: a phylogeographic analysis.

    PubMed

    Akram, Madiha; Fatima, Zareen; Purdy, Mike A; Sue, Amanda; Saleem, Sana; Amin, Irum; Shahid, Muhammad; Idrees, Muhammad; Nawaz, Rabia

    2015-09-22

    Pattern of Dengue periodic epidemics through the years along with sporadic cases of Dengue hemorrhagic fever followed by a severe 2011 epidemic of Dengue fever in Pakistan make Pakistan a Dengue endemic country. To study the entry and evolution of dengue virus serotype 2 (DENV-2) in Pakistan, we sequenced three full length genomes and 24 complete envelope sequences of DENV-2 from the years 2010, 2011 and 2013 collected from Punjab province of Pakistan. Phylogenetic and Bayesian phylogeographic analyses was applied to three full genome sequences as well as 24 envelope sequences to study the spatiotemporal dynamics of DENV-2 in Pakistan. Most of the DENV-2 viruses from the years 2008 to 2013 formed a monophyletic Pakistani clade in IVb sublineage of cosmopolitan genotype except one 2008 DENV-2 strain. Phylogeographic analysis revealed that this 2008 DENV-2 strain was rooted to India 25.4 years ago with a location probability of 0.88. However Pakistani clade rooted back to Sri Lanka 12.6 years ago with a location probability of 0.57. DENV-2 genotype IV was introduced in Pakistan in two time events. First event was introduction from India to Pakistan in the late 1980s (around 1986), and second event was introduction from Sri Lanka to Pakistan around 2000. The later introduction event was responsible for major outbreaks in the Punjab region of Pakistan, including major 2011 outbreak. After the second Introduction event, DENV-2 circulated locally in the region forming a distinct Sublineage within the IVb cosmopolitan genotype of DENV-2.

  1. Lymphoma cases referred to the radiation oncology service of a tertiary referral university hospital in Karachi, Pakistan: a retrospective study.

    PubMed

    Abbasi, Ahmed Nadeem; Zahid, Sumaiya; Karsan, Farrok; Ali, Nasir; Bhurgri, Yasmin

    2010-01-01

    Radiation therapy is an important component of curative therapy for Lymphoma [Hodgkin's disease (HD) and non Hodgkin's Lymphoma (NHL)]. The current study was conducted to give us an overview of lymphoma patients presenting to a tertiary care hospital for complementary adjuvant RT. Data of lymphoma patients who underwent radiotherapy during February 2006 till August 2009 at the department of radiation oncology, Aga Khan University, Hospital, Karachi was retrieved from the medical records and analyzed using SPSS (version 16.0). A total of 1,678 cancer patients were registered, 75 (0.45%) were lymphoma patients (25.3% HD; 74.7% NHL). HD and NHL were both seen predominantly in males, with a male:female ratio of 2 and 3 respectively. Nodal HD comprised 94.7% and nodal NHL comprised 41.1%. Extranodal NHL (EN-NHL) comprised 53.6% whereas 5.4% cases had both nodal and EN-NHL; 6.7% of EN-NHL were primary CNS lymphomas. Stages of presentation for HD were IIA (52.6%), 1A (21.1%), IIB (10.5%) and IB, IIIB and IVA collectively 15.9%. The ages of HD patients ranged from 11 to 54 years (median 23.5 years 13.2 SD). Response to therapy for HD was 52.6% complete remission, 36.8% partial response, and 5.3% each with stable and progressive disease. Almost all patients (94.7%) received radical treatment with radiation doses (between 1950 cG to 5404 cGy) with a median of 40 Grays.Stages at presentation for NHL were II (23.2%), IV (21.4%) and IE (17.9%); I, IIE, and III were found to be 12.5 %. NHL patients ranged from 15 to 88 years. It was more commonly observed amongst the elderly with 25% patients diagnosed in the fifth decade of life; 50% patients aged at or above 50 years, 41.1% belonged to the 25-49 years age group and 8.9% below 25 years of age. Majority of the cases were diffuse NHL (82.1%), follicular NHL (7.1%), Primary CNS unclassified type (8.9%), and unclassified other than CNS variety (1.8%). Response to chemotherapy for NHL was 51.8% complete remission, 25.9% progressive

  2. Pakistans Nuclear Weapons

    DTIC Science & Technology

    2016-02-12

    not be subject to International Atomic Energy Agency ( IAEA ) safeguards have the potential to produce 280...PNRA states that Pakistan follows IAEA physical protection standards. Proliferation A fundamental aspect of nuclear security is ensuring that...related to the design and fabrication of a nuclear explosive device,” according to the IAEA (Implementation of the NPT Safeguards Agreement in the

  3. Alternative Governance Structures in Megacities: Threats or Opportunities

    DTIC Science & Technology

    2016-11-01

    Intelligence Stud- ies and Data Informatics at Mercyhurst University as well as a graduate of that program. She teaches intelli- gence communication...States imported $11.6 billion in oil in 2013;35 and Karachi, Pakistan, due to its location at the crossroad of India and China and its state’s con...offer sustainable long-term solu- tions to Karachi’s violent politics. 38 Lagos, Nigeria. Although the United States imports 70 percent less oil

  4. Research productivity of Pakistan in medical sciences during the period 1996-2012.

    PubMed

    Meo, S A; Almasri, A A; Usmani, A M

    2013-11-01

    This study aimed to investigate the degree of research outcome in medical science subjects in Pakistan during the period 1996-2012. In this study, the research papers published in various global science journals during the period 1996-2012 were accessed. We recorded the total number of research documents having an affiliation with a Pakistan. The main source for information was Institute of Scientific Information (ISI) Web of Science, Thomson Reuters and SCI-mago/Scopus. In global science, Pakistan contributed 58133 research papers in all science and social sciences both in ISI and non ISI indexed journals. However, in medical sciences the total number of research papers from Pakistan are 25604, citable documents 23874, citations 128061, mean citations per documents 6.45 and mean Hirsch index is 35.33. In Pakistan, the upward trend of articles published in global medical science was from the period 1996-2008. However, from 2008 the trend is markedly declined. Pakistan significantly improved its international ranking positions in research during the period 2000-2008. However, the upward trend of research papers published in global medical science could not be retained and from the year 2008 the trend started declining. This trend of research papers further declined in year 2012 compared to year 2011. It is suggested that, Pakistan must take strategic steps to enhance the research culture and increase the research and development expenditure in the country.

  5. Exploring urban male non-marital sexual behaviours in Pakistan.

    PubMed

    Mir, Ali M; Wajid, Abdul; Pearson, Stephen; Khan, Mumraiz; Masood, Irfan

    2013-04-11

    In Pakistan, sexual practices outside marriage are proscribed by law. We aimed to assess the range and magnitude of non-marital sexual behaviours of urban men, focusing on men having sex with men. In this cross sectional survey undertaken in six cities of Pakistan, we interviewed 2400 men aged 16-45 years selected through a multistage systematic sampling design. Sexual behaviours were assessed through a structured questionnaire. Multivariable analysis was used to identify association between various individual level characteristics and probability of engaging in sexual activities involving men. Nearly one-third (29 percent) reported having had non-marital sex in their lifetime. Of these men 16 percent reported premarital sex, while 11 percent reported engaging in both pre- and extramarital sex. Only two percent reported exclusive extramarital sex. In total 211 respondents, 9 percent reported ever having had sexual relations with men. While 62 respondents, 2.6 percent reported exclusive sex with males. Factors that were significantly associated with MSM behaviours were being less than 27 years (adjusted OR 5.4, 95% CI 3.8-7.7, p < 0.000), less than 10 years of schooling (adjusted OR 2.1, 95% CI 1.4-3.2, p < 0.000), being unemployed (adjusted OR 2.7, 95% CI 1.6-4.3, p < 0.000), being exposed to pornographic materials (adjusted OR 4.8, 95% CI 3.0-7.7, p < 0.000) and being a migrant (adjusted OR 2.1, 95% CI 1.3-3.4, p < 0.002). Factors significantly associated with exclusive homosexual behaviour were having sexual debut at a younger age i.e. 16-22 years (adjusted OR 12.5, 95% CI: 3.8-40.7, p < 0.000), being unemployed (adjusted OR 8.8, 95% CI: 3.0-26.0, p = 0.000), having had exposure to pornographic materials (adjusted OR 3.3, 95% CI: 1.5-7.2, p = 0.002). To prevent the spread of STI's in Pakistan, preventive interventions should focus on reaching out to young uneducated men offering them with appropriate counselling and skills to adopt "safe sex practices" through

  6. Economic Burden of Mental Illnesses in Pakistan.

    PubMed

    Malik, Muhammad Ashar; Khan, Murad Moosa

    2016-09-01

    The economic consequences of mental illnesses are much more than health consequences. In Low and Middle Income Countries (LMIC) the economic impact of mental illnesses is rarely analyzed. This paper attempts to fill the gap in research on economics of mental health in LMIC. We provide economic burden of mental illness in Pakistan that can serve as an argument for reorienting health policy, resource allocation and priority settings. To estimate economic burden of mental illnesses in Pakistan. The study used prevalence based cost of illnesses approach using bottom-up costing methodology. We used Aga Khan University Hospital, Psychiatry department data set (N = 1882) on admission and ambulatory care for the year 2005-06. Healthcare cost data was obtained from finance department of the hospital. Productivity losses, caregiver and travel cost were estimated using socio-economic features of patients in the data set and data of national household survey. We used stratified random sampling and methods of ordinary least square multiple linear regressions to estimate cost on medicines for ambulatory care. All estimates of cost are based on 1000 bootstrap samples by ICD-10 disease classification. Prevalence data on mental illnesses from Pakistan and regional countries was used to estimate economic burden. The economic burden of mental illnesses in Pakistan was Pakistan Rupees (PKR) 250,483 million (USD 4264.27 million) in 2006. Medical care costs and productivity losses contributed 37% and 58.97% of the economic burden respectively. Tertiary care admissions costs were 70% of total medical care costs. The average length of stay (LOS) for admissions care was around 8 days. Daily average medical care cost of admitted patients was PKR 3273 (USD 55.72). For ambulatory care, on average a patient visited the clinic twice a year. The estimated average yearly cost for all mental illnesses was PKR 81,922 (USD 1394.65) and PKR 19,592 (USD 333.54) for admissions and ambulatory care

  7. Modeling falling groundwater tables in major cities of the world

    NASA Astrophysics Data System (ADS)

    Sutanudjaja, E.; Erkens, G.

    2015-12-01

    Groundwater use and its over-consumption are one of the major drivers in the hydrology of many major cities in the world, particularly in delta regions. Yet, a global assessment to identify cities with declining groundwater table problems has not been done yet. In this study we used the global hydrological model PCR-GLOBWB (10 km resolution, for 1960-2010). Using this model, we globally calculated groundwater recharge and river discharge/surface water levels, as well as global water demand and abstraction from ground- and surface water resources. The output of PCR-GLOBWB model was then used to force a groundwater MODFLOW-based model simulating spatio-temporal groundwater head dynamics, including groundwater head declines in all major cities - mainly in delta regions - due to escalation in abstraction of groundwater to meet increasing water demand. Using these coupled models, we managed to identify a number of critical cities having groundwater table falling rates above 50 cm/year (average in 2000-2010), such as Barcelona, Houston, Los Angeles, Mexico City, New York, Rome and many large cities in China, Libya, India and Pakistan, as well as in Middle East and Central Asia regions. However, our simulation results overestimate the depletion rates in San Jose, Tokyo, Venice, and other cities where groundwater usages have been aggressively managed and replaced by importing surface water from other places. Moreover, our simulation might underestimate the declining groundwater head trends in some familiar cases, such as Bangkok (12 cm/year), Ho Chi Minh City (34 cm/year), and Jakarta (26 cm/year). The underestimation was due to an over-optimistic model assumption in allocating surface water for satisfying urban water needs. In reality, many big cities, although they are located in wet regions and have abundant surface water availability, still strongly rely on groundwater sources due to inadequate facilities to treat and distribute surface water resources.

  8. Modeling falling groundwater tables in major cities of the world

    NASA Astrophysics Data System (ADS)

    Sutanudjaja, Edwin; Erkens, Gilles

    2016-04-01

    Groundwater use and its over-consumption are one of the major drivers in the hydrology of many major cities in the world, particularly in delta regions. Yet, a global assessment to identify cities with declining groundwater table problems has not been done yet. In this study we used the global hydrological model PCR-GLOBWB (10 km resolution, for 1960-2010). Using this model, we globally calculated groundwater recharge and river discharge/surface water levels, as well as global water demand and abstraction from ground- and surface water resources. The output of PCR-GLOBWB model was then used to force a groundwater MODFLOW-based model simulating spatio-temporal groundwater head dynamics, including groundwater head declines in all major cities - mainly in delta regions - due to escalation in abstraction of groundwater to meet increasing water demand. Using these coupled models, we managed to identify a number of critical cities having groundwater table falling rates above 50 cm/year (average in 2000-2010), such as Barcelona, Houston, Los Angeles, Mexico City, New York, Rome and many large cities in China, Libya, India and Pakistan, as well as in Middle East and Central Asia regions. However, our simulation results overestimate the depletion rates in San Jose, Tokyo, Venice, and other cities where groundwater usages have been aggressively managed and replaced by importing surface water from other places. Moreover, our simulation might underestimate the declining groundwater head trends in some familiar cases, such as Bangkok (12 cm/year), Ho Chi Minh City (34 cm/year), and Jakarta (26 cm/year). The underestimation was due to an over-optimistic model assumption in allocating surface water for satisfying urban water needs. In reality, many big cities, although they are located in wet regions and have abundant surface water availability, still strongly rely on groundwater sources due to inadequate facilities to treat and distribute surface water resources.

  9. Determinants of maternal health care services utilization in Pakistan: evidence from Pakistan demographic and health survey, 2012-13.

    PubMed

    Zakar, Rubeena; Zakar, Muhammad Zakria; Aqil, Nauman; Chaudhry, Ashraf; Nasrullah, Muazzam

    2017-04-01

    The aim of this study was to determine the association between maternal utilisation of health-care services and socio-demographic factors among reproductive-age women in Pakistan. We used the sample of ever-married reproductive-age women (n = 7446) from the Pakistan Demographic and Health Survey (PDHS), 2012-13. We measured maternal utilisation of health-care services by using three dependent variables: number of antenatal care (ANC) visits, delivery assistance by a skilled health provider, and delivery in a health-care facility. Around 36.6% of women had made four or more ANC visits, 59% had received assistance from skilled health providers during delivery, and 55.3% had given birth in a health-care facility. On multivariable logistic regression, all three variables were positively associated with education and wealth, and negatively associated with birth order and women's autonomy. Policymakers and health planners may use our findings to develop efficient strategies, particularly for uneducated women and those with poor economic status, to improve the utilisation of maternal health-care services in Pakistan.

  10. Drinking Water Quality Status and Contamination in Pakistan

    PubMed Central

    Nafees, Muhammad; Rizwan, Muhammad; Bajwa, Raees Ahmad; Shakoor, Muhammad Bilal; Arshad, Muhammad Umair; Chatha, Shahzad Ali Shahid; Deeba, Farah; Murad, Waheed; Malook, Ijaz

    2017-01-01

    Due to alarming increase in population and rapid industrialization, drinking water quality is being deteriorated day by day in Pakistan. This review sums up the outcomes of various research studies conducted for drinking water quality status of different areas of Pakistan by taking into account the physicochemical properties of drinking water as well as the presence of various pathogenic microorganisms. About 20% of the whole population of Pakistan has access to safe drinking water. The remaining 80% of population is forced to use unsafe drinking water due to the scarcity of safe and healthy drinking water sources. The primary source of contamination is sewerage (fecal) which is extensively discharged into drinking water system supplies. Secondary source of pollution is the disposal of toxic chemicals from industrial effluents, pesticides, and fertilizers from agriculture sources into the water bodies. Anthropogenic activities cause waterborne diseases that constitute about 80% of all diseases and are responsible for 33% of deaths. This review highlights the drinking water quality, contamination sources, sanitation situation, and effects of unsafe drinking water on humans. There is immediate need to take protective measures and treatment technologies to overcome unhygienic condition of drinking water supplies in different areas of Pakistan. PMID:28884130

  11. COST OF PRIMARY HEALTH CARE IN PAKISTAN.

    PubMed

    Malik, Muhammad Ashar; Gul, Wahid; Iqbal, Saleem Perwaiz; Abrejo, Farina

    2015-01-01

    Detailed cost analysis is an important tool for review of health policy and reforms. We provide an estimate of cost of service and its detailed breakup on out-door patient visits (OPV) to basic health units (BHU) in Pakistan. Six BHUs were randomly selected from each of the five districts in Khyber Pukhtonkhawa (KPK) and two agencies in Federally Administered Tribal Areas (FATA) of Pakistan for this study. Actual expenditure data and utilization data in the year 2005-06 of 42 BHUs was collected from selected district health offices in KPK and FATA. Costs were estimated for outpatient visits to BHUs. Perspective on cost estimates was district-based health planning and management of BHUs. Average recurring cost was PKR.245 (USD 4.1) per OPV to BHU. Staff salaries constituted 90% of recurrent cost. On the average there were 16 OPV per day to the BHUs. CONCLUDION: Recurrent cost per OPV has doubled from the previous estimates of cost of OPV in Baluchistan. The estimated recurrent cost was six times higher than average consultation charges with the private general practitioner (GP) in the country (i.e., PKR 50/ GP consultation). Performance of majority of the BHUs was much lower than the performance target (50 patients per day) set in the sixth five-year plan of the government of Pakistan. The Government of Pakistan may use these analyses to revisit the performance target, staffinL and location of BHUs.

  12. Characterization of energy exchange parameters in the Himalayan foothills Pakistan

    NASA Astrophysics Data System (ADS)

    Khalid, Bushra; Kumar, Mukul; Cholaw, Bueh; Aziz Khan, Junaid; Hayat Khan, Azmat

    2017-04-01

    The characterization of energy exchange parameters for spring season (April-May) has been done for Margalla hills national park (MHNP) Islamabad, Pakistan. It is important because Islamabad city lies in the foothills of Himalayas and micro meteorological activity makes the climate of surrounding areas. The activity on Himalaya's foothills (i.e., Margalla hills) regulate weather and also provide fresh water to the lakes and ponds by late afternoon thunder showers. This research is also important from the perspective of rain water harvesting in Islamabad, Pakistan. The objective of this study is to characterize the energy exchange parameters in the foothills of great Himalayas particularly on MHNP. Landsat ETM+ imageries have been used for calculating the land surface temperature (LST), normalized difference vegetation index (NDVI), and normalized difference moisture index (NDMI). SPOT 5 image has been used for land use/land cover classification over MHNP. The turbulent fluxes have been calculated by computing the values acquired from the processing of satellite imageries and real time observation data sets. The comparisons have been made between the land and atmospheric temperature and moisture to see the difference and its impacts on weather of twin cities i.e., Islamabad and Rawalpindi. The energy exchange parameters have been characterized by analyzing the impacts of weather parameters and turbulent fluxes on MHNP and surrounding cities. The potential rain water harvesting sites have been marked in the foothills. Weather and surface conditions become more favorable for the growth of vegetation by the end of April as the spring season reaches at its peak. There is the start of growing season in the month of April whereas the vegetation becomes thick over time during the month of May over Margalla hills however, the energy exchange parameters follow the same pattern in May as in April. The relative humidity remains between 18 - 55 % and the atmospheric temperature

  13. Satellite Monitoring of Pakistan's Rockslide-Dammed Lake Gojal

    NASA Astrophysics Data System (ADS)

    Kargel, Jeffrey S.; Leonard, Gregory; Crippen, Robert E.; Delaney, Keith B.; Evans, Stephen G.; Schneider, Jean

    2010-10-01

    On 4 January 2010, a rockslide 1200 meters long, 350 meters wide, and 125 meters high dammed the Hunza River in Attabad, northern Pakistan, and formed Lake Gojal. The initial mass movement of rock killed 20 people and submerged several villages and 22 kilometers of the strategic Karakoram Highway linking Pakistan and China. Tens of thousands of people were displaced or cut off from overland connection with the rest of the country. On 29 May, the lake overflow began to pour through a spillway excavated by Pakistani authorities. On approximately 20 July, the lake attained a maximum depth of 119 meters and a torrent at least 9 meters deep issued over the spillway, according to Pakistan's National Disaster Management Authority (NDMA). To date, the natural dam is holding and eroding slowly. However, the threat of a catastrophic outburst flood remains.

  14. Study on awareness of osteoporosis and its associated risk factors among housewives and working women in Karachi.

    PubMed

    Raza, Lubna; Ahmed, Anzar; Kumar, Vinod; Hasnain, Abid

    2017-12-01

    To compare awareness of osteoporosis and its associated risks among working women and housewives. This cross-sectional study was conducted at Karachi University and Dow University of Health Sciences, Karachi, from January to April 2015, and comprised working women and housewives who were enrolled using convenience sampling. Data was collected on awareness, dairy, fruit, vegetable, poultry/fish consumption as well as exercise, diagnosis and treatment taken for deficiency of vitamin D. Weight, height and body mass index were noted. Analysis was done using SPSS 17. Of the 600 participants, 300(50%) were housewives and 300(50%) were working women. Significant differences were observed in marriage years, number of children and income (p <0.05). Body mass index of groups demonstrated that more working women were within normal range weight than housewives (p<0.05). Fewer housewives had awareness about osteoporosis and the majority of them had a sedentary lifestyle (p<0.001). More housewives were diagnosed with vitamin D deficiency and were prescribed for treatment (p<0.001). Dairy and vegetable consumption was found comparable while fruits and poultry/ fish intake was better in working women (p<0.05). Since the subjects in both groups had no regular exercise programme, therefore the overall results were insignificant (p>0.05). Greater number of working women had awareness of osteoporosis.

  15. Health care utilization during terminal child illness in squatter settlements of Karachi.

    PubMed

    Hasan, I J; Khanum, A

    2000-12-01

    Information on health seeking behavior and health care utilization has important policy implications in health systems development. The paper presents some of the issues related to health care utilization and health seeking behavior in case of terminal child illness in seven squatter settlements of Karachi. From seven squatter settlements of Karachi, with a population of 100,000 approximately, we collected information, using pretested structured questionnaire, from the mothers on health care utilization during the final illness of under five children dying during 1995-1996. These deaths were identified from an earlier baseline health and demographic survey in these areas. Interviews were completed for 259 infant and child deaths of which 57% were boys. Of all deaths 72% were taken to a health care provider, of which 82% went as soon as the child got ill. Private sector is the most preferred first choice i.e., 83%. Of all those who had been to a health care provider, 65% were referred to some other place and 72% of them took more than 12 hours altogether to reach the referred facility. Children in older age categories (OR 4.4 95% CI 2.22-8.67 and OR 5.0, 95% CI 2.09-12.31), boys (OR 2.6, 95% CI 1.46-4.77) and those with appropriate or incomplete immunization (OR 4.1, 95% CI 2.13-7.94) were significantly associated with the health care utilization as compared to their counterparts. Living in urban areas does not ensure accessibility to effective health care. In poor urban communities, referral to other facility delay the initiation of effective treatment in case of child illness leading to death which could be prevented otherwise. Private sector constitutes an important segment of our health care system, which requires strengthening and back up support. Furthermore, the study finding is suggestive of gender discrimination in health seeking behavior.

  16. A cross-sectional assessment of knowledge, attitude and practice among Hepatitis-B patients in Quetta, Pakistan

    PubMed Central

    2013-01-01

    Background Hepatitis-B is a life threatening infection resulting in 0.6 million deaths annually. The prevalence of Hepatitis-B is rising in Pakistan and furthermore, there is paucity of information about Knowledge, Attitude and Practice among Hepatitis-B patients. Better disease related knowledge is important to have positive attitude and that will bring the good practices which will prevent the further spread of infection. This study aimed to evaluate knowledge, attitude and practice of Hepatitis-B Patients in Quetta city, Pakistan. Methods A cross-sectional, descriptive study was undertaken with 390 Hepatitis-B patients attending two public hospitals in Quetta city, Pakistan. Knowledge, attitude and practice regarding Hepatitis-B were assessed using a pre-validated questionnaire containing 20, 7 and 8 questions for knowledge, attitude and practice, respectively. Descriptive statistics were used for elaborating patients’ demographic characteristics and mean scores for knowledge, attitude and practice of Hepatitis-B patients. Inferential statistics (Mann–Whitney U test and Kruskal Wallis tests, p < 0.05) were used to establish association between study variables. Spearman’s rho correlation was used to identify the association between the knowledge, attitude and practice scores. Results Out of 390 patients, 223 (57.2%) were males, with the majority (136, 34.9%) in the age group of 38–47 years. Mean age of the study cohort was 32.6 ± 9.5 years. One hundred and four (26.7%) had primary level education, with 110 (28.2%) working in the private sector. The mean scores for knowledge, attitude and practice were 8.48 ± 2.7, 3.87 ± 1.2 and 2.37 ± 1.0, respectively. Education, locality and occupation were significantly associated with knowledge, attitude and practice scores. Significant positive linear correlations between knowledge-attitude (r = 0.466, p < 0.01) knowledge-practice (r = 0.221, p < 0.01) and attitude-practice (r

  17. Critical appraisal of apparently evidence-based written advertising in Pakistan.

    PubMed

    Rohra, Dileep Kumar; Bashir, Muhammad Umair; Khwaja, Ummey Aymen; Nazir, Muhammad Ressam

    2008-06-01

    The objective of the study was to critically assess references cited in support of claims in drug advertisements. Drug advertising brochures were collected from privately practicing General Practitioners from different parts of Karachi. Three blinded reviewers then categorized each reference in the brochure according to the sources viz: journals (both Medline indexed and non-indexed), medical reference books, web addresses, personal communications or testimonials, abstracts presented at symposia/conferences, WHO and National Health Guidelines, 'data on file' and 'others' (which included a diverse set of references). Each reviewer then assessed and analyzed the references further into 2 broad categories: traceable and non-traceable. Traceable references were appraised and, depending upon the claim with which the reference was attached, were classified into justifiable, inaccurate/false, exaggerated and ambiguous. We collected a total of 175 different brochures. Thirty-nine (22.3%) brochures did not cite any references and were not subjected to further analysis. The remaining 136 (77.7%) contained a total of 559 references. 305 (54.6%) of these references were from Medline-indexed journals; 67 (12.0%) were from non-indexed journals; 55 (9.8%) references quoted medical reference books; 27 (4.8%) references cited web addresses; 12 (2.1%) references were personal communications/testimonials; 11 (2.0%) references referred to abstracts presented at symposia/conferences; 12 (2.1%) references were from WHO and National Health Guidelines; 8 (1.4%) references were listed as 'data on file', while the remainder that could not be defined were classified as 'others' (13.1%). Out of a total of 559 references, 249 (44.5%) could not be traced. After critically analyzing the 310 traceable references, 197 (63.5%) were adjudged justifiable, 30 (9.7%) inaccurate/false, 79 (25.5%) exaggerated and 15 (4.8%) ambiguous. Results of this study show for the first time that the claims

  18. [Pakistan: emigration in the Gulf and its effects on the home economy].

    PubMed

    Imdad, N

    1985-01-01

    Pakistani emigration since the early 1970s has been primarily directed toward the oil-rich Gulf states. Over 2 million Pakistanis, 10% of the adult male workforce, now live outside their home country, 3/4 of them in the Gulf states. The emigration has shortterm advantages for Pakistan, which has a high unemployment rate and few other exports. 2 government bureaus and over 300 recruiting agencies encourage Pakistani emigration to the Gulf, and because of the foreign exchange earnings generated, such emigration has become an important concern of the government. Emigration has a long history in Pakistan as part of the migratory movements of the Indian subcontinent in general. Emigration in the 1960s was prompted by mechanization of agriculture and disturbances of traditional agrarian labor arrangements brought on by the Green Revolution. Concentrations of lands among the successful middle-sized producers led to a rural proletariat and exodus towards the cities, where possibilities of employment were scarce. Regions of declining income around the new capital of Islamabad were the 1st to take advantage of new employment opportunities in the Gulf states. Pakistani migration to the Gulf countries is temporary for individual workers, who stay an average of 3-6 years, but the effect is of chain migration as returning workers are replaced by other family members. Workers are not accompanied by family members and have almost no contact with the local Arab populations. They send most of their earnings to their families in Pakistan. 3/4 are under 30 years old, most are of rural origin, and the majority are from the northern provinces. Although 70% are married, only 4% of migrants, the most highly qualified, are accompanied by their families. About 41% are unskilled workers and 42.6% are semiskilled or skilled manual workers. In 1981, the average annual salary repatriated by a Pakistani working in the Gulf was $3000. The Pakistani government has not defined a migration policy

  19. 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.

  20. mtDNA sequence diversity of Hazara ethnic group from Pakistan.

    PubMed

    Rakha, Allah; Fatima; Peng, Min-Sheng; Adan, Atif; Bi, Rui; Yasmin, Memona; Yao, Yong-Gang

    2017-09-01

    The present study was undertaken to investigate mitochondrial DNA (mtDNA) control region sequences of Hazaras from Pakistan, so as to generate mtDNA reference database for forensic casework in Pakistan and to analyze phylogenetic relationship of this particular ethnic group with geographically proximal populations. Complete mtDNA control region (nt 16024-576) sequences were generated through Sanger Sequencing for 319 Hazara individuals from Quetta, Baluchistan. The population sample set showed a total of 189 distinct haplotypes, belonging mainly to West Eurasian (51.72%), East & Southeast Asian (29.78%) and South Asian (18.50%) haplogroups. Compared with other populations from Pakistan, the Hazara population had a relatively high haplotype diversity (0.9945) and a lower random match probability (0.0085). The dataset has been incorporated into EMPOP database under accession number EMP00680. The data herein comprises the largest, and likely most thoroughly examined, control region mtDNA dataset from Hazaras of Pakistan. Copyright © 2017 Elsevier B.V. All rights reserved.