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Sample records for karachi pakistan south

  1. 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

  2. Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan.

    PubMed

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

    2011-02-01

    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.

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

    PubMed Central

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Ali, Tazeen Saeed; Rizvi, Syeda Naghma

    2010-01-01

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

  5. 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…

  6. 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

  7. Fluoride concentration in drinking water of Karachi city (Pakistan).

    PubMed

    Siddique, Azhar; Mumtaz, Majid; Saied, Sumayya; Karim, Zahida; Zaigham, Nayyer A

    2006-09-01

    The ground and municipal water supply samples of Karachi city were analyzed for their fluoride contents. The fluoride contents in water samples collected from the subsurface and river sources were found below the WHO recommended value for the general health of the people. However, in some industrial areas the groundwater sample showed higher level of fluoride concentration. Continuous monitoring of water resources and cautious fluoridation is suggested to maintain proper status of fluoride concentration in the drinking water.

  8. Understanding unintentional childhood home injuries: pilot surveillance data from Karachi, Pakistan

    PubMed Central

    2012-01-01

    Background Childhood injuries, an important public health issue, globally affects more than 95% of children living in low-and middle-income countries. The objective of this study is to describe the epidemiology of childhood unintentional injuries in Karachi, Pakistan with a specific focus on those occurring within the home environment. Methods This was a secondary analysis of a childhood unintentional injury surveillance database setup in the emergency department of the Aga Khan Hospital, Karachi, Pakistan for 3 months. The data was collected by interviewing caretakers of children under 12 years of age presenting with an unintentional injury to the emergency departments of the four major tertiary care hospitals of Karachi, Pakistan. Results The surveillance included 566 injured children of which 409 (72%) injuries had taken place at/around home. Of 409 children, 66% were males and mostly between 5 and 11 years of age. Injuries commonly occurred during play time (51%). Fall (59%), dog bites (11%) and burns (9%) were the commonest mechanisms of injury. The majority of the children (78%) were directly discharged from the emergency room with predicted short term disability (42%). There were 2 deaths in the emergency department both due to falls. Conclusion Childhood injury surveillance system provides valuable in-depth information on child injuries. The majority of these unintentional childhood injuries occur at home; with falls, dog bites and burns being the most common types of unintentional childhood home injuries. Specific surveillance systems for child injuries can provide new and valuable information for countries like Pakistan. PMID:22260430

  9. Depression in the elderly in Karachi, Pakistan: a cross sectional study

    PubMed Central

    2013-01-01

    Background Depression in elderly is a major global public health concern. There has been no population-based study of depression in the elderly in Pakistan. The aim of the study was to estimate the prevalence of depression and its association with family support of elderly (age 60 years and above) in Karachi, Pakistan. Methods A population based cross-sectional study was carried out in Karachi from July-September 2008. Questionnaire based interviews were conducted with individuals (n = 953) recruited through multi-stage cluster sampling technique, using the 15- item Geriatric Depression Scale (GDS). Results Prevalence of depression was found to be 40.6%, with a higher preponderance in women than men (50% vs. 32%). Elderly currently not living with their spouses were 60% more depressed than those living with their spouses (Adjusted OR = 1.6, 95% CI = 1.3-2.1). Elderly who did not consider their children as future support were twice as likely to be depressed as those considering their children to be old age security (Adjusted OR = 2.1, 95% CI = 1.4-3.1). An increase in one male adult child showed 10% decrease in depression after adjusting for other variables (Adjusted OR = 0.9, 95% CI = 0.8-0.9). Conclusion A relatively high prevalence of depression was found in the elderly in Karachi. There appeared to be a strong association between depression and family support variables such as living with spouse, considering children as future security and number of male adult children in the sample studied. Mental wellbeing of the elderly in Pakistan needs to be given consideration in the health policy of the country. In collectivistic societies like Pakistan family support plays an important part in mental health of the elderly that needs to be recognized and supported through various governmental and non-governmental initiatives. Keypoints Assessment of depression in elderly, Cross-sectional study in Karachi-Pakistan PMID:23819509

  10. Applying community-based participatory research methods to improve maternal and child health in Karachi, Pakistan.

    PubMed

    Karmaliani, Rozina; McFarlane, Judith; Asad, Nargis; Madhani, Farhana; Hirani, Saima; Shehzad, Shireen; Zaidi, Anita

    2009-01-01

    To achieve health for all, the development of partnerships between community residents and researchers is essential. Community-based participatory research (CBPR) engages community members, uses local knowledge in the understanding of health problems and the design of interventions, and invests community members in the processes and products of research. CBPR pivots on an iterative process of open communication, mutual respect, and power sharing to build community capacity to sustain effective health interventions. This article describes how the tenets of CBPR were applied by a multidisciplinary, international research team of maternal-child health specialists toward better health for women and children in multilingual, multiethnic, low socioeconomic communities in Karachi, Pakistan.

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

    PubMed Central

    Sheikh, Sana Sadiq; Ali, Syed Asad

    2014-01-01

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

  12. 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

  13. 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

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

    PubMed Central

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

    2013-01-01

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

  15. Monitoring polio supplementary immunization activities using an automated short text messaging system in Karachi, Pakistan

    PubMed Central

    Murtaza, A; Khoja, S; Zaidi, AK; Ali, SA

    2014-01-01

    Abstract Problem Polio remains endemic in many areas of Pakistan, including large urban centres such as Karachi. Approach During each of seven supplementary immunization activities against polio in Karachi, mobile phone numbers of the caregivers of a random sample of eligible children were obtained. A computer-based system was developed to send two questions – as short message service (SMS) texts – automatically to each number after the immunization activity: “Did the vaccinator visit your house?” and “Did the enrolled child in your household receive oral polio vaccine?” Persistent non-responders were phoned directly by an investigator. Local setting A cluster sampling technique was used to select representative samples of the caregivers of young children in Karachi in general and of such caregivers in three of the six “high-risk” districts of the city where polio cases were detected in 2011. Relevant changes In most of the supplementary immunization activities investigated, vaccine coverages estimated using the SMS system were very similar to those estimated by interviewing by phone those caregivers who never responded to the SMS messages. In the high-risk districts investigated, coverages estimated using the SMS system were also similar to those recorded – using lot quality assurance sampling – by the World Health Organization. Lessons learnt For the monitoring of coverage in supplementary immunization activities, automated SMS-based systems appear to be an attractive and relatively inexpensive option. Further research is needed to determine if coverage data collected by SMS-based systems provide estimates that are sufficiently accurate. Such systems may be useful in other large-scale immunization campaigns. PMID:24700982

  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. 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

  18. 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.

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

    PubMed

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

    2013-06-01

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

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

    PubMed

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

    2013-06-01

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

  1. Elevated blood lead levels among children living in a fishing community, Karachi, Pakistan.

    PubMed

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

    2004-01-01

    Lead is a widespread environmental contaminant worldwide and is associated with adverse outcomes in children, including impaired neurobehavioral development and learning difficulties. A cross-sectional survey of 53 young children was conducted in a fishing village on an island adjacent to Karachi, Pakistan. Whole blood from each individual was tested for lead levels. Also tested were samples of cooked food, house dust, and drinking water from 36 households. Laboratory determinations were made by the Pakistan Council for Scientific and Industrial Research with quality control by the United States Centers for Disease Control and Prevention. Fifty-two subjects (98%) had blood lead levels above 10 microg/dl (mean 21.60 microg/dl), an internationally recognized threshold for potential neurotoxicity. The mean concentration was 3.90 microg/g in cooked food, 4.02 microg/l in drinking water, and 91.30 microg/g in house dust. These findings indicate possible major health concerns and suggest significant environmental contamination in this community as well as the need to identify locally relevant early childhood exposures.

  2. 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.

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

    PubMed

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

    2013-01-01

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

  4. 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.

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

    PubMed

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

    2013-01-01

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

  6. Understanding the Knowledge and Perceptions About Clubfoot in Karachi, Pakistan: A Qualitative Exploration

    PubMed Central

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

    2013-01-01

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

  7. 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

  8. 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

  9. 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

  10. 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

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

    PubMed Central

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

    2015-01-01

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

  12. 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

    2013-03-01

    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

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

    PubMed

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

    2013-08-01

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

  14. Knowledge and Practice Gaps among Pediatric Nurses at a Tertiary Care Hospital Karachi Pakistan

    PubMed Central

    Roshan Essani, Rozina; Ali, Tazeen Saeed

    2011-01-01

    The advancement in medical science has created health care environments that require nursing professionals who posses specialized clinical knowledge and skills to provide care and deal with critically and acutely ill children. This study explored gaps between knowledge and practice as perceived by the registered nurses of pediatric units by further recommending the changes suggested by them. A descriptive exploratory study design under the quantitative research methodology was utilized using universal sampling of all pediatric nurses working at a tertiary care hospital in Karachi, Pakistan. The gaps between knowledge and practice, as perceived by the participants, were categorized into five major categories: (1) medication (34%), (2) skills (28.3%), (3) knowledge (13.36%), (4) handling of code blue and intubations (12.6%), and (5) operating medical devices (11.58%). As a result, anxiety and incompetency were notably seen in the participants which had great amount of impact on the level of care provided to the patients. The implications of the findings for quality patient care were also analyzed. PMID:22389778

  15. Microbiologic effectiveness of hand washing with soap in an urban squatter settlement, Karachi, Pakistan.

    PubMed

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

    2001-10-01

    We conducted a study in a squatter settlement in Karachi, Pakistan where residents report commonly washing their hands to determine if providing soap, encouraging hand washing, and improving wash-water quality would improve hand cleanliness. We allocated interventions to 75 mothers and collected hand-rinse samples on unannounced visits. In the final model compared with mothers who received no hand-washing intervention, mothers who received soap would be expected to have 65% fewer thermotolerant coliform bacteria on their hands (95% CI 40%, 79%) and mothers who received soap, a safe water storage vessel, hypochlorite for water treatment, and instructions to wash their hands with soap and chlorinated water would be expected to have 74% fewer (95% CI 57%, 84%). The difference between those who received soap alone, and those who received soap plus the safe water vessel was not significant (P = 0.26). Providing soap and promoting hand washing measurably improved mothers' hand cleanliness even when used with contaminated water.

  16. Dengue outbreak in Karachi, Pakistan, 2006: experience at a tertiary care center.

    PubMed

    Khan, E; Siddiqui, J; Shakoor, S; Mehraj, V; Jamil, B; Hasan, R

    2007-11-01

    This is the first report of the largest epidemic of dengue hemorrhagic fever (DHF) virus infection (2006) with IgM-confirmed cases from Karachi, Pakistan. Medical records of 172 IgM-positive patients were reviewed retrospectively for demographic, clinical and laboratory data. Patients were categorized into dengue fever (DF) and DHF according to the WHO severity grading scale. The mean+/-SD age of the patients was 25.9+/-12.8 years, 55.8% were males and the hemoconcentration was recorded in a small number of patients [10 (7.0%)]. Male gender [odds ratio (OR)=14.7, P=0.003), positive history of vomiting (OR=4.3, P=0.047), thrombocytopenia at presentation (OR=225.2, P<0.001) and monocytosis (OR=5.8, P=0.030) were independently associated with DHF, but not with DF. Five cases (2.9%) had a fatal outcome, with a male-to-female ratio of 1:4. Three were from a pediatric group (<15 years). Pulmonary hemorrhages, disseminated intravascular coagulation and cerebral edema preceded death in these patients. The results have highlighted significant findings, such as adult susceptibility to DHF, pronounced abdominal symptoms and lack of hemoconcentration at time of presentation in the study population. These findings may play an important role in the case definitions of future studies from this part of the world.

  17. Acute health effects of the Tasman Spirit oil spill on residents of Karachi, Pakistan

    PubMed Central

    Janjua, Naveed Zafar; Kasi, Pashtoon Murtaza; Nawaz, Haq; Farooqui, Sadia Zohra; Khuwaja, Urooj Bakht; Najam-ul-Hassan; Jafri, Syed Nadim; Lutfi, Shahid Ali; Kadir, Muhammad Masood; Sathiakumar, Nalini

    2006-01-01

    Background On July 27 2003, a ship carrying crude oil run aground near Karachi and after two weeks released 37,000 tons of its cargo into the sea. Oil on the coastal areas and fumes in air raised health concerns among people. We assessed the immediate health impact of oil spill from the tanker Tasman Spirit on residents of the affected coastline in Karachi, Pakistan. Methods We conducted a study consisting of an exposed group including adults living in houses on the affected shoreline and two control groups (A and B) who lived at the distance of 2 km and 20 km away from the sea, respectively. We selected households through systematic sampling and interviewed an adult male and female in each household about symptoms relating to eyes, respiratory tract, skin and nervous system, smoking, allergies, beliefs about the effect on their health and anxiety about the health effects. We used logistic regression procedures to model each symptom as an outcome and the exposure status as an independent variable while adjusting for confounders. We also used linear regression procedure to assess the relationship exposure status with symptoms score; calculated by summation of all symptoms. Results Overall 400 subjects were interviewed (exposed, n = 216; group A, n = 83; and group B, n = 101). The exposed group reported a higher occurrence of one or more symptoms compared to either of the control groups (exposed, 96% vs. group A, 70%, group B 85%; P < 0.001). Mean summary symptom scores were higher among the exposed group (14.5) than control group A (4.5) and control group B (3.8, P < 0.001). Logistic regression models indicated that there were statistically significant, moderate-to-strong associations (Prevalence ORs (POR) ranging from 2.3 to 37.0) between the exposed group and the symptoms. There was a trend of decreasing symptom-specific PORs with increase in distance from the spill site. Multiple linear regression model revealed strong relationship of exposure status with the

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

    SciTech Connect

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

    2008-09-15

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

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

    PubMed Central

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

    2008-01-01

    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 to August 2005. Information from 540 mothers selected randomly from those registered for delivery was obtained about their pregnancy, diet, and current and past lead exposures. We collected umbilical cord blood for lead levels analyzed using graphite furnace atomic absorption spectrophotometry. We computed geometric and arithmetic means. We performed multiple linear regression analysis to identify factors associated with log transformed umbilical cord BLLs. We also performed logistic regression analysis to identify determinants of high lead cord BLLs (≥10μg/dl). Results The geometric mean cord BLLs of the neonates was 9.6μg/dl; arithmetic mean (SD) was 10.8 μg/dl (5.7) with a median of 9.7μg/dl and a range of 1.8 μg/dl–48.9μg/dl. Women who reported intake of less than 58.5 mg of elemental iron supplement per day during pregnancy had cord BLL of 10.0μg/dl; in comparison those women who had higher iron intake had lower cord BLL (8.4μg/dl). Those who used surma (an eye cosmetic) daily had higher cord BLL (11.5 μg/dl) as compared to those who used it less frequently (9.4μg/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 were associated with significantly higher umbilical cord blood lead levels. There was interaction of daily surma use and ethnicity. Geometric mean BLLs were varied among surma users by ethnicity. Conclusions Umbilical cord BLLs are high in Karachi, Pakistan in comparison to those in developed countries such as United States. Measures are needed to reduce fetal lead exposure to

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

    PubMed Central

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

    2005-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  2. 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…

  3. 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

  4. 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

  5. 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

  6. Ethnic disparities in routine immunization coverage: a reason for persistent poliovirus circulation in Karachi, Pakistan?

    PubMed

    Siddiqui, Nida Tariq; Owais, Aatekah; Agha, Ajmal; Karim, Mehtab S; Zaidi, Anita K M

    2014-01-01

    Karachi is the only mega city in the world with persistent poliovirus transmission. We determined routine childhood immunization rates in Karachi and identified predictors of vaccine completion. A population-based cross-sectional survey was conducted in Karachi between August and September 2008. Data on demographics, socioeconomic, and DTP3 vaccination status in children 12 to 23 months old were collected. Logistic regression was used to identify predictors of vaccination completion. Overall, 1401 participants were approached; 1391 consented to participate. Of these, 1038 (75%) were completely vaccinated. Punjabi families had the highest DTP3 coverage (82%), followed by Urdu-speaking families (79%). Pashtun (67%) and Bengali (48%) families had the lowest vaccine coverage. Children of mothers with ≥ 12 years of schooling (OR = 25.4; 95% CI = 5.7-113.1) were most likely to be vaccinated. A quarter of study participants were unvaccinated. Targeted strategies for boosting DTP3 rates in communities with low immunization coverage are essential for polio eradication in Karachi.

  7. 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

  8. 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

  9. 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.

  10. 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.

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

    PubMed

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

    2015-02-01

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

  12. 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

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

    PubMed Central

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

    2015-01-01

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

  14. Health Care Use Patterns for Diarrhea in Children in Low-Income Periurban Communities of Karachi, Pakistan

    PubMed Central

    Quadri, Farheen; Nasrin, Dilruba; Khan, Asia; Bokhari, Tabassum; Tikmani, Shiyam Sunder; Nisar, Muhammad Imran; Bhatti, Zaid; Kotloff, Karen; Levine, Myron M.; Zaidi, Anita K. M.

    2013-01-01

    Diarrhea causes 16% of all child deaths in Pakistan. We assessed patterns of healthcare use among caretakers of a randomly selected sample of 959 children ages 0–59 months in low-income periurban settlements of Karachi through a cross-sectional survey. A diarrheal episode was reported to have occurred in the previous 2 weeks among 298 (31.1%) children. Overall, 280 (80.3%) children sought care. Oral rehydration solution and zinc were used by 40.8% and 2%, respectively; 11% were admitted or received intravenous rehydration, and 29% sought care at health centers identified as sentinel centers for recruiting cases of diarrhea for a planned multicenter diarrheal etiology case-control study. Odds ratios for independent predictors of care-seeking behavior were lethargy, 4.14 (95% confidence interval = 1.45–11.77); fever, 2.67 (1.27–5.59); and stool frequency more than six per day, 2.29 (1.03–5.09). Perception of high cost of care and use of home antibiotics were associated with reduced care seeking: odds ratio = 0.28 (0.1–0.78) and 0.29 (0.11–0.82), respectively. There is a need for standardized, affordable, and accessible treatment of diarrhea as well as community education regarding appropriate care in areas with high diarrheal burden. PMID:23629928

  15. 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.

  16. 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…

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

    PubMed Central

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

    2016-01-01

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

  18. 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

  19. 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

  20. Assessment of characteristics of patients with cholelithiasis from economically deprived rural Karachi, Pakistan

    PubMed Central

    2012-01-01

    Background Gallstones have been regarded as one of the most expensive diseases in Gastroenterology, posing a great economic burden on developing nations. The majority of Pakistani people live in rural areas where healthcare facilities are not available or are very primitive. We aim to assess the characteristics among cholelithiasis patients from rural Karachi so that a prevention campaign can be launched in rural underprivileged settings to reduce the economic burden of this preventable disease. Method A total of 410 patients were included in the study after giving verbal consent as well as written consent. Variables such as age, weight, height, body mass index (BMI), blood pressure, waist circumference, number of children, monthly family income, number of siblings, and number of family members, were considered in this questionnaire. All data was analysed by SPSS ver. 16.0. Mean and standard deviation (SD) were calculated for continuous variables. Frequency and percentages were calculated for categorical variables. Results Nearly 85.4% of the participants were female. The mean ± S.D. for age was 43.8 ± 9.59. Nearly 61% of the patients were illiterate. All of our patients were from low socioeconomic status and their mean salary ± S.D. was 6915 ± 1992 PKR (1 US $ = 90.37PKR). 75% of them were smokers with mean consumption ± S.D. of 7.5 ± 10 cigarettes per day. Fibre in diet was not used by 83.65% of patients. 40.2% were living in combined families. 61% were living in purchased homes. A positive history of diabetes mellitus was given by 45.1%, family history of cholelithiasis by 61% and history of hypertension by 31.7% of subjects. Soft drink consumption was given by 45.1% of patients; while only 8.5% used snacked daily. Tea was consumed by 95.1% of the subjects. Daily physical activity for 30 minutes was reported by only 13.4% of participants. Conclusion In conclusion, rural dwellers from low socioeconomic strata are neglected

  1. Parental awareness and coverage of mass measles vaccination drive 2011: cross-sectional survey in the metropolitan city of Karachi, Pakistan.

    PubMed

    Khowaja, Asif Raza; Sheikh, Sana; Saleem, Ali Faisal; Zaidi, Anita K M

    2015-03-01

    High measles incidence and frequent epidemics are reported in Pakistan, given the low coverage for measles vaccine. This study evaluated coverage of mass measles campaign 2011 and estimated parental awareness and determinants for low/no coverage. Household survey was conducted 4 months after the measles campaign in Karachi, Pakistan. Parents of children younger than 5 years were administered structured questionnaire about their knowledge and participation in measles campaign. Of 1020 eligible households, only 282 (28%) parents knew about measles supplementary immunization activity, mainly from public announcements (49%). Of these, 174 (62%) children received measles vaccine, whereas, 108 (38%) parents refused measles vaccine. Overall, only 17% children received measles vaccine during this campaign. Low maternal education, not having received DPT/Pentavalent-3 vaccine, and routine vaccination from public Expanded Program on Immunization facility were significant determinants for low coverage. Measles vaccine coverage in Karachi remains low, and sporadic outbreaks of measles every 2 to 3 years are expected unless population coverage can be rapidly increased. PMID:23165488

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

    PubMed

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

    2016-07-01

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

  3. Phylogenetic analysis of HDV isolates from HBsAg positive patients in Karachi, Pakistan

    PubMed Central

    2012-01-01

    Background In spite of a high occurrence of Hepatitis Delta in the province of Sindh in Pakistan, no genetic study of Hepatitis Delta virus (HDV) isolates from this region was carried out. The aim of this study is to analyze the genetic proximity within local HDV strains, and relationship with other clades of HDV, using phylogenetic analysis. Results Phylogenetic analysis of nucleotide sequences of the Hepatitis Delta Antigen (HDAg) R0 region obtained in this study, showed considerable diversity among the local strains with a potential subgroup formation within clade I. The multiple sequence alignment of predicted amino acids within clade I showed many uncommon amino acid substitutions within some conserved regions that are crucial for replication and assembly of HDV. Conclusions The studied strains showed a range of genetic diversity within HDV clade I. There is clustering of sequences into more than one group, along with formation of potential subgroup within clade I. Clustering shows the genetic closeness of strains and indicates a common origin of spread of HDV infection. Further phylogeny-based studies may provide more information about subgroup formation within clade I and may be used as an effective tool in checking and/or preventing the spread of hepatitis D virus infection in this region. PMID:22894717

  4. Antimicrobial susceptibility pattern of aerobic microbial isolates in a clinical laboratory in Karachi - Pakistan

    PubMed Central

    Sabir, Rubina; Danish Alvi, S. Faraz; Fawwad, Asher

    2013-01-01

    Backgroun and Objective: Resistance to multiple antimicrobials is the major cause of debility and death due to infectious diseases around the world. Our objective was to determine the frequency and antimicrobial susceptibility pattern of aerobic microbial isolates in a clinical laboratory. Methodology: All culture specimens of tissue, pus, urine, bone, blood, fluid, stool, sputum, and high vaginal swab received in the Microbiology Department of Clinical & Research Laboratory, Baqai Institute of Diabetology and Endocrinology from May 2010 to January 2011 were included in the present study. Bacterial isolates were identified and their antimicrobial susceptibility pattern was determined. Results: Out of 312 cultured specimens, 272 (87.17%) were found infected with 437 microbial organisms (412 bacteria and 25 Candida isolates). A total of 90 (20.59%) multi-drug resistant (MDR) isolates were found. MDR Escherichia coli was isolated in 40 (34.19%) out of 117 culture specimens which showed the growth of Escherichia coli, Pseudomonas aeruginosa in 17 (22.08%), Methicillin-resistant Staphylococcus aureus in 13 (11.50%), Klebsiella pneumoniae in 7 (22.58%), Proteus species in 6 (31.58%), Acinetobacter species in 3 (33.33%), Enterobacter species in 2 (28.57%), Coliform (Escherichia coli) in 1 (16.67%) and Enterococcus species were isolated in 1 (50%) culture specimen. Conclusions: High prevalence of multi-drug resistant bacteria was found in the present study. Emergence of antimicrobial resistance has become a major challenge in infectious disease medicine. Antimicrobial resistance may be due to misuse of antimicrobials by physicians and self medication in Pakistan. Further large scale studies are needed to validate our findings. PMID:24353642

  5. Pakistan.

    PubMed

    1992-06-01

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

  6. Pakistan.

    PubMed

    1992-06-01

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

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

    PubMed

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

    2015-04-01

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

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

    PubMed

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

    2015-04-01

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

  9. 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.

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

    PubMed Central

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

    2016-01-01

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

  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. 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. Knowledge and Awareness about Cervical Cancer and Its Prevention amongst Interns and Nursing Staff in Tertiary Care Hospitals in Karachi, Pakistan

    PubMed Central

    Ali, Syed Faizan; Ayub, Samia; Manzoor, Nauman Fazal; Azim, Sidra; Afif, Muneeza; Akhtar, Nida; Jafery, Wassi Ali; Tahir, Imran; Farid-ul-Hasnian, Syed; Uddin, Najam

    2010-01-01

    Background and Objective Cervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide, especially in developing countries. It is imperative for at least health professionals in developing countries like Pakistan to have a sound knowledge about the disease. This study was carried out to assess the knowledge and awareness about cervical cancer and its prevention amongst health professionals in tertiary care hospitals in Karachi, Pakistan. Methods and Design A cross-sectional, interview based survey was conducted in June, 2009. Sample of 400 was divided between the three tertiary care centers. Convenience sampling was applied as no definitive data was available regarding the number of registered interns and nurses at each center. Results Of all the interviews conducted, 1.8% did not know cervical cancer as a disease. Only 23.3% of the respondents were aware that cervical cancer is the most common cause of gynecological cancers and 26% knew it is second in rank in mortality. Seventy-eight percent were aware that infection is the most common cause of cervical cancer, of these 62% said that virus is the cause and 61% of the respondents knew that the virus is Human Papilloma Virus (HPV). Majority recognized that it is sexually transmitted but only a minority (41%) knew that it can be detected by PCR. Only 26% of the study population was aware of one or more risk factors. Thirty seven percent recognized Pap smear as a screening test. In total only 37 out of 400 respondents were aware of the HPV vaccine. Conclusion This study serves to highlight that the majority of working health professionals are not adequately equipped with knowledge concerning cervical cancer. Continuing Medical Education program should be started at the hospital level along with conferences to spread knowledge about this disease. PMID:20548787

  14. 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

  15. 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.

  16. 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

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

    PubMed Central

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

    2010-01-01

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

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

    PubMed Central

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

    2016-01-01

    Objectives 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. Design A multicentre hospital-based case–control study. Setting Four leading maternity hospitals of Karachi. Participants 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. Primary and secondary outcome measures Adverse birth outcomes (preterm delivery, low birth weight, stillbirth, low Apgar score) and obstetric complications (antepartum haemorrhage, caesarean section, etc). Results 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. Conclusions 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. PMID

  19. 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

  20. 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

  1. Better physician-patient communication; an important milestone in control of hypertension, a multicenter study from Karachi, Pakistan.

    PubMed

    Almas, Aysha; Bhamani, Faridah; Khan, Aamir Hameed

    2014-12-01

    Control of hypertension is an important cornerstone in prevention of cardiovascular morbidity and mortality. This study was designed to compare physician encounter score in patients with controlled and uncontrolled hypertension. It was conducted at three tertiary care hospitals in Karachi. Patients were categorized into controlled and uncontrolled hypertension based on their initial blood pressure readings on presentation. Primary outcome variable was control of hypertension and physician encounter score (a composite score of 12 item question) was the main candidate variable. Higher scores reflected favorable encounter with physician. Mean age of participants was 57.7 ± 12 years; 224 (50.1%) were men. Controlled hypertension was present in 72.3% (323) and uncontrolled hypertension was present in 27.4% (124). Mean physician encounter score in uncontrolled hypertensive was 7.25 ± 2.64 versus 7.83 ± 2.22 (p=0.02) in controlled hypertensive. Patient-physician encounter is an important milestone in control of hypertension in hypertensive patients and directly translates into better adherence to antihypertensives in these patients.

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    2013-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  6. 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

  7. 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

  8. Immune Responses to Vi Capsular Polysaccharide Typhoid Vaccine in Children 2 to 16 Years Old in Karachi, Pakistan, and Kolkata, India

    PubMed Central

    Khan, M. Imran; Soofi, Sajid B.; Sur, Dipika; Kanungo, Suman; You, Young Ae; Habib, M. Atif; Sahito, Shah Muhammad; Manna, Byomkesh; Dutta, Shanta; Acosta, Camilo J.; Ali, Mohammad; Bhattacharya, Sujit K.; Bhutta, Zulfiqar A.; Clemens, John D.

    2014-01-01

    The geometric mean concentration (GMC) and the proportion maintaining a protective level (150 enzyme-linked immunosorbent assay (ELISA) units [ELU]/ml) 2 years following a single dose of 25 μg of injectable Vi capsular polysaccharide typhoid vaccine was measured against that of the control hepatitis A vaccine in children 2 to 16 years old in cluster randomized trials in Karachi and Kolkata. The GMC for the Vi group (1,428 ELU/ml) was statistically significantly different from the GMC of the control hepatitis A vaccine group (86 ELU/ml) after 6 weeks. A total of 117 children (95.1%) in the Vi group and 9 (7.5%) in the hepatitis A group showed a 4-fold rise in Vi IgG antibody concentrations at 6 weeks (P < 0.01). Protective antibody levels remained significantly different between the two groups at 2 years (38% in the Vi vaccine groups and 6% in the hepatitis A group [P < 0.01]). A very small proportion of younger children (2 to 5 years old) maintained protective Vi IgG antibody levels at 2 years, a result that was not statistically significantly different compared to that for the hepatitis A group (38.1% versus 10.5%). The GMCs of the Vi IgG antibody after 2 years were 133 ELU/ml for children 2 to <5 years old and 349 ELU/ml for children 5 to 16 years old. In conclusion, Vi capsular polysaccharide typhoid vaccine is immunogenic in children in settings of South Asia where typhoid is highly endemic. The antibody levels in children who received this vaccine remained higher than those in children who received the control vaccine but were significantly reduced at 2 years of follow-up. PMID:24599532

  9. Immune responses to Vi capsular polysaccharide typhoid vaccine in children 2 to 16 years old in Karachi, Pakistan, and Kolkata, India.

    PubMed

    Ochiai, R Leon; Khan, M Imran; Soofi, Sajid B; Sur, Dipika; Kanungo, Suman; You, Young A; Habib, M Atif; Sahito, Shah Muhammad; Manna, Byomkesh; Dutta, Shanta; Acosta, Camilo J; Ali, Mohammad; Bhattacharya, Sujit K; Bhutta, Zulfiqar A; Clemens, John D

    2014-05-01

    The geometric mean concentration (GMC) and the proportion maintaining a protective level (150 enzyme-linked immunosorbent assay (ELISA) units [ELU]/ml) 2 years following a single dose of 25 μg of injectable Vi capsular polysaccharide typhoid vaccine was measured against that of the control hepatitis A vaccine in children 2 to 16 years old in cluster randomized trials in Karachi and Kolkata. The GMC for the Vi group (1,428 ELU/ml) was statistically significantly different from the GMC of the control hepatitis A vaccine group (86 ELU/ml) after 6 weeks. A total of 117 children (95.1%) in the Vi group and 9 (7.5%) in the hepatitis A group showed a 4-fold rise in Vi IgG antibody concentrations at 6 weeks (P < 0.01). Protective antibody levels remained significantly different between the two groups at 2 years (38% in the Vi vaccine groups and 6% in the hepatitis A group [P < 0.01]). A very small proportion of younger children (2 to 5 years old) maintained protective Vi IgG antibody levels at 2 years, a result that was not statistically significantly different compared to that for the hepatitis A group (38.1% versus 10.5%). The GMCs of the Vi IgG antibody after 2 years were 133 ELU/ml for children 2 to <5 years old and 349 ELU/ml for children 5 to 16 years old. In conclusion, Vi capsular polysaccharide typhoid vaccine is immunogenic in children in settings of South Asia where typhoid is highly endemic. The antibody levels in children who received this vaccine remained higher than those in children who received the control vaccine but were significantly reduced at 2 years of follow-up.

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

    PubMed

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

    2013-09-01

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

  11. 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.

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

    PubMed Central

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

    2013-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1975-01-01

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

  14. Pakistan.

    PubMed

    1987-03-01

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

  15. Pakistan.

    PubMed

    1987-03-01

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

  16. Impossible Fictions: The Lived Experiences of Women Teachers in Karachi

    ERIC Educational Resources Information Center

    Kirk, Jackie

    2004-01-01

    This article discusses data from a study of women teachers in Karachi, Pakistan, that present their alternative perspectives so as to inform educational policy development and to develop more explicitly gendered theories of teaching. It begins with a brief introduction to the positioning of women teachers within the international context of…

  17. Pakistan: Summary Report. Education Financing and People's Aspirations in Pakistan. Asia-South Pacific Education Watch

    ERIC Educational Resources Information Center

    Lozada, Rebecca, Ed.

    2008-01-01

    This study was conducted across the country in a total of 23 districts, 5 districts each in the four provinces of Pakistan, i.e. Balochistan, Punjab, Sindh, North Western Frontier Province (NWFP), and 2 districts in Azad Jammu & Kashmir (AJK). The main purpose of the paper was to unravel the intricate budgeting process in the education sector,…

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

    PubMed

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

    2015-06-01

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

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

    PubMed

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

    2013-01-01

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

  20. 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 Central

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

    2016-01-01

    BACKGROUND: 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. AIM: 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. MATERIAL AND METHODS: 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. RESULTS: 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). CONCLUSIONS

  1. Pakistan. Spotlight.

    PubMed

    Greene, M

    1985-01-01

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

  2. Pakistan. Spotlight.

    PubMed

    Greene, M

    1985-01-01

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

  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. International trends in health science librarianship part 12: South Asia (India, Pakistan and Sri Lanka).

    PubMed

    Joshi, Medha; Ali Anwar, Mumtaz; Ullah, Midrar; Kuruppu, Chandrani

    2014-12-01

    This is the 12th in a series of articles exploring international trends in health science librarianship. This issue describes developments in health science librarianship in the first decade of the 21st century in South Asia. The three contributors report on challenges facing health science librarians in India, Pakistan and Sri Lanka. There is consensus as to the need for education, training and professional development. Starting in the next issue, the focus will turn to Africa, starting with countries in southern Africa. JM.

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

    ERIC Educational Resources Information Center

    Rahman, Tariq

    2005-01-01

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

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

    PubMed

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

    2013-12-01

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

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

    SciTech Connect

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

    1985-01-01

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

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

    ERIC Educational Resources Information Center

    Zaman, Riffat Moazam

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

  9. 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

    Saleem, Ali Faisal; Mahmud, Sadia; Baig-Ansari, Naila; Zaidi, Anita K M

    2014-12-01

    This cluster-randomized interventional trial at periurban 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%; OR(adj) 8.36 (5.6-12.42) and 5% (25% vs. 20%; OR(adj) 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.

  10. 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

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

    PubMed

    Miller, Andrew C; Arquilla, Bonnie

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    King, Denise E.

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

  13. An experience of teaching bioethics at secondary schools in Karachi.

    PubMed

    Khan, Mahjabeen

    2013-01-01

    Bioethics is the "critical analysis of emerging moral issues in health". The term was first used to refer to "the moral problems of the life sciences encompassing medicine, biology, environment, population and social sciences". Teaching bioethics is complex and challenging within multi-system educational program as in Pakistan for secondary schools. The objectives are difficult as bioethics teaching require changes in knowledge, skills and attitudes along with strong improvement in moral reasoning. The objectives of the study were to teach bioethics and evaluate comprehension and skills of ethical reasoning in students of secondary school in Karachi. This was a quasi-experimental study conducted in two schools (public and private-sector) of Karachi from January 2007 to December 2009. This was a preliminary study and used simple random sampling to recruit one hundred and ten students. The qualitative analysis of comprehension and skills were evaluated on numeric scales. The study found higher comprehension and skills level in females (66%) compared to male students during class-room sessions.

  14. An experience of teaching bioethics at secondary schools in Karachi.

    PubMed

    Khan, Mahjabeen

    2013-01-01

    Bioethics is the "critical analysis of emerging moral issues in health". The term was first used to refer to "the moral problems of the life sciences encompassing medicine, biology, environment, population and social sciences". Teaching bioethics is complex and challenging within multi-system educational program as in Pakistan for secondary schools. The objectives are difficult as bioethics teaching require changes in knowledge, skills and attitudes along with strong improvement in moral reasoning. The objectives of the study were to teach bioethics and evaluate comprehension and skills of ethical reasoning in students of secondary school in Karachi. This was a quasi-experimental study conducted in two schools (public and private-sector) of Karachi from January 2007 to December 2009. This was a preliminary study and used simple random sampling to recruit one hundred and ten students. The qualitative analysis of comprehension and skills were evaluated on numeric scales. The study found higher comprehension and skills level in females (66%) compared to male students during class-room sessions. PMID:23286632

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

    PubMed

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

    2012-01-01

    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.

  16. Initial Teacher Training: South Asian Approaches. Quality in Basic Education: Professional Development of Teachers. Papers Prepared for a South Asian Colloquium on Teacher Training in Bangladesh, India, Pakistan, and Sri Lanka (Colombo, Sri Lanka, April 1992).

    ERIC Educational Resources Information Center

    Commonwealth Secretariat, London (England).

    This publication is one of two prepared for a South Asian Colloquium on issues related to teacher training in Bangladesh, India, Pakistan, and Sri Lanka. The papers in this volume focus on innovations and alternative strategies designed to improve quality in teacher education at preservice phase. The publication is in five sections. The first four…

  17. 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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    2016-02-01

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

  3. Sandfly (Diptera, Psychodidae, Phlebotominae) fauna of South-Western Pakistan. 1. Diagnostic morphology of Phlebotomus papatasi (Scopoli), Ph. bergeroti (Parrot) and Ph. salehi (Mesghali).

    PubMed

    Kakarsulemankhel, Juma-Khan

    2003-06-01

    A survey was conducted to study the morphology of the sandfly fauna in South-Western Pakistan (Balochistan). During the revision of different genera of sandflies the specimens of Phlebotomus papatasi (Scopoli) (N = 720), Ph. bergeroti Parrot (N = 30) and Ph. salehi Mesghali (N = 70) were encountered in various localities. These localities appear to be new records of the subgenus in the literature to date. Ph. bergeroti is reported for the first time from Pakistan and Ph. salehi from Balochistan as well. Characters of these three Pakistanese Phlebotomus are compared with the published data of these species from other countries. Keys for the identification of Pakistanese Phlebotomus are also constructed. Two female Ph. papatasi collected from indoors out of 132 female flies (1.5%) were found positive with flagellate infection in pharynx and midgut. The possible vectorial role of these flies is also discussed. Further surveys are necessary in parts of the country that have not been systematically surveyed.

  4. Understanding the HIV / AIDS context in Pakistan.

    PubMed

    Ali, S; Khinani, R; Tariq, W U; Shah, S A

    1995-08-01

    Understanding the social context of sexual relations is important in understanding the AIDS epidemic. To date, however, no systematic studies on sexual behavior have been conducted in Pakistan. HIV has so far spread in the country through heterosexual contact and blood transfusions. Although the magnitude of the problem is difficult to determine, health authorities estimate that 10,000-12,000 people have been infected with HIV. This paper posits that rapid urbanization, together with the sex behavior of single migrant workers, deported HIV-infected expatriates, the exploitation of women, and the easy availability of narcotic drugs, especially in Karachi, are some important factors which may be responsible for the spread of HIV in Pakistan. Pakistan's population profile, patterns of HIV transmission, and government initiatives are discussed. The social context of sexual relations is also discussed in sections on laws relating to sexuality, the effects of urbanization, and marriage and sexual relations. PMID:12290783

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

    NASA Astrophysics Data System (ADS)

    Siddiqui, Jawad M.

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

  6. 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, ... and Aug 11, 2010 Images:  Pakistan Flood location:  Asia thumbnail:  ...

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

    PubMed

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

    2014-09-01

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

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

    PubMed

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

    2014-09-01

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

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

    SciTech Connect

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

    2012-10-15

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

  10. 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

  11. How our practice of histopathology, especially tumour pathology has changed in the last two decades: reflections from a major referral center in Pakistan.

    PubMed

    Ahmad, Zubair; Idrees, Romana; Fatima, Saira; Arshad, Huma; Din, Nasir-ud; Memon, Aisha; Minhas, Khurram; Ahmed, Arsalan; Fatima, Syeda Samia; Arif, Muhammad; Ahmed, Rashida; Haroon, Saroona; Pervez, Shahid; Hassan, Sheema; Kayani, Naila

    2014-01-01

    Continued advances in the field of histo-pathology (and cyto-pathology) over the past two decades have resulted in dramatic changes in the manner in which these disciplines are now practiced. This is especially true in the setting of a large university hospital where the role of pathologists as clinicians (diagnosticians), undergraduate and postgraduate educators, and researchers has evolved considerably. The world around us has changed significantly during this period bringing about a considerable change in our lifestyles and the way we live. This is the world of the internet and the world-wide web, the world of Google and Wikipedia, of Youtube and Facebook where anyone can obtain any information one desires at the push of a button. The practice of histo (and cyto) pathology has also evolved in line with these changes. For those practicing this discipline in a poor, developing country these changes have been breathtaking. This is an attempt to document these changes as experienced by histo (and cyto) pathologists practicing in the biggest center for Histopathology in Pakistan, a developing country in South Asia with a large (180 million) and ever growing population. The Section of Histopathology, Department of Pathology and Microbiology at the Aga Khan University Hospital (AKUH) in Karachi, Pakistan's largest city has since its inception in the mid-1980s transformed the way histopathology is practiced in Pakistan by incorporating modern methods and rescuing histopathology in Pakistan from the primitive and outdated groove in which it was stuck for decades. It set histopathology in Pakistan firmly on the path of modernity and change which are essential for better patient management and care through accurate and complete diagnosis and more recently prognostic and predictive information as well.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  13. Pakistan seminar.

    PubMed

    1970-02-01

    Public participation in the national family planning programme and the promotion of population education were the main topics discussed at the national conference of the Family Planning Association of Pakistan held at Cokilla in December. The Conference was opened by the Governor of East Pakistan, Vice-Admiral S.M. Ahsan. The Minister of Health, Dr. A.M. Malik, presided at the first session when delegates and visitors were welcomed by Begum Manzoor Quadir, President of the Pakistan Association. Experience in India, Cylon and Nepal, as well as in Pakistan was examined in relation to public participation in national programmes. At the session concerned with the promotion of a population education programme special attention was paid to a new element in the education programme, the proposals for teaching the elements of responsible parenthood and population dynamics to school children and young people. Mrs. Sarwat Rahman and Mrs. Fatema Iftekhar, members of the Pakistan Association who recently attended a prototype course in family life education at IPPF headquarters in London, addressed the conference on certain approaches to the education of young people that they consider particulary suitable for Pakistan. Dr. Malcolm Potts, Medical Secretary of the IPPF, also took part in the session on population education. He subsequently addressed meetings of doctors in three towns in East Pakistan as well as visiting urban and rural projects of the Pakistan Association and saw vasectomy clinics at work.

  14. An epidemic of Dengue fever in Karachi--associated clinical manifestations.

    PubMed

    Qureshi, J A; Notta, N J; Salahuddin, N; Zaman, V; Khan, J A

    1997-07-01

    Dengue is a mosquito borne disease with worldwide distribution. Depending on virulence factors and host immune status, infection can manifest as a severe but non fatal viral syndrome or a rapidly progressive and a frequently fatal haemorrhagic fever. During the course of an outbreak of viral fever in Karachi, Pakistan from June, 1994 to September, 1995, we studied 145 cases admitted at the Aga Khan University Hospital. 43% of the cases were between the age group of 20-30 years, majority of these being male (75%). Amongst the clinical signs and symptoms, the most frequent findings were fever, vomiting and abdominal pain. Spontaneous hemorrhagic manifestations occurred in 66 patients and of these petechiae and mucosal bleed were the commonest, that is, 42% and 38% respectively. At presentation thrombocytopenia (platelet count < or = 50,000) per cubic millimeter) was present in 78%, leucopenia (white cell count < 4,000 per cubic millimeter) in 34%. Apart from one patient who died from hemorrhagic shock on the 5th day of admission, the remaining patients recovered and their platelet counts normalized on an average in 9 days. This is the first reported epidemic in Karachi of dengue infection.

  15. 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.

  16. Pakistan programme thrives despite unrest.

    PubMed

    1996-01-01

    In Pakistan, strikes and riots in the Korangi district of Karachi during 1995 prevented staff from finding a suitable location for the new Marie Stopes International family planning clinic. Once the clinic opened, field workers received violent threats and had to be escorted to and from work. A mobile clinic was hijacked at gun point. Nevertheless, the Pakistan program has expanded to five clinics with one more to open soon. It has established an extensive community-based distribution (CBD) network. Before the CBD project was implemented, less than 10% of couples within the target group used a modern contraceptive method. An effective information and education strategy along with high quality service provision has increased use of modern contraceptives three-fold in some areas. The program plans to expand into underserved areas of rural Sind Province and Balochistan. 4% of women in Balochistan and 9% in Sind have access to modern contraceptives. In fact, many women resort to illegal and unsafe abortion. The program aims to submit a proposal to UK's Overseas Development Administration for major funding.

  17. Parasuicide in Pakistan: experience at a university hospital.

    PubMed

    Khan, M M; Islam, S; Kundi, A K

    1996-04-01

    There have been few reports of parasuicide from Pakistan, where the act is considered to be a criminal offence and the Islamic religion strongly disapproves of it. In order to address the problem, a retrospective case report analysis of all index cases of parasuicide presenting over a period of 3.5 years to a university hospital in Karachi, Pakistan, was undertaken. Our results showed that most of the subjects were young adults, with married women representing the single largest group. Self-poisoning with medication was the most common method, and benzodiazepines the most frequently used drug. Interpersonal conflict with the opposite sex was the most common precipitating cause. In Pakistani culture, marriage appears to be a significant source of stress for women. Reports based on official police records do not reflect the true picture of the problem in Pakistan. PMID:8712026

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

    PubMed Central

    2009-01-01

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

  19. 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

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

    USGS Publications Warehouse

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

    1989-01-01

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

  1. 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.

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

    PubMed

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

    2014-03-01

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

  3. 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

  4. Aflatoxin B1 in betel nuts (Areca catechu L.) imported to Pakistan from different regions of South Asia.

    PubMed

    Asghar, Muhammad Asif; Iqbal, Javed; Ahmed, Aftab; Khan, Mobeen Ahmed; Shamsuddin, Zuzzer Ali

    2014-01-01

    Aflatoxin B1 (AFB1) levels were evaluated in betel nuts (Areca catechu L.) being imported to Pakistan during 2010-2011. In total, 278 betel nut samples (India = 21, Indonesia = 51, Sri-Lanka = 34 and Thailand = 172) were received from the Department of Customs and were analysed by thin layer chromatography (TLC). All Indian origin betel nuts showed AFB1 contamination ranging from 11.7-262.0 µg kg(-1) with a mean of 92.5 µg kg(-1). Among Indonesian and Sri Lankan shipments, 80.4% and 73.5% betel nuts were contaminated with AFB1 ranging between 3.3-39.2 and 6.5-103.4 µg kg(-1) with a mean of 11.6 and 35.0 µg kg(-1), respectively. However, only 30.2% of Thailand origin samples showed AFB1 contamination ranging 3.3-77.0 µg kg(-1) with a mean of 6.6 µg kg(-1). The widespread occurrence of AFB1 increases the hazard associated with betel nuts. Thus, strict control is a pre-requisite for the production and import/export of psychoactive substances as betel nuts.

  5. 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

  6. 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.

  7. Teaching Bioethics to Medical Technology Students in Pakistan

    PubMed Central

    Naqvi, Rubina

    2009-01-01

    Incorporating ethics education in curriculum of medical technology students and highlighting the importance of teaching the subject to this particular population in this part of world are our aims. At SIUT we have a school with name of “Zain ul Abidin” school of Biomedical Technology, which is supposed to award B.S. degree in 5 sub-specialties that is hemodialysis, radiology, laboratory sciences, operation theater technology and intensive care technology. This school is affiliated by Karachi University. The students entering in school have done fellow in science (F.Sc.)with pre-medical group, thus have background knowledge of biology, physics, chemistry, languages, religion and Pakistan studies. Here for B.S. included in their curriculum are the subjects of anatomy, physiology, biochemistry, microbiology, pharmacology, pathology, Islamiat and English for all and then related sub-specialty topics to each group for example student in hemodialysis group more exposed to nephrology topics etc. I planned to add ethics with subjects, which are common to all specialties and designed curriculum. Curriculum was approved (after minor changes), from Karachi University and I started teaching ethics to these students. This paper highlights methods and tools of teaching and evaluation and results observed. This will be the first examination in bioethics from medical technologists, at university level in the history of country. This is a great achievement in country to start teaching bioethics to medical technologists. Karachi University has implemented the same curriculum to other medical technology schools affiliated with University. PMID:23908722

  8. Geographical distribution of cutaneous leishmaniasis and sand flies in Pakistan.

    PubMed

    Shakila, Ashraf; Bilqees, Fatima Mujib; Salim, Azra; Moinuddin, Moinuddin

    2006-01-01

    Cutaneous leishmaniasis is found in all the four provinces of Pakistan; these are NWFP, Balochistan, Sindh and Punjab. In Balochistan the areas from where the patients came are Uthal, Quetta and Ormara. The highest number of patients came from Quetta and least from Ormara. The patients included in this study were from the Mangopir and Chakewara, areas of Karachi. The infection is endemic in this country and the recent epidemics in the Dadu District and Nawabshah indicate its importance in the locality. The sand fly vector is found in all four provinces of Pakistan that are listed here. It is quite obvious that presence of leishmaniasis indicates the presence of sand flies and cutaneous leishmaniasis is more common.

  9. Prevalence and Factors Associated with Intestinal Parasitic Infection among Children in an Urban Slum of Karachi

    PubMed Central

    Mehraj, Vikram; Hatcher, Juanita; Akhtar, Saeed; Rafique, Ghazala; Beg, Mohammad Asim

    2008-01-01

    Background Intestinal parasitic infections are endemic worldwide and have been described as constituting the greatest single worldwide cause of illness and disease. Poverty, illiteracy, poor hygiene, lack of access to potable water and hot and humid tropical climate are the factors associated with intestinal parasitic infections. The study aimed to estimate prevalence and identify factors associated with intestinal parasitic infections among 1 to 5 years old children residing in an urban slum of Karachi Pakistan. Methods and Principal Findings A cross sectional survey was conducted from February to June 2006 in Ghosia Colony Gulshan Town Karachi, Pakistan. A simple random sample of 350 children aged 1–5 years was collected. The study used structured pre-tested questionnaire, anthropometric tools and stool tests to obtain epidemiological and disease data. Data were analyzed using appropriate descriptive, univariate and multivariable logistic regression methods. The mean age of participants was 2.8 years and 53% were male. The proportions of wasted, stunted and underweight children were 10.4%, 58.9% and 32.7% respectively. The prevalence of Intestinal parasitic infections was estimated to be 52.8% (95% CI: 46.1; 59.4). Giardia lamblia was the most common parasite followed by Ascaris lumbricoides, Blastocystis hominis and Hymenolepis nana. About 43% children were infected with single parasite and 10% with multiple parasites. Age {Adjusted Odds Ratio (aOR) = 1.5; 95% CI: 1.1; 1.9}, living in rented households (aOR = 2.0; 95% CI: 1.0; 3.9) and history of excessive crying (aOR = 1.9; 95% CI: 1.0; 3.4) were significantly associated with intestinal parasitic infections. Conclusions Intestinal parasites are highly prevalent in this setting and poverty was implicated as an important risk factor for infection. Effective poverty reduction programmes and promotion of deworming could reduce intestinal parasite carriage. There is a need for mass scale campaigns to

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

    PubMed

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

    2014-09-15

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

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

    PubMed

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

    2014-09-15

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

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

    SciTech Connect

    Ahmad, S.

    1995-12-31

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

  13. Consanguineous marriage and differentials in age at marriage, contraceptive use and fertility in Pakistan.

    PubMed

    Hussain, R; Bittles, A H

    1999-01-01

    Fertility rates in Pakistan have remained consistently high over the past three decades. While numerous studies have examined sociodemographic determinants, the role of biological factors, and particularly consanguinity, has received little attention, even though marriage between close biological relatives continues to be the norm in Pakistan. Reproductive behaviour among women in consanguineous (first cousin) and non-consanguineous unions was compared, using data from a 1995 study of multi-ethnic communities in Karachi and the 1990-91 Pakistan Demographic & Health Survey (PDHS). The results show that, although female age at first marriage has been gradually rising in both study samples, women in consanguineous unions married at younger ages and were less likely to use modern contraceptive methods. In the Karachi sample, women in first cousin unions experienced a higher mean number of pregnancies and also reported a higher mean number of children ever born (CEB). However, their mean number of surviving children did not differ from those born to women in non-consanguineous unions, implying higher prenatal and/or postnatal losses in couples related as first cousins. On the other hand, the PDHS showed both lower CEB values for women in consanguineous marriages and a lower number of surviving children. Given the continuing popularity of consanguineous marriage, these findings have important implications for future fertility reduction in Pakistan.

  14. 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

  15. 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. PMID:9560167

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

    PubMed

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

    2016-03-01

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

  17. 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.

  18. Use of miltefosine in the treatment of visceral leishmaniasis in children at a tertiary care hospital of Karachi.

    PubMed

    Humayun, Khadija Nuzhat; Saleem, Taimur; Khalid, Umair; Jehan, Fyezah; Soofi, Sajid

    2010-06-01

    Existing standard treatment options for visceral leishmaniasis are less than optimal. We report here the use of oral miltefosine in the treatment of two paediatric cases of visceral leishmaniasis at a tertiary care hospital in Karachi, Pakistan. One patient came from Balochistan while the second patient was from Northern Pakistan. Both presented with a prolonged history of fever, massive hepatosplenomegaly, anaemia and thrombocytopenia. Visceral leishmaniasis was diagnosed with bone marrow studies. Amphotericin B was first started in the first patient; however severe hypokalaemia and allergic reaction occurred. Oral miltefosine was then administered. The child showed clinical improvement with regards to signs of leishmania infection but succumbed to a nosocomial infection during the hospital stay. In the second patient, miltefosine was started in the first instance. He showed remarkable clinical improvement. At 2 months follow-up, the child showed adequate weight gain along with successful resolution of hepatosplenomegaly and fever. Miltefosine has the potential to be considered a first line therapy for visceral leishmaniasis in developing countries; however larger studies are warranted to validate the trends observed in this small case series.

  19. Women's mental health in Pakistan

    PubMed Central

    Niaz, Unaiza

    2004-01-01

    In Pakistan, societal attitudes and norms, as well as cultural practices (Karo Kari, exchange marriages, dowry, etc.), play a vital role in women's mental health. The religious and ethnic conflicts, along with the dehumanizing attitudes towards women, the extended family system, role of in-laws in daily lives of women, represent major issues and stressors. Such practices in Pakistan have created the extreme marginalisation of women in numerous spheres of life, which has had an adverse psychological impact. Violence against women has become one of the acceptable means whereby men exercise their culturally constructed right to control women. Still, compared to other South Asian countries, Pakistani women are relatively better off than their counterparts. PMID:16633458

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

    PubMed

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

    2015-06-19

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

  1. A point survey of periurban and urban malaria in Karachi.

    PubMed

    Nalin, D R; Mahood, F; Rathor, H; Muttalib, A; Sakai, R; Chowdhry, M A; Safdar, G; ul Haq, I; Munir, M; Suleiman, M

    1985-02-01

    A point survey of malaria in Karachi revealed a concentration of malaria cases in the periurban perimeter and marginal areas where immigrating groups, including Afghan refugees and Biharis from Bangladesh are concentrated. Populations of Anopheles stephensi, Karachi's main vector, were low, and were feeding chiefly on buffaloes which are also concentrated along the periurban perimeter. Maintenance of malaria transmission in periurban zones may depend on immigration of susceptibles, bovid hosts which help maintain zoophilic vector populations, and mosquito breeding sites in water tanks or buffalo hoofprints. The vector's switch to man-biting behaviour may occur either due to a 'spillover' effect from buffalo corrals to surrounding houses, or when buffaloes become less available for biting. Four types of chromosome inversions were found in the Karachi An. stephensi; as this species is not a vector in similar habitats in Lahore and Pondicherry where such inversions are not prevalent, it is likely that its status as a vector is related to chromosomal polymorphism influencing behaviour.

  2. An assessment of Pakistan's urban policies 1947-1997.

    PubMed

    Qadeer, M A

    1996-01-01

    This paper aims at analyzing and assessing the evolution and outcomes of Pakistan's urban policies during 1947-97. One-third of Pakistan's population live in urban areas, and the level of urbanization increased from 18% in 1951 to 32% in 1991. The rapid rate of urbanization has produced two megacities, Karachi with a population of 8-10 million and Lahore with a population of about 5 million, and 6 other cities with populations of 1 million or more. Pakistan is one of the pioneering countries in implementing physical planning and planned housing; this is reflected in its urban policies as constituted by the Five-Year Plan and national development budgets. The programs through which the policies were implemented are divided into three phases. Phase 1 (1947-70) involved the resettlement of refugees and laying of the institutional framework; core housing schemes (consisting of 1- to 2-room quarters) were the key element of the urban strategy in this period. Phase 2 (1971-78) policies were guided by the promise of mass housing, particularly for the working and lower classes. At this time, too, a set of squatter settlements known as Katchi Abadis emerged, and international organizations started funding Pakistan's urban development programs. Phase 3 (1980-95) saw the steady "privatization" of the housing and land markets and improved housing conditions, while urban policy continued to concentrate on public works, plots and construction. Despite the improvements, urban crises persist, and policies are shifting towards more complex issues of quality and the provision of new collective goods. In general, the achievements of Pakistan's urban policies have outweighed its failures, as both the rich and the poor have benefitted from them.

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

    PubMed

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

    2015-05-01

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

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

    PubMed

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

    2015-09-01

    Consumption of energy drinks has become popular among students and athletes over the past few years. To explore the phenomenon, a cross-sectional survey was conducted through a self-administered pilot-tested questionnaire. Frequency of energy drinks consumption was found to be 121(52%) in a sample of 233 medical students. Red bull was the most common brand consumed 101(43%). The major reasons reported for its usage were to gain/replenish energy by 36(15.4%), and studying for examination by 34(14.6%). Television was reported as the major source of information 153(66%) followed by friends 113(48%). There was a high frequency of energy drinks' consumption among medical students of a private university. There is a strong need to create awareness regarding these drinks, especially among adolescents and teenagers. PMID:26338750

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

    SciTech Connect

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

    2014-01-01

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

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

    PubMed

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

    2015-09-01

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

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

    PubMed

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

    2008-01-01

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

  8. Evidence for a "Founder Effect" among HIV-infected injection drug users (IDUs) in Pakistan

    PubMed Central

    2010-01-01

    Background We have previously reported a HIV-1 subtype A infection in a community of injection drug users (IDUs) in Karachi, Pakistan. We now show that this infection among the IDUs may have originated from a single source. Methods Phylogenetic analysis was performed of partial gag sequences, generated using PCR, from 26 HIV-positive IDU samples. Results Our results showed formation of a tight monophyletic group with an intra-sequence identity of < 98% indicating a "founder effect". Our data indicate that the HIV-1 epidemic in this community of IDUs may have been transmitted by an HIV positive overseas contract worker who admitted to having contact with commercial sex workers during stay abroad. Conclusion Specific measures need to implemented to control transmission of HIV infection in Pakistan through infected migrant workers. PMID:20064274

  9. 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.

  10. Nuclear programs in India and Pakistan

    SciTech Connect

    Mian, Zia

    2014-05-09

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

  11. 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…

  12. Islamic Education in Pakistan

    ERIC Educational Resources Information Center

    Fair, C. Christine

    2006-01-01

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

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

    PubMed

    Bota, Rafaqat; Ahmed, Mushtaq; Aziz, Adnan

    2015-12-01

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

  14. 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

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

    PubMed

    Ghafoor, Shazia; Sheikh, Nadeem

    2016-01-01

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

  16. 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.

  17. Bioethics on the subcontinent: the Sindh Institute in Karachi.

    PubMed

    Lombardo, Paul A

    2011-03-01

    In this personal narrative the author recounts his experiences teaching bioethics in Pakistan. He notes the different moral, cultural and legal environments of Pakistan as compared to the United States, and in particular, the ways in which subtle interpretations of Sharia law shape bioethical reflections as well as the biomedical legal environment. As he argues, any attempt to export models of bioethics from one country to another with no attention to social and cultural differences is a recipe for failure. To presume that all ethical considerations are universal is to devalue moral traditions that differ from our own, and dismiss cultural values of other societies. PMID:21188473

  18. Bioethics on the subcontinent: the Sindh Institute in Karachi.

    PubMed

    Lombardo, Paul A

    2011-03-01

    In this personal narrative the author recounts his experiences teaching bioethics in Pakistan. He notes the different moral, cultural and legal environments of Pakistan as compared to the United States, and in particular, the ways in which subtle interpretations of Sharia law shape bioethical reflections as well as the biomedical legal environment. As he argues, any attempt to export models of bioethics from one country to another with no attention to social and cultural differences is a recipe for failure. To presume that all ethical considerations are universal is to devalue moral traditions that differ from our own, and dismiss cultural values of other societies.

  19. Report: prevalence of shigellosis in three different areas of Karachi.

    PubMed

    Qureshi, Tasneem; Saeed, Aftab; Usmanghani, Khan

    2014-03-01

    Shigellosis is communicated when the pathogen is swallowed down through the factors like stool or polluted hands with dust. Inappropriate hygienic conditions may reach such clinical manifestations. Shigellosis is frequently originated in crowded places and where hygienic conditions are insufficient and sanitation is poor. Infections easily transmissible from person to person like family members or infected playmates. The disease can easily transmit through infected food handlers with inappropriate hygienic conditions, crops nurturing in contaminated water with sewage line system, swimming in contaminated pool water. Similarly houseflies can also form an important vector for its transmission. In this study, Ecological factors were also the causative indicators for the disease. The issue was the water contamination of the different areas of Karachi mainly the Pehlwan Goth, Safora Goth. Then another area we focused was Patel Para in which Salmonella species were present. Other indicator was the individual-to-individual transfer that was common in Safora Goth. PMID:24577930

  20. 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.

  1. Suicides in the Developing World: Case Study from Pakistan

    ERIC Educational Resources Information Center

    Khan, Murad Moosa; Hyder, Adnan Ali

    2006-01-01

    There are no official data on suicide from Pakistan, a conservative South Asian Islamic country with traditionally low suicide rates. Both suicide and attempted suicide are illegal acts, as well as socially and religiously condemned, making research in this area difficult. Recent reports suggest an increase in suicide rates. In this study, police…

  2. Forensic psychiatry in Pakistan.

    PubMed

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

    2015-01-01

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

  3. 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

  4. Three Cups of Tea: Building Collaborations to Assess Earthquake Hazard in Pakistan

    NASA Astrophysics Data System (ADS)

    Hough, Susan E.; Yong, Alan

    2009-12-01

    Modern Methods in Seismic Hazard Assessment; Nagarkot, Nepal, 8-12 June 2009; The M7.6 Muzaffarabad, Pakistan, earthquake struck the Pakistani Kashmir on 8 October 2005, claiming more than 80,000 lives. The earthquake underscored two points about earthquake hazard in Pakistan: first, that it is high, and, second, that it is poorly understood. In Karachi, for example, hazard is generally considered to be low, yet this rapidly growing megacity is as close to a major strike-slip fault system as Los Angeles is to the San Andreas fault. The Pakistani engineering community has sought guidance from seismologists on improved characterization of seismic hazard. This requires both improved hazard assessment methodology and improved constraints on the critical inputs to seismic hazard maps, for example, assessment of fault slip rates and geological site characterization. These inputs are currently unavailable. Efforts to map seismicity and attenuation and to estimate fault slip rates have been hampered by political instability. Yet there is no shortage of intellectual energy—Pakistan boasts an eager community of trained earthquake professionals.

  5. Community perceptions of reasons for preference for consanguineous marriages in Pakistan.

    PubMed

    Hussain, R

    1999-10-01

    Although the recent Pakistan Demographic and Health Survey (DHS) show that two-thirds of marriages in Pakistan are consanguineous, the sociocultural determinants of such marriages remain largely unexplored. This paper examines the relative importance of the three commonly perceived reasons for such marriages: religious, economic and cultural. The analysis is based on qualitative data collected in 1995 from multi-ethnic and multi-religious communities in Karachi, the largest city of Pakistan. Results show that consanguineous marriages are preferred across all ethnic and religious groups to a varying degree, and that parents continue to be the prime decision-makers for marriages of both sons and daughters. The major reasons for a preference for consanguineous marriages are sociocultural rather than any perceived economic benefits, either in the form of consolidation of family property or smaller and less expensive dowries. Among Muslims, following religious traditions is the least commonly cited reason for such marriages. Despite the reported sociocultural advantages of consanguineous marriages, such unions are perceived to be exploitative as they perpetuate the existing power structures within the family. PMID:10581876

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

    PubMed

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

    2015-09-22

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

  7. 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.

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

    PubMed

    Shaikh, Masood Ali

    2014-05-01

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

  9. Cretaceous source rocks in Pakistan

    SciTech Connect

    Kari, I.B. )

    1993-02-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-09-01

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

  11. Pakistan boosts science budget

    NASA Astrophysics Data System (ADS)

    Harris, Margaret

    2009-08-01

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

  12. University Libraries in Pakistan.

    ERIC Educational Resources Information Center

    Haider, Syed Jalaluddin

    1986-01-01

    This profile of university libraries in Pakistan covers history of higher education and role of the library; organization of library service (strong central library, decentralized library service, central library with department libraries); resources and collection building; technical processing; readers' services; administration and staffing;…

  13. Country Profiles, Pakistan.

    ERIC Educational Resources Information Center

    Hardee, J. Gilbert; Satterthwaite, Adaline P.

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

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

    NASA Astrophysics Data System (ADS)

    Khalid, Bushra; Ghaffar, Abdul

    2015-03-01

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

  15. 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. PMID:18561738

  16. Tectonics of the Himalayan thrust belt in northern Pakistan

    NASA Technical Reports Server (NTRS)

    Yeats, R. S.; Lawrence, R. D.

    1982-01-01

    It is pointed out that the Himalayan ranges of southern Asia represent a dilemma in modern plate tectonic theory. Alvarez (1982) has tried to resolve some of the problems, but inconsistencies remain. The present investigation considers some of the problems which are now encountered in light of present knowledge. The investigation is concerned mainly with the evolution of the Himalaya south of the Main Mantle Thrust (MMT) and the Indus-Tsangpo suture zone, taking into account the neotectonic setting of northern Pakistan. Attention is given to subdivisions of the central Indian Himalaya, the transition from central Himalaya to northern Pakistan, subdivisions of the Himalaya of northern Pakistan, and aspects of neotectonics. Problems for future work are also discussed.

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

    PubMed

    Kiani, Muhammad Shoaib; Van Waerebeek, Koen

    2015-01-01

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

  18. 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.

  19. Invasive candidiasis in Pakistan: clinical characteristics, species distribution and antifungal susceptibility

    PubMed Central

    Farooqi, J. Q.; Jabeen, K.; Saeed, N.; Iqbal, N.; Malik, B.; Lockhart, S. R.; Zafar, A.; Brandt, M. E.; Hasan, R.

    2015-01-01

    This study reports for the first time, to our knowledge, descriptive epidemiological data for 18 invasive Candida isolates from Pakistan, including species identification and antifungal susceptibility against fluconazole, itraconazole, voriconazole, caspofungin, micafungin, anidulafungin and amphotericin. Risk factors for invasive candidiasis (IC) were determined for 96 patients from Karachi, Pakistan. In adults and neonates, Candida tropicalis (38 and 36 %, respectively) was the most common species, followed in adults by Candida parapsilosis (17.8 %), Candida glabrata (15.9 %) and Candida albicans (12.3 %). C. albicans (21 %) was the second most common in neonates. In children, C. albicans (31.9 %), C. tropicalis (26.4 %) and C. parapsilosis (19.4 %) were the most common. C. albicans IC was significantly associated with paediatric age [crude odds ratio (COR) 3.46, 95% confidence interval (CI) 1.63–7.32]. Rare species made up 17.5% of the total isolates studied. Resistance to fluconazole was seen in C. glabrata (15.0%) and Candida krusei (100.0%). Only one isolate (C. glabrata) was resistant to all three echinocandins. Low MICs of fluconazole for 98% (184/188) of isolates tested support its continued use as an empiric therapy for IC. Non-C. albicans IC was associated with the use of β lactam inhibitor combinations (COR 3.16, 95% CI 1.05–9.57). Use of healthcare devices was documented in 85.4% of IC patients, whilst 75.0% had been admitted to special care units. Surprisingly, 66.7% of patients with IC were not obviously immunosuppressed. The high frequency of modifiable risk factors in this population indicates that candidaemia can be reduced with stringent antibiotic and infection control measures. These data will be useful for empiric selection of antifungals in Karachi, and contribute to global assessments of antifungal resistance. PMID:23105021

  20. 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.

  1. 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

  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. PMID:12295466

  3. 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.

  4. Association of airborne Aspergillus with asthma exacerbation in Southern Pakistan

    PubMed Central

    Zubairi, Ali Bin Sarwar; Azam, Iqbal; Awan, Safia; Zafar, Afia

    2014-01-01

    Background Exposure to airborne fungi has been related with exacerbation of asthma in adults and children leading to increased outpatient, emergency room visits, and hospitalizations. Hypersensitivity to these airborne fungi may be an important initial predisposing factor in the development and exacerbation of asthma. Objective This study was conducted to determine an association between fungal types and spore concentrations with the risk of asthma exacerbation in adults. Methods This cross-sectional study was conducted from May 2008 to August 2009 at the Aga Khan University Hospital Karachi, Pakistan. All adult (age≥16 years) patients presenting to the hospital with acute asthma exacerbation were enrolled after informed consent. A home survey was conducted for each patient to assess their environmental characteristics. Indoor air samples were also obtained from the patient's home to determine the type and spore concentration of fungi within the week of their enrollment in the study. Results Three hundred and ninety-one patients with an acute asthma exacerbation were enrolled during the study period. The mean age of participants was 46 years (standard deviation, ±18 years) and 247 (63.2%) were females. A trend of higher asthma enrollment associated with higher Aspergillus concentrations was found in two consecutive summers. A total of nineteen types of fungi were found in air samples. Aspergillus spp. was the most frequently isolated fungus with acute asthma exacerbation. Conclusion An association of higher concentration of indoor Aspergillus spp. with asthma exacerbation in adults was observed in this study. PMID:24809014

  5. Duality of female employment in Pakistan.

    PubMed

    Kazi, S; Raza, B

    1991-01-01

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

  6. A systematic approach of tracking and reporting medication errors at a tertiary care university hospital, Karachi, Pakistan

    PubMed Central

    Khowaja, Khurshid; Nizar, Rozmin; Merchant, Rashida J; Dias, Jacqueline; Bustamante-Gavino, Irma; Malik, Amina

    2008-01-01

    Introduction: Administering medication is one of the high risk areas for any health professional. It is a multidisciplinary process, which begins with the doctor’s prescription, followed by review and provision by a pharmacist, and ends with preparation and administration by a nurse. Several studies have highlighted a high medication incident rate at several healthcare institutions. Methods: Our study design was exploratory and evaluative and used methodological triangulation. Sample size was of two types. First, a convenient sample of 1000 medication dosages to estimate the medication error (95% CI). We took another sample from subjects involved in medication usage processes such as physicians, nurses, pharmacists, and patients. Two sets of instruments were designed via extensive literature review: a medication tracking error form and a focus group interview questionnaire. Results: Our study findings revealed 100% compliance with a computerized physician order entry (CPOE) system by physicians, nurses, and pharmacists. The main error rate was 5.5% and pharmacists contributed an higher error rate of 2.6% followed by nurses (1.1%) and physicians (1%). Major areas for improvement in error rates were identified: delay in medication delivery, lab results reviewed electronically before prescription, dispension, and administration. PMID:19209247

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    PubMed

    Shaikh, Masood Ali; Ali, Mir Shabbar

    2016-07-01

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

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

    PubMed

    Shaikh, Masood Ali; Ali, Mir Shabbar

    2016-07-01

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

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

    PubMed

    Greenspan, A

    1992-12-01

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

  11. Measures of socioeconomic status for child health research: comparative results from Bangladesh and Pakistan.

    PubMed

    Durkin, M S; Islam, S; Hasan, Z M; Zaman, S S

    1994-05-01

    This paper examines the reliability and validity of several hypothesized indicators of socioeconomic status for use in epidemiologic research, particularly in studies of child health in the less developed world. Population-based surveys of child health and disability were completed in Bangladesh and Pakistan using standard questionnaires designed to measure four domains of household socioeconomic status: wealth, housing, parental education and occupation. Test-retest data indicate moderate to excellent reliability of most of the socioeconomic indicators in both countries. Loadings from factor analyses of the survey data provide further evidence of the reliability of the data, and confirm that the questionnaire measures housing and wealth as distinct domains in both countries. Parental education and occupation are correlated with housing and/or wealth in these data sets. Bivariate logistic regression analyses show that, although 11 of 12 dichotomous indicators of low socioeconomic status constructed from the data are predictive of child death in at least one of the four sub-populations studied (rural and urban Bangladesh, and rural and urban areas of Karachi, Pakistan), no single indicator is predictive of child death in all four sub-populations. These along with multivariate results demonstrate the importance of including multiple measures of distinct domains if the research aims include investigation and/or control of the effects of socioeconomic status on health in diverse populations.

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

    PubMed Central

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

    2000-01-01

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

  13. Molecular characterisation of banana bunchy top virus (BBTV) from Pakistan.

    PubMed

    Amin, Imran; Qazi, Javaria; Mansoor, Shahid; Ilyas, Muhammad; Briddon, Rob W

    2008-02-01

    Banana bunchy top disease is caused by a single-stranded circular DNA virus, banana bunchy top virus (BBTV), which is a member of the genus Babuvirus (family Nanoviridae). We have cloned and sequenced five components (DNA-R, DNA-S, DNA-N, DNA-M and DNA-C) of a BBTV isolate originating from Pakistan. In addition, the DNA-R and several other components of five further isolates, originating from geographically distinct sites across the banana-growing area of Sindh province, Pakistan, were cloned and sequenced. Analysis of the sequences indicates that BBTV present in Pakistan belongs to the "South Pacific" group of isolates and that the genetic diversity of the virus in the country is very low. The virus shows the highest levels of sequence identity to BBTV isolates originating from Egypt, India and Australia. The significance of these results with respect to the possible origin of the virus in Pakistan and the prospects for obtaining genetically engineered resistance to the virus are discussed.

  14. 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. PMID:24112271

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

    PubMed Central

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

    2012-01-01

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

  16. Survey report: Pakistan.

    PubMed

    Zheng, J

    1991-10-01

    Pakistan suffers an unsuccessful population policy, with a resultant annual population growth of greater than 3%. Cultural and religious objections to family planning (FP) are recognized as the major obstacles to reducing fertility. Accordingly, a 1990-91 demographic and health survey was conducted to elicit information or fertility, family planning, marriage patterns, breastfeeding, and child health for planners and policymakers. The survey was jointly funded by the U.S. Agency for International Development and the government of Pakistan, and interviewed 6,494 ever-married women aged 15-49. The average total fertility rate for the 6-year period prior to the survey was 5.5 lifetime births/woman, less than the figure of greater than 6 found in previous surveys. Increasing age at 1st marriage and a slightly higher level of contraceptive use may be causal factors for the observed decline. Decreased fertility notwithstanding, contraceptive prevalence is low compared to other developing countries in Asia. 1 out of 5 Pakistani women report ever having used contraceptives, and no single method has ever been used by more than 7% of married women. 7% use condoms, 5% the pill, 3% female sterilization, and 3 the IUD and injections, with male sterilization virtually nonexistent, and only limited knowledge of barrier methods. Contraceptive prevalence, including traditional methods, among married women was 12%, with higher coverage in cities, especially among educated women. 37% desire no additional children, and 18% wish to delay child birth for 2 years. Intervention strategy may include working to improve the status of women, fostering greater educational opportunities for women, changing traditional attitudes toward large families and son preference, providing sufficient FP services, and getting commitments for support and action from government and community leaders. PMID:12284304

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

    PubMed Central

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

    2014-01-01

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

  18. SSA 02-4 DISPARITIES IN HYPERTENSION MANAGEMENT OF CKD IN SOUTH ASIA.

    PubMed

    Jafar, Tazeen

    2016-09-01

    population lives in conditions of poverty (Fortunately, adverse complications of CKD can be prevented by prompt detection and early institution of therapy. Healthy lifestyle (maintaining ideal body weight, physical activity, healthy diet, and smoking cessation) and pharmaceutical interventions including maintaining blood pressure control preferably with blockers of renin angiotensin system (RAS) to reduce proteinuria, and glycemic control, and reduce the risk of atherosclerotic events with lipid lowering are important for prevention of CVD and delaying progression to ESRD. However, despite the publication of evidence-based guidelines on management of CKD, serious deficiencies in provider knowledge and practices regarding management of hypertension and CKD have been identified. Thus, CKD awareness rates are abysmally poor (6 and 10%) in the general and high risk population with CKD, respectively, in South Asia. Moreover, evidence of effective community based program to prevent and manage CKD has been lacking.The Control of Blood Pressure and Risk Attenuation Trial assessed the effects of a combined public health intervention on the kidney health of hypertensive adults in Pakistan's general population. The intervention included training of community health workers on aspects of a healthy lifestyle (such as improving diet, stopping smoking, increasing physical activity, and taking prescribed blood pressure-lowering medications) and training of community general practitioners (GP) on the updated guidelines related to managing hypertension.The combined home health education (HHE) plus trained GP intervention was beneficial in preserving kidney function over 7 years among adults with hypertension in communities in Karachi. These findings highlight the importance of scaling-up simple strategies for renal risk reduction in LMICs. Efforts are needed for integrate CKD prevention and management program within the broader NCD policy framework in South Asia. PMID:27642932

  19. National Level Assessment of Mangrove Forest Cover in Pakistan

    NASA Astrophysics Data System (ADS)

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

    2011-09-01

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

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

    ERIC Educational Resources Information Center

    Hirani, Shela Akbar Ali

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Huma, Afshan

    2013-01-01

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

  2. Pakistan: update on breastfeeding.

    PubMed

    Lambert, J

    1988-01-01

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

  3. Evolution of the lithosphere in Pakistan

    NASA Astrophysics Data System (ADS)

    Farah, Abul; Abbas, Ghazanfar; De Jong, Kees A.; Lawrence, Robert D.

    1984-06-01

    The geological setting of Pakistan in the framework of the modern concept of plate tectonics is unique in the sense that, within an area of about 800,000 km 2, critical tectonic junctions of different interacting plates and microplates are present in an environment where field exposures are excellent. Here we discuss the dynamics of these various plate boundaries. Two types of active plate boundaries are conspicuous: (1) convergent boundaries characterized by continent-continent collision, obduction, and thrusting in the northern region of the Himalaya and by oceanic crust subduction with a volcanic arc and a wide accretionary wedge in the southern region of Chagai and Makran; (2) a transform boundary, the Chaman transform zone, characterized by very large strike-slip and lesser thrusting. The Chaman transform zone connects the Makran convergence zone, where oceanic lithosphere is being subducted beneath the Lut and Afghan microplates, with the Himalayan convergence zone, where the Indo-Pakistan lithosphere is underthrusting Eurasia. The Chaman zone is at present an intracontinental plate boundary with oblique motion, characterized by north-south strike-slip faults and eastward thrusting and folding in the Kirthar-Sulaiman mountain belt. This mountain belt, the northwestern margin of the Indo-Pak subcontinent, was an Atlantic-type margin from the late Paleozoic until the Cretaceous. In the Cretaceous, the continental margin became a plate boundary; a thrust belt was formed in the Paleocene, and fragments of the oceanic crust were obducted, either as thrust sheets (Muslimbagh) or as an ophiolitic melange (Bela and Waziristan).

  4. Molecular epidemiology of glanders, Pakistan.

    PubMed

    Hornstra, Heidie; Pearson, Talima; Georgia, Shalamar; Liguori, Andrew; Dale, Julia; Price, Erin; O'Neill, Matthew; Deshazer, David; Muhammad, Ghulam; Saqib, Muhammad; Naureen, Abeera; Keim, Paul

    2009-12-01

    We collected epidemiologic and molecular data from Burkholderia mallei isolates from equines in Punjab, Pakistan from 1999 through 2007. We show that recent outbreaks are genetically distinct from available whole genome sequences and that these genotypes are persistent and ubiquitous in Punjab, probably due to human-mediated movement of equines.

  5. Democracy and Education in Pakistan

    ERIC Educational Resources Information Center

    Nazir, Muhammad

    2010-01-01

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

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

    PubMed

    Hussain, Mirza Izhar; Naqvi, Baqir Shyum

    2015-03-01

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

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

    PubMed

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

    2013-12-01

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

  8. Enterococci vs coliforms as a possible fecal contamination indicator: baseline data for Karachi.

    PubMed

    Hussain, Mushtaq; Rasool, Sheikh Ajaz; Khan, Muhammad Tanweer; Wajid, Abdul

    2007-04-01

    Fecal contamination of drinking water is the major cause of water borne illnesses. For long time coliforms are exploited as fecal contamination indicator. However, recent studies indicate low survival rate of coliforms in stress conditions, hence it's use as indicator of fecal pollution is being abandoned in many parts of the developed world. Implementation of such strategy demands availability of local data in the cities like Karachi. The present study provides a comparison between coliforms and enterococcal load and its variation in sewage samples collected (June, August and November, 2006) from eighteen towns of Karachi. All the diluted samples were selective media to obtain colony-forming units (CFU) mainly for coliforms and enterococci. The bacteria isolated were identified on the basis of conventional microbiological methods. Observations thus obtained were subjected to rigorous statistical analysis. The total load of enterococci was found in range of 1.27-8.47 X 10(7) as compared to coliforms (3.03-13.9 X 10(7)). However, segregation of data reveals greater inter town variability in CFU/ml both in coliforms and enterococci as suggested by their cumulative standard deviation +/-1.5 X 107. Furthermore, CFU/ml of both coliforms and enterococci also varies to variable scale when collected at different time intervals and at intra town level. Conclusively, the studies suggest high survival rate and lower variability of Enterococci compared to escherichia hence indicating its potential advantage to be used as fecal contamination indicator. PMID:17416563

  9. 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

  10. 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.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz

    2016-01-01

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

  13. 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

  14. Delayed marriages in Pakistan.

    PubMed

    Sathar, Z A; Kiani, M F

    1986-01-01

    Data from the Migration Module of the Population, Labor Force, and Migration (PLM) Survey of 1979 and from the population censuses of 1961, 1972, and 1981 were examined to explore the impact of modernization, particularly of expansion of education and modern sector employment, urbanization, and migration on proportions never married in various age groups in Pakistan. Table 1 shows a noticeable and substantial increase in proportions never married between 1961 and 1975 and subsequently until 1981. The increase in proportions never married was more pronounced for young females aged 15-29 years than for males in the same age group. The figures for 1972 and 1981 were similar, indicating that increases in the proportions never married occurred more in the 1960s. The singulate mean age at marriage for females was computed to be 18.1 years in 1961, 19.8 years in 1972, and 20.7 years in 1981. Over the 1961-81 period, marital postponement for males was considerably less pronounced. In the age groups above age 30, the proportions never married were lower in 1981 than in 1961 for both males and females. Overall increases in the proportions never married were not as marked in the case of Pakistani males, which may be attributed to the fact that beginning in 1961 male marriage age was already considerably higher than female marriage age -- 23.6 years. Patterns of marriage behavior were expected to vary in the 4 provinces -- Punjab, Sind, NWFP, and Baluchistan -- because of differences in cultural patterns, levels of development, and urbanization. Punjab, the most developed province, contained the bulk of the proportion never married in the 15-19 age group, both in urban and in rural areas. The provincial differential in proportions never married was much greater for females than for males. Punjab had the highest proportions of never married females, followed by the NWFP and Sind, in both urban and rural areas. Urban Punjab had the least differences in average ages at marriage

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

    PubMed

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

    2011-07-01

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

  16. 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

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

    PubMed

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

    2016-08-01

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

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

    PubMed

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

    2016-08-01

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

  19. 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

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

    PubMed Central

    2015-01-01

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

  1. 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%.

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

    PubMed

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

    2014-10-01

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

  3. 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

  4. 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.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Khalid, Bushra; Ghaffar, Abdul

    2015-11-01

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

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

    PubMed

    Khalid, Bushra; Ghaffar, Abdul

    2015-11-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Khalid, Bushra; Ghaffar, Abdul

    2015-03-01

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

  11. 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.

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

    PubMed

    Khalid, Bushra; Ghaffar, Abdul

    2015-11-01

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

  13. Analysis of ochratoxin A blood levels in bladder cancer cases and healthy persons from Pakistan.

    PubMed

    Aslam, Muhammad; Rivzi, S Abidul Hassan; Beg, Anwer Ejaz; Blaszkewicz, Meinolf; Golka, Klaus; Degen, Gisela H

    2012-01-01

    The mycotoxin ochratoxin A (OTA), a well-known human nephrotoxic and carcinogenic agent, is a public health concern in many countries. Exposure is assessed by means of mycotoxin analysis in food commodities and by human biomonitoring of OTA in blood samples. Data available from several European countries and some studies in Africa, Asia, and the Americas indicate frequent detection of OTA. Thus far, data from developing countries that compare blood levels in healthy and diseased individuals are scarce. Thus, the aim of this investigation was to determine OTA levels in blood samples of bladder cancer patients (n = 96) and healthy controls (n = 31) from Pakistan. OTA in blood plasma was analyzed after extraction by high-performance liquid chromatography (HPLC) with fluorescence detection. Among samples of 87 cancer patients and 30 controls, 92% in total contained quantifiable amounts of OTA. In bladder cancer cases the median OTA concentration was 0.19 ng/ml (mean 0.296; range: 0.03 to 3.41 ng/ml), and in healthy controls the median OTA was 0.19 ng/ml (mean 0.3; range: 0.04 to 1.24 ng/ml). The OTA levels found in the Pakistanian cohorts were comparable to those reported previously for the general population in the European Union. In conclusion, OTA is not likely to play a major role in the etiology of bladder cancer in the Karachi cohort, at least as the sole risk factor.

  14. 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

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

    PubMed

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

    2012-03-01

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

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

    PubMed

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

    2012-03-01

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

  17. A palaeomagnetic reconnaissance of northeastern Baluchistan, Pakistan

    NASA Astrophysics Data System (ADS)

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

    1981-01-01

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

  18. 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…

  19. Culture and 'compliance' among leprosy patients in Pakistan.

    PubMed

    Mull, J D; Wood, C S; Gans, L P; Mull, D S

    1989-01-01

    In Pakistan approx. 30% of the 18,000 known leprosy patients have dropped out of their treatment programs. To investigate reasons for such widespread noncompliance, 128 diagnosed leprosy patients--59 outpatients and 69 inpatients--were interviewed in Karachi. More than half of the 'noncompliant' outpatients denied having the disease. Denial was found to be an understandable coping mechanism in view of the severe stigma associated with leprosy. The presence of close-knit extended families, in which joint decision-making was the norm and in which such a dread diagnosis could spell the end of job and marriage prospects for even distant relatives, contributed to the likelihood of denial. In such a setting, the very term 'noncompliant' appeared to be an oversimplification since it covered so many different types of culturally-constrained behavior. In addition, many of the patients who initially seemed most 'compliant' by virtue of being long-term hospital inpatients in fact owed their hospitalization to the fact that they had been markedly noncompliant in the past. Thus the usual view that adherence to a biomedical treatment regimen constitutes 'compliance' and that nonadherence to such a regimen constitutes 'noncompliance' proved inadequate for understanding the health behavior of these Third World leprosy victims. The study also showed that many patients had initially consulted traditional healers, inadequately-trained physicians, and/or untrained medical practitioners for treatment of their symptoms, which resulted in lengthy delays before they were correctly diagnosed. Further, even after the diagnosis was made and appropriate medications were prescribed by trained personnel, most patients were not told what had caused their leprosy and how the drug regimen worked to combat it: when questioned, only 4% of the 128 respondents attributed the disease to infectious organisms. In addition, patients were usually not warned in advance of the possibility of undesirable side

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

    PubMed Central

    2011-01-01

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

  1. 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

  2. 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

  3. Roles of European blocking and tropical-extratropical interaction in the 2010 Pakistan flooding

    NASA Astrophysics Data System (ADS)

    Hong, Chi-Cherng; Hsu, Huang-Hsiung; Lin, Nai-Hsin; Chiu, Hsun

    2011-07-01

    A sequence of monsoon surges struck Pakistan and Northwestern India during late July-early August 2010. The unusually heavy monsoon rainfall resulted in record-breaking floods, which affected 20 million people with a death toll of near 3000. Simultaneously, a long-lived blocking high appeared over Europe and Russia in middle June and persisted for nearly two months. Extreme flooding occurred when the southward penetration of extratropical potential vorticity in the deep trough east of the European blocking and the tropical monsoon surges arrived concurrently in Pakistan. This study demonstrates that the interaction between the tropical monsoon surges and the extratropical disturbances downstream of the European blocking was the key factor leading to the severe flooding in Pakistan. The 2010 La Niña condition contributed indirectly to the flooding by inducing a low-level easterly anomaly in South and Southeast Asia, which weakened eastward moisture transport and helped enhance moisture transport (convergence) to (in) the Northern Arabian Sea and Pakistan.

  4. 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.

  5. NASA's IMERG Measures Flooding Rainfall in Pakistan

    NASA Video Gallery

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

  6. 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

  7. Blasphemy laws and mental illness in Pakistan

    PubMed Central

    Husain, Muzaffar

    2014-01-01

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

  8. Epidemiology of drowning and near drowning at Karachi beaches from 2012 to 2014.

    PubMed

    Shaikh, Masood Ali

    2016-05-01

    Karachi Municipal Corporation's Emergency Response Center's lifeguards save drowning individuals, recover dead bodies of drowned individuals, and provide first aid care to injured victims of near-drowning and road traffic accidents on the road along the various beaches.Cumulatively302 drowning and near-drowning 302 incidents were recorded from 2012 to 2014, with 291 (96.3%) incidents involving males. One hundred ninety-six (64.9%) individuals were saved from drowning, out of which 116 (59.2%) were saved on Sundays, followed by 31 (15.8%) on Saturdays; with 79 (40.3%) being saved during the hours 06:00 PM to 07:59 PM. Out of total 34 dead bodies were recovered, Sundays registered 8 (23.5%) such incidents. Out of the 72 individuals who received first-aid care, 60 (83.3%) received it on Sundays and Saturdays. The months of April, May, and June were the peak months of incidents for saving from drowning. Results augur the need for targeted health education campaigns, especially during summer months.

  9. Epidemiology of drowning and near drowning at Karachi beaches from 2012 to 2014.

    PubMed

    Shaikh, Masood Ali

    2016-05-01

    Karachi Municipal Corporation's Emergency Response Center's lifeguards save drowning individuals, recover dead bodies of drowned individuals, and provide first aid care to injured victims of near-drowning and road traffic accidents on the road along the various beaches.Cumulatively302 drowning and near-drowning 302 incidents were recorded from 2012 to 2014, with 291 (96.3%) incidents involving males. One hundred ninety-six (64.9%) individuals were saved from drowning, out of which 116 (59.2%) were saved on Sundays, followed by 31 (15.8%) on Saturdays; with 79 (40.3%) being saved during the hours 06:00 PM to 07:59 PM. Out of total 34 dead bodies were recovered, Sundays registered 8 (23.5%) such incidents. Out of the 72 individuals who received first-aid care, 60 (83.3%) received it on Sundays and Saturdays. The months of April, May, and June were the peak months of incidents for saving from drowning. Results augur the need for targeted health education campaigns, especially during summer months. PMID:27183945

  10. 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

  11. HIV and homosexuality in Pakistan.

    PubMed

    Rajabali, Alefiyah; Khan, Saeed; Warraich, Haider J; Khanani, Mohammad R; Ali, Syed H

    2008-08-01

    In Pakistan, seven times more men are reported to be infected with HIV than women. Among the Pakistani population, modes of HIV transmission include infection through sexual contact, contaminated blood and blood products, injecting drug use, and mother-to-child transmission. Although most sexual transmission of HIV results from unsafe heterosexual contact, homosexual and bisexual contact also represent important modes of transmission. According to unpublished reports, the prevalence of HIV among homosexual and bisexual Pakistani men is reaching alarming proportions. We describe the Pakistani homosexual and bisexual culture, review statistics regarding HIV prevalence and risk behaviour, and identify areas of improvement in the HIV policy with specific focus on men who have sex with men. PMID:18652997

  12. Ethnic fertility differentials in Pakistan.

    PubMed

    Muhammad, A

    1996-01-01

    This study examined differences in residence, marriage age, and education among 6 language groups (Balochi-Brohi, Urdu, Siraiki, Punjabi, Sindhi, and Pushto) in Pakistan. Ethnic differences were reported for fertility preferences and family planning attitudes, knowledge, and practices. Data were obtained from the 1990-91 Pakistan Demographic and Health Survey among 6582 eligible ever-married women aged 15-30 and 31-49 years. 95% of Urdu and 50% of Balochi-Brohi speakers lived in urban areas. 73.4% of Siraiki speakers lived in rural areas. Urdu speakers were the best educated, with 31% having a secondary or higher education. Lack of formal education was 46.5% among Urdu, 68.4% among Punjabi, and 88% among Pushto women. Sindhi speakers had the lowest marriage age; the median age at first marriage was 15 years. Marriages at ages younger than 17 years were common among Balochi-Brohi-, Pushto-, and Siraiki-speaking women. Later age of marriage was more common among Urdu and Punjabi women. Fertility was highest among younger women speaking Balochi-Brohi, followed by those speaking Urdu. Fertility was lowest among younger Siraiki-speaking women. Among older women, fertility was highest among Siraiki speakers, followed by Balochi-Brohi and Pushto speakers. It was lowest among older Urdu-speaking women. 80% of Balochi-Brohi- and 76% of Siraiki-speaking women had no ideal family size. Over 25% of Urdu and Punjabi speakers desired 4 children. "Up to God" responses were strongest among Balochi-Brohi speakers, followed by Siraiki and Sindhi speakers. Current modern method use was 22.1 among Urdu speakers, 12.7% among those speaking a language other than the 6 groups studied, 11.7% among Punjabi speakers, 8.3% among Pushto speakers, 4.9% among Siraiki speakers, 3.4% among Sindhi speakers, and 3.3% among Balochi-Brohi speakers. PMID:12294612

  13. 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

  14. Surface Deformation in Quetta Valley, Balochistan, Pakistan

    NASA Astrophysics Data System (ADS)

    Huang, J.; Shuhab, K.; Wulamu, A.; Crupa, W.; Khan, A. S.; Kakar, D. M.; Kasi, A.

    2015-12-01

    In February 2011, several ground fissures up to ~1.8 km in length appeared in the Quetta Valley, Balochsitan, Pakistan. It is not clear what caused the sudden occurrence of these fissures. The region is tectonically active and bounded to the west by several regional strike-slip faults including the north-south striking left-lateral Chaman fault system that slips at ~10 mm per year. Several large earthquakes have occurred recently in this area, one fatal 6.4 magnitude (Mw) earthquake occurred on October 28th, 2008. Some parts of Quetta Valley are subsiding; GPS data from two stations in Quetta that span mid-2006 - 2009 recorded subsidence rates of ~10 cm per year. Although subsidence in urban areas is generally attributed to groundwater depletion, it is not clear whether ground fissures are caused by water withdrawal or related to tectonics of the region. This study is designed to quantify and assess the source of surface deformation in Quetta Valley using InSAR, GPS, seismic and earthquake centroid moment tensor data. To detect and map the spatial-temporal features of the processes that led to the surface deformation, we used two time series, i.e., 15 European Remote Sensing (ERS-1/2) satellite images from 1992 - 1999 and 27 ENVISAT images spanning 2003 - 2010. A Differential Interferometric Synthetic Aperture Radar (DInSAR) Small Baseline Subset (SBAS) technique was used to investigate surface deformation. Eleven continuous-GPS stations within the InSAR antenna footprint were compared with the InSAR time series for quality control. Preliminary InSAR results revealed that the areas in and around the fissures are subsiding at 5 cm per year. Five seismic lines totaling ~60 km, acquired in 2003, were used to interpret faults beneath Holocene alluvium in the Quetta Valley. One of the blind faults is a north-south striking thrust fault mapped north into the Takatu range. However, a focal mechanism for the 2008 earthquake in this region indicated northwest

  15. Differences in various biochemical and clinical parameters with respect to family history of Non Communicable Diseases in fourth year MBBS students of Karachi, Pakistan

    PubMed Central

    Basit, Khalid Abdul; Fawwad, Asher; Munir, Muhammad Asadullah; Siddiqui, Iftikhar Ahmed; Siddiqui, Sidra; Basit, Abdul

    2015-01-01

    Objective: To observe the differences of various biochemical and clinical parameters with respect to Family History (FH) of Non-communicable Diseases (NCDs) in fourth year Bachelor of Medicine, Bachelor of Surgery (MBBS) students. Methods: This observational study was conducted at Baqai Institute of Diabetology & Endocrinology from December 2013 to January 2014. Total 50 medical students from Dow University of Health Sciences (DUHS) participated in the study. Statistical Package for Social Sciences (SPSS) version 13 was used to analyze the data. For cross tabulation and mean comparison z-test and t test were applied. Results: Out of 50 subjects, there were 26 (52%) females. Mean age of the study population was 21.56 ± 0.90 years. Mean serum cholesterol levels with positive FH of NCDs was significantly higher than negative FH of NCDs (p=0.005). Mean value of low density lipoprotein (LDL) of positive family history of NCDs was found higher than those with negative FH (p=0.006) being statistically significant. The insulin levels in subjects with positive FH of NCDs were higher than subjects with negative FH of NCDs (p=0.685). However, serum leptin and plasma renin showed no significant difference with the negative FH of NCDs being higher compared to positive FH of NCDs (p=0.068) and (p=0.884) respectively. However, Waist circumference, Body mass index and central obesity in subjects with positive FH of NCDs shows increasing trend but no statistically significant difference (p > 0.05) was observed. Conclusion: In our study of various biochemical and clinical parameters with respect to FH of NCDs, Serum Cholesterol and LDL levels were observed higher and statistically significant. PMID:26430439

  16. 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

  17. 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).

  18. 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.

  19. Drug-related HIV epidemic in Pakistan: a review of current situation and response and the way forward beyond 2015.

    PubMed

    Bergenstrom, Anne; Achakzai, Baseer; Furqan, Sofia; ul Haq, Manzoor; Khan, Rajwal; Saba, Marc

    2015-01-01

    Pakistan is among four countries in Asia where the estimated number of new HIV infections has been increasing year by year ever since 1990. The Asian Epidemic Modelling (AEM), conducted in 2015, reconfirmed that the use of contaminated injection equipment among people who inject drugs (PWID) remains the main mode of HIV transmission in the country. The estimated number of PWID ranges from 104,804 to 420,000 PWID. HIV prevalence in this population is above 40 % in several cities, including Faisalabad (52.5 %), D.G. Khan (49.6 %), Gujrat (46.2 %), Karachi (42.2 %) and Sargodha (40.6 %), respectively. Harm reduction service delivery is being implemented through a public-private partnership led by the National and Provincial AIDS Control Programmes and Nai Zindagi with funding support from the Global Fund. Current programmatic coverage of the needle and syringe programme, HIV testing and counselling and antiretroviral treatment among PWID remain insufficient to control ongoing transmission of HIV in the country. While opioid substitution therapy (OST) is yet to be introduced, significant progress and coordination among various ministries have taken place recently to register buprenorphine in the dosage required for treatment of opioid dependence, and possible introduction of OST will greatly facilitate adherence to antiretroviral treatment among PWID living with HIV.

  20. Drug-related HIV epidemic in Pakistan: a review of current situation and response and the way forward beyond 2015.

    PubMed

    Bergenstrom, Anne; Achakzai, Baseer; Furqan, Sofia; ul Haq, Manzoor; Khan, Rajwal; Saba, Marc

    2015-01-01

    Pakistan is among four countries in Asia where the estimated number of new HIV infections has been increasing year by year ever since 1990. The Asian Epidemic Modelling (AEM), conducted in 2015, reconfirmed that the use of contaminated injection equipment among people who inject drugs (PWID) remains the main mode of HIV transmission in the country. The estimated number of PWID ranges from 104,804 to 420,000 PWID. HIV prevalence in this population is above 40 % in several cities, including Faisalabad (52.5 %), D.G. Khan (49.6 %), Gujrat (46.2 %), Karachi (42.2 %) and Sargodha (40.6 %), respectively. Harm reduction service delivery is being implemented through a public-private partnership led by the National and Provincial AIDS Control Programmes and Nai Zindagi with funding support from the Global Fund. Current programmatic coverage of the needle and syringe programme, HIV testing and counselling and antiretroviral treatment among PWID remain insufficient to control ongoing transmission of HIV in the country. While opioid substitution therapy (OST) is yet to be introduced, significant progress and coordination among various ministries have taken place recently to register buprenorphine in the dosage required for treatment of opioid dependence, and possible introduction of OST will greatly facilitate adherence to antiretroviral treatment among PWID living with HIV. PMID:26471874

  1. 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

  2. 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 Pakistan's most…

  3. Productive and reproductive choices: report of a pilot survey of urban working women in Karachi.

    PubMed

    Kazi, S; Sathar, Z A

    1986-01-01

    The primary objective of the pilot survey of urban working women in Karachi was to collect information on women's productive and reproductive choices within the context of the conditions in their household. A sample of working women in the formal sectors was selected through procurement of lists of personnel from factories, government offices, and so forth. The sample was not chosen systematically. The intention was not only to sample but to identify commonly found occupations among women. The sample of 110 working women included respondents between 19-50 years. 93 of these women were currently married, 6 were separated or divorced, and 11 were widowed. Most of the ethnic groups living in Karachi were represented. The sample includes 3 distinct socioeconomic groups: highly educated women employed in high status jobs with earnings above the average; women of lower middle class backgrounds who work in the formal sector but in lower-status occupations as compared with those of the professional group; and mostly uneducated women who work as low-status workers and whose incomes are meager. More than 70% of the women gave financial pressure as a reason for their entering the labor force. Women for whom the important reason for work was pursuit of a career or job satisfaction were highly educated and employed in high-status, remunerative jobs. Only 20 of the sample of 110 women worked for noneconomic reasons. Of 64 women working as factory workers, domestic servants, and other miscellaneous workers in the informal sector, there were only 2 women working out of choice. Women who worked before marriage comprised nearly 51% of the sample. There was a very strong positive association between work before marriage and level of education and occupation. A much larger percentage of educated women in professional jobs worked before marriage as compared with their uneducated or less educated counterparts. The majority of women in the static, low-income occupations did not work

  4. Baseline for Monitoring Water Resources Along Kabul and Indus Rivers of Pakistan for Potential Terrorist Contamination

    NASA Astrophysics Data System (ADS)

    Hamidullah, S.; Tariq, S.; Shah, M. T.; Bishop, M. P.; Kamp, U.; Olsenholler, J.

    2002-05-01

    Baseline for Monitoring Water Resources Along Kabul and Indus Rivers of Pakistan for Potential Terrorist Contamination Terrorism has temporarily constrained the dynamism of the world it was enjoying before September 11, 2001, but also has opened avenues for people of all ethnicities, creeds, and professions to join hands in combating it. Scientific efforts to combat terrorism are likely to lead to better use of existing scientific knowledge as well as to discoveries that will increase world organization, interconnectivity, and peace promotion. Afghanistan and surrounding regions are major focal points for current anti-terrorist activities of the USA and its allies, including Pakistan. The United States, Pakistan, and Afghanistan have shared many similar political objectives, as well as differences, in cold war and post-cold-war eras, reflected by variable provisions of material aid. It is well recognized that understanding Afghanistan requires comprehension of the Pakistan situation as well, especially for common resources. Water is paramount because it is absolutely vital, but can be contaminated by internal or cross-border terrorism. The Kabul and Indus rivers originate in the Hindu Kush - Himalaya ranges. The Kabul River flows from Afghanistan into Pakistan, and after irrigating Peshawar basin, joins the Indus. The Indus, after its origin in Tibet and flow through the Indian Himalaya, enters Pakistan and flows south as the irrigation lifeblood of the country. Any terroristic addition of radioactive nuclides or contaminants to either river could dramatically impact the dependent riverine ecologies. Monitoring cells thus need to be established at locations in Afghanistan and Pakistan to assess base-line river variances for possible future contamination by terrorists. This paper presents a general view and the physical and chemical parameters of parts of the two rivers, and of the surrounding underground water in Peshawar Basin, including pH, conductivity, total

  5. Potential Risk of Cross-Infection by Tourniquets: A Need for Effective Control Practices in Pakistan

    PubMed Central

    Mehmood, Zara; Mubeen, Syed Muhammad; Afzal, Muhammad Shehzad; Hussain, Zainab

    2014-01-01

    Background: Tourniquets used repeatedly on patients for blood sampling are a potential source of nosocomial infections. They harbor numerous microorganisms, including methicillin-resistant Staphylococcus aureus (MRSA). The aim of this study was to investigate tourniquets for the presence of microorganisms and to ascertain the infection control practices of health care workers. Methods: A cross-sectional study was carried out in 2012 on 100 samples of tourniquets collected from public and private sector hospitals in Karachi, Pakistan. The samples were cultured, and pathogenic microorganisms were identified and tested for methicillin resistance. A questionnaire was administered simultaneously to 100 health care workers who had used the tourniquets. Descriptive data are represented as frequencies and percentages. Ethical considerations were taken into account. Results: The total colonization rate was 51%, with no bacterial growth in 17/40 and 32/60 samples from public and private sector hospitals, respectively. S. aureus was isolated from 12 (42%) private sector hospital samples and 10 (43%) public sector hospital samples. Although MRSA was found in more samples from public than private sector hospitals, the difference was not statistically significant. Nevertheless, 90% of all elastic and 41% of all rubber tourniquets harbored microorganisms (P < 0.001). Although 96% of health care workers agreed that hospital staff and fomites can transmit infection, none identified tourniquets as a potential source. When asked whether tourniquets appeared clean before use, 66% agreed, and only 25% considered that tourniquets should be washed or cleaned before use. Conclusions: Tourniquets are a potential reservoir and vehicle for the spread of nosocomial infections, including MRSA. Health care workers have inadequate knowledge about infection control procedures and personal hygiene for disinfecting reusable items. PMID:25317294

  6. Survey of sharp waste disposal system in clinics of New Karachi.

    PubMed

    Qaiser, Seher

    2012-02-01

    The World Health Organization (WHO) estimates that there are 350 million people with chronic HBV infection and 170 million people with chronic HCV infection worldwide. Hepatitis B is estimated to result in 563, 000 deaths and hepatitis C in 366, 000 deaths annually. Given its large population (180 million) and intermediate to high rates of infection, Pakistan is among the worst afflicted nations. The reuse of syringes and needles was a major factor contributing towards increased HCV prevalence. It was reported that there are several small groups involved in recycling and repacking of used unsterilized syringes, which were available in various drug stores. It was difficult for the public to differentiate between new sterilized syringes and recycled unsterilized syringes In Pakistan, the number of estimated injections per person per year ranged from 8.2 to 13.6, which was the highest among developing countries, out of which 94.2% were unnecessary. In 2000, the WHO recommended that countries should implement strategies to change the behaviour of health care workers and patients in order to decrease the over-use of injections, to ensure the practice of sterile syringes and needles, and to properly destroy sharp waste after use. PMID:22755380

  7. Pakistan (country/area statements).

    PubMed

    1985-09-01

    According to this statement presented to the Committee on Population of the UN Economic and Social Commission for Asia and the Pacific, Pakistan's crude birth rate at present is 40/1000. The Pakistan Fertility Survey (PFS) of 1974-75 showed a marital total fertility rate of 8 and marital gross reproduction rate of 3.9. The total fertility rate is estimated at around 6. Evaluation of past family planning activities indicates that the impact of the program on the birth rate has been minimal. Although a large majority of married women know about family planning methods, few fertile couples use a method. Of the 90% of respondents in the PFS who had never used a method, 57% indicated they intended to use a method at some point and 23% said they did not. The average age of all current users was 34 in 1975. Preliminary results of a contraceptive prevalence survey indicate that current use is 10%. The crude birth rate was 46 or 47/1000 in 1965 when an official population program was initiated. The gains from the reduction of the total fertility rate have been partly offset by change in the age structure. Pakistan's population policy was formulated in light of the recommendations of the 1974 World Population Plan of Action. The program approach is multidisciplinary and due consideration is given to the interrelationships between population, resources, environment, and development stratgey. The program relies primarily on community participation and involvement of local leadership to promote acceptability. At the federal level, the major focus of the program is on development of national policy, planning and coordination, funding, training, procurement of contraceptives and equipment, research and evaluation, monitoring, and statistics. The population welfare departments at the provincial level are responsible for the administration and supervision of all field activities relating to service delivery, motivation, training, coordination, monitoring, evaluation, and feedback

  8. Immunogenicity of poliovirus vaccines in chronically malnourished infants: a randomized controlled trial in Pakistan.

    PubMed

    Saleem, Ali Faisal; Mach, Ondrej; Quadri, Farheen; Khan, Asia; Bhatti, Zaid; Rehman, Najeeb Ur; Zaidi, Sohail; Weldon, William C; Oberste, Steven M; Salama, Maha; Sutter, Roland W; Zaidi, Anita K M

    2015-06-01

    Reaching high population immunity against polioviruses (PV) is essential to achieving global polio eradication. Efficacy of oral poliovirus vaccine (OPV) varies and is lower among children living in tropical areas with impoverished environments. Malnutrition found as a risk factor for lower serological protection against PV. We compared whether inactivated polio vaccine (IPV) can be used to rapidly close the immunity gap among chronically malnourished (stunted) infants in Pakistan who will not be eligible for the 14 week IPV dose in routine EPI schedule. A phase 3, multicenter 4-arm randomized controlled trial conducted at five Primary Health Care (PHC) centers in Karachi, Pakistan. Infants, 9-12 months were stratified by length for age Z score into chronically malnourished and normally nourished. Infants were randomized to receive one dose of either bivalent OPV (bOPV) alone or bOPV+IPV. Baseline seroprevalence of PV antibodies and serum immune response to study vaccine dose were assessed by neutralization assay. Vaccine PV shedding in stool was evaluated 7 days after a bOPV challenge dose. Sera and stool were analyzed from 852/928 (92%) enrolled children. At baseline, the seroprevalence was 85.6% (n=386), 73.6% (n=332), and 70.7% (n=319) in malnourished children against PV types 1, 2 and 3 respectively; and 94.1% (n=448), 87.0% (n=441) and 83.6% (n=397) in the normally nourished group (p<0.05). Children had previously received 9-10 doses of bOPV (80%) or tOPV (20%). One dose of IPV+bOPV given to malnourished children increased their serological protection (PV1, n=201, 97.6%; PV2, n=198, 96.1% and PV3, n=189, 91.7%) to parity with normally nourished children who had not received IPV (p=<0.001). Seroconversion and boosting for all three serotypes was significantly more frequent in children who received IPV+bOPV than in those with bOPV only (p<0.001) in both strata. Shedding of polioviruses in stool did not differ between study groups and ranged from 2.4% (n=5) to 7

  9. Lithosphere, crust and basement ridges across Ganga and Indus basins and seismicity along the Himalayan front, India and Western Fold Belt, Pakistan

    NASA Astrophysics Data System (ADS)

    Ravi Kumar, M.; Mishra, D. C.; Singh, B.

    2013-10-01

    Spectral analysis of the digital data of the Bouguer anomaly of North India including Ganga basin suggest a four layer model with approximate depths of 140, 38, 16 and 7 km. They apparently represent lithosphere-asthenosphere boundary (LAB), Moho, lower crust, and maximum depth to the basement in foredeeps, respectively. The Airy's root model of Moho from the topographic data and modeling of Bouguer anomaly constrained from the available seismic information suggest changes in the lithospheric and crustal thicknesses from ˜126-134 and ˜32-35 km under the Central Ganga basin to ˜132 and ˜38 km towards the south and 163 and ˜40 km towards the north, respectively. It has clearly brought out the lithospheric flexure and related crustal bulge under the Ganga basin due to the Himalaya. Airy's root model and modeling along a profile (SE-NW) across the Indus basin and the Western Fold Belt (WFB), (Sibi Syntaxis, Pakistan) also suggest similar crustal bulge related to lithospheric flexure due to the WFB with crustal thickness of 33 km in the central part and 38 and 56 km towards the SE and the NW, respectively. It has also shown the high density lower crust and Bela ophiolite along the Chamman fault. The two flexures interact along the Western Syntaxis and Hazara seismic zone where several large/great earthquakes including 2005 Kashmir earthquake was reported. The residual Bouguer anomaly maps of the Indus and the Ganga basins have delineated several basement ridges whose interaction with the Himalaya and the WFB, respectively have caused seismic activity including some large/great earthquakes. Some significant ridges across the Indus basin are (i) Delhi-Lahore-Sargodha, (ii) Jaisalmer-Sibi Syntaxis which is highly seismogenic. and (iii) Kachchh-Karachi arc-Kirthar thrust leading to Sibi Syntaxis. Most of the basement ridges of the Ganga basin are oriented NE-SW that are as follows (i) Jaisalmer-Ganganagar and Jodhpur-Chandigarh ridges across the Ganga basin intersect

  10. 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.

  11. Nuclear weapons issues in South Asia

    SciTech Connect

    Joeck, N.

    1993-07-02

    This report discusses how the US can play a productive mediating role in South Asia by engaging India and Pakistan in an international forum to manage nuclear weapons, as Edward Teller advocated. India and Pakistan have developed their nuclear capabilities because they fear their neighbors, not because they want to threaten fear their neighbors, not because they want to threaten the US. The appropriate response for the US, therefore, is diplomatic engagement and negotiations. In addition to the international approach, encouragement and facilitation of regional and bilateral interactions will also be important. Formal arms control agreements have been reached, but less formal confidence-building measures, and unilateral security pledges may well be combined to form a more secure strategic environment in South Asia than a nuclear armed confrontation across the porous South Asian border.

  12. Advisory board approves Pakistan SMC marketing plan.

    PubMed

    1986-01-01

    Under a 2-year contract funded by the US Agency for International Development, PSI Marketing Associates is providing technical assistance for the development of a social marketing project in Pakistan. The national launch of a new condom, Sathi, is planned for 1987. This new social marketing of contraceptives project emphasizes child spacing and will use the slogan, "Until you want another child." As a result of the Pakistan Government's generic family planning advertising and promotion campaigns, there is a high degree of public awareness of contraception. However, this awareness is not reflected in levels of contraceptive use. A 3-month test market for Sathi (which means "companion") will take place in 2 areas representative of Pakistan's socioeconomic and ethnic composition. All printed materials (including posters, stickers, mobiles, and shop signs) will use the Sathi logo--2 birds flying into the sun. Other project materials include a 1-minute video and pamphlets for consumers, dealers, and medical professionals. PMID:12341468

  13. Advisory board approves Pakistan SMC marketing plan.

    PubMed

    1986-01-01

    Under a 2-year contract funded by the US Agency for International Development, PSI Marketing Associates is providing technical assistance for the development of a social marketing project in Pakistan. The national launch of a new condom, Sathi, is planned for 1987. This new social marketing of contraceptives project emphasizes child spacing and will use the slogan, "Until you want another child." As a result of the Pakistan Government's generic family planning advertising and promotion campaigns, there is a high degree of public awareness of contraception. However, this awareness is not reflected in levels of contraceptive use. A 3-month test market for Sathi (which means "companion") will take place in 2 areas representative of Pakistan's socioeconomic and ethnic composition. All printed materials (including posters, stickers, mobiles, and shop signs) will use the Sathi logo--2 birds flying into the sun. Other project materials include a 1-minute video and pamphlets for consumers, dealers, and medical professionals.

  14. Depression among hospitalized and non-hospitalized gonadal cancer patients in tertiary care public hospitals in Karachi.

    PubMed

    Yousaf, Tahira; Zadeh, Zainab Fotowwat

    2015-03-01

    The study aimed at determining the differences in the levels of depression between hospitalized and non-hospitalized Gonadal cancer patients in tertiary care public hospitals in Karachi. The present study was conducted at the Jinnah Postgraduate Medical Centre and Civil Hospital, Karachi, from July to October 2009. One hundred adult patients diagnosed with Gonadal cancer volunteered for the study. Cases with any other co-morbidity were excluded. Urdu version of Siddiqui Shah Depression Scale (SSDS) was administered. Purposive and snowball sampling methods were used for data collection. The ages of participants in the sample ranged from 20 to 27 years with the mean age of 23.85 years. The participants belonged to the lower and middle classes. Out of the 30 hospitalized gonadal cancer patients 40% were moderately depressed and 60% were severely depressed, whereas out of 70 non-hospitalized gonadal cancer patients 74.3% were mildly depressed, 24.3% were moderately depressed and only 1.4% were severely depressed, which clearly indicated that the depression level of hospitalized gonadal cancer patients was high as compared to non-hospitalized gonadal cancer patients.

  15. Source rock potential in Pakistan

    SciTech Connect

    Raza, H.A. )

    1991-03-01

    Pakistan contains two sedimentary basins: Indus in the east and Balochistan in the west. The Indus basin has received sediments from precambrian until Recent, albeit with breaks. It has been producing hydrocarbons since 1914 from three main producing regions, namely, the Potwar, Sulaisman, and Kirthar. In the Potwar, oil has been discovered in Cambrian, Permian, Jurassic, and Tertiary rocks. Potential source rocks are identified in Infra-Cambrian, Permian, Paleocene, and Eocene successions, but Paleocene/Eocene Patala Formation seems to be the main source of most of the oil. In the Sulaiman, gas has been found in Cretaceous and Tertiary; condensate in Cretaceous rocks. Potential source rocks are indicated in Cretaceous, Paleocene, and Eocene successions. The Sembar Formation of Early Cretaceous age appears to be the source of gas. In the Kirthar, oil and gas have been discovered in Cretaceous and gas has been discovered in paleocene and Eocene rocks. Potential source rocks are identified in Kirthar and Ghazij formations of Eocene age in the western part. However, in the easter oil- and gas-producing Badin platform area, Union Texas has recognized the Sembar Formation of Early Cretaceous age as the only source of Cretaceous oil and gas. The Balochistan basin is part of an Early Tertiary arc-trench system. The basin is inadequately explored, and there is no oil or gas discovery so far. However, potential source rocks have been identified in Eocene, Oligocene, Miocene, and Pliocene successions based on geochemical analysis of surface samples. Mud volcanoes are present.

  16. Underestimation of weight and its associated factors among overweight and obese adults in Pakistan: a cross sectional study

    PubMed Central

    2011-01-01

    Background Weight loss is known to decrease the health risks associated with being overweight and obese. Awareness of overweight status is an important determinant of weight loss attempts and may have more of an impact on one's decision to lose weight than objective weight status. We therefore investigated the perception of weight among adults attending primary care clinics in Karachi, Pakistan, and compared it to their weight categories based on BMI (Body Mass Index), focusing on the underestimation of weight in overweight and obese individuals. We also explored the factors associated with underestimation of weight in these individuals. Methods This was a cross sectional study conducted on 493 adults presenting to the three primary care clinics affiliated with a tertiary care hospital in Karachi, Pakistan. We conducted face to face interviews to gather data on a pre-coded questionnaire. The questionnaire included detail on demographics, presence of comorbid conditions, and questions regarding weight assessment. We measured height and weight of the participants and calculated the BMI. The BMI was categorized into normal weight, overweight and obese based on the revised definitions for Asian populations. Perception about weight was determined by asking the study participants the following question: Do you consider yourself to be a) thin b) just right c) overweight d) obese. We compared the responses with the categorized BMI. To identify factors associated with underestimation of weight, we used simple and multiple logistic regression to calculate crude odds Ratios (OR) and adjusted Odds Ratios (AOR) with 95% Confidence Intervals. Results Overall 45.8% (n = 226) of the study participants were obese and 18% (n = 89) were overweight. There was poor agreement between self perception and actual BMI (Kappa = 0.24, SE = 0.027, p < 0.001). Among obese participants a large proportion (73%) did not perceive themselves as obese, although half (n = 102) of them thought they may

  17. 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

  18. Knowledge and practices of barbers regarding HIV transmission in Karachi: a cross-sectional study.

    PubMed

    Bawany, Faizan Imran; Khan, Muhammad Shahzeb; Shoaib, Atif Bilal; Naeem, Muhammad; Kazi, Abdul Nafey; Shehzad, Abdul Moid

    2014-10-01

    A barber shop is a potential place for non-sexual transmission of deadly blood borne diseases such as acquired immuno-deficient syndrome. Few researches have been conducted to assess the knowledge of barbers regarding human immunodeficiency virus (HIV) transmission in Pakistan. With majority of the population visiting roadside saloons, it is imperative to have local data in this regard. The objective of this study was to investigate the knowledge and practices of barbers with reference to razor use and steps taken to sterilize their instruments. A total of 300 barber saloons were conveniently selected for this cross-sectional study during a time period of 5 months from May 2012 till September 2012. The shops were categorized into three groups: big saloons, small saloons and roadside saloons based on the inclusion criteria. One barber was randomly selected as a representative from each saloon. Data collection from each barber shop was carried out by an interviewer using a pre-coded questionnaire. Majority of the barbers had low school education. Awareness regarding sharing of blades as a route of HIV transmission was known by 90 % (n = 90) of big saloon barbers with awareness decreasing in small (n = 55) and roadside saloon barbers (n = 27). Only 60.3 % (n = 181) of the barbers used new blades between customers. In comparison to big saloon barbers, the majority (n = 53) of roadside saloon barbers used tap water for cleaning purposes. Only 40 % of the roadside barbers used antiseptic after shaving. The results of our study indicate that roadside saloon barbers, to whom majority of Pakistani population visit, have inadequate awareness regarding HIV transmission. Their poor barbering practices were mainly due to their low education. This potentiates a great risk for aggravating the HIV endemic in Pakistan.

  19. Emission Sources and Chemical Composition of the Atmosphere of a Mega-city in South Asia

    NASA Astrophysics Data System (ADS)

    Husain, L.; Farhana, B. K.; Ghauri, B. M.

    2007-05-01

    The environmental regulations in the countries in the western hemisphere have greatly decreased the concentrations of PM2.5, black carbon (BC), SO4, SO2, and trace elements. Owing to rapid industrialization, concentrations of many chemical species in South Asia are rising and are expected to continue to increase. The impact of aerosols on global climate and on human health would also increase with time. Therefore, we conducted an extensive campaign to determine PM2.5 mass, concentrations of 25 trace elements, 13 ions, black and organic carbon, acidic gases and NH3 in the mega-cities of Karachi (population, ~14.5 million), and Lahore (population, 10 million), Pakistan. Here we present the data from Lahore. Continuous sampling of PM2.5 (particulate matter of <2.5 µm aerodynamic diameter) and acidic and alkaline gases was carried out in winter (2005-2006) in Lahore which is highly impacted by urban and agricultural emissions but has remained unexplored in terms of atmospheric chemistry. While sampling continued from November 2005 to February 2006, it was possible to collect several samples during fog episodes. A low volume sampler equipped with two inlets was deployed for simultaneous collection of aerosol on quartz and PTFE filters, the latter being coupled to an annular diffusion denuder to collect acidic and alkaline gases. Water soluble ions in denuder gas samples and PM2.5 collected on PTFE filters were analyzed using ion chromatography, trace elements by ICP-MS, and organic and elemental carbon on quartz filters using thermal-optical carbon analyzer. Concentrations of BC were determined every 5 min with an Aethalometer. PM2.5 mass concentration varied an order of magnitude, 53 to 476 μg m-3 (mean, 191 μg m-3). Concentrations of the anthropogenic elements were exceedingly high, as much 100 to 1000 fold of those observed in cities such as New York. Maximum concentrations of BC, OC, Pb, Zn, SO4 2- , NH4+ were 110, 250, 12, 48, 66, and 60 μgm-3, respectively

  20. Attitude toward blood donation among medical and nonmedical students across Karachi

    PubMed Central

    Anwer, Muhammad Osama; Ul Fawwad, Shaikh Hamiz; Anwer, Sanam; Ali, Arif

    2016-01-01

    Aim: To evaluate the factors that motivate and discourage medical and nonmedical students from donating blood voluntarily and to assess the level of awareness and knowledge regarding blood donation. Materials and Methods: We conducted a cross-sectional descriptive study from August 2011 to May 2012 across different universities of Karachi covering both private and public sector. Predesigned questionnaires were filled by students. A total of 690 students participated in the study, 345 from each. Data collected was analyzed using SPSS Version 17.0. Simple frequencies and percentages were calculated, and Pearson Chi-square and Fisher's exact tests were applied to calculate association between different variables with P value set as significant when <0.05. Results: Mean age of the students was found to be between 21 and 23 (64.6%) in medical, whereas in nonmedical, 66.7% fell in this age group. Astonishingly, blood donors in nonmedical (27%) were quite more than that in medical group, where they were only 18%. Males constituted the majority in both of the groups. Most commonly reported factor that motivated blood donation in medical group was feeling of self-satisfaction (40.2%), whereas in nonmedical group, 32.9% reported that they had only donated blood when their friends/family were in need. When asked about the adverse effects after blood donation, weakness was common among both medical and nonmedical, i.e. 46.8% and 46.7%, respectively. Among the factors that impeded our subjects from donating blood were primarily health concerns in medical students (19%), whereas in nonmedical students they claimed they were not approached by anyone and were unaware of the importance of blood donation (34.8%). Conclusion: Proportion of blood donors was significantly low in both medical and nonmedical students, especially in females. Most important motivating factor in medical students was feeling of self–satisfaction, whereas in nonmedical students, it was family/friend in need

  1. Attitude toward blood donation among medical and nonmedical students across Karachi

    PubMed Central

    Anwer, Muhammad Osama; Ul Fawwad, Shaikh Hamiz; Anwer, Sanam; Ali, Arif

    2016-01-01

    Aim: To evaluate the factors that motivate and discourage medical and nonmedical students from donating blood voluntarily and to assess the level of awareness and knowledge regarding blood donation. Materials and Methods: We conducted a cross-sectional descriptive study from August 2011 to May 2012 across different universities of Karachi covering both private and public sector. Predesigned questionnaires were filled by students. A total of 690 students participated in the study, 345 from each. Data collected was analyzed using SPSS Version 17.0. Simple frequencies and percentages were calculated, and Pearson Chi-square and Fisher's exact tests were applied to calculate association between different variables with P value set as significant when <0.05. Results: Mean age of the students was found to be between 21 and 23 (64.6%) in medical, whereas in nonmedical, 66.7% fell in this age group. Astonishingly, blood donors in nonmedical (27%) were quite more than that in medical group, where they were only 18%. Males constituted the majority in both of the groups. Most commonly reported factor that motivated blood donation in medical group was feeling of self-satisfaction (40.2%), whereas in nonmedical group, 32.9% reported that they had only donated blood when their friends/family were in need. When asked about the adverse effects after blood donation, weakness was common among both medical and nonmedical, i.e. 46.8% and 46.7%, respectively. Among the factors that impeded our subjects from donating blood were primarily health concerns in medical students (19%), whereas in nonmedical students they claimed they were not approached by anyone and were unaware of the importance of blood donation (34.8%). Conclusion: Proportion of blood donors was significantly low in both medical and nonmedical students, especially in females. Most important motivating factor in medical students was feeling of self–satisfaction, whereas in nonmedical students, it was family/friend in need

  2. Epidemiology of major incidents: an EMS study from Pakistan

    PubMed Central

    2011-01-01

    Background A major incident is defined as an event that owing to the number of casualties has the potential to overwhelm the available resources. This paper attempts to describe the incidence and epidemiology of major incidents dealt with by a government-run emergency medical service (EMS) in the Punjab province of Pakistan, a developing country in South Asia. A major incident in this EMS is defined as any incident that produces three or more patients, or any incident in which extraordinary resources are needed. Methods All the calls received by an EMS Rescue 1122 were studied over a 6-month period. Calls that were defined as major incidents were identified, and further details were sought from the districts regarding these incidents. Questions specifically asked were the type of incident, time of the incident, response time for the incident, the resources needed, and the number of dead and injured casualties. Retrospective data were collected from the submitted written reports. Results Road traffic crashes (RTCs) emerged as the leading cause of a major incident in the province of Punjab and also led to the greatest number of casualties, followed by fire incidents. The total number of casualties was 3,380, out of which 73.7% were RTC victims. There was a high rate of death on the scene (10.4%). Certain other causes of major incidents also emerged, including violence, gas explosions and drowning. Conclusion Road traffic crashes are the most common cause of a major incident in developing countries such as Pakistan. Injury prevention initiatives need to focus on RTCs. PMID:21798011

  3. Circumglobal wave train and the summer monsoon over northwestern India and Pakistan: the explicit role of the surface heat low

    NASA Astrophysics Data System (ADS)

    Saeed, Sajjad; Müller, Wolfgang A.; Hagemann, Stefan; Jacob, Daniela

    2011-09-01

    This study examines the influence of the mid-latitude circulation on the surface heat low (HL) and associated monsoon rainfall over northwestern India and Pakistan using the ERA40 data and high resolution (T106L31) climate model ECHAM5 simulation. Special emphasis is given to the surface HL which forms over Pakistan and adjoining areas of India, Iran and Afghanistan during the summer season. A heat low index (HLI) is defined to depict the surface HL. The HLI displays significant correlations with the upper level mid-latitude circulation over western central Asia and low level monsoon circulation over Arabian Sea and acts as a bridge connecting the mid-latitude wave train to the Indian summer monsoon. A time-lagged singular value decomposition analysis reveals that the eastward propagation of the mid-latitude circumglobal wave train (CGT) influences the surface pressure anomalies over the Indian domain. The largest low (negative) pressure anomalies over the western parts of the HL region (i.e., Iran and Afghanistan) occur in conjunction with the upper level anomalous high that develops over western-central Asia during the positive phase of the CGT. The composite analysis also reveals a significant increase in the low pressure anomalies over Iran and Afghanistan during the positive phase of CGT. The westward increasing low pressure anomalies with its north-south orientation provokes enormous north-south pressure gradient (lower pressure over land than over sea). This in turn enables the moist southerly flow from the Arabian Sea to penetrate farther northward over northwestern India and Pakistan. A monsoon trough like conditions develops over northwestern India and Pakistan where the moist southwesterly flow from the Arabian Sea and the Persian Gulf converge. The convergence in association with the orographic uplifting expedites convection and associated precipitation over northwestern India and Pakistan. The high resolution climate model ECHAM5 simulation also

  4. Risk Factors and Epidemiology of Gastric Cancer in Pakistan.

    PubMed

    Daniyal, Muhammad; Ahmad, Saeed; Ahmad, Mukhtiar; Asif, Hafiz Muhammad; Akram, Muhammad; Ur Rehman, Saif; Sultana, Sabira

    2015-01-01

    Gastric cancer is the 2nd most common cause of death among all cancers and is the 4th most common cancer in the world. The number of deaths due to gastric cancer is about 800,000 annually. Gastric cancer is more common in men as compared to women and is 3rd most common cancer after colorectal and breast cancers in women. A progressive rise in the incidence rate has been observed in females over the last 5 years. The highest incidence of stomach cancer is in China, South America and Eastern Europe. The incidence of gastric cancer has 20 fold variation worldwide. Global variation is linked by two factors which play important role in developing gastric cancer. One is infection with Helicobacter pylori and the 2nd is diet. South Asia is a region with low risk, despite a high prevalence of H.pylori. Gastric carcinoma is common in southern region of India. Gastric cancer is more readily treated if diagnosed early. This study aims to provide awareness about gastric cancer as well as an updated knowledge about risk factors and epidemiology of gastric cancer in Pakistan.

  5. Food safety challenges--a Pakistan's perspective.

    PubMed

    Akhtar, Saeed

    2015-01-01

    Biological, chemical, and physical contamination of foods is a terrifying threat for the health and economic growth in developing societies. Rampantly available literature on foodborne illnesses especially diarrhea among children exclusively depicts the intensified disease burden associated with foodborne illness in the underdeveloped economies. Prevalence of many pathogens in several foods is commonplace in Pakistan. Precise estimates for foodborne illnesses in Pakistan are hard to make because of the absence of any monitoring, surveillance, and infection control. Poor processing and storage of milk, cereal grains, and nuts are a major cause of aflatoxin contamination and mold proliferation. Numerous studies manifest a multitude of foods to be contaminated with heavy metals. Escalating population growth limits the economic potential of the individual and the state through a tendency among the traders and manufacturers to intentionally debase food commodities offered for sale to make profit at the cost of their quality and safety. Therefore, a growing trend of adulteration in foods during the recent past, particularly adulteration of milk, poses a pressing challenge for the government. This review is a concerted attempt to elucidate the prevailing food safety scenario in Pakistan. Information derived from local and related international studies will be presented to clearly depict a picture of food safety in Pakistan. It is proposed that an extensive food safety infrastructure leading to a safer supply of foods needs to be devised, designed, and implemented.

  6. Polarisation of Social Studies Textbooks in Pakistan

    ERIC Educational Resources Information Center

    Zaidi, Syed Manzar Abbas

    2011-01-01

    This article looks at the evolution of the social studies curricula in Pakistan, which are of critical importance in shaping the outlook of many young Pakistanis, who are affected by this polarised discourse. The author argues that this trend of polarisation springing from dynamics of education also effectively contributes to a widening social…

  7. Administering and Preserving District Records in Pakistan.

    ERIC Educational Resources Information Center

    Moir, Martin

    1990-01-01

    Reports on a 1986-87 study of the value, storage conditions, use, and management of district records in Pakistan. Possible solutions to some of the problems identified are analyzed. Recommendations include relocation of records, microfilming, and development of records management and public access policies. Several immediate actions are also…

  8. Food safety challenges--a Pakistan's perspective.

    PubMed

    Akhtar, Saeed

    2015-01-01

    Biological, chemical, and physical contamination of foods is a terrifying threat for the health and economic growth in developing societies. Rampantly available literature on foodborne illnesses especially diarrhea among children exclusively depicts the intensified disease burden associated with foodborne illness in the underdeveloped economies. Prevalence of many pathogens in several foods is commonplace in Pakistan. Precise estimates for foodborne illnesses in Pakistan are hard to make because of the absence of any monitoring, surveillance, and infection control. Poor processing and storage of milk, cereal grains, and nuts are a major cause of aflatoxin contamination and mold proliferation. Numerous studies manifest a multitude of foods to be contaminated with heavy metals. Escalating population growth limits the economic potential of the individual and the state through a tendency among the traders and manufacturers to intentionally debase food commodities offered for sale to make profit at the cost of their quality and safety. Therefore, a growing trend of adulteration in foods during the recent past, particularly adulteration of milk, poses a pressing challenge for the government. This review is a concerted attempt to elucidate the prevailing food safety scenario in Pakistan. Information derived from local and related international studies will be presented to clearly depict a picture of food safety in Pakistan. It is proposed that an extensive food safety infrastructure leading to a safer supply of foods needs to be devised, designed, and implemented. PMID:24915401

  9. Pesticides exposure in Pakistan: a review.

    PubMed

    Tariq, Muhammad Ilyas; Afzal, Shahzad; Hussain, Ishtiaq; Sultana, Nargis

    2007-11-01

    This is the first systematic review of studies done since 1960, and to give an integrated picture of pesticides exposure to humans, animals, plants, waters, soils/sediments, atmosphere etc. in Pakistan. Authors have extracted data from different departments, published literature in research journals and National reports. Although the wide-spread usage of pesticides in Pakistan has controlled the pests, but like other countries, it has started causing environmental problems in the area. In some areas of Punjab and Sindh groundwater has been found contaminated and is constantly being under the process of contamination due to pesticide use. There is considerable evidence that farmers have overused and misused pesticides especially in cotton-growing areas. It is evident from the biological monitoring studies that farmers are at higher risk for acute and chronic health effects associated with pesticides due to occupational exposure. Furthermore, the intensive use of pesticides (higher sprays more than the recommended dose) in cotton areas involves a special risk for the field workers, pickers, and of an unacceptable residue concentration in cottonseed oil and cakes. The authors have also discussed the merits and demerits of different studies. The review will set the future course of action of different studies on pesticide exposure in Pakistan. Data limitations are still the major obstacle towards establishing clear environmental trends in Pakistan. The authors suggest that a reliable monitoring, assessment and reporting procedures shall be implemented in accordance with appropriate environmental policies, laws and regulations in order to minimize the pesticides exposure.

  10. Population Bulletin. Pakistan: A Demographic Report.

    ERIC Educational Resources Information Center

    Population Reference Bureau, Inc., Washington, DC.

    This report presents a brief history of Pakistan as a nation and reviews a number of demographic variables. Major topics discussed are population growth and shifts, urbanization, and labor characteristics and problems. Based on this information and projections, the report concludes with a discussion of the failure of family planning programs and…

  11. Status of Project Management Education in Pakistan

    ERIC Educational Resources Information Center

    Arain, Faisal Manzoor; Tipu, Syed Awais Ahmad

    2009-01-01

    Emerging contractual delivery systems, collaborative partnerships, new management initiatives, and global product markets require professionals and students to have a broader awareness of construction methods and project management issues. This paper presents the state of the project management education in Pakistan. The analysis is based on…

  12. Library Web OPACs in Pakistan: An Overview

    ERIC Educational Resources Information Center

    Mahmood, Khalid

    2008-01-01

    Purpose: This paper aims to analyse features and functions of indigenously developed web-based catalogues of academic, special and national libraries of Pakistan. Design/methodology/approach: The assessment of 16 OPACs is based on a 91-item checklist developed with the help of previous studies conducted in other countries. Findings: The paper…

  13. On the Dynamics of Extreme Meteorological Droughts during Pakistan Summer Monsoon by Focusing the Anomalous States of Upper Troposphere

    NASA Astrophysics Data System (ADS)

    Ahmad, S.; Koike, T.; Nishii, K.

    2012-12-01

    The lack of summer monsoon sometimes brings severe droughts in many parts of the world including South Asian countries like Pakistan. Human life and economy in Pakistan considerably depends on the summer monsoon. So, an essential question arises "how can we contribute better to manage the water resources during drought conditions for the societal needs". To address the concern as a hydrologist, we need to develop a basis of the scientific understanding of the different contrast of the climatology during extremely dry rainfall events over Pakistan region. However, compared to other regional studies i.e. Indian Summer Monsoon (ISM) and South-East Asian Monsoon (SEAM), the basis of the thermodynamical structure and the processes associated with upper tropospheric conditions during the climatological mean Pakistan Summer Monsoon (PSM) and its extreme events have not been addressed deeply yet and need to be investigated, because it is immensely vital for the hydrologist as a first step to develop the basis of scientific understanding. By data analysis, an attempt has been made to accomplish this objective. Firstly, the climatological tropospheric conditions and the associated processes from pre-monsoon phase to the PSM mature phase are investigated. During the PSM mature phase (mid July), the climatological-mean structure of the atmosphere favors convective activity compared to the pre-monsoon phase (late June) with weakening of the subsidence in the upper troposphere and also with increasing of incoming moisture flux in the lower troposphere from Arabian Sea and Bay of Bengal around Pakistan. Specifically, in the upper troposphere, the upper-level subsidence and convergence observed over Pakistan during pre-monsoon phase shifts and reallocates to the northwest of Pakistan during mature phase, which results in weakening of the subsidence just over Pakistan, and then the PSM mature phase initiated. Secondly, comparing the PSM mature phase climatological mean

  14. HIV / AIDS among men who have sex with men in Pakistan.

    PubMed

    Khan, O A; Hyder, A A

    1998-01-01

    1200 South Asian men from India, Pakistan, and Bangladesh who lived in either South Asia or the UK participated in focus group discussions conducted by the Naz Foundation to gain insight into the sociocultural dimensions of sex between men in the region. Although participants noted the lack of accessibility to women as the main reason for such behavior, the overwhelming majority of these men who have sex with men were married. Those aged 14-16 years had an average of 2 sex partners per year, while those aged 17-20 had 5, those aged 21-35 had 42, and those aged 36-45 had 35. There are many anecdotal reports of young men in South Asia who have sex with men and/or women in exchange for money or other tangible goods. By early 1997, 1232 cases of HIV infection had been reported in Pakistan, of which 88.4% were in men. These data come from the National AIDS Program, and consist largely of cases reported from 4 provinces. While the mode of HIV transmission was not recorded in 41% of cases, male-male sex was the acknowledged mode of transmission among 3.2% of HIV-positive men. Male-male sex appears to exist among married men who have extramarital sex contacts, prisoners, seafarers, IV drug users, truck drivers, and male prostitutes. In Pakistan, men who have sex with men comprise a highly vulnerable group which needs to be targeted for HIV/AIDS awareness-raising interventions.

  15. Aid cutoff threatens condom program in Pakistan.

    PubMed

    Barron, T

    1991-01-01

    The Pressler Amendment, a law prohibiting US assistance to any country that does not sign the UN Nuclear Nonproliferation Treaty, is forcing USAID to shut down its highly successful Social Marketing of Contraceptives (SMC) program in Pakistan. Adopted in 1985, the amendment calls for an end of funding for projects in Pakistan as of fiscal year 1991, since the country has refused to sign the treaty. Only previously committed funds have kept SMC running, but it may soon have a close shop. The cutoff comes at an especially inopportune time--just when SMC had begun to make an impact. Introduced 5 years ago, Sathi condoms (the project's main product) account for 2/3 of all condoms used in Pakistan. Sales jumped from 30 million in 1978 to 74 million last year. SMC administrators explain that the country has a vast potential for social marketing. But because of the cutoff in aid, the program will exhaust its supply of condoms by March 1992. The end of the SMC program will mean a serious setback for Pakistan, which already has the 2nd largest population in southern Asia, and which has double the fertility of the most populous country in the region, India. Only 7% of the women in Pakistan rely on a modern method of contraception, compared to 42% in India and 26% in Bangladesh. USAID officials explain that the organization is working with the Pakistani government to find ways to continue funding the program after US funds run out. They add that this development will provide Pakistani Prime Minister Nawaz Sharif an opportunity to demonstrate his stated commitment to curb population growth.

  16. MAHFIL: A Quarterly of South Asian Literature, Spring-Summer 1971.

    ERIC Educational Resources Information Center

    Coppola, Carlo, Ed.

    This volume contains both literature from South Asia and articles about South Asian literature. The first article consists of an interview with a leading Pakistani poet, N.M. Rashed, who discusses modern Urdu literature. Other articles are: "Five 'Dangerous' Books"--on censorship in East Pakistan--by P. Sarkar; "Baluchi Language and Literature"…

  17. Anthropoid primates from the Oligocene of Pakistan (Bugti Hills): Data on early anthropoid evolution and biogeography

    PubMed Central

    Marivaux, Laurent; Antoine, Pierre-Olivier; Baqri, Syed Rafiqul Hassan; Benammi, Mouloud; Chaimanee, Yaowalak; Crochet, Jean-Yves; de Franceschi, Dario; Iqbal, Nayyer; Jaeger, Jean-Jacques; Métais, Grégoire; Roohi, Ghazala; Welcomme, Jean-Loup

    2005-01-01

    Asian tarsiid and sivaladapid primates maintained relictual distributions in southern Asia long after the extirpation of their close Holarctic relatives near the Eocene–Oligocene boundary. We report here the discovery of amphipithecid and eosimiid primates from Oligocene coastal deposits in Pakistan that demonstrate that stem anthropoids also survived in southern Asia beyond the climatic deterioration that characterized the Eocene–Oligocene transition. These fossils provide data on temporal and paleobiogeographic aspects of early anthropoid evolution and significantly expand the record of stem anthropoid evolution in the Paleogene of South Asia. PMID:15937103

  18. Towards balanced development in Pakistan.

    PubMed

    Pyatt, G

    1992-01-01

    Pakistan is a country whose economic growth is surprising in light of its social indicators. The aim of this article is to examine why conditions are such and to develop a framework for understanding the issues as an aid to redesigning policies. 5 sections are devoted to a summary of the main findings, the diagnosis of development and the impact on social sectors, a proposal for balanced development, and implications for policy changes. A sound macro economic context is needed with reforms economically in price and incentive systems, institutionally, and in the law and order sector. Public administration needs to be improved and individual opportunities need to be expanded. Internal security needs to be secured, so that law and order are restored. Economic growth has been high between 1960 and 1988, due to exploitation of natural resources and cheap unskilled labor, expansion of irrigated land, and growth of the unregulated informal sector. The major constraints on economic growth will come from a lack of fiscal discipline. 40% of government revenues are consumed by the military and 20% for servicing debt. Other constraints are the population growth rate in excess of 3%/year, an urban bias in allocation of resources, neglected primary education, and gender bias in education. There has been little incentive for provincial governments to balance budgets, and civil service has become disorganized. Balanced development entails recognizing human capital, natural resources, and infrastructure; accepting the status quo; and creating and maintaining an institutional framework to correct market failures and promote individual opportunities. The environmental polluter must pay. Income must be increased through higher wages, increasing the demand for labor, and transfers to households in the form of food rations, schooling, and medical care. Investment in women will increase household earnings, and improve living conditions and the health of themselves and their children

  19. Towards balanced development in Pakistan.

    PubMed

    Pyatt, G

    1992-01-01

    Pakistan is a country whose economic growth is surprising in light of its social indicators. The aim of this article is to examine why conditions are such and to develop a framework for understanding the issues as an aid to redesigning policies. 5 sections are devoted to a summary of the main findings, the diagnosis of development and the impact on social sectors, a proposal for balanced development, and implications for policy changes. A sound macro economic context is needed with reforms economically in price and incentive systems, institutionally, and in the law and order sector. Public administration needs to be improved and individual opportunities need to be expanded. Internal security needs to be secured, so that law and order are restored. Economic growth has been high between 1960 and 1988, due to exploitation of natural resources and cheap unskilled labor, expansion of irrigated land, and growth of the unregulated informal sector. The major constraints on economic growth will come from a lack of fiscal discipline. 40% of government revenues are consumed by the military and 20% for servicing debt. Other constraints are the population growth rate in excess of 3%/year, an urban bias in allocation of resources, neglected primary education, and gender bias in education. There has been little incentive for provincial governments to balance budgets, and civil service has become disorganized. Balanced development entails recognizing human capital, natural resources, and infrastructure; accepting the status quo; and creating and maintaining an institutional framework to correct market failures and promote individual opportunities. The environmental polluter must pay. Income must be increased through higher wages, increasing the demand for labor, and transfers to households in the form of food rations, schooling, and medical care. Investment in women will increase household earnings, and improve living conditions and the health of themselves and their children

  20. Mapping human health risks from exposure to trace metal contamination of drinking water sources in Pakistan.

    PubMed

    Bhowmik, Avit Kumar; Alamdar, Ambreen; Katsoyiannis, Ioannis; Shen, Heqing; Ali, Nadeem; Ali, Syeda Maria; Bokhari, Habib; Schäfer, Ralf B; Eqani, Syed Ali Musstjab Akber Shah

    2015-12-15

    The consumption of contaminated drinking water is one of the major causes of mortality and many severe diseases in developing countries. The principal drinking water sources in Pakistan, i.e. ground and surface water, are subject to geogenic and anthropogenic trace metal contamination. However, water quality monitoring activities have been limited to a few administrative areas and a nationwide human health risk assessment from trace metal exposure is lacking. Using geographically weighted regression (GWR) and eight relevant spatial predictors, we calculated nationwide human health risk maps by predicting the concentration of 10 trace metals in the drinking water sources of Pakistan and comparing them to guideline values. GWR incorporated local variations of trace metal concentrations into prediction models and hence mitigated effects of large distances between sampled districts due to data scarcity. Predicted concentrations mostly exhibited high accuracy and low uncertainty, and were in good agreement with observed concentrations. Concentrations for Central Pakistan were predicted with higher accuracy than for the North and South. A maximum 150-200 fold exceedance of guideline values was observed for predicted cadmium concentrations in ground water and arsenic concentrations in surface water. In more than 53% (4 and 100% for the lower and upper boundaries of 95% confidence interval (CI)) of the total area of Pakistan, the drinking water was predicted to be at risk of contamination from arsenic, chromium, iron, nickel and lead. The area with elevated risks is inhabited by more than 74 million (8 and 172 million for the lower and upper boundaries of 95% CI) people. Although these predictions require further validation by field monitoring, the results can inform disease mitigation and water resources management regarding potential hot spots.

  1. Mapping human health risks from exposure to trace metal contamination of drinking water sources in Pakistan.

    PubMed

    Bhowmik, Avit Kumar; Alamdar, Ambreen; Katsoyiannis, Ioannis; Shen, Heqing; Ali, Nadeem; Ali, Syeda Maria; Bokhari, Habib; Schäfer, Ralf B; Eqani, Syed Ali Musstjab Akber Shah

    2015-12-15

    The consumption of contaminated drinking water is one of the major causes of mortality and many severe diseases in developing countries. The principal drinking water sources in Pakistan, i.e. ground and surface water, are subject to geogenic and anthropogenic trace metal contamination. However, water quality monitoring activities have been limited to a few administrative areas and a nationwide human health risk assessment from trace metal exposure is lacking. Using geographically weighted regression (GWR) and eight relevant spatial predictors, we calculated nationwide human health risk maps by predicting the concentration of 10 trace metals in the drinking water sources of Pakistan and comparing them to guideline values. GWR incorporated local variations of trace metal concentrations into prediction models and hence mitigated effects of large distances between sampled districts due to data scarcity. Predicted concentrations mostly exhibited high accuracy and low uncertainty, and were in good agreement with observed concentrations. Concentrations for Central Pakistan were predicted with higher accuracy than for the North and South. A maximum 150-200 fold exceedance of guideline values was observed for predicted cadmium concentrations in ground water and arsenic concentrations in surface water. In more than 53% (4 and 100% for the lower and upper boundaries of 95% confidence interval (CI)) of the total area of Pakistan, the drinking water was predicted to be at risk of contamination from arsenic, chromium, iron, nickel and lead. The area with elevated risks is inhabited by more than 74 million (8 and 172 million for the lower and upper boundaries of 95% CI) people. Although these predictions require further validation by field monitoring, the results can inform disease mitigation and water resources management regarding potential hot spots. PMID:26312405

  2. Perceptions of Private College Teachers of Karachi about the Curriculum Prescribed by Sindh Bureau of Curriculum (BOC)

    ERIC Educational Resources Information Center

    Syeda, Talat Jehan

    2015-01-01

    Curriculum at the college level is prescribed at provincial level to ensure a standardized education throughout. A prescribed curriculum aligns educational standards and maintains them to ensure teaching standards. In Pakistan the curriculum for intermediate students at both private and government colleges is designed and proposed by Sindh Bureau…

  3. Cooperative Monitoring Center Occasional Paper/11: Cooperative Environmental Monitoring in the Coastal Regions of India and Pakistan

    SciTech Connect

    Rajen, Gauray

    1999-06-01

    The cessation of hostilities between India and Pakistan is an immediate need and of global concern, as these countries have tested nuclear devices, and have the capability to deploy nuclear weapons and long-range ballistic missiles. Cooperative monitoring projects among neighboring countries in South Asia could build regional confidence, and, through gradual improvements in relations, reduce the threat of war and the proliferation of weapons of mass destruction. This paper discusses monitoring the trans-border movement of flow and sediment in the Indian and Pakistani coastal areas. Through such a project, India and Pakistan could initiate greater cooperation, and engender movement towards the resolution of the Sir Creek territorial dispute in their coastal region. The Joint Working Groups dialogue being conducted by India and Pakistan provides a mechanism for promoting such a project. The proposed project also falls within a regional framework of cooperation agreed to by several South Asian countries. This framework has been codified in the South Asian Seas Action Plan, developed by Bangladesh, India, Maldives, Pakistan and Sri Lanka. This framework provides a useful starting point for Indian and Pakistani cooperative monitoring in their trans-border coastal area. The project discussed in this paper involves computer modeling, the placement of in situ sensors for remote data acquisition, and the development of joint reports. Preliminary computer modeling studies are presented in the paper. These results illustrate the cross-flow connections between Indian and Pakistani coastal regions and strengthen the argument for cooperation. Technologies and actions similar to those suggested for the coastal project are likely to be applied in future arms control and treaty verification agreements. The project, therefore, serves as a demonstration of cooperative monitoring technologies. The project will also increase people-to-people contacts among Indian and Pakistani policy

  4. Drifting continents and endemic goitre in northern Pakistan.

    PubMed Central

    Stewart, A G

    1990-01-01

    Although Baltistan, north east Pakistan, is in a region of iodine deficiency disorders, the distribution of goitre within the district, according to age and sex, has not been clearly defined. To establish the prevalence of the condition and to measure the reported difference in prevalence in the north and south of the district thyroid size was assessed in new patients attending the Aman clinic, Khapalu, and outlying areas between April and September from 1981 to 1986. Samples of potable water collected from villages were analysed for iodine (as iodide) concentrations in Britain. Population weighted prevalences were: in the north in males 20.4%, in females 28.1% and in the south in males 13.9%, in females 21.2%. There was an overall deficiency of iodine in the water (mean iodine (as iodide) concentrations (north) 11.0 nmol/l (1.4 micrograms/l), (south) 11.8 nmol/l (1.5 micrograms/l) (95% confidence interval -0.7 to 0.9). The differences followed the Main Karakoram Thrust, suggesting a geological goitrogen in the north, which might be minerals containing ions such as BF4- and SO3F-, and molybdenite and calcium, which are present in rocks in Baltistan. A new hypothesis for the genesis of endemic goitre is proposed--that is, that continents on crustal plates drift across the earth and collide, one plate sliding under the other and melting, giving rise to characteristic mineral assemblages in the overlying rocks. As the minerals weather out they enter the diet of the local population, where in the presence of iodine deficiency they produce or enhance iodine deficiency disorders. Despite the current iodised oil campaign by the Pakistani government with Unicef a long term working iodisation programme is still urgently needed. PMID:2372605

  5. 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

  6. Solar daily variation at geomagnetic observatories in Pakistan

    NASA Astrophysics Data System (ADS)

    Rahim, Zain; Kumbher, Abdul Salam

    2016-03-01

    A study of solar daily variation is performed using the famous Chapman-Miller method for solar cycles 22 & 23 (1986-2007). The objective is to study the characteristics of Sq variation at Pakistani geomagnetic observatories using solar harmonics and a more traditional five quietest day's method. The data recorded at the Karachi geomagnetic observatory for SC 22 and 23 and data sets from other Pakistani geomagnetic observatories; Sonmiani, Quetta and Islamabad are analyzed for H, D and Z components of the geomagnetic field. Except for the D and Z components at Karachi and Sonmiani and H component at Islamabad, the two solar daily variations correlated well with each other. Also, the synthesized daily variation from the solar harmonics of H, D and Z components explained the equivalent Sq current system reasonably well for all seasons. For H component, the first solar harmonic (s1) obtained from spherical harmonic analysis of the data, appeared as the largest harmonic with no significant changes for the seasonal division of data. However, for D and Z components, amplitudes are comparable, but undergo distinct variations. s1 for H and D components increases with magnetic activity while for Z component it is the largest for the medium phase of magnetic activity. With the sunspot number division of data, the weighted mean of the Wolf ratio of all three components is in good agreement with the previous studies. The synthesized solar daily variation for D component, S(D), at Karachi, Sonmiani, Quetta and Islamabad did not show any signs of winter anomaly for the period studied. However, S(D) variation at Karachi during winter season showed morning minimum followed by a maximum at local noon and another minimum in the afternoon. We suggest this could be the effects of Equatorial Ionospheric Anomaly (EIA) observable at the Karachi observatory only during the winter season. Similarly, much disturbed in equinoctial and summer months, S(Z) illustrated an unwavering daily

  7. Hydrocarbon prospects of southern Indus basin, Pakistan

    SciTech Connect

    Quadri, V.U.N.; Shuaib, S.M.

    1986-06-01

    The Southern Indus basin extends approximately between lat. 23/sup 0/ and 28/sup 0/31'N, and from long. 66/sup 0/E to the eastern boundary of Pakistan. Of the 55 exploratory wells drilled (1955-1984), 27 were based on results of multifold seismic surveys. Five commercial oil discoveries and one gas discovery in Cretaceous sands, three gas discoveries in Paleocene limestone or sandstone, and one gas-condensate discovery from lower Eocene limestone prove that hydrocarbons are present. The main hydrocarbon fairways are Mesozoic tilted fault blocks. Tertiary reefal banks, and drape and compressional anticlines. Older reservoirs are accessible toward the east and northeast, and younger mature source rocks are to the west, including offshore, of the Badin block oil field area. The Indus offshore basin reflects sedimentation associated with Mesozoic rifting of the Pakistan-Indian margin, superimposed by a terrigenous clastic depositional system comprised of deltas, shelves, and deep-sea fans of the Indus River.

  8. 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.

  9. Factors affecting the process of obtaining informed consent to surgery among patients and relatives in a developing country: results from Pakistan.

    PubMed

    Jahan, F; Roshan, R; Nanji, K; Sajwani, U; Warsani, S; Jaffer, S

    2014-10-12

    Efforts have been made in Pakistan to create ethical guidelines for research and medical practice. This study explored the perceptions of and factors affecting the process of obtaining informed consent to surgery among inpatients and families at a tertiary-care hospital in Karachi. A random sample of 400 post-surgery adult patients answered a pre-tested, structured questionnaire. Overall, 233 patients (58.3%) had signed the surgery consent form themselves, while 167 relatives (41.7%) had signed on behalf of the patient. Perceived factors significantly associated with patients not signing the consent form themselves were: language used (adjusted OR = 4.6), medical terminology used (aOR = 2.7), insufficient time allocation (aOR = 3.8), cultural/traditional reasons (aOR = 1.5) and low education (aOR = 2.4). Inappropriate timing for taking consent and not being informed/asked about consent were not statistically significant factors. Health-care practitioners should encourage patients to sign the consent form themselves.

  10. Makran Mountain Range, Iran and Pakistan

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The long folded mountain ridges and valleys of the coastal Makran Ranges of Iran and Pakistan (26.0N, 63.0E) illustrate the classical Trellis type of drainage pattern, common in this region. The Dasht River and its tributaries is the principal drainage network for this area. To the left, the continental drift of the northward bound Indian sub-continent has caused the east/west parallel ranges to bend in a great northward arc.

  11. Pakistan: social basis of the economy.

    PubMed

    Maloney, C

    1987-01-01

    Pakistan's gross domestic product (GDP) has grown at an average of 5.3%/year since 1950 and real per capita income has increased 3.7%/year over the past decade, despite a 3% annual population growth rate. Contributing to this dynamic economic growth have been migration, the construction of a new national economy following independence, controlled irrigation, foreign exchange availability, and an expectation on the part of the public of higher earnings and consumption. Despite these trends, the Pakistan economy is structurally weak and there have been rapid increases in both the domestic and foreign debt. Economic growth has been based largely on trading and soft services. Government departments are known for their corruption. This self-contradictory economic picture derives directly from the structure of Pakistani society, which is dominated by the elite of Punjab Province. Urbanization is increasing economic inequality in the society, and government taxation policies are biased toward big agriculture and industry. Pakistan's poor performance in education, social development, and family planning are expected to inhibit future economic development. Only 26% of Pakistanis are literate, reflecting the low social value placed on education. Even in urban areas, there is no evidence of a decline in fertility. This results from the psychological and economic need for children, women's limited roles, Islamic opposition to family planning, and inefficient government delivery of social services. Within a few years, population growth will magnify the structural weaknesses of the Pakistan economy. It is hoped that the dynamic nature of Panjabi values and behavior, especially of the new middle class, will lead to a redress of this situation.

  12. The Status of Women Physicists in Pakistan

    NASA Astrophysics Data System (ADS)

    Hasnain, Aziz Fatima; Islam, Jabeen

    2009-04-01

    A significant number of women physicists work in high-ranking positions in the universities and research institutes of Pakistan; however, the number of women is much lower compared with men. We surveyed these women about the challenges they faced in the workplace and the pace of their progress and scientific work in a male-dominant society. We also surveyed girls' attitudes toward studying physics at the graduate and undergraduate levels.

  13. Growing burden of stroke in Pakistan: a review of progress and limitations.

    PubMed

    Hashmi, Mubashirah; Khan, Maria; Wasay, Mohammad

    2013-10-01

    Stroke rates in middle-aged people are five to ten times higher in Pakistan, India, Russia, China, and Brazil, compared with the United Kingdom or United States. South Asia is home to 20% of the world's population and has one of the highest burdens of cardiovascular disease in the world. With an aging population, there is an expected increase in the number of stroke cases and a corresponding increase in the burden of stroke in developing countries including South Asian countries like Pakistan. Limited data from prior studies in developing countries indicate that stroke epidemiology differs between these and Western countries. These differences include a higher incidence of stroke at younger ages, a higher prevalence of hemorrhagic stroke, and higher age-specific prevalence rates of stroke in women. The reasons for these differences in stroke epidemiology in developing countries are not clear. This may be explained by higher prevalence of established stroke risk factors, or potential nontraditional risk factors such as water pipe smoking, use of daldaghee or naswaar, and paan chewing; hepatitis and rheumatic heart disease may also contribute to these differences. Acute and long-term stroke treatment has shown limited progress in Pakistan like other developing countries because of poor awareness of patients and general physician on stroke symptomatology, management of stroke risk factors, lack of specialized stroke units in the country, very low utilization of thrombolytic therapy because of financial constraints and, above all, poor knowledge of physicians on the role of rehabilitation and its different aspects in the management of post stroke disability.

  14. An overview of smoking practices in Pakistan

    PubMed Central

    Shah, Noreen; Siddiqui, Saad

    2015-01-01

    Smoking remains a major player in morbidity and mortality worldwide. It is a matter of immense public health importance as single leading cause of preventable deaths. The aim of this study was to assess smoking practices that prevail across Pakistan & Attitude of people towards this issue. We conducted an extensive search on major databases as well as search of bibliography of published literature for studies assessing Attitudes and Practices of tobacco smoking that prevail across Pakistan. Data from available studies was abstracted and utilized in preparation of this manuscript. After screening of 613 articles, we were able to identify 22 studies matching our criteria for inclusion. Majority of studies reported adolescence as time of initiation. Average national prevalence was 21.6%. A significant portion of smokers comprised of females. The prevalence of smoking in healthcare professionals ranged from 32 – 37%. Passive smoking was a major contributor of tobacco exposure. Prevalence of ‘Shisha’ use was 33%. Smoking continues to be a major Public Health issue in Pakistan. The prevalence in healthcare professionals and adolescents is alarming. Adequate measures need to be taken to ensure its control. PMID:26101513

  15. An overview of poultry industry in Pakistan

    PubMed Central

    HUSSAIN, J.; RABBANI, I.; ASLAM, S.; AHMAD, H.A.

    2015-01-01

    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. PMID:26696690

  16. Assessment of Blood Glucose and Electrolytes during Cardiopulmonary Bypass in Diabetic and Non-Diabetic Patients of Pakistan

    PubMed Central

    Bilal, Muhammad; Haseeb, Abdul; Khan, Mohammad Hassaan; Khetpal, Akash; Saad, Muhammad; Arshad, Mohammad Hussham; Dar, Mudassir Iqbal; Hasan, Najya; Rafiq, Rafia; Sherwani, Maryam; Abbas, Haider; Sultan, Ayesha; Inam, Maha

    2016-01-01

    Introduction: Perioperative hyperglycemia has been shown to be related to higher levels of morbidity and mortality in patients on cardiopulmonary bypass (CPB) undergoing coronary artery bypass grafting (CABG), both diabetic and non-diabetic. Blood electrolytes, like sodium, potassium, calcium, and chloride play a very important role in the normal functioning of the body and can lead to a variety of clinical disorders if they become deficient. A minimal number of studies have been conducted on the simultaneous perioperative changes in both blood glucose and electrolyte levels during CPB in Pakistan. Therefore, our aim is to record and compare the changes in blood glucose and electrolyte levels during CPB in diabetic and non-diabetic patients. Materials and Methods: This was a prospective, observational study conducted on 200 patients who underwent CABG with CPB, from October 2014 to March 2015. The patients were recruited from the Cardiac Surgery Ward, Civil Hospital Karachi after they complied with the inclusion criteria. Repeated-measures analysis of variance (ANOVA) was used to compare the trend of the changes perioperatively for the two groups. Results: There was no significant difference in changes in blood glucose between the two groups (P = 0.62). The only significant difference detected between the two groups was for PaCO2 (P = 0.001). Besides, further analysis revealed insignificant group differences for the trend changes in other blood electrolytes (P > 0.05). Conclusion: Our findings highlighted that there is no significant difference in blood electrolytes changes and the increase in blood glucose levels between diabetic and non-diabetic patients. PMID:27157174

  17. Evidence for the recurrence of large-magnitude earthquakes along the Makran coast of Iran and Pakistan

    USGS Publications Warehouse

    Page, W.D.; Alt, J.N.; Cluff, L.S.; Plafker, G.

    1979-01-01

    The presence of raised beaches and marine terraces along the Makran coast indicates episodic uplift of the continental margin resulting from large-magnitude earthquakes. The uplift occurs as incremental steps similar in height to the 1-3 m of measured uplift resulting from the November 28, 1945 (M 8.3) earthquake at Pasni and Ormara, Pakistan. The data support an E-W-trending, active subduction zone off the Makran coast. The raised beaches and wave-cut terraces along the Makran coast are extensive with some terraces 1-2 km wide, 10-15 m long and up to 500 m in elevation. The terraces are generally capped with shelly sandstones 0.5-5 m thick. Wave-cut cliffs, notches, and associated boulder breccia and swash troughs are locally preserved. Raised Holocene accretion beaches, lagoonal deposits, and tombolos are found up to 10 m in elevation. The number and elevation of raised wave-cut terraces along the Makran coast increase eastward from one at Jask, the entrance to the Persian Gulf, at a few meters elevation, to nine at Konarak, 250 km to the east. Multiple terraces are found on the prominent headlands as far east as Karachi. The wave-cut terraces are locally tilted and cut by faults with a few meters of displacement. Long-term, average rates of uplift were calculated from present elevation, estimated elevation at time of deposition, and 14C and U-Th dates obtained on shells. Uplift rates in centimeters per year at various locations from west to east are as follows: Jask, 0 (post-Sangamon); Konarak, 0.031-0.2 (Holocene), 0.01 (post-Sangamon); Ormara 0.2 (Holocene). ?? 1979.

  18. Education and Gendered Citizenship in Pakistan. Postcolonial Studies in Education

    ERIC Educational Resources Information Center

    Naseem, M. Ayaz

    2010-01-01

    "Education and Gendered Citizenship in Pakistan" challenges the uncritical use of the long held dictum of the development discourse that education empowers women. Situated in the post-structuralist feminist position, it argues that in its current state the educational discourse in Pakistan actually disempowers women. Through a systematic…

  19. 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…

  20. Faunistics of tiger beetles (Coleoptera: Cicindelidae) from Pakistan.

    PubMed

    Rafi, Muhammad Ather; Jürgen, Wiesner; Matin, Muhammad Abdul; Zia, Ahmed; Sultan, Amir; Naz, Falak

    2010-01-01

    The present biogeographic distribution of tiger beetle fauna is an attempt to register all modern taxa from Pakistan. It includes 55 taxa under 14 genera and 11 subgenera. Three species, Cylindera (Eriodera) albopunctata (Chaudoir 1852), Cicindela viridilabris (Chaudoir 1852) and Neocollyris (Neocollyris) redtenbacheri (Horn 1894) are recorded from Pakistan for the first time.

  1. A Study of Students' Attitude Towards Virtual Education in Pakistan

    ERIC Educational Resources Information Center

    Hussain, Irshad

    2007-01-01

    Virtual education paradigm has been developing as a form of distance education to provide education across the boundaries of a nation and/or country. It imparts education through information and communication technologies. In Pakistan the Virtual University of Pakistan imparts it. The main objective of the study was to evaluate the students'…

  2. Faunistics of Tiger Beetles (Coleoptera: Cicindelidae) from Pakistan

    PubMed Central

    Rafi, Muhammad Ather; Jürgen, Wiesner; Matin, Muhammad Abdul; Zia, Ahmed; Sultan, Amir; Naz, Falak

    2010-01-01

    The present biogeographic distribution of tiger beetle fauna is an attempt to register all modern taxa from Pakistan. It includes 55 taxa under 14 genera and 11 subgenera. Three species, Cylindera (Eriodera) albopunctata (Chaudoir 1852), Cicindela viridilabris (Chaudoir 1852) and Neocollyris (Neocollyris) redtenbacheri (Horn 1894) are recorded from Pakistan for the first time. PMID:20874597

  3. Education Reform in Pakistan: Building for the Future

    ERIC Educational Resources Information Center

    Hathaway, Robert M., Ed.

    2005-01-01

    Washington seems to be in a season of worrying--some might say "obsessing"--about the education system in Pakistan. The 9/11 Commission, whose final report has become a fixture on the bestseller lists, has highlighted the links between international terrorism and Pakistan's religious seminaries, or "madaris", and recommended that the United States…

  4. Empowerment of Women through Distance Education in Pakistan

    ERIC Educational Resources Information Center

    Bukhsh, Qadir

    2007-01-01

    The present study was undertaken to highlight the gender disparities of Pakistan as well as at regional and international level. The study, measured the comparative outcome of formal and non-formal system of education in Pakistan. To achieve the desired goal, documentary analysis was considered appropriate. The number of schools and enrollment…

  5. Promoting Primary Education for Girls in Pakistan. CDIE Impact Evaluation.

    ERIC Educational Resources Information Center

    Agency for International Development (IDCA), Washington, DC.

    This report details a field study to evaluate the efforts of Pakistan's Primary Education Development Program (PED) to improve the access, equity, and quality of primary education in Pakistan, especially for rural girls. A 3-week visit was conducted in 1997 by a team from the United States Agency for International Development (USAID) Center for…

  6. Ethnic Nationalities, Education, and Problems of National Integration in Pakistan.

    ERIC Educational Resources Information Center

    Kazi, Aftab A.

    1988-01-01

    This study analyzes the standard Pakistan social studies curriculum to investigate (1) the extent to which it represents ethnic nationalities of Pakistan, and (2) the extent to which it demonstrates its contribution to the process of national cohesion and integration. The findings presented are based on a content analysis (both trend and variable)…

  7. Munazza's story: Understanding science teaching and conceptions of the nature of science in Pakistan through a life history study

    NASA Astrophysics Data System (ADS)

    Halai, Nelofer

    In this study I have described and tried to comprehend how a female science teacher understands her practice. Additionally, I have developed some understanding of her understanding of the nature of science. While teaching science, a teacher projects messages about the nature of science that can be captured by observations and interviews. Furthermore, the manner is which a teacher conceptualizes science for teaching, at least in part, depends on personal life experiences. Hence, I have used the life history method to understand Munazza's practice. Munazza is a young female science teacher working in a private, co-educational school for children from middle income families in Karachi, Pakistan. Her stories are central to the study, and I have represented them using a number of narrative devices. I have woven in my own stories too, to illustrate my perspective as a researcher. The data includes 13 life history interviews and many informal conversations with Munazza, observations of science teaching in classes seven and eight, and interviews with other science teachers and administrative staff of the school. Munazza's personal biography and experiences of school and undergraduate courses has influenced the way she teaches. It has also influenced the way she does not teach. She was not inspired by her science teachers, so she has tried not to teach the way she was taught science. Contextual factors, her conception of preparation for teaching as preparation for subject content and the tension that she faces in balancing care and control in her classroom are some factors that influence her teaching. Munazza believes that science is a stable, superior and value-free way of knowing. In trying to understand the natural world, observations come first, which give reliable information about the world leading inductively to a "theory". Hence, she relies a great deal on demonstrations in the class where students "see" for themselves and abstract the scientific concept from the

  8. 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

  9. 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

  10. 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

  11. Review of the idiocerine leafhoppers of Pakistan (Hemiptera, Cicadellidae) with a description of a new species.

    PubMed

    Khatri, Imran; Webb, M D

    2014-01-01

    The Idiocerinae of Pakistan are reviewed and a new species, Tasnimocerus sindhensis sp. nov. (Pakistan: Tandojam), is described and illustrated from Pakistan. Two new junior synonyms of Idioscopus nitidulus (Walker) are recognized: Idioscopus karachiensis Ahmed, Naheed & Ahmed syn. nov. and I. freytagi Ahmed, Naheed & Ahmed syn. nov. Idioscopus nagpurensis (Pruthi) is newly recorded from Pakistan. A checklist of Idiocerinae from Pakistan is also provided together with a key to genera and species. 

  12. Women's rights in Pakistan: a forensic perspective.

    PubMed

    Hadi, Sibte

    2003-04-01

    Pakistan is a large and an important West Asian country which came into being in the name of Islam and therefore Islamic tenets remain the core of its constitution. The laws of the state have to conform to Islamic law so that they can have a positive impact on the society. Unfortunately, in Pakistan today not all men enjoy the rights and facilities to which they are entitled and women are doubly disadvantaged by poverty and gender. With their own political agendas, various governments have promulgated laws which affect the society in various ways. The laws which directly influence women's rights merit mention, as women comprise more than 50% of the population of Pakistan and are still kept on the sidelines by the male dominant society. The Muslim Family Law Ordinance, 1961, and the Hudood Ordinance, 1979 were both promulgated by military dictators with different visions. The former codified the rights of women bestowed by Islamic law; the latter repealed laws for sexual offences according to the injunctions of Islam and had a negative impact. Both laws need the assistance of forensic medicine as age estimation and medical examinations are necessary if they are to be followed in the right perspective. However, a legal need for an examination by an expert in forensic medicine is sadly lacking in both laws. This has happened due to lack of training of forensic physicians and therefore a lack of research in important areas of forensic medicine in the country. This paper examines these laws and the interaction they have with forensic medicine and proposes that the laws need revision in accordance with modern science, incorporating forensic sciences as well as the injunctions of Islam. PMID:12741660

  13. Women's rights in Pakistan: a forensic perspective.

    PubMed

    Hadi, Sibte

    2003-04-01

    Pakistan is a large and an important West Asian country which came into being in the name of Islam and therefore Islamic tenets remain the core of its constitution. The laws of the state have to conform to Islamic law so that they can have a positive impact on the society. Unfortunately, in Pakistan today not all men enjoy the rights and facilities to which they are entitled and women are doubly disadvantaged by poverty and gender. With their own political agendas, various governments have promulgated laws which affect the society in various ways. The laws which directly influence women's rights merit mention, as women comprise more than 50% of the population of Pakistan and are still kept on the sidelines by the male dominant society. The Muslim Family Law Ordinance, 1961, and the Hudood Ordinance, 1979 were both promulgated by military dictators with different visions. The former codified the rights of women bestowed by Islamic law; the latter repealed laws for sexual offences according to the injunctions of Islam and had a negative impact. Both laws need the assistance of forensic medicine as age estimation and medical examinations are necessary if they are to be followed in the right perspective. However, a legal need for an examination by an expert in forensic medicine is sadly lacking in both laws. This has happened due to lack of training of forensic physicians and therefore a lack of research in important areas of forensic medicine in the country. This paper examines these laws and the interaction they have with forensic medicine and proposes that the laws need revision in accordance with modern science, incorporating forensic sciences as well as the injunctions of Islam.

  14. Factors affecting contraceptive use in Pakistan.

    PubMed

    Mahmood, N; Ringheim, K

    1996-01-01

    This study postulates that contraceptive use in Pakistan is affected by the usual demographic factors as well as husband-wife communication, female autonomy, son preference, religious beliefs, and family planning service supply. Analysis is based on data obtained from the Pakistan Demographic and Health Survey of 1990-91. Findings indicate that 74% of women never talked in the past year with their husbands about family planning. Almost 60% believed that family size was "up to God." About 47% knew where to obtain contraception; only 20.4% had easy access to a source of supplies. Current use was 14% and ever use was 22.4%. Analysis is based on three basic models. Model 1 includes the control variables and son preference. Model 2 includes husband-wife communication, religious attitudes, and female autonomy. Model 3 includes the addition of family planning to model 2 variables. Urban residence increases the odds of contraceptive use considerably only in Model 1. The influence of urban residence in the other models is reduced. Husband's education is significant only in Models 1 and 2 and insignificant in Model 3 when the family planning variable is included. Increased women's age is also insignificant in Model 3. Of the supply factors in Model 3, knowledge of a source and easy access to a source were highly significant, while mass media exposure was not important. Knowledge of a source was the most important predictor. Model 3 explained 90% of use. Among urban women, lack of husband-wife communication and fatalistic beliefs reduce the log-odds of contraceptive use. For rural women, age and women's secondary education were key predictors. Findings confirm that demographic and socio-cultural factors affect contraceptive use in Pakistan. All the theorized variables exerted a strong influence on contraceptive use, which can be counteracted by improved supply and service strategies.

  15. Pakistan has unventured regions, untested plays

    SciTech Connect

    Quadri, V.N.; Quadri, S.M.J.G.

    1998-01-05

    Quantitative numerical models for integrating known geological, geophysical, and geochemical processes, including 3D basin simulation and visualization, are important innovations that are helping to reduce the cost of exploration. It is unfortunate that against this background, in Pakistan there still exist some unventured sedimentary basins and untested plays. This article discusses in some detail one of the unventured regions, the Peshawar basin, and an untested play area, the Punjab platform zone. The intermontane Peshawar basin lies immediately north of Potwar-Kohat basin, the latter the site of several oilfields. Source rocks for gas, condensate, and possibly oil exist in the Sulaiman Range located in the Punjab zone.

  16. Assessment of hydrocarbons concentration in marine fauna due to Tasman Spirit oil spill along the Clifton beach at Karachi coast.

    PubMed

    Siddiqi, Hina A; Ansari, Fayyaz A; Munshi, Alia B

    2009-01-01

    On 27 July 2003, Tasman Spirit spilled 31,000 tonnes of crude oil into the sea at the Karachi coast. This disaster badly affected the marine life (Flora and Fauna.) Present research has been proposed to ascertain the level of Polycyclic Aromatic hydrocarbons (PAHs) contamination in different fisheries including Fishes, Crustaceans; Crabs and Shrimps, Mollusks and Echinoderms along with passing time. Heavier components of crude oil such as Polycyclic Aromatic Hydrocarbons (PAHs) appear to cause most damages as these are relatively unreactive and persist in water. High concentrations of toxic PAHs were observed in all the fisheries and shellfishes caught form oil-impacted area. In this study fishes were found most contaminated than shellfishes i.e. summation operator 16 PAH = 1821.24 microg/g and summation operator 1164.34 microg/g, respectively. Naphthalene was found in the range of 0.042-602.23 microg/g. Acenaphthylene, acenaphthene, fluorene, phenanthrene and anthracene were detected in the range 0.008-80.03 microg/g, fluoranthene, pyrene, benzo(a)anthracene and chrysene 0.0008-221.32 microg/g, benzo(b) fluoranthene, benzo(k)fluoranthene and benzo(a) pyrene 0.0005-7.71 microg/g, benzo(g,h,i)perylene and indeno(1,2,3-c,d)pyrene 0.02-503.7 microg/g. Dibenzo(a,h)anthracenre was not detected in any specie. PMID:18302003

  17. Assessment of hydrocarbons concentration in marine fauna due to Tasman Spirit oil spill along the Clifton beach at Karachi coast.

    PubMed

    Siddiqi, Hina A; Ansari, Fayyaz A; Munshi, Alia B

    2009-01-01

    On 27 July 2003, Tasman Spirit spilled 31,000 tonnes of crude oil into the sea at the Karachi coast. This disaster badly affected the marine life (Flora and Fauna.) Present research has been proposed to ascertain the level of Polycyclic Aromatic hydrocarbons (PAHs) contamination in different fisheries including Fishes, Crustaceans; Crabs and Shrimps, Mollusks and Echinoderms along with passing time. Heavier components of crude oil such as Polycyclic Aromatic Hydrocarbons (PAHs) appear to cause most damages as these are relatively unreactive and persist in water. High concentrations of toxic PAHs were observed in all the fisheries and shellfishes caught form oil-impacted area. In this study fishes were found most contaminated than shellfishes i.e. summation operator 16 PAH = 1821.24 microg/g and summation operator 1164.34 microg/g, respectively. Naphthalene was found in the range of 0.042-602.23 microg/g. Acenaphthylene, acenaphthene, fluorene, phenanthrene and anthracene were detected in the range 0.008-80.03 microg/g, fluoranthene, pyrene, benzo(a)anthracene and chrysene 0.0008-221.32 microg/g, benzo(b) fluoranthene, benzo(k)fluoranthene and benzo(a) pyrene 0.0005-7.71 microg/g, benzo(g,h,i)perylene and indeno(1,2,3-c,d)pyrene 0.02-503.7 microg/g. Dibenzo(a,h)anthracenre was not detected in any specie.

  18. Haemorrhagic manifestations and utility of haematological parameters in dengue fever: a tertiary care centre experience at Karachi.

    PubMed

    Ali, Natasha; Usman, Mohammad; Syed, Naveen; Khurshid, Mohammad

    2007-01-01

    A retrospective observational study of dengue fever was performed, including 210 patients (male:female ratio 1.6:1, ages 6-74 y, mean 29.7 y) attending the Aga Khan University Hospital, Karachi from January 2001 to December 2006. All included patients proved dengue IgM antibody positive. Of these, 19 (9%) showed increased haemoglobin/haematocrit levels on admission which remained elevated in 4 (2.1%) at the time of discharge. 56 patients (26.6%) had leucopenia and neutropenia and 77.1% (161) had thrombocytopenia at the time of admission; 2.5% (5) and 16.7% (35) had deranged PT and APTT, respectively. Atypical lymphocytes were seen in 109 patients (52%). Platelet transfusion was given in 45 (22.1%) cases. The majority of patients were discharged without any adverse sequelae. The fatality rate was 3.3% (n=7) and these patients died of dengue shock syndrome, while 196 (93.3%) recovered completely. Haematological parameters are an important clue and should be tested when a patient presents with symptoms suggestive of dengue fever.

  19. Liberating the shackled half. Family planning in Pakistan.

    PubMed

    Geary, J

    1995-01-01

    Pakistan's national family planning program dates back to 1965. Despite these many years of family planning campaigns, Pakistan still has one of the highest population growth rates in the world. Only 12% of Pakistani couples currently use contraceptives, approximately the same percentage as in 1972, and the average total fertility rate per woman is 5.5 children, only 1 less than two decades ago. Average annual per capita income in Pakistan is less than US$400. Were each Pakistani woman to limit her family to just two children, effective immediately, Pakistan's population would still exceed 150 million by 2000. If fertility rates remain at current levels, however, Pakistan's population will surpass 280 million by 2020. The manner in which Islam is interpreted by some religious leaders, a broad preference for sons over daughters, early and almost universal marriage, the low status of women, traditional support for natural fertility, and poor health status are principle reasons why population growth remains high in Pakistan. Poor health and the low status of women play particularly important roles. Health conditions therefore need to be improved and women educated so that birth spacing and birth limiting at lower levels may become realities. The actions of Prime Minister Benazir Bhutto and that a woman holds her position should go far to help improve women's status in Pakistan. Well-trained health professionals are also needed to become more aware about family planning and to take the lead for change. PMID:12319515

  20. High HIV Incidence among Persons Who Inject Drugs in Pakistan: Greater Risk with Needle Sharing and Injecting Frequently among the Homeless

    PubMed Central

    Samo, Rab Nawaz; Altaf, Arshad; Agha, Ajmal; Pasha, Omrana; Rozi, Shafquat; Memon, Ashraf; Azam, Saleem; Blevins, Meridith; Vermund, Sten H.; Shah, Sharaf Ali

    2013-01-01

    Background The incidence of HIV among persons who inject drugs (PWIDU) has fallen in many nations, likely due to successes of clean needle/syringe exchange and substance abuse treatment and service programs. However in Pakistan, prevalence rates for PWID have risen dramatically. In several cities, prevalence exceeded 20% by 2009 compared to a 2003 baseline of just 0.5%. However, no cohort study of PWID has ever been conducted. Methods We enrolled a cohort of 636 HIV seronegative PWID registered with three drop-in centers that focus on risk reduction and basic social services in Karachi. Recruitment began in 2009 (March to June) and PWID were followed for two years. We measured incidence rates and risk factors associated with HIV seroconversion. Results Incidence of HIV was 12.4 per 100 person-years (95% exact Poisson confidence interval [CI]: 10.3–14.9). We followed 474 of 636 HIV seronegative persons (74.5%) for two years, an annual loss to follow-up of <13 per 100 person years. In multivariable Cox regression analysis, HIV seroconversion was associated with non-Muslim religion (Adjusted risk ratio [ARR] = 1.7, 95%CI:1.4, 2.7, p = 0.03), sharing of syringes (ARR = 2.3, 95%CI:1.5, 3.3, p<0.0001), being homeless (ARR = 1.7, 95%CI:1.1, 2.5, p = 0.009), and daily injection of drugs (ARR = 1.1, 95%CI:1.0, 1.3, p = 0.04). Conclusions Even though all members of the cohort of PWID were attending risk reduction programs, the HIV incidence rate was very high in Karachi from 2009–2011. The project budget was low, yet we were able to retain three-quarters of the population over two years. Absence of opiate substitution therapy and incomplete needle/syringe exchange coverage undermines success in HIV risk reduction. PMID:24358123

  1. Uses and abuses of biostatistics in medical research in Pakistan.

    PubMed

    Mahmood, Z

    1990-11-01

    Medical research in Pakistan has gained momentum over the past several years. However, the logical conclusions based on information and data are rarely witnessed. This could be due to the fact that medical researchers and doctors are unaware of Biostatistics, its logic, use and inferences to be obtained. Most researches are based on the pattern of works already done elsewhere. Following others blindly generates various snags. In the present study, research articles published during 1986 in the Journal of Pakistan Medical Association (JPMA) and Pakistan Journal of Medical Research (PJMR) are being reviewed with respect to use and abuse of Statistical Methods. PMID:2126809

  2. Political determinants of Health: Lessons for Pakistan

    PubMed Central

    Jooma, Rashid; Sabatinelli, Guido

    2014-01-01

    There is much concern about the capacity of the health system of Pakistan to meet its goals and obligations. Historically, the political thrust has been absent from the health policy formulation and this is reflected in the low and stagnant public allocations to health. Successive political leaderships have averred from considering healthcare is a common good rather than a market commodity and health has not been recognized as a constitutional right. Over 120 of world’s nation states have accepted health as a constitutional right but the 1973 Constitution of Pakistan does not mandate health or education as a fundamental right and the recently adopted 18th constitutional amendment missed the opportunity to extend access to primary health care as an obligation of the State. It is argued in this communication that missing from the calculations of policy formulation and agenda setting is the political benefits of providing health and other social services to underserved populations. Across the developing world, many examples are presented of governments undertaking progressive health reforms that bring services where none existed and subsequently reaping electoral benefit. The political determinant of healthcare will be realized when the political leaders of poorly performing countries can be convinced that embracing distributive policies and successfully bringing healthcare to the poor can be major factors in their re-elections. PMID:24948958

  3. Indian psychiatry and research in Pakistan

    PubMed Central

    Chaudhry, Haroon Rashid

    2010-01-01

    In Asian culture, there is much stigmatization attached on having mental health problems and seeking help from a mental health expert. It is therefore, not surprising, that this stigmatization results in the refutation of the subsistence of a psychiatric problem in an individual and his family but also produces obstruction to help-seeking desires. To get a clear picture of the existence of psychiatric issues in the population, various research projects addressing psychiatric issues in children, women, and elderly are conducted both in Pakistan and India. A significant input has been taken from research conducted in India combating disaster management. In addition, public awareness programs are organized to provide information about common psychiatric disorders in children, adults, women, and the elderly.-Furthermore, psychiatric patients and their families are educated for the management of mental heath problems related to marriage, pregnancy, birth and hazards of smoking & substance abuse in young adults. Keeping in view the similarity in cultural background, treatment models, family structure, and psychosocial factors, collaborative research studies should be encouraged leading to improvement in psychiatric care of the patients both in India and Pakistan. PMID:21836720

  4. Y-Chromosomal DNA Variation in Pakistan

    PubMed Central

    Qamar, Raheel; Ayub, Qasim; Mohyuddin, Aisha; Helgason, Agnar; Mazhar, Kehkashan; Mansoor, Atika; Zerjal, Tatiana; Tyler-Smith, Chris; Mehdi, S. Qasim

    2002-01-01

    Eighteen binary polymorphisms and 16 multiallelic, short-tandem-repeat (STR) loci from the nonrecombining portion of the human Y chromosome were typed in 718 male subjects belonging to 12 ethnic groups of Pakistan. These identified 11 stable haplogroups and 503 combination binary marker/STR haplotypes. Haplogroup frequencies were generally similar to those in neighboring geographical areas, and the Pakistani populations speaking a language isolate (the Burushos), a Dravidian language (the Brahui), or a Sino-Tibetan language (the Balti) resembled the Indo-European–speaking majority. Nevertheless, median-joining networks of haplotypes revealed considerable substructuring of Y variation within Pakistan, with many populations showing distinct clusters of haplotypes. These patterns can be accounted for by a common pool of Y lineages, with substantial isolation between populations and drift in the smaller ones. Few comparative genetic or historical data are available for most populations, but the results can be compared with oral traditions about origins. The Y data support the well-established origin of the Parsis in Iran, the suggested descent of the Hazaras from Genghis Khan’s army, and the origin of the Negroid Makrani in Africa, but do not support traditions of Tibetan, Syrian, Greek, or Jewish origins for other populations. PMID:11898125

  5. Y-chromosomal DNA variation in Pakistan.

    PubMed

    Qamar, Raheel; Ayub, Qasim; Mohyuddin, Aisha; Helgason, Agnar; Mazhar, Kehkashan; Mansoor, Atika; Zerjal, Tatiana; Tyler-Smith, Chris; Mehdi, S Qasim

    2002-05-01

    Eighteen binary polymorphisms and 16 multiallelic, short-tandem-repeat (STR) loci from the nonrecombining portion of the human Y chromosome were typed in 718 male subjects belonging to 12 ethnic groups of Pakistan. These identified 11 stable haplogroups and 503 combination binary marker/STR haplotypes. Haplogroup frequencies were generally similar to those in neighboring geographical areas, and the Pakistani populations speaking a language isolate (the Burushos), a Dravidian language (the Brahui), or a Sino-Tibetan language (the Balti) resembled the Indo-European-speaking majority. Nevertheless, median-joining networks of haplotypes revealed considerable substructuring of Y variation within Pakistan, with many populations showing distinct clusters of haplotypes. These patterns can be accounted for by a common pool of Y lineages, with substantial isolation between populations and drift in the smaller ones. Few comparative genetic or historical data are available for most populations, but the results can be compared with oral traditions about origins. The Y data support the well-established origin of the Parsis in Iran, the suggested descent of the Hazaras from Genghis Khan's army, and the origin of the Negroid Makrani in Africa, but do not support traditions of Tibetan, Syrian, Greek, or Jewish origins for other populations.

  6. Indian psychiatry and research in Pakistan.

    PubMed

    Chaudhry, Haroon Rashid

    2010-01-01

    In Asian culture, there is much stigmatization attached on having mental health problems and seeking help from a mental health expert. It is therefore, not surprising, that this stigmatization results in the refutation of the subsistence of a psychiatric problem in an individual and his family but also produces obstruction to help-seeking desires. To get a clear picture of the existence of psychiatric issues in the population, various research projects addressing psychiatric issues in children, women, and elderly are conducted both in Pakistan and India. A significant input has been taken from research conducted in India combating disaster management. In addition, public awareness programs are organized to provide information about common psychiatric disorders in children, adults, women, and the elderly.-Furthermore, psychiatric patients and their families are educated for the management of mental heath problems related to marriage, pregnancy, birth and hazards of smoking & substance abuse in young adults. Keeping in view the similarity in cultural background, treatment models, family structure, and psychosocial factors, collaborative research studies should be encouraged leading to improvement in psychiatric care of the patients both in India and Pakistan. PMID:21836720

  7. Pakistan's pattern of development and prospects.

    PubMed

    Baqui, M

    1979-01-01

    This paper analyzes past and present development experiences in Pakistan, and gives indications of possible directions for future development. Since 1969 there has been an open dissatisfaction with economic management from the government, which has resulted in a drying up of private investment. However, this drawback was partly balanced by a rapid increase in income received by Pakistanis working abroad, particularly in the Middle East. There have been slight increases in growth in agriculture, industry, and in the service sector, such as banking, insurance, and shipping. The growth of per capita income, however, is constantly offset by the acceleration in population growth, which has reached 3% a year. Literacy rate is still 19% of the total population, and basic health facilities cover only 50% of the population, while potable water supply is available to 11.2% of the rural population. Possible development directions would include the denationalization of some industries, and the creation of competition between the private and public sectors, so to improve the climate for private investment. Water availability for land irrigation should be expanded, and mineral fields better surveyed and exploited. Pakistan should develop the possibility of growing trade offered by its geographical location, improve all kinds of social services, including family planning, education, and health services, and provide the means to produce energy for all the prospected programs. PMID:12261814

  8. Hazard of NORM from phosphorite of Pakistan.

    PubMed

    Sabiha-Javied; Tufail, M; Asghar, M

    2010-04-15

    In order to investigate the radiological hazard of naturally occurring radioactive material (NORM) in phosphorite deposits of Pakistan, 26 samples of phosphorite were collected from the phosphorite mines near Abbottabad, and 20 samples of single superphosphate (SSP) fertilizer were obtained from the warehouses in Pakistan. Activity concentration in all the samples was assayed using HPGe detection system. Specific activity values of (238)U, (40)K, (226)Ra and (232)Th in the samples of phosphorite were 550+/-156 (329-845), 206+/-72 (93-362), 511+/-189 (316-830) and 52+/-17 (23-81) Bq kg(-1), respectively; and those in SSP fertilizer due to these radionuclides were 637+/-44 (596-687), 164+/-24 (113-215), 589+/-44 (521-671) and 29+/-6 (16-45) Bq kg(-1), respectively. The results were compared with that of worldwide soil. Outdoor external dose rate due to gamma rays from phosphorite was calculated to be 276+/-94 (177-441) nGy h(-1) and external dose rate in a room made of phosphorite containing material was estimated to be 706+/-243 (455-1129) nGy h(-1). The concentration of radon was measured in phosphorite mines and in the warehouses for SSP fertilizer by an active method. Protective measures have been proposed to control the pollution in the phosphorite mining and processing, and fertilizer storage areas. PMID:19963319

  9. Comments on "Consanguineous Marriages in Pakistan".

    PubMed

    Hakim, A

    1994-01-01

    Some critical comments are made on a paper entitled "Consanguineous Marriages in Pakistan." Most studies have considered early age at marriage, rural or extended family setup and low socioeconomic status when investigating the issue. The background demographic variables and behavioral aspects of consanguinity were studied only by a few, therefore a lack of data exists on pertinent social, cultural, and behavioral dynamics. In Pakistan over 60% of marriages are between first or second cousins. The highest rates of such marriages have been reported in rural areas, among individuals with low educational level, and among the poorest. However, cousin unions are also common among landowning families. In addition to socioeconomic reasons, these marriages are socially acceptable because they facilitate prenuptial negotiations and provide more compatibility between the husband and wife as well as the bride and the mother-in-law. The evidence on consanguinity and fertility is conflicting. The effect of inbreeding on fertility has been demonstrated by most studies. The effect of consanguinity on mortality is also wrought with ambiguities because of methodological flaws. Although the present authors used limited bivariate analysis, they could not account for increased fertility and mortality in consanguineous matings by examining socioeconomic differences and background demographic variables. There is a need to indicate clearly to what extent the genetic effect is responsible for the excess fertility and mortality after controlling for maternal, sociodemographic, and behavioral characteristics. The article made a contribution to elucidating the impact of cousin marriages, a well entrenched custom, on fertility, mortality, and the status of women.

  10. Pakistan's pattern of development and prospects.

    PubMed

    Baqui, M

    1979-01-01

    This paper analyzes past and present development experiences in Pakistan, and gives indications of possible directions for future development. Since 1969 there has been an open dissatisfaction with economic management from the government, which has resulted in a drying up of private investment. However, this drawback was partly balanced by a rapid increase in income received by Pakistanis working abroad, particularly in the Middle East. There have been slight increases in growth in agriculture, industry, and in the service sector, such as banking, insurance, and shipping. The growth of per capita income, however, is constantly offset by the acceleration in population growth, which has reached 3% a year. Literacy rate is still 19% of the total population, and basic health facilities cover only 50% of the population, while potable water supply is available to 11.2% of the rural population. Possible development directions would include the denationalization of some industries, and the creation of competition between the private and public sectors, so to improve the climate for private investment. Water availability for land irrigation should be expanded, and mineral fields better surveyed and exploited. Pakistan should develop the possibility of growing trade offered by its geographical location, improve all kinds of social services, including family planning, education, and health services, and provide the means to produce energy for all the prospected programs.

  11. Terrorism in Pakistan: a behavioral sciences perspective.

    PubMed

    Nizami, Asad Tamizuddin; Rana, Mowadat Hussain; Hassan, Tariq Mahmood; Minhas, Fareed Aslam

    2014-01-01

    This article reviews the behavioral science perspectives of terrorism in Pakistan. It can be argued that Pakistan has gained worldwide attention for "terrorism" and its role in the "war against terrorism". The region is well placed geopolitically for economic successes but has been plagued by terrorism in various shapes and forms. A behavioral sciences perspective of terrorism is an attempt to explain it in this part of the world as a complex interplay of historical, geopolitical, anthropological and psychosocial factors and forces. Drawing from theories by Western scholars to explain the behavioral and cognitive underpinnings of a terrorist mind, the authors highlight the peculiarities of similar operatives at individual and group levels. Thorny issues related to the ethical and human right dimensions of the topic are visited from the unique perspective of a society challenged by schisms and divergence of opinions at individual, family, and community levels. The authors have attempted to minimize the political descriptions, although this cannot be avoided entirely, because of the nature of terrorism.

  12. Priorities for toxic wastewater management in Pakistan

    SciTech Connect

    Rahman, A.

    1996-12-31

    This study assesses the number of industries in Pakistan, the total discharge of wastewater, the biological oxygen demand (BOD) load, and the toxicity of the wastewater. The industrial sector is a major contributor to water pollution, with high levels of BOD, heavy metals, and toxic compounds. Only 30 industries have installed water pollution control equipment, and most are working at a very low operational level. Priority industrial sectors for pollution control are medium- to large-scale textile industries and small-scale tanneries and electroplating industries. Each day the textile industries discharge about 85,000 m{sup 3} of wastewater with a high BOD, while the electroplating industries discharge about 23,000 m{sup 3} of highly toxic and hazardous wastewater. Various in-plant modifications can reduce wastewater discharges. Economic incentives, like tax rebates, subsidies, and soft loans, could be an option for motivating medium- to large-scale industries to control water pollution. Central treatment plants may be constructed for treating wastewater generated by small-scale industries. The estimated costs for the treatment of textile and electroplating wastewater are given. The legislative structure in Pakistan is insufficient for control of industrial pollution; not only do existing laws need revision, but more laws and regulations are needed to improve the state of affairs, and enforcement agencies need to be strengthened. 15 refs., 1 fig., 9 tabs.

  13. Hydrology of mountainous areas in the upper Indus Basin, Northern Pakistan with the perspective of climate change.

    PubMed

    Ahmad, Zulfiqar; Hafeez, Mohsin; Ahmad, Iftikhar

    2012-09-01

    Mountainous areas in the northern Pakistan are blessed by numerous rivers that have great potential in water resources and hydropower production. Many of these rivers are unexploited for their water resource potential. If the potential of these rivers are explored, hydropower production and water supplies in these areas may be improved. The Indus is the main river originating from mountainous area of the Himalayas of Baltistan, Pakistan in which most of the smaller streams drain. In this paper, the hydrology of the mountainous areas in northern Pakistan is studied to estimate flow pattern, long-term trend in river flows, characteristics of the watersheds, and variability in flow and water resource due to impact of climate change. Eight watersheds including Gilgit, Hunza, Shigar, Shyok, Astore, Jhelum, Swat, and Chitral, Pakistan have been studied from 1960 to 2005 to monitor hydrological changes in relation to variability in precipitation, temperature and mean monthly flows, trend of snow melt runoff, analysis of daily hydrographs, water yield and runoff relationship, and flow duration curves. Precipitation from ten meteorological stations in mountainous area of northern Pakistan showed variability in the winter and summer rains and did not indicate a uniform distribution of rains. Review of mean monthly temperature of ten stations suggested that the Upper Indus Basin can be categorized into three hydrological regimes, i.e., high-altitude catchments with large glacierized parts, middle-altitude catchments south of Karakoram, and foothill catchments. Analysis of daily runoff data (1960-2005) of eight watersheds indicated nearly a uniform pattern with much of the runoff in summer (June-August). Impact of climate change on long-term recorded annual runoff of eight watersheds showed fair water flows at the Hunza and Jhelum Rivers while rest of the rivers indicated increased trends in runoff volumes. The study of the water yield availability indicated a minimum trend in

  14. Pattern of fall injuries in Pakistan: the Pakistan National Emergency Department Surveillance (Pak-NEDS) study

    PubMed Central

    2015-01-01

    Background We aimed to analyse the frequency and patterns of fall-related injuries presenting to the emergency departments (EDs) across Pakistan. Methods Pakistan National Emergency Departments surveillance system collected data from November 2010 to March 2011 on a 24/7 basis using a standardized tool in seven major EDs (five public and two private hospitals) in six major cities of Pakistan. For all patients presenting with fall-related injuries, we analysed data by intent with focus on unintentional falls. Simple frequencies were run for basic patient demographics, mechanism of falls, outcomes of fall injuries, mode of arrival to ED, investigations, and procedures with outcomes. Results There were 3335 fall-related injuries. In cases where intent was available, two-thirds (n = 1186, 65.3%) of fall injuries were unintentional. Among unintentional fall patients presenting to EDs, the majority (76.9%) were males and between 15-44 years of age (69%). The majority of the unintentional falls (n = 671, 56.6%) were due to slipping, followed by fall from height (n = 338, 28.5%). About two-thirds (n = 675, 66.6%) of fall injuries involved extremities, followed by head/neck (n = 257, 25.4%) and face (n = 99, 9.8%). Most of the patients were discharged from the hospital (n = 1059, 89.3%). There were 17 (1.3%) deaths among unintentional fall cases. Conclusion Falls are an important cause of injury-related visits to EDs in Pakistan. Most of the fall injury patients were men and in a productive age group. Fall injuries pose a burden on the healthcare system, especially emergency services, and future studies should therefore focus on safety measures at home and in workplaces to reduce this burden. PMID:26691821

  15. Emigration dynamics from and within South Asia.

    PubMed

    Shah, N M

    1995-01-01

    This review of current knowledge about emigration dynamics from and within South Asia (Bangladesh, India, Pakistan, and Sri Lanka) opens with a brief history of the three phases of emigration from the area since the 1830s (plantation labor; postindependence to the UK, US, Canada, and Australia; and labor migration to the oil-exporting countries). The influence of the creation of Pakistan and Bangladesh is also covered as are British colonial and commonwealth policies. It is noted that migration data are incomplete and that India exhibits an ambivalence about collecting such information. The discussion then turns to emigration since 1970 and considers permanent migration from South Asia to the traditional receivers; South Asian asylum seekers in Europe; South Asian refugees, illegal migrants, migrant workers (flows and destinations), the stock of contract migrant workers (and their characteristics); returnee migrant workers; and skill levels. Analysis is provided of macro level determinants of emigrations such as gross national product (level and growth), the general demographic and social situation, labor force growth and structure, poverty and inequality, and internal and international migration. Environmental factors causing displacement in Southern Asia include floods, cyclones, river bank erosion, drought, and desertification. Global warming could displace millions of people in the region, and development projects have contributed to displacement. The remainder of the report covers political and ethnic factors, micro-factors influencing migration decision-making, the policies of sending and receiving countries, the consequences of emigration, and the potential for migration in the future.

  16. Predicting impacts of climate change on medicinal asclepiads of Pakistan using Maxent modeling

    NASA Astrophysics Data System (ADS)

    Khanum, Rizwana; Mumtaz, A. S.; Kumar, Sunil

    2013-05-01

    Maximum entropy (Maxent) modeling was used to predict the potential climatic niches of three medicinally important Asclepiad species: Pentatropis spiralis, Tylophora hirsuta, and Vincetoxicum arnottianum. All three species are members of the Asclepiad plant family, yet they differ in ecological requirements, biogeographic importance, and conservation value. Occurrence data were collected from herbarium specimens held in major herbaria of Pakistan and two years (2010 and 2011) of field surveys. The Maxent model performed better than random for the three species with an average test AUC value of 0.74 for P. spiralis, 0.84 for V. arnottianum, and 0.59 for T. hirsuta. Under the future climate change scenario, the Maxent model predicted habitat gains for P. spiralis in southern Punjab and Balochistan, and loss of habitat in south-eastern Sindh. Vincetoxicum arnottianum as well as T. hirsuta would gain habitat in upper Peaks of northern parts of Pakistan. T. hirsuta is predicted to lose most of the habitats in northern Punjab and in parches from lower peaks of Galliat, Zhob, Qalat etc. The predictive modeling approach presented here may be applied to other rare Asclepiad species, especially those under constant extinction threat.

  17. Seismic safety assessment of unreinforced masonry low-rise buildings in Pakistan and its neighbourhood

    NASA Astrophysics Data System (ADS)

    Korkmaz, K. A.

    2009-06-01

    Pakistan and neighbourhood experience numerous earthquakes, most of which result in damaged or collapsed buildings and loss of life that also affect the economy adversely. On 29 October, 2008, an earthquake of magnitude 6.5 occurred in Ziarat, Quetta Region, Pakistan which was followed by more than 400 aftershocks. Many villages were completely destroyed and more than 200 people died. The previous major earthquake was in 2005, known as the South Asian earthquake (Mw=7.6) occurred in Kashmir, where 80 000 people died. Inadequate building stock is to be blamed for the degree of disaster, as the majority of the buildings in the region are unreinforced masonry low-rise buildings. In this study, seismic vulnerability of regionally common unreinforced masonry low-rise buildings was investigated using probabilistic based seismic safety assessment. The results of the study showed that unreinforced masonry low-rise buildings display higher displacements and shear force. Probability of damage due to higher displacements and shear forces can be directly related to damage or collapse.

  18. The challenges of injuries and trauma in Pakistan: an opportunity for concerted action.

    PubMed

    Hyder, A A; Razzak, J A

    2013-08-01

    Injuries and trauma are a major cause of mortality and morbidity in low and middle income countries (LMICs). In Pakistan, a low income South Asian developing country, they are among the top ten contributors to disease burden and causes of disabilities, with the majority of the burden falling on younger people in the population. This burden of injuries comes with a high social and economic cost. Several distal and proximal determinants, such as poverty, political instability, frequent natural disasters, and the lack of legislation and enforcement of preventive measures, make the Pakistani population susceptible to injuries. Historically, there has been a low level of investment in the prevention of injuries in Pakistan. Data is limited and while a public sector surveillance project has been initiated in one major urban centre, the major sources of information on injuries have been police and hospital records. Given the cost-effectiveness of injury prevention programs and their success in other LMICs, it is essential that the public sector invest in injury prevention through improving national policies and creating a strong evidence-based strategy while collaborating with the private sector to promote injury prevention and mobilizing people to engage in these programs. PMID:23489711

  19. "Social marketing" for early neonatal care: saving newborn lives in Pakistan.

    PubMed

    Ejaz, Iram; Shaikh, Babar Tasneem

    2010-01-01

    According to the World Health Organization and the United Nations Children's Fund, developing countries carry a large share of neonatal mortality in the world. According to UNICEF, almost 450 newborn children die every hour, mostly from preventable causes. Restricted access to quality and hygienic delivery services and limited knowledge about handling the newborn aggravate the situation. South Asia, and Pakistan in particular, have reduced their child and infant mortality during the last decade; however, neonatal mortality still remains unacceptably high. There are multiple reasons, mainly related to practices and behaviours of communities and traditional birth attendants. Rural and poor populations suffer most in Pakistan, where three out of five deliveries still occur at home. Traditional community practices and conservative norms drastically affect neonatal health outcomes. Preventing sepsis at the umbilical cord, keeping the baby at the correct temperature after birth and early initiation of exclusive breastfeeding are three simple strategies or messages that need to be disseminated widely to prevent many neonatal mortalities and morbidities. Since inappropriate practices in handling newborns are directly linked with persistent and unremitting behaviours among health providers and the community at large, we suggest doing robust "social marketing" for saving newborn lives. The objective of the paper is to present a social-marketing strategy and a marketing mix that will help address and surmount actual barriers and promote alternative behaviours in early neonatal care.

  20. Preliminary Efficacy of a Behavioral Parent Training Program for Children With ADHD in Pakistan.

    PubMed

    Malik, Tamkeen Ashraf; Rooney, Mary; Chronis-Tuscano, Andrea; Tariq, Naeem

    2014-03-12

    Objective: In an effort to address the lack of evidence-based interventions for ADHD in developing South Asian countries, we examined the preliminary efficacy of a behavioral parent training program in Pakistan. Method: A quasi-experimental design was utilized. Eighty-five 4- to 12-year-old children with clinically significant ADHD symptoms participated: 55 were recruited from hospital clinics (active treatment group) and 30 were recruited from schools (waitlist control group). Parent and teacher ratings of ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms and impairment were collected. Results: Using intent-to-treat analyses, the treatment group showed significant pre-post improvement on parent-reported ODD symptoms and ADHD-related impairment. Teacher ratings showed no improvement. Conclusion: This study provides preliminary evidence for the feasibility and effectiveness of behavioral parenting training for children with ADHD in Pakistan and represents a critical first step in identifying evidence-based treatments for Pakistani children with ADHD. PMID:24621459

  1. A descriptive profile of β-thalassaemia mutations in India, Pakistan and Sri Lanka.

    PubMed

    Black, M L; Sinha, S; Agarwal, S; Colah, R; Das, R; Bellgard, M; Bittles, A H

    2010-09-01

    Thalassaemia is a common and debilitating autosomal recessive disorder affecting many populations in South Asia. To date, efforts to create a regional profile of β-thalassaemia mutations have largely concentrated on the populations of India. The present study updates and expands an earlier profile of β-thalassaemia mutations in India, and incorporates comparable data from Pakistan and Sri Lanka. Despite limited data availability, clear patterns of historical and cultural population movements were observed relating to major β-thalassaemia mutations. The current regional mutation profiles of β-thalassaemia have been influenced by historical migrations into and from the Indian sub-continent, by the development and effects of Hindu, Buddhist, Muslim and Sikh religious traditions, and by the major mid-twentieth century population translocations that followed the Partition of India in 1947. Given the resultant genetic complexity revealed by the populations of India, Pakistan and Sri Lanka, to ensure optimum diagnostic efficiency and the delivery of appropriate care, it is important that screening and counselling programmes for β-thalassaemia mutations recognise the underlying patterns of population sub-division throughout the region. PMID:22460247

  2. The challenges of injuries and trauma in Pakistan: an opportunity for concerted action.

    PubMed

    Hyder, A A; Razzak, J A

    2013-08-01

    Injuries and trauma are a major cause of mortality and morbidity in low and middle income countries (LMICs). In Pakistan, a low income South Asian developing country, they are among the top ten contributors to disease burden and causes of disabilities, with the majority of the burden falling on younger people in the population. This burden of injuries comes with a high social and economic cost. Several distal and proximal determinants, such as poverty, political instability, frequent natural disasters, and the lack of legislation and enforcement of preventive measures, make the Pakistani population susceptible to injuries. Historically, there has been a low level of investment in the prevention of injuries in Pakistan. Data is limited and while a public sector surveillance project has been initiated in one major urban centre, the major sources of information on injuries have been police and hospital records. Given the cost-effectiveness of injury prevention programs and their success in other LMICs, it is essential that the public sector invest in injury prevention through improving national policies and creating a strong evidence-based strategy while collaborating with the private sector to promote injury prevention and mobilizing people to engage in these programs.

  3. Mini Review: Prevalence and correlates of vitamin D deficiency-perspectives from Pakistan.

    PubMed

    Akhtar, Saeed

    2016-07-01

    Health outcomes of vitamin D deficiency (VDD) are beyond rickets, osteomalacia, osteoporosis, falls and fractures and have now touched the boundaries of CVD, diabetes and many types of cancer. Therefore, thinking of mere dependence on the sun to meet vitamin D requirements under the existing set of conditions is erroneous. Pakistan as a developing economy of South Asia and a region spanning latitude 24° 35' North and longitude 61° East to 78° East, gravely suffers from increased VDD among pregnant women, neonates, infants, children, adolescents, adults, and the elderly people despite its abundant sunshine. Multiple indicators inflating VDD have been widely reported such as food habits, sociocultural and religious taboos, restricted sun exposure, unavailability of fortified diets, age, season, gender, lack of vitamin D supplementation, skin pigmentation and genetic factors. Strategies entailing mandatory food fortification, pragmatic implementation of vitamin D supplementation program, developing awareness on health damaging effects of the syndrome and sagacious sun exposure in tandem with global support to incline the government, program managers and consumers, need to be followed. Concerted efforts are further required to scale up the surveillance and monitoring of the magnitude of VDD by taking NGOs, industry, academia and health sector into loop to devise remedies for VDD in Pakistan. PMID:27393445

  4. "Social marketing" for early neonatal care: saving newborn lives in Pakistan.

    PubMed

    Ejaz, Iram; Shaikh, Babar Tasneem

    2010-01-01

    According to the World Health Organization and the United Nations Children's Fund, developing countries carry a large share of neonatal mortality in the world. According to UNICEF, almost 450 newborn children die every hour, mostly from preventable causes. Restricted access to quality and hygienic delivery services and limited knowledge about handling the newborn aggravate the situation. South Asia, and Pakistan in particular, have reduced their child and infant mortality during the last decade; however, neonatal mortality still remains unacceptably high. There are multiple reasons, mainly related to practices and behaviours of communities and traditional birth attendants. Rural and poor populations suffer most in Pakistan, where three out of five deliveries still occur at home. Traditional community practices and conservative norms drastically affect neonatal health outcomes. Preventing sepsis at the umbilical cord, keeping the baby at the correct temperature after birth and early initiation of exclusive breastfeeding are three simple strategies or messages that need to be disseminated widely to prevent many neonatal mortalities and morbidities. Since inappropriate practices in handling newborns are directly linked with persistent and unremitting behaviours among health providers and the community at large, we suggest doing robust "social marketing" for saving newborn lives. The objective of the paper is to present a social-marketing strategy and a marketing mix that will help address and surmount actual barriers and promote alternative behaviours in early neonatal care. PMID:20357556

  5. Mini Review: Prevalence and correlates of vitamin D deficiency-perspectives from Pakistan.

    PubMed

    Akhtar, Saeed

    2016-07-01

    Health outcomes of vitamin D deficiency (VDD) are beyond rickets, osteomalacia, osteoporosis, falls and fractures and have now touched the boundaries of CVD, diabetes and many types of cancer. Therefore, thinking of mere dependence on the sun to meet vitamin D requirements under the existing set of conditions is erroneous. Pakistan as a developing economy of South Asia and a region spanning latitude 24° 35' North and longitude 61° East to 78° East, gravely suffers from increased VDD among pregnant women, neonates, infants, children, adolescents, adults, and the elderly people despite its abundant sunshine. Multiple indicators inflating VDD have been widely reported such as food habits, sociocultural and religious taboos, restricted sun exposure, unavailability of fortified diets, age, season, gender, lack of vitamin D supplementation, skin pigmentation and genetic factors. Strategies entailing mandatory food fortification, pragmatic implementation of vitamin D supplementation program, developing awareness on health damaging effects of the syndrome and sagacious sun exposure in tandem with global support to incline the government, program managers and consumers, need to be followed. Concerted efforts are further required to scale up the surveillance and monitoring of the magnitude of VDD by taking NGOs, industry, academia and health sector into loop to devise remedies for VDD in Pakistan.

  6. Understanding gendered influences on women's reproductive health in Pakistan: moving beyond the autonomy paradigm.

    PubMed

    Mumtaz, Zubia; Salway, Sarah

    2009-04-01

    Recent research and policy discourse commonly view the limited autonomy of women in developing countries as a key barrier to improvements in their reproductive health. Rarely, however, is the notion of women's autonomy interrogated for its conceptual adequacy or usefulness for understanding the determinants of women's reproductive health, effective policy formulation or program design. Using ethnographic data from 2001, including social mapping exercises, observation of daily life, interviews, case studies and focus group discussions, this paper draws attention to the incongruities between the concept of women's autonomy and the gendered social, cultural, economic and political realities of women's lives in rural Punjab, Pakistan. These inadequacies include: the concept's undue emphasis on women's independent, autonomous action; a lack of attention to men and masculinities; a disregard for the multi-sited constitution of gender relations and gender inequality; an erroneous assumption that uptake of reproductive health services is an indicator of autonomy; and a failure to explore the interplay of other axes of disadvantage such as caste, class or socio-economic position. This paper calls for alternative, more nuanced, theoretical approaches for conceptualizing gender inequalities in order to enhance our understanding of women's reproductive wellbeing in Pakistan. The extent to which our arguments may be relevant to the wider South Asian context, and women's lives in other parts of the world, is also discussed.

  7. Child Labor in Pakistan: A Study of the Lahore Area.

    ERIC Educational Resources Information Center

    Ahmed, Mian Aftab

    1991-01-01

    Child labor is exceptionally extensive in Pakistan. An interview survey in the Lahore area documented the magnitude, causes, and effects of child labor. Steps for fighting this problem are recommended. (BC)

  8. Monitoring spatio-temporal aerosol patterns over Pakistan based on MODIS, TOMS and MISR satellite data and a HYSPLIT model

    NASA Astrophysics Data System (ADS)

    Alam, Khan; Qureshi, Salman; Blaschke, Thomas

    2011-09-01

    Three different satellite-borne sensors, namely the Total Ozone Mapping Spectrometer (TOMS), the Moderate Resolution Imaging Spectroradiometer (MODIS), and the Multi-angle Imaging Spectroradiometer (MISR), were used to investigate the spatial and temporal variations of aerosols over several cities in Pakistan. A Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model was used for trajectory analysis in order to reconstruct the origins of air masses and understand the spatio-temporal variability of aerosol concentrations. Recent MODIS aerosol data (2002-2008) and earlier TOMS data (1979-2001) revealed increasing concentrations of aerosols over Pakistan and adjacent areas. Validation of MODIS and MISR derived aerosol optical depths (AODs) with Aerosol Robotic Network (AERONET) data for 2007 demonstrated that the MISR data was more accurate when close to the ocean, while the MODIS was more accurate over vegetated areas. The relationship between MODIS and MISR AOD data from 2002 to 2008 was analyzed, revealing a strong correlation between the two datasets. An assessment of seasonal variability in AOD for industrial, urban, semi-urban, rural, and semi-arid areas revealed maximum AOD values during the summer over all the areas investigated. Back trajectory analyses indicated that while winter air masses reaching Pakistan had travelled long distances, summer air masses had travelled only short distances. The higher aerosol concentrations during the summer are interpreted to be a result of the air masses spending more time over land during the summer than they do during the winter. While monsoonal rainfall tends to reduce aerosol concentrations by washing aerosols out of the atmosphere, this effect is mainly restricted to the eastern and south-eastern parts of Pakistan.

  9. A statistical downscaling model for summer rainfall over Pakistan

    NASA Astrophysics Data System (ADS)

    Kazmi, Dildar Hussain; Li, Jianping; Ruan, Chengqing; Zhao, Sen; Li, Yanjie

    2016-10-01

    A statistical approach is utilized to construct an interannual model for summer (July-August) rainfall over the western parts of South Asian Monsoon. Observed monthly rainfall data for selected stations of Pakistan for the last 55 years (1960-2014) is taken as predictand. Recommended climate indices along with the oceanic and atmospheric data on global scales, for the period April-June are employed as predictors. First 40 years data has been taken as training period and the rest as validation period. Cross-validation stepwise regression approach adopted to select the robust predictors. Upper tropospheric zonal wind at 200 hPa over the northeastern Atlantic is finally selected as the best predictor for interannual model. Besides, the next possible candidate `geopotential height at upper troposphere' is taken as the indirect predictor for being a source of energy transportation from core region (northeast Atlantic/western Europe) to the study area. The model performed well for both the training as well as validation period with correlation coefficient of 0.71 and tolerable root mean square errors. Cross-validation of the model has been processed by incorporating JRA-55 data for potential predictors in addition to NCEP and fragmentation of study period to five non-overlapping test samples. Subsequently, to verify the outcome of the model on physical grounds, observational analyses as well as the model simulations are incorporated. It is revealed that originating from the jet exit region through large vorticity gradients, zonally dominating waves may transport energy and momentum to the downstream areas of west-central Asia, that ultimately affect interannual variability of the specific rainfall. It has been detected that both the circumglobal teleconnection and Rossby wave propagation play vital roles in modulating the proposed mechanism.

  10. Structure and evolution of the northern Potwar deformed zone, Pakistan

    SciTech Connect

    Jaswal, T.M.; Lillie, R.J.; Lawrence, R.D.

    1997-02-01

    The northern Potwar deformed zone (NPDZ) is part of the active foreland fold and thrust belt of the Salt Range and Potwar Plateau in northern Pakistan. About 500 km of seismic reflection profiles are integrated with surface geologic and drilling data to examine the deformation style and structure of the NPDZ with particular emphasis on history of deformation of the Dhurnal oil field. The seismic lines suggest that the overall structure of the eastern NPDZ is a duplex structure developed beneath a passive roof thrust. The roof thrust is generated from a tipline in the Miocene Murree Formation, and the sole thrust is initiated from the same Eocambrian evaporate zone that extends 80 km southward beneath the Soan syncline and Salt Range. The Dhurnal oil field structure is a pop-up at the southern margin of the NPDZ, and developed beneath the passive roof thrust. The passive roof thrust crops out just north of Dhurnal on the steep, northern limb of the Soan syncline. An overstep passive roof thrust (Sakhwal fault) is interpreted west of Dhurnal; this fault developed due to southward progression of the deformation front beneath the earlier passive roof thrust. Very gentle basement dip and almost zero topographic slope in the NPDZ suggest that the Eocambrian salt provides effective decoupling at the present position of the NPDZ. The strong deformation in the NPDZ appears to have developed farther north, in an area where the evaporates may be lacking. Since 2 Ma, the NPDZ moved farther south over the evaporates without further deformation, whereas erosion removed any former topographic slope. Restoring a balanced cross section suggests that the minimum shortening across the NPDZ is more than 55 km. Assuming that this shortening occurred between 5.1 and 2 Ma, the shortening rate is about 18 mm/yr.

  11. 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

  12. Diseases caused by Ganoderma spp. on perennial crops in Pakistan.

    PubMed

    Nasir, Nasreen

    2005-01-01

    Ganoderma applanatum (Pres. Wallr) Pat. and G. lucidum (Leyss. ex Fr.) Karst attack species of Pinus, Dalbergia, Artocarpus, Morus, Cedrus, Melia, Quercus, Populus and other trees in Pakistan causing stem, butt and root rot diseases. A research institution to manage the diseases of perennial crops in general and of trees yielding edible oil in particular such as coconut and oil palm needs to be established in Pakistan.

  13. Comments on "Determinants of Aggregate Fertility in Pakistan".

    PubMed

    Greene, M E

    1986-01-01

    Puzzling to demographic researchers has been Pakistan's continuing high fertility, despite a strong family planning component to development efforts. Soomro's paper attempts to assess whether the dynamics of demand and supply versus costs are crucial determinants of aggregate fertility in Pakistan. The author assumes that the presence of family planning clinics in Pakistan makes the costs of fertility regulation negligible. However, this assumption ignores the social and psychological costs of fertility regulation. Given the fact that childbearing is a major source of status for women in Pakistan, the practice of contraception may involve considerable costs in terms of the marital relationship and one's position in the extended family. Modifications in the status of women and the value of children are necessary before there will be a significant fertility decline in Pakistan. In both urban and rural areas, age at marriage is positively related to the level of schooling and female labor force participation. However, a policy aimed at raising the age at marriage in Pakistan is unlikely to have a significant impact until the fundamental social conditions that produce low female status are addressed.

  14. Progress in the Gondwanan Carboniferous-Permian palynology and correlation of the Nilawahan Group of the Salt Range, Pakistan: A brief review

    NASA Astrophysics Data System (ADS)

    Jan, Irfan U.

    2014-02-01

    This paper comprises of two sections. The first section describes challenges in the Carboniferous-Permian Gondwanan stratigraphic palynology, and progress in techniques such as presence of the `rare-marine intervals', and `radiometric dating' in some Gondwanan successions, e.g., South Africa, Australia and South America, as tools to confidently calibrate these palynozones. The second section describes developments in the palynological work on the Carboniferous-Permian Nilawahan Group of the Salt Range, Pakistan, and summarises their correlation with the coeval succession of the Gondwana continents and with the Russian/International stages.

  15. 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

  16. Chewing of betel, areca and tobacco: perceptions and knowledge regarding their role in head and neck cancers in an urban squatter settlement in Pakistan.

    PubMed

    Khawaja, Muhammad RizwanulHaq; Mazahir, Samia; Majeed, Atif; Malik, Farida; Merchant, Kanwal AliRaza; Maqsood, Maria; Malik, Rabia; Ghaffar, Shehzad; Fatmi, Zafar

    2006-01-01

    The link of betel, areca and chewable tobacco with head and neck cancers is clearly established. Fifty eight percent of the global head and neck cancers occur in South and Southeast Asia, where chewing of betel, areca and tobacco are common. This study was carried out to establish the pattern of use of Paan, Chaalia, Gutka, Niswar, Tumbaku and Naas among population of squatter settlement of Karachi and to determine the perceptions and knowledge regarding their role in the etiology of head and neck cancers. It was a cross-sectional study, performed at Bilal colony in Karachi. Through systematic sampling, 425 subjects [a male and female from a household] were interviewed with a structured questionnaire. Knowledge regarding etiology of head and neck cancers was classified in ordinals of "good", "some" and "poor", for each substance separately, while practices were classified into "daily user", "occasional user" and "never user". About 40% of the participants were chewing at least one item [betel, areca or tobacco products] on daily basis. This prevalence was 2.46 times higher among males than females and 1.39 times higher among adolescents than adults. At least 79% of the participants were classified as having poor knowledge about the carcinogenicity of each of these items. Knowledge increased with age and level of education. Health hazards of these items were poorly recognized and about 20% perceived at least one of these items to be beneficial. Positive attitudes were seen regarding the steps to curb the production, business and consumption of these substances. In conclusion, prevalence of chewing of betel, areca and tobacco among adults and adolescents is high. Deficiency in knowledge and wrong perception of favorable effect of chewing products is common. Besides curtailing the availability of chewing products, correct knowledge regarding its ill-effects should be inculcated among population to decrease the burden of head and neck cancers.

  17. AID seeks proposals for Pakistan's CSM project.

    PubMed

    1985-01-01

    The US Agency for International Development (AID) has prepared a request for proposals (RFP) for an international contractor to provide technical advice to Pakistan's projected contraceptive social marketing program. Sales of both condoms and a low-dose oral contraceptive were planned for 1986. At this point, however, the social marketing project's implementation remains in doubt as a result of internal government opposition. The government had hoped to implement the project without an outside contractor, but this proved infeasible. The RFP prepared by USAID outlines a 4-year involvement for a resident advisor. Funds will come from a 5-year US$20 million contract signed in 1984 by USAID and the Pakistani government. USAID remains optimistic that the project will continue, despite this delay, and is proceeding to procure commodities. PMID:12267251

  18. Rural women and power in Pakistan.

    PubMed

    Lee, M B; Hezekiah, J; Watters, D

    1995-01-01

    Perceptions of power in women living in rural villages in Pakistan were explored. The Lee-Hezekiah Power Perception Scale was developed by the authors to measure women's perception of their power. The instrument was administered in interviews conducted by a group of Lady Health Visitors who were participating in a project funded by the Canadian International Development Agency. Sixty-nine women ranging in age from 20 to 65 were interviewed. One-way analysis of variance revealed that the oldest group perceived themselves to have more power than the youngest group perceived themselves to have. Stepwise multiple regression indicated that the number of male children a woman had was predictive of the amount of power she perceived herself to have. The results are discussed in relation to existing literature on women and power in developing countries. Implications for further research on women's perceptions of power and health are discussed.

  19. A Survey of Communication/Journalism Education in South Asian Universities.

    ERIC Educational Resources Information Center

    Vilanilam, John V.

    In South Asia (the land mass that includes Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan, and the island nation Sri Lanka), college-level programs in journalism and communication, which can help developing nations to promote social change and to improve societal living standards, have not progressed with media growth. The reasons for…

  20. Food poverty and its causes in Pakistan.

    PubMed

    Mahmood, S; Sheikh, K H; Mahmood, T

    1991-01-01

    Economists and a demographer analyzed data from the 1984-1985 Household and Income Expenditure Survey using the Foster and Thorbeke model to measure the poverty level in Pakistan. This model considers the minimum level of food expenditure/adult equivalent required to purchase the required daily allowance of energy intake. The analysts calculated the poverty lines to be Rs 246.00 for urban areas and Rs 149.00 for rural areas. They learned that the real poor and less poor households did not rank expenditures on food as a top priority despite deficient food intake. Thus traditional diet pattern did not differentiate the real poor from the less power, but rather lower purchasing power. They defined real poor households as those who had a negative or O relationship between income and food and less poor households as those who had a positive relationship even though the magnitude of the slope coefficient was extremely small (.024 for urban areas and .082 for rural areas). The larger the family size the more likely a household was poor and the members malnourished. This was especially true if the family size grew because of the addition of more dependents. On the other hand, the more education the head of the household and his wife the less likely the household was poor and the members malnourished. In fact, the negative effect of education on poverty and malnutrition was strongest for the wife. 2% of all urban households and 3% of all rural households ranked as real poor households. 59% and 35% respectively ranked as less poor households. Even though the difference in food poverty between extended and nuclear families was insignificant, extended families fared better than nuclear families. These findings showed that Pakistan should design its food policy to target the real poor by improving their nutritional status without forsaking that of the less poor. PMID:12285313

  1. Linking population to conservation. Special report: Pakistan.

    PubMed

    Rowley, J

    1990-01-01

    The National Conservation Strategy of Pakistan took 5 years to prepare and it was produced in close consultation with the World Conservation Union (IUCN), on whose World Conservation Strategy it is modeled. The environment has been under grave stress for the past 30 years, the ecosystem has been greatly damaged, and natural resources are being depleted at an alarming rate. Deforestation is occurring at a rate of 1'%/year in a country where forest cover is down to 5%. Desertification has affected 60% of Pakistan's land. Soil erosion threatens over 11 million hectares and waterlogging and salinity 1/2 as much. Many species of plants, animals, and fish face extinction, as river and mangrove systems are almost destroyed. Over 25% of hospital patients are ill from waterborne diseases, and 60% of infant deaths are caused by infectious and parasitic diseases. The neglect of women's development is responsible for the average family size of 6.7 children. The population is projected to double in 22 years, from 100 million to 200 million, and at the present rate it could reach 400 million by the year 2033. Although the crude death rate has dropped from over 25/1000 in 1984-86, and the infant mortality rate has fallen from 180/1000 to 106, the birth rate has hardly changed, falling only from 45 to 43/1000. In the 40 years since independence government family planning efforts have been feeble without success in reducing birth rates. Water resources are also scarce: only a 25-30% expansion in the volume of water is available in the Indus Basin. Biological solutions, farm forestry, increased water efficiency, demand-based irrigation, less wasteful and more decentralized use of energy are recommended rather than cost-intensive use of the soil. Community-based management systems, strengthened nongovernmental organization action, and a new role for women in development is emphasized.

  2. Pakistan: opening chinks in the armour.

    PubMed

    Chhabra, R

    1998-01-01

    In Pakistan, a dozen young women attended a "Girl Child Project (GCP) Supervisors Meeting" in a rural home. While this gathering hardly seems revolutionary, the young women had to take the unusual step of travelling unescorted to attend, relying on community recognition of their hard-earned status as Baiji (aunt/elder sister). Later, a effervescent leader conducted a tour of her project ward where girls do needlework, operate nursery schools, attend sewing or literacy classes, and tend a vegetable garden. At the start of her 7-year involvement with the GCP, this leader, who now inspires awe for her ability to call a public meeting, was a newly widowed mother of a baby who resented the workshops that forced her to talk to outsiders. Another role model is a leader who used the project to develop skills that landed her a full-time job as an extension worker in the National Rural Support Program. The recent arrangements for this young woman's marriage included the unprecedented agreement of her fiance to live with her widowed mother so his new bride could continue to help care for her three younger siblings. The GCP began in the early 1990s by training 500 young women who, in turn, trained others, has expanded to 10,000 girls in 200 locations, and is beginning another major expansion. While the GCP has achieved community support, it will require connections to governmental programs and nonexploitative market mechanisms in order to continue its success. This effort may be aided by the networking of the Family Planning Association of Pakistan and by the government's new educational policy that focuses on the needs of girls.

  3. Food poverty and its causes in Pakistan.

    PubMed

    Mahmood, S; Sheikh, K H; Mahmood, T

    1991-01-01

    Economists and a demographer analyzed data from the 1984-1985 Household and Income Expenditure Survey using the Foster and Thorbeke model to measure the poverty level in Pakistan. This model considers the minimum level of food expenditure/adult equivalent required to purchase the required daily allowance of energy intake. The analysts calculated the poverty lines to be Rs 246.00 for urban areas and Rs 149.00 for rural areas. They learned that the real poor and less poor households did not rank expenditures on food as a top priority despite deficient food intake. Thus traditional diet pattern did not differentiate the real poor from the less power, but rather lower purchasing power. They defined real poor households as those who had a negative or O relationship between income and food and less poor households as those who had a positive relationship even though the magnitude of the slope coefficient was extremely small (.024 for urban areas and .082 for rural areas). The larger the family size the more likely a household was poor and the members malnourished. This was especially true if the family size grew because of the addition of more dependents. On the other hand, the more education the head of the household and his wife the less likely the household was poor and the members malnourished. In fact, the negative effect of education on poverty and malnutrition was strongest for the wife. 2% of all urban households and 3% of all rural households ranked as real poor households. 59% and 35% respectively ranked as less poor households. Even though the difference in food poverty between extended and nuclear families was insignificant, extended families fared better than nuclear families. These findings showed that Pakistan should design its food policy to target the real poor by improving their nutritional status without forsaking that of the less poor.

  4. Anthracobunids from the middle eocene of India and pakistan are stem perissodactyls.

    PubMed

    Cooper, Lisa Noelle; Seiffert, Erik R; Clementz, Mark; Madar, Sandra I; Bajpai, Sunil; Hussain, S Taseer; Thewissen, J G M

    2014-01-01

    Anthracobunidae is an Eocene family of large mammals from south Asia that is commonly considered to be part of the radiation that gave rise to elephants (proboscideans) and sea cows (sirenians). We describe a new collection of anthracobunid fossils from Middle Eocene rocks of Indo-Pakistan that more than doubles the number of known anthracobunid fossils and challenges their putative relationships, instead implying that they are stem perissodactyls. Cranial, dental, and postcranial elements allow a revision of species and the recognition of a new anthracobunid genus. Analyses of stable isotopes and long bone geometry together suggest that most anthracobunids fed on land, but spent a considerable amount of time near water. This new evidence expands our understanding of stem perissodactyl diversity and sheds new light on perissodactyl origins.

  5. Anthracobunids from the Middle Eocene of India and Pakistan Are Stem Perissodactyls

    PubMed Central

    Cooper, Lisa Noelle; Seiffert, Erik R.; Clementz, Mark; Madar, Sandra I.; Bajpai, Sunil; Hussain, S. Taseer; Thewissen, J. G. M.

    2014-01-01

    Anthracobunidae is an Eocene family of large mammals from south Asia that is commonly considered to be part of the radiation that gave rise to elephants (proboscideans) and sea cows (sirenians). We describe a new collection of anthracobunid fossils from Middle Eocene rocks of Indo-Pakistan that more than doubles the number of known anthracobunid fossils and challenges their putative relationships, instead implying that they are stem perissodactyls. Cranial, dental, and postcranial elements allow a revision of species and the recognition of a new anthracobunid genus. Analyses of stable isotopes and long bone geometry together suggest that most anthracobunids fed on land, but spent a considerable amount of time near water. This new evidence expands our understanding of stem perissodactyl diversity and sheds new light on perissodactyl origins. PMID:25295875

  6. Dimensions of urban growth in Pakistan.

    PubMed

    Kiani, M F; Siyal, H B

    1991-01-01

    The nature and patterns of Pakistani urban growth and implications for the future are discussed. Specific attention is given to the effects of natural increase, in migration, and reclassification or city extension or urban growth. Development expenditures on urban population are also provided. The effects of population pressure on housing, education, health, and employment are also presented. Future growth is anticipated at 55.5 million by 2000 with a constant fertility rate; 36% are expected to live in cities. The maximum increase is expected in Karachi and the urban areas in the provinces of the Punjab and Sindh. The contribution of natural increase to urban growth is estimated at 3.36%, while internal migration is .83% and reclassification or city extension is .11%. The rural-to-urban flow contributes the highest volume to migration flows over urban-to-urban migration. Urban fertility has been stable, and other urban fertility continues to be higher than rural fertility and major urban fertility. Urban infrastructure costs 27% or by 2000 4.7% of the projected gross national products (GNP). Housing growth rates of 3.71% between 1960-80 have not kept pace with population growth of 4.4%, but the shortage of housing has declined faster in urban areas than rural areas where the shortages of housing are greater. Housing conditions in urban areas have not improved. 45% live in pucca kutcha and kutcha housing. 1.3 million housing units are needed in urban areas during 1988-93. There is overcrowding in schools and literacy remains low in rural and urban areas. 2% of the GNP during 1971-85 went to educational funding. 80% of hospital beds and physicians are located in urban areas. There is 1 doctor/1801 persons, 1 bed/610 persons, and 1 hospital/50,000 persons. Only 7% of the 19.4 million urban residents in 1983 had access to potable water, and 48% of 12.12 million people had sewerage and drainage facilities. Agricultural employment is being replaced in urban areas by

  7. 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

  8. K-means cluster analysis and seismicity partitioning for Pakistan

    NASA Astrophysics Data System (ADS)

    Rehman, Khaista; Burton, Paul W.; Weatherill, Graeme A.

    2014-07-01

    Pakistan and the western Himalaya is a region of high seismic activity located at the triple junction between the Arabian, Eurasian and Indian plates. Four devastating earthquakes have resulted in significant numbers of fatalities in Pakistan and the surrounding region in the past century (Quetta, 1935; Makran, 1945; Pattan, 1974 and the recent 2005 Kashmir earthquake). It is therefore necessary to develop an understanding of the spatial distribution of seismicity and the potential seismogenic sources across the region. This forms an important basis for the calculation of seismic hazard; a crucial input in seismic design codes needed to begin to effectively mitigate the high earthquake risk in Pakistan. The development of seismogenic source zones for seismic hazard analysis is driven by both geological and seismotectonic inputs. Despite the many developments in seismic hazard in recent decades, the manner in which seismotectonic information feeds the definition of the seismic source can, in many parts of the world including Pakistan and the surrounding regions, remain a subjective process driven primarily by expert judgment. Whilst much research is ongoing to map and characterise active faults in Pakistan, knowledge of the seismogenic properties of the active faults is still incomplete in much of the region. Consequently, seismicity, both historical and instrumental, remains a primary guide to the seismogenic sources of Pakistan. This study utilises a cluster analysis approach for the purposes of identifying spatial differences in seismicity, which can be utilised to form a basis for delineating seismogenic source regions. An effort is made to examine seismicity partitioning for Pakistan with respect to earthquake database, seismic cluster analysis and seismic partitions in a seismic hazard context. A magnitude homogenous earthquake catalogue has been compiled using various available earthquake data. The earthquake catalogue covers a time span from 1930 to 2007 and

  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. Hydrology of Himalayas Mountains through gauging of flood and Glaciers Melt historic data hydrographs over selected watersheds under changing climate, Pakistan

    NASA Astrophysics Data System (ADS)

    Ahmad, Z.

    2013-12-01

    Mountainous areas of higher altitudes in the northern Pakistan have numerous rivers of great surface runoff during the rainy months and glaciers melt seasons that play a significant role in water resources and hydro-power production. Many of these rivers are unexploited for their water resource potential. If the potential of these rivers are explored, hydro-power production and water supplies in these areas may be improved. The Indus is the mighty river in the Asian countries originating from mountainous area of the Himalayas of Baltistan, Pakistan in which most of the smaller streams and four main rivers drain. Under the larger interest of the economic development of the country, hydrology of these mountainous in northern Pakistan is studied in the perspective of climate change, which includes eight watersheds namely Gilgit, Hunza, Shigar, Shyok, Astore, Jhelum, Swat and Chitral. Available historic data from1960-2005 have been precisely utilized to study the hydrological changes with respect to variability in precipitation, temperature and mean monthly flows, trend of snow melt runoff, daily hydrographs of selected periods (1990 to 1999), water yield and runoff relationship, and flow duration curves. Precipitation from ten meteorological stations in mountainous area of northern Pakistan has not shown uniform distribution of rains but variability in the winter and summer rains is noticed. Review of mean monthly temperature of ten stations suggested that the Upper Indus Basin can be categorized into three hydrological regimes i.e., high altitude catchments with large glacierized parts, middle altitude catchments south of Karakoram, and foothill catchments. A 3-D finite element model (Feflow) has also been used for regional groundwater flow modeling of the Upper Chaj Doab in Indus Basin, Pakistan.

  11. 2D Ball-and-Socket Tectonic Rotation in a Heterogeneous Strain Field: The 2013 Mw7.7 Balochistan, Pakistan Earthquake

    NASA Astrophysics Data System (ADS)

    Barnhart, W. D.; Hayes, G. P.; Briggs, R. W.; Gold, R. D.; Bilham, R. G.

    2014-12-01

    The September 2013 Mw7.7 Balochistan strike-slip earthquake ruptured a ~200 km long segment of the curved Hoshab fault within the Makran accretionary prism - the active zone of convergence between the northward subducting Arabia plate and overriding Eurasia. The Hoshab fault ruptured bilaterally with ~10 m of mean sinistral and ~1.7 m of dip slip along the length of the rupture, quantified jointly from geodetic and seismological observations. This rupture is unusual because the fault dips ~60o towards the focus of a small circle centered in northwest Pakistan, and, despite a 30o increase in obliquity along the curving strike of the fault with respect to Arabia:Eurasia convergence, the ratio of strike and dip slip remain relatively uniform. Static friction prior to rupture was unusually weak ( <0.05) as inferred from topographic and slab profiles, and friction may have approached zero during dynamic rupture, thus permitting in part this unusual event. In this presentation, we argue that the northward dipping Hosab fault defines the northern rim of a structural unit in southeast Makran. This unit rotates - akin to a 2-D ball-and-socket joint - counter clockwise in response to India's penetration into the Eurasia plate. According to this interpretation, the mechanically weak Makran accretionary prism is subjected to a highly heterogeneous strain and deforms in response to convergence from both the Arabia and India plates. Rotation of the southeast Makran block accounts for complexity in the Chaman fault system and, in principle, reduces the seismic potential near Karachi by accommodating some slip along the southern Ornach-Nal fault. At the same time, geological indicators and along-strike fault slip profiles indicate that the Hoshab fault may also slip as a reverse fault in response to Arabia:Eurasia convergence - indicating that a single fault may accommodate multiple components of strain partitioning in a heterogeneous strain field over several seismic cycles.

  12. The usage of complementary and alternative medicine in gastrointestinal patients visiting the outpatients’ department of a large tertiary care centre-views from Pakistan

    PubMed Central

    Lail, Ghulamullah; Luck, Nasir; Tasneem, Abbas Ali; Rai, AyeshaAslam; Laeeq, Syed Mudasir; Majid, Zain

    2016-01-01

    Introduction The use of complementary and alternative medicine (CAM) has increased over the last few years, and an emergent data suggests that some CAM modalities may be helpful in addressing gastrointestinal (GI) conditions. Our aim was to find out the prevalence of such practices for GI condition amongst patients visiting an OPD of a large tertiary care centre of Karachi, Pakistan. Methods Patients visiting outpatient department of Hepatogastroenterology department at SIUT, Pakistan from March 2014 to March 2015, were included in this cross sectional study. A pre designed questionnaire was used that included the demographic data, primary disease of the patient, CAM modality used, reason for the use of CAM therapy and reasons for stopping it. Frequencies of different variables were computed using SPSS version 18. Results 906 patients were interviewed, out of which 52% (471) were males. The mean age at presentation was 39.81±12.4 years. 234 (25.8%) of the participants used one of the CAM modalities; Herbal medicine being most common one, seen in 122 (52.13%) followed by spiritual 61 (26%), and homeopathy 33 (14%). The duration of therapy was limited to six months in 161(68%), whereas 7 patients (2.9%) had prolonged duration of use of more than five years. Reasons for using CAM therapy included advice by family and friends in 66 patients (28%), personal will in 42 (17.94%), no benefit from allopathic treatment in 34 (14.5%), while high cost was the reason of use in 3(5%) of the patients. The most common reason for discontinuation of CAM was no benefit, seen in 113 patients (48.30%), followed by physician's advice in 32 (17%) patients, and side effects in 19 (8%). On the other hand 44 patients (18.80%) reported benefit from the therapy while 14 (5.9%) were still continuing with CAM modality. Among the CAM users 140 (60.09%) were un-educated or had primary education while CAM nonusers had 328 (47%) were either uneducated or had primary education only correlation

  13. Flux and accumulation of sedimentary particles off the continental slope of Pakistan: a comparison of water column and seafloor estimates from the oxygen minimum zone, NE Arabian Sea

    NASA Astrophysics Data System (ADS)

    Schulz, H.; von Rad, U.

    2013-07-01

    Due to the lack of bioturbation, the 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 near shore part of the northeastern Arabian Sea, and to explore the effects of the margin topography and the low oxygen conditions on the accumulation of organic matter and other particles. West of Karachi, in the Hab river area of EPT and WPT (Eastern and Western PAKOMIN Traps), 16 short sediment profiles from water depths between 250 m and 1970 m on a depth transect crossing the OMZ (~ 120 to ~ 1200 m water depth) were investigated, and correlated on the basis of a thick, light-gray- to reddish-colored turbidite layer. Varve counting yielded a date for this layer of AD 1905 to 1888. We adopted the young age which agrees with 210Pb- dating, and used this isochronous stratigraphic marker bed to calculate sediment accumulation rates, that we could directly compare with the flux rates from the sediment traps installed within the water column above. All traps in the area show exceptionally high, pulsed winter fluxes of up to 5000 mg m-2 d-1 in this margin environment. The lithic flux at the sea floor is as high as 4000 mg m-2 d-1 , and agrees remarkably well with the bulk winter flux of material. This holds as well for the individual bulk components (organic carbon, calcium carbonate, opal, lithic fraction). However, the high winter flux events (HFE) by their extreme mass of remobilized matter terminated the recording in the shallow traps by clogging the funnels. Based on our comparisons, we argue that HFE for the past 5000 yr most likely occurred as regular events within the upper OMZ off Pakistan. Coarse fraction and foraminiferal accumulation rates from sediment surface samples along the Hab transect show distribution patterns that seem to be a function of water depth and distance from the shelf. Some of these sediment fractions show sudden shifts at the lower boundary

  14. Molecular characterization of Ephedra species found in Pakistan.

    PubMed

    Ghafoor, S; Shah, M M; Ahmad, H; Swati, Z A; Shah, S H; Pervez, A; Farooq, U

    2007-12-11

    Ephedra, also known as "ma huang", is a dioecious, drought- and frost-resistant, perennial, evergreen shrub with compelling medicinal value. The genus is represented by 42 species around the world, 9 of which were provisionally reported from Pakistan. Species of the genus have a controversial taxonomy due to their overlapping morphological features. Conventional tools alone are not sufficient for characterizing the species. The objective of present study was to assess the genetic variability present in different biotypes of Ephedra growing in Pakistan using molecular markers. A total of six genotypes collected from diverse geographic zones of Pakistan were used. The DNA of all genotypes was amplified using nine randomly amplified polymorphic DNA (RAPD) primers to study genetic variability at the molecular level. The dissimilarity coefficient matrix based on the data of 9 RAPD primers was used to construct a dendrogram which was then used to group the genotypes in clusters. Based on the dendrogram and dissimilarity coefficient matrix, the RAPD markers used here revealed a moderate to high level of genetic polymorphism (6 to 49%) among the genotypes. It was found that the collection of genotype accessions from Swat Valley in northwestern Pakistan was most distantly related to the other five collections. More molecular markers including functional genes and ribosomal spacer regions are suggested to find a better estimate of the genetic diversity present in Ephedra growing in Pakistan. The information provided here is useful for identifying valuable Ephedra variants which will be used for medicinal purposes and earning foreign currency.

  15. Non-communicable diseases and injuries in Pakistan: strategic priorities.

    PubMed

    Jafar, Tazeen H; Haaland, Benjamin A; Rahman, Atif; Razzak, Junaid A; Bilger, Marcel; Naghavi, Mohsen; Mokdad, Ali H; Hyder, Adnan A

    2013-06-29

    Non-communicable diseases, including cardiovascular diseases, cancers, respiratory diseases, diabetes, and mental disorders, and injuries have become the major causes of morbidity and mortality in Pakistan. Tobacco use and hypertension are the leading attributable risk factors for deaths due to cardiovascular diseases, cancers, and respiratory diseases. Pakistan has the sixth highest number of people in the world with diabetes; every fourth adult is overweight or obese; cigarettes are cheap; antismoking and road safety laws are poorly enforced; and a mixed public-private health-care system provides suboptimum care. Furthermore, almost three decades of exposure to sociopolitical instability, economic uncertainty, violence, regional conflict, and dislocation have contributed to a high prevalence of mental health disorders. Projection models based on the Global Burden of Disease 2010 data suggest that there will be about 3·87 million premature deaths by 2025 from cardiovascular diseases, cancers, and chronic respiratory diseases in people aged 30-69 years in Pakistan, with serious economic consequences. Modelling of risk factor reductions also indicate that Pakistan could achieve at least a 20% reduction in the number of these deaths by 2025 by targeting of the major risk factors. We call for policy and legislative changes, and health-system interventions to target readily preventable non-communicable diseases in Pakistan. PMID:23684257

  16. 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.

  17. A Study on Extremely Dry and Wet Summer Monsoon in Pakistan by Focusing on the Anomalous States of the Upper Troposphere

    NASA Astrophysics Data System (ADS)

    Ahmad, S.; Koike, T.; Nishii, K.

    2012-04-01

    Seasonally-changes in wind pattern, monsoon, sometimes results in severe droughts and intense flooding in many parts of the world including South Asian countries like Pakistan. The livelihood of a vast population in Pakistan depends on agriculture and land use is strongly influenced by water-based ecosystems that depend on the monsoon rains. Furthermore, climate change studies undertaken so far reveal that action is essential in order to prevent long term damage to water cycle and thus of great concern to the community and stakeholders. Pakistan Summer Monsoon (PSM) is generally affected by both the disturbances from the tropical and the extratropical regions; however there is lack of understanding of physical mechanisms of PSM compared to other regional studies i.e. Indian Summer Monsoon (ISM) and South-East Asian Monsoon (SEAM). In our study, we applied heat and vorticity budgets and wave train analysis to reveal the mechanisms of the extremely dry and wet PSM events associated with the anomalous upper tropospheric circulation. We found that the extremely dry (wet) PSM events are closely related with the strengthening(weakening) of the upper-tropospheric central Asian high. We also found that in addition to Rossby-wave (Matsuno-Gill) type atmospheric response, the Rossby wave train along the Asian Jet originating from northwestern Europe or North Atlantic Ocean strengthened(weakened) the upper-tropospheric central Asian high. Therefore strong convection anomalies resulting in severe flooding (drought) events over the PSM region are induced by both the tropical and extratropical processes. Key Words: Pakistan, Extremes Monsoon Events, Physical Processes, Heat Budget, Vorticity, Wave Train

  18. Violence against Children: A Challenge for Public Health in Pakistan

    PubMed Central

    Hyder, Adnan Ali; Malik, Fauzia Aman

    2007-01-01

    World Health Organization has identified violence against children as a growing public-health issue with a global magnitude. This paper explored violence against children as a challenge in the developing world using Pakistan as a case study. A systematic review of existing research and literature on violence against children was followed by assessing the magnitude of this challenge and its impact on policy. Most research done in Pakistan is observational, descriptive, and anecdotal with data collected through survey methods and interviews with small sample sizes. The findings suggest that the confluence of macro risk factors, such as poverty, poor legal protections, illiteracy, large family size, and unemployment, create an enabling environment for violence against children. Lack of empirical data makes it difficult to assess the magnitude of this issue. The health problems reported and the extent of human potential destroyed are unknown. Conclusion calls for focused research to examine the prevalence, potential interventions, and policies in Pakistan. PMID:17985818

  19. Hepatic cystic echinococcosis: clinical characteristics and outcomes in Pakistan.

    PubMed

    Mumtaz, Khalid; Kamani, Lubna; Chawla, Tabish; Hamid, Saeed; Jafri, Wasim

    2009-10-01

    Hepatic cystic echinococcosis (HCE) is an emerging disease in central Asia, particularly in Pakistan, due to the migration of infected people. Medical records of patients with HCE admitted between 1995 and 2006 to a tertiary care hospital were reviewed. A total of 106 patients were admitted with a mean age of 34+/-17 years; 60 (56.6%) were men, 72 (67.9%) were residing in rural areas of Pakistan and 21 (19.8%) were Afghan refugees. Twenty-seven (25.4%) had extra hepatic cysts and liver cysts. All patients received albendazole. Percutaneous aspiration, instillation and reaspirarion was done in 14 (13.2%) patients and 71 (66.9%) underwent surgery. Three (2.8%) died and 14 (13.2%) had morbidity. This is one of the largest series of HCE reported from Pakistan. HCE is mostly prevalent in rural areas and among Afghan refugees with low mortality and recurrence, but with significant morbidity. PMID:19762573

  20. Statistical Analysis of Factors Affecting Child Mortality in Pakistan.

    PubMed

    Ahmed, Zoya; Kamal, Asifa; Kamal, Asma

    2016-06-01

    Child mortality is a composite indicator reflecting economic, social, environmental, healthcare services, and their delivery situation in a country. Globally, Pakistan has the third highest burden of fetal, maternal, and child mortality. Factors affecting child mortality in Pakistan are investigated by using Binary Logistic Regression Analysis. Region, education of mother, birth order, preceding birth interval (the period between the previous child birth and the index child birth), size of child at birth, and breastfeeding and family size were found to be significantly important with child mortality in Pakistan. Child mortality decreased as level of mother's education, preceding birth interval, size of child at birth, and family size increased. Child mortality was found to be significantly higher in Balochistan as compared to other regions. Child mortality was low for low birth orders. Child survival was significantly higher for children who were breastfed as compared to those who were not.

  1. Foraminiferal stratigraphy of Ranikot (Paleocene) of Pakistan

    SciTech Connect

    Kureshy, A.A.

    1983-03-01

    The sedimentary deposits of Pakistan are divided into three distinct basins: the Lower Indus basin, the Upper Indus basin, and the Baluchistan basin. The Lower Indus basin is further divided into two parts; the northern part is the Sulaiman Province, and the southern part is known as Kirthar Province. The tertiary stratigraphy of Kirthar Province is conspicuous for its characteristic lithostratigraphic units. The Paleocene deposits of Kirthar Province are designated as Ranikot Group. The Ranikot Group was divided by Cheema et al in 1977 into three distinct lithostratigraphic units: the Khadro formation (Cardita beaumonti beds), Bara formation (Lower Ranikot), and Lakhra formation (Upper Ranikot). The Khadro and Lakhra formations are marine, characterized by foraminiferal assemblages. The characteristic planktonic forms are: Globigerina triloculinoides Plummer, Globorotalia pseudobulloids (Plummer), G. compressa (Plummer), G. valascoensis (Cushman), and G. pseudomenardii Bolli. The diagnostic forms of larger foraminifera are: Nummulites nuttalli Davies, Miscellanea (d'Archiac and Haime), Kathina major Smout, and Lockartia conditii (Nuttall). The planktonic foraminifera were assigned to Globorotali trinidadensis, G. pseudomenardii, and G. velasoensis zones of Kureshy in 1977, and larger foraminifera were assigned to Nummulities nuttalli zones of Kureshy in 1978.

  2. Radiological significance of building bricks in Pakistan.

    PubMed

    Khan, K; Aslam, M; Orfi, S D; Khan, H M

    2001-01-01

    Baked clay bricks samples were collected from both urban and rural areas of the North West Frontier Province of Pakistan and natural radioactivity due to 40K, 226Ra and 232Th has been measured in these samples. The specific absorbed dose rates due to natural radioactivity emanating from the walls, floors and ceilings of the typical model rooms made of these building bricks have been calculated applying the mesh size adaptive volume integral methodology. The occupancy factor, representing the weighted average of all the population in the country, was taken to be 0.3 in this study. The values of estimated annual effective dose rates for whole body were found to be 0.38 and 0.35 mSv.y(-1) for the two types of model rooms. These values are smaller than those predicted by UNSCEAR for normal background areas. Thus the building bricks analysed in this study do not pose any significant health problem to the population.

  3. Abnormally high formation pressures, Potwar Plateau, Pakistan

    USGS Publications Warehouse

    Law, B.E.; Shah, S.H.A.; Malik, M.A.

    1998-01-01

    Abnormally high formation pressures in the Potwar Plateau of north-central Pakistan are major obstacles to oil and gas exploration. Severe drilling problems associated with high pressures have, in some cases, prevented adequate evaluation of reservoirs and significantly increased drilling costs. Previous investigations of abnormal pressure in the Potwar Plateau have only identified abnormal pressures in Neogene rocks. We have identified two distinct pressure regimes in this Himalayan foreland fold and thrust belt basin: one in Neogene rocks and another in pre-Neogene rocks. Pore pressures in Neogene rocks are as high as lithostatic and are interpreted to be due to tectonic compression and compaction disequilibrium associated with high rates of sedimentation. Pore pressure gradients in pre-Neogene rocks are generally less than those in Neogene rocks, commonly ranging from 0.5 to 0.7 psi/ft (11.3 to 15.8 kPa/m) and are most likely due to a combination of tectonic compression and hydrocarbon generation. The top of abnormally high pressure is highly variable and doesn't appear to be related to any specific lithologic seal. Consequently, attempts to predict the depth to the top of overpressure prior to drilling are precluded.

  4. Radiological implications of granite of northern Pakistan.

    PubMed

    Asghar, M; Tufail, M; Sabiha-Javied; Abid, A; Waqas, M

    2008-09-01

    Granite is an igneous rock that contains natural radioactivity of primordial radionuclides. In Pakistan, granite is distributed in a vast area called the Ambela Granitic Complex (AGC) in North West Frontier Province (NWFP). Granite is a hard rock that exists in different colours and is used to decorate floors, kitchen counter tops, etc. The use of granite in a building as a decor material is a potential source of radiation dose; therefore, natural radioactivity has been measured in 20 granite samples of the AGC with an HPGe (high purity germanium) based gamma ray spectrometer. The average specific activities and their range (given in parentheses) for primordial radionuclides (40)K, (226)Ra and (232)Th were 1218 (899-1927), 659 (46-6120) and 598 (92-3214) Bq kg(-1), respectively. The measured activity concentrations were used for the assessment of hazard indices and radiation dose which were evaluated based on the permissible limits defined for these parameters. The measured specific activities and the derived quantities, hazard indices and radiation dose, have been compared with those given in the literature for these parameters.

  5. The Tribe Scymnini (Coccinellidae: Coleoptera) From Sindh Province, Pakistan

    PubMed Central

    Ali, Muhammad; Perveen, Rukhsana; Naqvi, Arif-Un-Nisa; Ahmed, Khalil; Raza, Ghulam; Hussain, Ishtiaq

    2015-01-01

    Coccinellids are important natural enemies of aphids, scale insects, mealybugs, whiteflies, jassids and mites. They are being augmented or conserved for population reduction of different agricultural crop pests in the concept of Integrated Pest Management throughout the world. The genera and species in the tribe Scymnini known from Pakistan are revised and redescribed. Two genera including two subgenera and six species among which three species are newly reported, is therefore, a new addition to Coccinellid fauna of Pakistan. Keys to all taxa, descriptions of the higher taxa, species diagnoses, synonymies, and distribution records are included. PMID:26454480

  6. Hunza Landslide and Monsoon Flooding in Pakistan Call for International Attention to Transboundary Natural Hazards

    NASA Astrophysics Data System (ADS)

    Kargel, J. S.; Fink, W.; Furfaro, R.; Leonard, G. J.; Patterson, M.; Glims, Gaphaz

    2010-12-01

    Two major disasters in Pakistan and innumerable lesser disasters throughout the Himalaya-Karakoram region in 2010 highlight geologic events and extreme weather (perhaps climate change) in affecting the well being of whole nations and commerce and relations between nations. Two chief events in Pakistan include the Jan. 4 rockslide into the Hunza River and the subsequent formation of a natural dam lake (Lake Gojal); and the monsoon precipitation-fed flooding across the Indus Basin. The first event severed Pakistan’s major land link with China. The second event devastated Pakistan’s national land-based transportation infrastructure and agriculture and displaced millions of people. In a country plagued by monsoon-driven floods, the lack of catastrophic breakout of Lake Gojal is welcome. Satellite-based monitoring shows the spillway to be eroding more rapidly (but not alarmingly) under August’s monsoon peak flow. Similar events have occurred before in the region and will occur again. These mega-events in Pakistan should be an alert for all of South Asia, as climate change increases or shifts the hazard environment, encroaching development and urbanization increases the vulnerabilities, and as improved capacity for trans-national commerce breaks down the Himalayan barrier and both promotes new opportunities and possible conflicts. 2010's natural mega-calamities in Pakistan and widespread landsliding and flooding elsewhere in South Asia underscores the subcontinent’s need for a thorough field-, remote sensing-, and modeling-based assessment of the disaster potential related to landslides, glacier surges, extreme monsoon precipitation events, natural glacier and landslide dam lake outbursts, and unseasonal snow melting. The Himalayan-Karakoram region is remarkable for its heterogeneous responses to climate change. For instance, some areas are undergoing rapid glacier recession and stagnation; others are undergoing glacier growth. We take the instance of the

  7. Phytoecological evaluation with detail floristic appraisal of the vegetation arround Malam Jabba, Swat, Pakistan

    PubMed Central

    Rashid, Abdur; Swati, Mohammad Farooq; Sher, Hassan; Al-Yemeni, Mohammad N

    2011-01-01

    Objective To determine the present status of plant communities and their possible association with the habitat in Malam Jabba, Swat, Pakistan. Methods A study on the phytoecology was conducted in various ecologically important sites of Malam Jabba, Swat, Pakistan from 2002 to 2004. The altitude of these sites ranged from 1 200 m to 3 200 m. Quadrat method was used for evaluation of plants communities and the data on these attributes was converted to relative values. The plant communities were named after 3 leading species with highest importance values. Biological spectrum of the flora based on the life form was prepared by following Raunkiar's life form classes. Results The floristic composition and structure of the study area were found to be 200 species belonging to 75 families. Asteraceae, Lamiaceae and Poaceae were important families in the study area. The biological spectrum showed that therophytic and hemicrytophytic life form and micro-nonophyllous leaf sizes were dominant in the area. The air and soil temperatures were decreasing with increasing elevation. Both the air and soil temperatures were relatively higher in south slopes than on the northeast slopes. The vegetation analysis of the area indicated eleven plant communities around the area. The present vegetation is the relics of moist temperate coniferous forest in the area. The communities reflect highly deteriorated conditions. Both the structure and composition of the surrounding vegetation were associated with the types of habitats. Conclusions The conservation of the remaining populations of the reported communities will be best achieved by proper time of sustainable harvesting. It is only possible with the participation of local communities. PMID:23569814

  8. Comments on "Towards Balanced Development in Pakistan".

    PubMed

    Fitzgerald, E V

    1992-01-01

    Critical comment on the proposal of Professor Pyatt for balanced development in Pakistan focused on broad methodological issues. Professor Pyatt's approach proposes to balance efficiency criteria with longterm objectives of sustainable economic and human development: changing asset distribution through new investment and shifting investment returns in the social sector to households. I is a systematic attempt to compensate for deficits in human development. Policies would include "tariffisation of quota allocation of goods such as water, differential pricing to protect the poor; national conservation and polluter penalties; foreign aid shift to human maintenance expenditure; and reform of fiscal policy on income and expenditure to allow for support of social objectives." Patterns of property and institutional privilege can be effectively altered through market practices, such that wage goods could be subsidized in order to increase productivity. Constructive rethinking of assumptions underlying the balanced development argument is suggested, because of Pyatt model is contrary to the Dornbusch assumptions behind structural adjustment of the standard World Bank model. The assumption in question is that nontraditional expenditure on health, education, and the environment reduces unit labor costs. Concern is also raised about the approach to "efficiency wages" and the inputs of health and education, and food and housing, which are required to supply labor. Real wages might be conceptualized as affecting labor productivity in a more dynamic way than Professor Pyatt recognized. Use of human capital would be maximized and would be equivalent to the formation of new human capital. Wages may be construed to act like internal trade, where prices and markets are effectively interchanged so that farmers receive not only agricultural products, but also essential and nonessential consumer goods. Professor Pyatt's article is relevant to any country's development planning and

  9. Comments on "Towards Balanced Development in Pakistan".

    PubMed

    Fitzgerald, E V

    1992-01-01

    Critical comment on the proposal of Professor Pyatt for balanced development in Pakistan focused on broad methodological issues. Professor Pyatt's approach proposes to balance efficiency criteria with longterm objectives of sustainable economic and human development: changing asset distribution through new investment and shifting investment returns in the social sector to households. I is a systematic attempt to compensate for deficits in human development. Policies would include "tariffisation of quota allocation of goods such as water, differential pricing to protect the poor; national conservation and polluter penalties; foreign aid shift to human maintenance expenditure; and reform of fiscal policy on income and expenditure to allow for support of social objectives." Patterns of property and institutional privilege can be effectively altered through market practices, such that wage goods could be subsidized in order to increase productivity. Constructive rethinking of assumptions underlying the balanced development argument is suggested, because of Pyatt model is contrary to the Dornbusch assumptions behind structural adjustment of the standard World Bank model. The assumption in question is that nontraditional expenditure on health, education, and the environment reduces unit labor costs. Concern is also raised about the approach to "efficiency wages" and the inputs of health and education, and food and housing, which are required to supply labor. Real wages might be conceptualized as affecting labor productivity in a more dynamic way than Professor Pyatt recognized. Use of human capital would be maximized and would be equivalent to the formation of new human capital. Wages may be construed to act like internal trade, where prices and markets are effectively interchanged so that farmers receive not only agricultural products, but also essential and nonessential consumer goods. Professor Pyatt's article is relevant to any country's development planning and

  10. Shy / silent users of contraceptives in Pakistan.

    PubMed

    Hashmi, S S

    1996-01-01

    This study examines the hypothesis that shy, silent users of contraceptives in Pakistan underreport contraceptive usage. Data were obtained from the 1984-85 and 1994-95 Contraceptive Prevalence Surveys, the 1990-91 Demographic and Health Survey, and a Punjab 1993 survey. The data were reorganized to indicate the number of women who were fecund but did not have a birth within the preceding 5 years before the surveys. 698,864 women in 1984-85 did not have children and did not report contraceptive use, or 5.9% of total respondents. If these women were added to the contraceptive prevalence rate (CPR), it would rise from 7.6% to 13.5%. The higher CPR is consistent with the observed total fertility rate of 5.95. Shy or silent users were 11.9% in 1990-91 and 11.3% in 1994-95. The revised CPRs are 23.7% and 29.1%, respectively. In 1993, a follow-up survey among non-users in Punjab province showed that CPR increased from 13% in 1990-91 to 18% in 1993. Withdrawal was the most widely used method, followed by the condom and female sterilization. The increase in CPR is attributed to more open reporting among shy or silent users. Revised CPRs that include shy or silent users were consistent with total fertility rates in all 3 nationally representative surveys. Typically shy or silent users were older by about 2.3 years than current users, but had similarly aged husbands. Shy or silent users had longer duration of marriage, greater illiteracy, and less contraceptive knowledge about methods and sources. Shy or silent women had lower children ever born rates than current users. PMID:12294611

  11. Pakistan launches media blitz on AIDS.

    PubMed

    Lynn, W

    1994-01-01

    In March 1994, the National AIDS Prevention and Control Programme in Pakistan launched its media campaign. Staffers have had to work within Islamic principles to inform the public about the risk of HIV infection and to encourage the public to adopt behavior to prevent its transmission. The media messages are not sexually explicit. They call for Pakistanis to call a hotline for or to ask medical professionals about more detailed information on AIDS. The hotline number is memorable (123). The 2 hotlines in Islamabad receive 250-300 calls/day. These hotlines deliver a recorded message with information on the significance of condoms in AIDS prevention and allows callers an opportunity to leave a telephone number or address if they want information. Staff advise callers who are concerned that they may be infected with HIV to obtain a test at 1 of 30 sites and to attend the National Institute for Health in Islamabad for more testing and counseling if the first test is positive. The hotline system will soon expand to all other major Pakistani cities. The program receives 300-400 letters/week asking for specific information. The program had workshops for journalists as its first wave of increasing AIDS awareness. The journalists followed with thoughtful articles on AIDS. Program staff spent much energy to obtain support from Islamic leaders. More media professionals have joined efforts to disseminate information through various media forums to encourage people to seek treatment for sexually transmitted diseases. The program's goal is a 55% increase in the number of people who can name at least 2 correct ways to prevent HIV transmission and an increase in condom use from 1% to 70%. The program eventually would like to increase outreach efforts by working with nongovernmental organizations and by developing videos and short stories.

  12. Gender and livelihoods in northern Pakistan.

    PubMed

    Joekes, S

    1995-01-01

    This article reports on findings from a study in 1993-94 on women and sustainable development in Hunza and Nagar districts in the Karakorum mountains of northern Pakistan. The study aims to explore the impact of development on women's work burden and sustainable use of natural resources. Local natural resource management has been a complex system of agro-pastoralist use, with poor yields. Modernization resulted in construction of the Karakorum Highway in 1978 and the Aga Khan Support Program, which mobilized the community in irrigation and agricultural projects. Village organizations were formed as a forum for community decision making and information exchange. These changes resulted in the doubling of household income during 1983-92. Agricultural productivity increased without compromising soil fertility. Livestock herds doubled during 1976-86. The road created the opportunity for new strategies for improving income. Wholesale markets became accessible. Tourism increased, the economy diversified in ways that increased women's income and control of income, and demand for education increased. Women reported that the increased demands on workload were worth the improved standard of living. Gendered work was reallocated, and division of labor changed among women of various ages. Village councils began protecting depleted forest reserves. Men collected wood on the higher slopes, according to anthropomorphic and spiritual beliefs. Women's knowledge of the environment was greater with age and specific to the tasks performed. Men and women did not have permanently fixed gender roles. Women were not exclusive managers of the environment. Women benefited the most from technology that was in their interest and not controlled by men.

  13. South Africa

    Atmospheric Science Data Center

    2013-04-16

    article title:  Red Tide Strands South African Rock Lobsters     ... and on atmospheric and oceanic conditions. At Elands Bay in South Africa's Western Cape province, about 1000 tons of rock lobsters beached ...

  14. Dubai syndrome in Karachi.

    PubMed

    Ahmed, S H; Zainulabdin, F

    1991-01-01

    This is an attempt to study the effects of migration of earning member (to Gulf States) on the family, specially children left behind. Twenty five families who sought psychiatric help for one of their members were included. A control group (of non-migrant family) attending the out-patient's department was selected for comparison. The wife and children left behind experienced considerable emotional hardship. Twenty two families (88%) reported statistically significant recent maladjustment in 35 children (30%) as compared to control group of twelve families (48%) in 15 children (10%). Undoubtedly the major brunt is faced by the wives but the damage done to children is much less appreciated. This study identifies the current disturbance but the future effects on the personality of other children could manifest much later.

  15. A socioeconomic survey of kidney vendors in Pakistan.

    PubMed

    Naqvi, Syed Ali Anwar; Ali, Bux; Mazhar, Farida; Zafar, Mirza Naqi; Rizvi, Syed Adibul Hasan

    2007-11-01

    In recent years, Pakistan has emerged as one of the largest centres for commerce and tourism in renal transplantation. Kidney vendors belong to Punjab in eastern Pakistan, the agricultural heartland, where 34% people live below poverty line. We report results of a socioeconomic and health survey of 239 kidney vendors. The mean age was 33.6 +/- 7.2 years (M:F 3.5:1). Mean nephrectomy period was 4.8 +/- 2.3 years. Ninety per cent of the vendors were illiterate. Sixty-nine per cent were bonded labourers who were virtual slaves to landlords, labourers 12%, housewives 8.5% and unemployed 11%. Monthly income was $US15.4 +/- 8.9 with 2-11 dependents per family. Majority (93%), vended for debt repayment with mean debt of $1311.4 +/- 819. The mean agreed sale price was $1737 +/- 262. However, they received $1377 +/- 196 after deduction for hospital and travel expenses. Postvending 88% had no economic improvement in their lives and 98% reported deterioration in general health status. Future vending was encouraged by 35% to pay off debts and freedom from bondage. This study gives a snapshot of kidney vendors from Pakistan. These impoverished people, many in bondage, are examples of modern day slavery. They will remain exploited until law against bondage is implemented and new laws are introduced to ban commerce and transplant tourism in Pakistan. PMID:17645418

  16. Home Economics Curricula in Pakistan: Time for Reform?

    ERIC Educational Resources Information Center

    Saeed, Fouzia; McClelland, Jerry

    1991-01-01

    Most home economics in Pakistan focuses on women's homemaking skills (food preparation, clothing, interior design), not career orientation; it caters to upper/middle class needs and traditional roles. Rural/lower class women's needs (agricultural production, nutrition, hygiene, family planning) are not generally served. (SK)

  17. The Changing Perspective of Art Education in Pakistan

    ERIC Educational Resources Information Center

    Khan, Muhammad Sher Ali

    2014-01-01

    The development of art education in Pakistan over the last five decades is explored through three major phases: Arts as traditional crafts together with proficiency in painting and calligraphy. Such skills; somewhat existed in academies but, were then transferred through apprenticeship system. Arts in the academies; the first turning point, that…

  18. A Long-Term Investment in Pakistan: Early Childhood Education

    ERIC Educational Resources Information Center

    Hunzai, Zohra Nisar

    2006-01-01

    Despite the enormous demand for early childhood education care and education, it remains a privilege for young children in most of the world's nine high population countries, known as the E-9 group (Bangladesh, Brazil, China, Egypt, India, Indonesia, Mexico, Nigeria and Pakistan), according to a report published by UNESCO (2003). The World…

  19. Acquisition of Scientific Literature in Developing Countries. 3: Pakistan.

    ERIC Educational Resources Information Center

    Haider, Syed Jalaluddin

    1989-01-01

    Summarizes the development of science and technology in Pakistan and the existing library resources in science and technology. The organization of acquisitions work is described, including acquisitions policy, book selection, financial support, procurement of books and periodicals, import restrictions, book order work, and gifts and exchanges.…

  20. Qualitative Inquiry into Local Education Administration in Pakistan

    ERIC Educational Resources Information Center

    Komatsu, Taro

    2009-01-01

    The level of educational development in Pakistan is low. A decentralisation reform was introduced in 2000 to improve the delivery of basic education by designating the local government body with primary responsibility for administering it. A qualitative field study on local education administration at the North West Frontier Province found…

  1. Temperament Styles of Children from Pakistan and the United States

    ERIC Educational Resources Information Center

    Oakland, Thomas; Callueng, Carmelo; Rizwan, Muhammad; Aftab, Sobia

    2012-01-01

    Age, gender, and cross-national differences of children ages 9 through 16 in Pakistan (n = 463) and the United States (n = 500) are examined on four bipolar temperament styles: Extroversion-introversion, practical-imaginative, thinking-feeling, and organized-flexible. In general, Pakistani children prefer extroverted over introverted, practical…

  2. A Portrayal of Women Educational Leadership in Pakistan

    ERIC Educational Resources Information Center

    Malik, Samina

    2011-01-01

    The researcher is stimulated to work on the growing trends of women leadership. The problem has been designed to investigate the factors influencing the emergence of women leadership at higher education level in Pakistan. On the basis of the studies conducted by Oplatka (2006) and Cubillo, Brown, 2003, it was assumed that specific factors…

  3. Household Schooling Decisions in Rural Pakistan. Working Paper.

    ERIC Educational Resources Information Center

    Sawada, Yasuyuki; Lokshin, Michael

    A study of household schooling decisions in rural Pakistan found serious supply-side constraints on female primary education in the villages studied. Field surveys of 25 Pakistani villages were integrated with economic theory and econometric analysis to investigate the sequential nature of educational decisions. The full-information maximum…

  4. Instructional Leadership Potential among School Principals in Pakistan

    ERIC Educational Resources Information Center

    Niqab, Muhammad; Sharma, Sailesh; Wei, Leong Mei; Maulod, Shafinaz Bt A.

    2014-01-01

    This study highlights the pivotal role of the school principal in relation to organizational commitment and expected student outcomes in schools in Pakistan. By critically examining the available literature, and by evaluating relevant data, this study will draw attention to how successful principals manage their schools, by providing an…

  5. Hepatocellular Carcinoma in Pakistan: National Trends and Global Perspective.

    PubMed

    Hafeez Bhatti, Abu Bakar; Dar, Faisal Saud; Waheed, Anum; Shafique, Kashif; Sultan, Faisal; Shah, Najmul Hassan

    2016-01-01

    Hepatocellular carcinoma (HCC) ranks second amongst all causes of cancer deaths globally. It is on a rise in Pakistan and might represent the most common cancer in adult males. Pakistan contributes significantly to global burden of hepatitis C, which is a known risk factor for HCC, and has one of the highest prevalence rates (>3%) in the world. In the absence of a national cancer registry and screening programs, prevalence of hepatitis and HCC only represents estimates of the real magnitude of this problem. In this review, we present various aspects of HCC in Pakistan, comparing and contrasting it with the global trends in cancer care. There is a general lack of awareness regarding risk factors of HCC in Pakistani population and prevalence of hepatitis C has increased. In addition, less common risk factors are also on a rise. Majority of patients present with advanced HCC and are not eligible for definitive treatment. We have attempted to highlight issues that have a significant bearing on HCC outcome in Pakistan. A set of strategies have been put forth that can potentially help reduce incidence and improve HCC outcome on national level. PMID:26955390

  6. 75 FR 51615 - Establishment of Pakistan and Afghanistan Support Office

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-23

    ... temporary organization to be known as the Pakistan and Afghanistan Support Office (PASO). Sec. 2. Purpose of the Temporary Organization. The purpose of the PASO shall be to perform the specific project of.... diplomatic presence in both countries. Sec. 3. Functions of the Temporary Organization. In carrying out...

  7. Gender Representation in the Public Sector Schools Textbooks of Pakistan

    ERIC Educational Resources Information Center

    Ullah, Hazir; Skelton, Christine

    2013-01-01

    This paper examines gender biases in school textbooks after a decade long effort by the ministry of education (MoE) Pakistan and international organisation (IOs) to eliminate all forms of gender inequality in education. The intention underpinning these initiatives was to nurture a view of gender equality based consciousness through the…

  8. Time and Opportunity To Learn in Pakistan's Schools.

    ERIC Educational Resources Information Center

    Reimers, Fernando

    This paper challenges the current conventional policy view of time as a critical resource for learning. After reviewing literature on the subject, the paper analyzes the contribution of instructional time to learning using data from primary schools in Pakistan. The principal finding reported in this paper is that the amount of contact time between…

  9. Satellite-Based Study of Glaciers Retreat in Northern Pakistan

    NASA Astrophysics Data System (ADS)

    Munir, Siraj

    Glaciers serve as a natural regulator of regional water supplies. About 16933 Km 2 area of glaciers is covered by Pakistan. These glaciers are enormous reservoirs of fresh water and their meltwater is an important resource which feed rivers in Pakistan. Glacier depletion, especially recent melting can affect agriculture, drinking water supplies, hydro-electric power, and ecological habitats. This can also have a more immediate impact on Pakistan's economy that depends mainly on water from glacier melt. Melting of seasonal snowfall and permanent glaciers has resulted not only in reduction of water resources but also caused flash floods in many areas of Pakistan. With the advent of satellite technology, using optical and SAR data the study of glaciers, has become possible. Using temporal data, based on calculation of snow index, band ratios and texture reflectance it has been revealed that the rate of glacier melting has increased as a consequent of global warming. Comparison of Landsat images of Batura glacier for October 1992 and October 2000 has revealed that there is a decrease of about 17 sq km in Batura glaciers. Although accurate changes in glacier extent cannot be assessed without baseline information, these efforts have been made to analyze future changes in glaciated area.

  10. Conflict, Development and Community Participation in Education: Pakistan and Yemen

    ERIC Educational Resources Information Center

    Jones, Adele

    2005-01-01

    In development policy, community participation has increasingly come to be seen as a way to encourage community interest, involvement, ownership and ultimately, sustainability of projects. Education has also been affected by this discourse. The following paper examines two countries affected by conflict (Pakistan and Yemen), asking what type of…

  11. Simulating the Afghanistan-Pakistan opium supply chain

    SciTech Connect

    Watkins, Jennifer H; MacKerrow, Edward P; Merritt, Terence M

    2010-04-08

    This paper outlines an opium supply chain using the Hilmand province of Afghanistan as exemplar. The opium supply chain model follows the transformation of opium poppy seed through cultivation and chemical alteration to brown heroin base. The purpose of modeling and simulating the Afghanistan-Pakistan opium supply chain is to discover and test strategies that will disrupt this criminal enterprise.

  12. Hepatocellular Carcinoma in Pakistan: National Trends and Global Perspective

    PubMed Central

    Hafeez Bhatti, Abu Bakar; Dar, Faisal Saud; Waheed, Anum; Shafique, Kashif; Sultan, Faisal; Shah, Najmul Hassan

    2016-01-01

    Hepatocellular carcinoma (HCC) ranks second amongst all causes of cancer deaths globally. It is on a rise in Pakistan and might represent the most common cancer in adult males. Pakistan contributes significantly to global burden of hepatitis C, which is a known risk factor for HCC, and has one of the highest prevalence rates (>3%) in the world. In the absence of a national cancer registry and screening programs, prevalence of hepatitis and HCC only represents estimates of the real magnitude of this problem. In this review, we present various aspects of HCC in Pakistan, comparing and contrasting it with the global trends in cancer care. There is a general lack of awareness regarding risk factors of HCC in Pakistani population and prevalence of hepatitis C has increased. In addition, less common risk factors are also on a rise. Majority of patients present with advanced HCC and are not eligible for definitive treatment. We have attempted to highlight issues that have a significant bearing on HCC outcome in Pakistan. A set of strategies have been put forth that can potentially help reduce incidence and improve HCC outcome on national level. PMID:26955390

  13. School Inspection and Supervision in Pakistan: Approaches and Issues

    ERIC Educational Resources Information Center

    Jaffer, Kulsoom

    2010-01-01

    This article traces how the concept of educational inspection has evolved in Pakistan, especially in the province of Sindh, and discusses whether the existing inspection system helps to improve quality and establish accountability. The inspection system that originated in colonial days has evolved to incorporate the notion of using supervision to…

  14. Kiran Libraries for Children in Prison in Pakistan

    ERIC Educational Resources Information Center

    Shinji, Tajima

    2009-01-01

    In Pakistan, there are 7,000 children in 70 jails. From observations on why children commit crime, the author offers that the core cause is poverty; 99 per cent of young prisoners belong to deprived sections of society. They do not have access to education; living in prison is difficult; the degrading and harsh treatment adversely affects the…

  15. The Determinants of Child Health in Pakistan: An Economic Analysis

    ERIC Educational Resources Information Center

    Shehzad, Shafqat

    2006-01-01

    This paper estimates linear structural models using LISREL and employs MIMIC models to find out factors determining child health in Pakistan. A distinction has been made in permanent and transitory health states that lend support to Grossman's (1972) stock and flow concepts of health. The paper addresses the issue of health unobservability and…

  16. Early Childhood Teacher Education in Pakistan: Time for Action

    ERIC Educational Resources Information Center

    Zada, Khan

    2014-01-01

    This paper presents a critical account of early childhood education (ECE) in Pakistan. It moves from a general review of the benefits of ECE to focus on the issues and challenges connected to the professional development of early childhood teachers. It highlights problems encountered in developing practitioners who are highly skilled in the…

  17. Burn Wound Infections and Antibiotic Susceptibility Patterns at Pakistan Institute of Medical Sciences, Islamabad, Pakistan

    PubMed Central

    Saaiq, Muhammad; Ahmad, Shehzad; Zaib, Muhammad Salman

    2015-01-01

    BACKGROND Burn wound infections carry considerable mortality and morbidity amongst burn injury victims who have been successfully rescued through the initial resuscitation. This study assessed the prevalent microrganisms causing burn wound infections among hospitalized patients; their susceptibility pattern to commonly used antibiotics; and the frequency of infections with respect to the duration of the burn wounds. METHODS This study was carried out at Burn Care Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan over a period of two years (i.e. from June 2010 to May 2012). The study included all wound-culture-positive patients of either gender and all ages, who had sustained deep burns and underwent definitive management with wound excisions and skin auto-grafting. Patients with negative cultures of the wounds were excluded. Tissue specimens for culture and sensitivity were collected from burn wounds using standard collection techniques and analyzed at microbiological laboratory. RESULTS Out of a total of 95 positive microbial growths, 36 were Pseudomonas aeruginosa (35.29%) as the most frequent isolate found, followed by 21 Klebsiella pneumoniae (20.58%), 19 Staphylococcus aureaus (18.62%), 10 Proteus (9.80%), 7 E. coli (6.86%), 7 Acinetobacter (6.86%), and 4 Candida (3.92%). A variable antibiotic susceptibility pattern was observed among the grown microbes. Positive cultures were significantly more frequent among patients with over two weeks duration of burn wounds. CONCLUSION P. aeruginosa, K. pneumoniae and S. aureus constituted the most common bacterial microbes of burn wounds in our in-patients cases. Positive cultures were more frequent among patients with over two weeks duration of burn wounds. Early excision and skin grafting of deep burns and adherence to infection control measures can help to effectively reduce the burden of these infections. PMID:25606471

  18. Association Between Grading of Oral Submucous Fibrosis With Frequency and Consumption of Areca Nut and Its Derivatives in a Wide Age Group: A Multi-centric Cross Sectional Study From Karachi, Pakistan

    PubMed Central

    Hosein, Mervyn; Mohiuddin, Sidra; Fatima, Nazish

    2015-01-01

    Background: Oral submucous fibrosis (OSMF) is a chronic, premalignant condition of the oral mucosa and one of the commonest potentially malignant disorders amongst the Asian population. The objective of this study was to investigate the association of etiologic factors with: age, frequency, duration of consumption of areca nut and its derivatives, and the severity of clinical manifestations. Methods: A cross-sectional, multi centric study was conducted over 8 years on clinically diagnosed OSMF cases (n = 765) from both public and private tertiary care centers. Sample size was determined by World Health Organization sample size calculator. Consumption of areca nut in different forms, frequency of daily usage, years of chewing, degree of mouth opening and duration of the condition were recorded. Level of significance was kept at P ≤ 0.05. Results: A total of 765 patients of OSMF were examined, of whom 396 (51.8%) were male and 369 (48.2%) female with a mean age of 29.17 years. Mild OSMF was seen in 61 cases (8.0%), moderate OSMF in 353 (46.1%) and severe OSMF in 417 (54.5%) subjects. Areca nut and other derivatives were most frequently consumed and showed significant risk in the severity of OSMF (P ≤ 0.0001). Age of the sample and duration of chewing years were also significant (P = 0.012). Conclusions: The relative risk of OSMF increased with duration and frequency of areca nut consumption especially from an early age of onset. PMID:26473161

  19. Reduced susceptibility to chlorhexidine disinfectant among New Delhi metallo-beta-lactamase-1 positive Enterobacteriaceae and other multidrug-resistant organisms: Report from a tertiary care hospital in Karachi, Pakistan.

    PubMed

    Mal, P B; Farooqi, J; Irfan, S; Hughes, M A; Khan, E

    2016-01-01

    We analysed susceptibility of multidrug-resistant organisms (MDROs) including New Delhi metallo-beta-lactamase-1 positive Enterobacteriaceae to chlorhexidine and compared results to their susceptible counterparts. Susceptibilities of chlorhexidine digluconate in a standard (CHX-S) preparation and two commercial disinfectants containing different CHX concentrations (2% w/v and 4% w/w) were performed. MDROs had narrower range of higher CHX-S minimum inhibitory concentrations (MICs) as compared to pan-sensitive organisms. The MIC values for commercial disinfectants products for MDROs were many folds higher (20-600 times), than CHX-S for in vitro use. Increasing antibiotic resistance among bacterial isolates can be an indirect marker of reduced susceptibility to chlorhexidine in hospital setting. PMID:27514958

  20. 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

  1. Cooperative Development of the Pakistan Seismic Network System (PSNS)

    NASA Astrophysics Data System (ADS)

    Detweiler, S.; Mooney, W.; McDonald, S.

    2005-12-01

    We propose to cooperate with the Pakistan Meteorological Department for the design and construction of the new Pakistan Seismic Network System (PSNS) that has been funded by the government of Pakistan. The PSNS will consist of 12-15 broadband stations, 50 short-period stations, and 50 accelerometers. Our role will be to provide technical assistance in site selection, to prepare the Request for Proposals (RFP) from industry, and to evaluate performance. The relative importance of tsunami warnings, national earthquake and landslide hazards, and whether a largely urban or truly national network is envisioned will be determined early in the program. Final placement of stations will take many factors into consideration including proximity to faults and seismic activity, geographic accessibility, the consistency of bedrock, and various cultural or social effects. This cooperation has the potential to lead to the development of a desperately needed tsunami early warning network that could protect the Pakistani coastal population in the event of a natural disaster such as the Dec. 26, 2004 Sumatra earthquake and tsunami. The seismic hazard off the coast of Pakistan is high due to the proximity of the Makran and Sumatra subduction zones, the former of which could trigger tsunamis in Pakistan with heights of 12m within minutes. In addition to monitoring earthquake activity, the PSNS will provide seismic data of interest to the world-wide scientific community for a region in which there is little understanding of the upper crust and mantle. It will furthermore address educational outreach and diplomacy issues by providing training to Pakistani scientists in routine network operation and data processing.

  2. Governance and Higher Education in Pakistan: What Roles Do Boards of Governors Play in Ensuring the Academic Quality Maintenance in Public Universities versus Private Universities in Pakistan?

    ERIC Educational Resources Information Center

    Usman, Sidra

    2014-01-01

    There are major structural issues in the higher education system in Pakistan leading to poor governance of institutions and questionable quality of education. This paper looks at the differences in the role of boards of governors in maintaining quality of education in both the public and the private sector universities in Pakistan. After having…

  3. Determination of Guidelines for the Extension Educational Leadership Function of the College of Agriculture, West Pakistan Agricultural University, Lyallpur, Pakistan.

    ERIC Educational Resources Information Center

    Mian, Hidayat Ullah

    Focusing on basic instruction, inservice training, research, and coordination of functions and personnel, this study used a theoretical model approach to develop guidelines for more effective extension educational operation and leadership by West Pakistan Agricultural University. A brief analysis of the cultural and socioeconomic situation in West…

  4. Literacy, Income Generation, and Poverty Alleviation in Sindh Pakistan and Its Impact on Economic Development, Human Resource Development in Pakistan.

    ERIC Educational Resources Information Center

    Panhwar, Farzana

    Rural poverty in Sindh, Pakistan, has been artificially created by low prices of wheat, fixed by the federal government's price control board. Agriculture and agro-based industries account for 80 percent of the country's labor force. Among the consequences of this price control are low margins of profit to the farming community; low capacity to…

  5. 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

  6. 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

  7. Immunisation and infant mortality in Pakistan.

    PubMed

    Khan, Z

    1993-01-01

    Pakistan has been engaged with the Expanded Program on Immunization since 1982. In January 1991 an evaluation was conducted in order to ascertain coverage results for children aged 12-23 months of age, tetanus toxoid coverage for mothers of infants aged 0-11 months of age, and to review management of the program at all levels. The survey was based on information provided in the mother's history of children aged 12-23 months and by the immunization card in urban and rural clusters. Coverage included 8651 households in 240 clusters, 1968 children aged 12-23 months, and 1965 mothers of infants aged 0-11 months. The results showed high coverage in Punjab, Northwest Frontier Province, and Azad Jammu and Kashmir. Tetanus toxoid coverage of mothers could be improved. Provinces which had low coverage included Sindh and Balochistan. Between 1984-85 and 1990-91 infant mortality was reduced from 106.4 deaths/1000 live births to 100.9 deaths/1000 live births. In the Punjab immunization coverage among children aged 0-11 months was 56.3% in urban areas and 93.8% in rural areas with outreach and a mobile team. Hospital administration of vaccines was lower in rural areas (4.8%) compared to urban areas (22.1%) in the Punjab. Most children were immunized through outreach or a mobile team (56.3% in urban and 93.8% in rural areas of the Punjab). Outreach in Northwest Frontier Province was 30.6% in urban areas and 70.7% in rural areas. Hospital coverage was 36.5% in urban areas and 24.4% in rural areas. Coverage in Balochistan was 64.9% by outreach, 24.7% for health centers, and 9.1% for hospitals. Among partially immunized children, 10.3% indicated lack of awareness of need and 15.0% indicated lack of awareness of need for a subsequent visit. Fear of side effects affected 3.1% of those partially vaccinated. Lack of information affected 33.0%. Motivation was a reason for 4.1%. 62.9% indicated obstacles such as distance, time, health personnel absent, busy mother, family problems, and

  8. Motivational determinants among physicians in Lahore, Pakistan

    PubMed Central

    2010-01-01

    Introduction Human resource crises in developing countries have been identified as a critical aspect of poor quality and low accessibility in health care. Worker motivation is an important facet of this issue. Specifically, motivation among physicians, who are an important bridge between health systems and patients, should be considered. This study aimed to identify the determinants of job motivation among physicians, a neglected perspective, especially in developing countries. Methods A stratified random sample of 360 physicians was selected from public primary, public secondary and public and private tertiary health facilities in the Lahore district, Pakistan. Pretested, semi-structured, self-administered questionnaires were used. For the descriptive part of this study, physicians were asked to report their 5 most important work motivators and demotivators within the context of their current jobs and in general. Responses were coded according to emergent themes and frequencies calculated. Of the 30 factors identified, 10 were classified as intrinsic, 16 as organizational and 4 as socio-cultural. Results Intrinsic and socio-cultural factors like serving people, respect and career growth were important motivators. Conversely, demotivators across setups were mostly organizational, especially in current jobs. Among these, less pay was reported the most frequently. Fewer opportunities for higher qualifications was a demotivator among primary and secondary physicians. Less personal safety and poor working conditions were important in the public sector, particularly among female physicians. Among private tertiary physicians financial incentives other than pay and good working conditions were motivators in current jobs. Socio-cultural and intrinsic factors like less personal and social time and the inability to financially support oneself and family were more important among male physicians. Conclusion Motivational determinants differed across different levels of care

  9. Why are older peoples' health needs forgotten post-natural disaster relief in developing countries? A healthcare provider survey of 2005 Kashmir, Pakistan earthquake.

    PubMed

    Chan, Emily Ying Yang

    2009-01-01

    Although older people may be recognized as a vulnerable group post-natural disasters, their particular needs are rarely met by the providers of emergency services. Studies about older people's health needs post disasters in the South East Asia Tsunami, Kashmir, Pakistan, China, and United States has revealed the lack of concern for older people's health needs. Recent study of older people's health needs post the Kashmir Pakistan earthquake (2005) found older peoples' health needs were masked within the general population. This survey study examines the providers' perceptions of older people's vulnerabilities post-2005 Pakistan earthquake. It aims to understand the awareness of geriatric issues and issues related to current service provision/planning for older people's health needs post disasters. Specifically, service delivery patterns will be compared among different relief agencies. Cross-sectional, structured stakeholder interviews were conducted within a 2 weeks period in February 2006, 4 months post-earthquake in Pakistan-administrated Kashmir. Health/medical relief agencies of three different types of organizational nature: international nongovernmental organization (INGO), national organization, and local/community group were solicited to participate in the study. Descriptive analysis was conducted. Important issues identified include the need to sensitize relief and health workers about older people's health needs post disaster the development of relevant clinical guidelines for chronic disease management postdisaster in developing countries and the advocacy of building in geriatric related components in natural disaster medical relief programs. To effectively address the vulnerability of older people, it is important for governments, relief agencies, and local partners to include and address these issues during their relief operations and policy planning.

  10. Determinants of neonatal mortality in Pakistan: secondary analysis of Pakistan Demographic and Health Survey 2006–07

    PubMed Central

    2014-01-01

    Background Globally 7.6 million children died in 2010 before reaching their fifth birthday and 40% of these deaths occur in the neonatal period. Pakistan has the third highest rate of neonatal mortality globally. To implement evidence-based interventions for the reduction of neonatal mortality, it is important to investigate factors associated with neonatal mortality. The aim of the current study was to identify determinants of neonatal mortality in Pakistan. Methods Data was derived from the Pakistan Demographic and Health Survey 2006–07. All singleton live births between 2002 and 2006 were selected for the current analyses. Data was analysed by using STATA 13 and adjusted for the cluster sampling design. Multivariate Cox proportional hazard models were performed using step-wise backward elimination procedures to identify the determinants of neonatal mortality. Results A total of 5,702 singleton live births in the last five years preceding the survey were selected. Multivariate analyses showed that living in Punjab province (Adj HR = 2.10, p = 0.015), belonging to the poorest household wealth index quintile (Adj HR = 1.95, p = 0.035), male infants (Adj HR = 1.57, p = 0.014), first rank baby (Adj HR = 1.59, p = 0.049), smaller than average birth size (Adj HR = 1.61, p = 0.023) and mothers with delivery complications (Adj HR = 1.93, p = 0.001) had significantly higher hazards of neonatal death in Pakistan. Conclusions To reduce neonatal mortality, there is a need to implement interventions focusing on antenatal care, effective referral system and retraining of healthcare providers to manage delivery complications and smaller than average birth size babies in resource poor communities of Pakistan. PMID:24972633

  11. View looking south from pavilion, showing south entrance house, south ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View looking south from pavilion, showing south entrance house, south wing, and engine house - Fairmount Waterworks, East bank of Schuylkill River, Aquarium Drive, Philadelphia, Philadelphia County, PA

  12. InSAR observations of strain accumulation and fault creep along the Chaman Fault system, Pakistan and Afghanistan

    NASA Astrophysics Data System (ADS)

    Fattahi, Heresh; Amelung, Falk

    2016-08-01

    We use 2004-2011 Envisat synthetic aperture radar imagery and InSAR time series methods to estimate the contemporary rates of strain accumulation in the Chaman Fault system in Pakistan and Afghanistan. At 29 N we find long-term slip rates of 16 ± 2.3 mm/yr for the Ghazaband Fault and of 8 ± 3.1 mm/yr for the Chaman Fault. This makes the Ghazaband Fault one of the most hazardous faults of the plate boundary zone. We further identify a 340 km long segment displaying aseismic surface creep along the Chaman Fault, with maximum surface creep rate of 8.1 ± 2 mm/yr. The observation that the Chaman Fault accommodates only 30% of the relative plate motion between India and Eurasia implies that the remainder is accommodated south and east of the Katawaz block microplate.

  13. Geochemistry of the Bela Ophiolite, Pakistan

    NASA Astrophysics Data System (ADS)

    Khan, M.; Nicholson, K. N.; Mahmood, K.

    2008-12-01

    The Bela ophiolite complex of Balochistan, Pakistan has been the subject of several geochemical and tectonic studies in the past. However until now there has never been a combined structural, geochemical and tectonic assimilation study which adequately explains the observed geochemistry and structural geology in a global tectonic framework. Here we present the geochemical findings of our work. The Bela ophiolite complex consists of two major units: the basal section or Lower Unit, and the Upper Unit, between the two is a mélange zone. The Lower Unit is relatively homogeneous and consists almost entirely of flow basalts and pillow basalts. The base of the Upper Unit is the metamorphic sole which is overlain by a sequence of massive basalts flows and intrusions of gabbro and granites. The entire Upper Unit is cut by doleritic dykes and sills. Geochemically the Lower Unit is comprised of basaltic lavas with E-MORB affinities. These lavas are tholeiitic, low-K series lavas with trace element signatures of E-type MORB. For example ratios such as V/Ti, Zr/Y, Nb/Th, Th/La and Nb/U all suggest these lavas are E-MORB. Previous workers have suggested these lavas are back-arc basin (BAB) however the samples lack the characteristic signatures of subduction modified MORB. This conclusion is supported by chondrite and N-MORB normalized spider diagrams where the Lower Unit lavas are enriched in the LILE with respect to the HFSE. The Upper Unit of the Bela Ophiolite sequence has a slightly more complex history. The older lavas sequences, the massive basalt flows, gabbros and granites, all formed in an oceanic arc environment. These lavas exhibit classic arc signatures such as a negative Nb and Ti anomalies, are enriched in LILE and LREE relative to HSFE, and plot in the volcanic arc and island arc fields in classic ternary plots such as 2Nb- Zr/4-Y and Y/15-La/10-Nb/8. The younger sequence of intrusions found in the Bela ophiolite appear to have BAB signatures. These lavas have

  14. Supporting Innovations in Education: Preparing Administrators, Supervisors and Other Key Personnel. Report of a Technical Working Group Meeting (Seoul, South Korea, September 29-October 11, 1980).

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and the Pacific.

    Eleven countries (Bangladesh, India, Indonesia, Japan, Malaysia, Nepal, Pakistan, Philippines, South Korea, Sri Lanka, and Thailand) participated in a 1980 meeting on methods of training educational administrators and supervisors to be supportive of educational innovation. This report summarizes the proceedings of that meeting and the…

  15. Next big threat for Pakistan Hepatocellular Carcinoma (HCC).

    PubMed

    Parkash, Om; Hamid, Saeed

    2016-06-01

    In our country, world hepatitis day (28th May 2013) was observed as a liver cancer day to draw global attention on the global health menace caused by Hepatocellular carcinoma (HCC). This is the right time to write a review article to apprise the nation of this growing burden of HCC caused most commonly by viruses in our country. Pakistan is also recognized as one of the countries of the world where hepatitis C virus (HCV) is endemic. Recent large national surveys suggest an overall HCV prevalence of 4.8% and that of HBV as 2.5%. There are however communities where the sero-prevalence of HCV can be as high as 23%. No wonder that chronic liver disease is the fifth most common reason for morbidity and mortality in the country and Pakistan has been perhaps accurately called a "cirrhotic state". Hence majority of such patients are at risk of developing HCC.

  16. Diagnostic Testing for Hemorrhagic Fevers in Pakistan: 2007–2013

    PubMed Central

    Hasan, Zahra; Atkinson, Barry; Jamil, Bushra; Samreen, Azra; Altaf, Lamia; Hewson, Roger

    2014-01-01

    Crimean–Congo hemorrhagic fever virus (CCHFV) and dengue virus (DENV) are endemic to Pakistan. Patients presenting with symptoms of fever, bleeding, and rash cannot be distinguished without appropriate testing. We report data on 354 samples tested for CCHFV at The Aga Khan University Hospital in Pakistan between 2007 and 2013. All samples were tested for the presence of CCHFV RNA. Some samples were also tested for DENV RNA, NS-1 antigen, and/or reactive immunoglobulin M antibodies. Of 354 clinical specimens screened for CCHFV, 52 specimens were positive, with 24 cases in 2013 alone. Most cases were from Sindh and Baluchistan, which border other CCHFV-endemic regions: Iran and Afghanistan. Among CCHFV-negative samples, 168 samples were tested for DENV, and 36% of these samples were found to be DENV-positive. Rapid differentiation of CCHFV and DENV can prevent nosocomial transmission and result in time and cost savings for patients and healthcare workers. PMID:25311694

  17. Estimates of outage costs of electricity in Pakistan

    SciTech Connect

    Ashraf, J.; Sabih, F.

    1993-12-31

    This article estimates outage costs of electricity for each of the four provinces in Pakistan (Punjab, North-West Frontier Province, Baluchistan, and Sind). The term {open_quotes}power outage{close_quotes} refers to all problems associated with electricity supply, such as voltage drops (brownouts), power failures (blackouts), and load shedding. The most significant of these in Pakistan is load shedding when power supply to different consumers is shut off during different times of the day, especially during peak hours when the pressure on the system is the highest. Power shortages mainly arise during the low-water months when the effective capacity of hydropower plants drops significantly. This decline in power supplied by hydro plants cannot be made up by operating thermal power plants because of the limited availability of gas and the high cost of alternative fuels required for the operation of gas turbines.

  18. Polio in Pakistan: Social constraints and travel implications.

    PubMed

    Mushtaq, Asim; Mehmood, Sajid; Rehman, Muhammad Ateeq Ur; Younas, Asma; Rehman, Muhammad Saif Ur; Malik, Muhamamd Faheem; Hyder, Muhammad Zeeshan

    2015-01-01

    The Global Polio Eradication Initiative (GPEI) in Pakistan has faced failure despite being implemented successfully. Polio cases were successfully reduced by 99% until 2005. However, thereafter, new polio cases were registered, which continue to rise annually. This repeat polio outbreak has placed the country on watch by the World Health Organization (WHO) due to travelers, and Hajj and Umrah pilgrims. The present report reviews the published literature for determining the social constraints to the polio eradication initiative in Pakistan. Religion, politics, awareness, insecurity, inequity, governance, and social responsibility have been identified as key social factors in the failure of any vaccination campaign. Possible interventions have been proposed, which include effectively using modern mass media and educating vaccinators on the social and cultural background of the target community.

  19. Next big threat for Pakistan Hepatocellular Carcinoma (HCC).

    PubMed

    Parkash, Om; Hamid, Saeed

    2016-06-01

    In our country, world hepatitis day (28th May 2013) was observed as a liver cancer day to draw global attention on the global health menace caused by Hepatocellular carcinoma (HCC). This is the right time to write a review article to apprise the nation of this growing burden of HCC caused most commonly by viruses in our country. Pakistan is also recognized as one of the countries of the world where hepatitis C virus (HCV) is endemic. Recent large national surveys suggest an overall HCV prevalence of 4.8% and that of HBV as 2.5%. There are however communities where the sero-prevalence of HCV can be as high as 23%. No wonder that chronic liver disease is the fifth most common reason for morbidity and mortality in the country and Pakistan has been perhaps accurately called a "cirrhotic state". Hence majority of such patients are at risk of developing HCC. PMID:27339578

  20. On the fog variability over south Asia

    NASA Astrophysics Data System (ADS)

    Syed, F. S.; Körnich, H.; Tjernström, M.

    2012-12-01

    An increasing trend in fog frequencies over south Asia during winter in the last few decades has resulted in large economical losses and has caused substantial difficulties in the daily lives of people. In order to better understand the fog phenomenon, we investigated the climatology, inter-annual variability and trends in the fog occurrence from 1976 to 2010 using observational data from 82 stations, well distributed over India and Pakistan. Fog blankets large area from Pakistan to Bangladesh across north India from west to east running almost parallel to south of the Himalayas. An EOF analysis revealed that the fog variability over the whole region is coupled and therefore must be governed by some large scale phenomenon on the inter-annual time scale. Significant positive trends were found in the fog frequency but this increase is not gradual, as with the humidity, but comprises of two distinct regimes shifts, in 1990 and 1998, with respect to both mean and variance. The fog is also detected in ERA-Interim 3 hourly, surface and model level forecast data when using the concept of "cross-over temperature" combined with boundary layer stability. This fog index is able to reproduce the regime shift around 1998 and shows that the method can be applied to analyze fog over south Asia. The inter-annual variability seems to be associated with the wave train originating from the North Atlantic in the upper troposphere that when causing higher pressure over the region results in an increased boundary layer stability and surface-near relative humidity. The trend and shifts in the fog occurrence seems to be associated with the gradual increasing trend in relative humidity from 1990 onwards.

  1. On the fog variability over south Asia

    NASA Astrophysics Data System (ADS)

    Syed, F. S.; Körnich, H.; Tjernström, M.

    2012-04-01

    An increasing trend in fog frequencies over south Asia during winter in the last few decades has resulted in large economical losses and has caused substantial difficulties in the daily lives of people. In order to better understand the fog phenomenon, we investigated the climatology, inter-annual variability and trends in the fog occurrence from 1976 to 2010 using observational data from 82 stations, well distributed over India and Pakistan. Fog blankets large area from Pakistan to Bangladesh across north India from west to east running almost parallel to south of the Himalayas. An EOF analysis revealed that the fog variability over the whole region is coupled and must therefore be governed by some large scale phenomenon on the inter-annual time scale. Significant trends were found in the fog frequencies and this increase is not gradual, as seen in the humidity, but shows two distinct regimes shifts in 1990 and 1998 with respect to both mean and variance. The fog is also detected in ERA-Interim 3 hourly, surface and model level forecast data when using the concept of "cross-over temperature" combined with boundary layer stability. This detected fog index is able to reproduce the regime shift around 1998 and shows that the method can be applied to detect fog over south Asia. The inter-annual variability seems to be associated with the wave train originating from north Atlantic in the upper atmosphere that causes higher pressure over the region,resulting in increased boundary layer stability and surface-near relative humidity. The trend and shifts in the fog occurrence seems to be associated with the gradual increasing trend in relative humidity from 1990 onwards.

  2. Genetic diversity and phylogeography of begomoviruses infecting legumes in Pakistan.

    PubMed

    Ilyas, Muhammad; Qazi, Javaria; Mansoor, Shahid; Briddon, Rob W

    2010-08-01

    Grain legumes are an important source of dietary protein across southern Asia, but they suffer extensive losses due to several viruses that are members of the genus Begomovirus (family Geminiviridae), which are collectively known as legume yellow mosaic viruses (LYMVs). Despite their economic importance, little attention has been paid to LYMVs in Pakistan and only partial sequences of virus isolates originating from this country are available in the databases. Here, a survey of LYMVs occurring across Pakistan is described. Complete sequences of 44 components (23 DNA-A, 19 DNA-B and 2 betasatellites) were determined. The results show that only the mungbean yellow mosaic India virus (MYMIV) is of agricultural significance in Pakistan having been isolated from all cultivated grain legumes examined. Mungbean yellow mosaic virus, a significant crop pathogen in India, was only identified in a weed, which together with a novel species of LYMV we reported earlier, represents the first LYMV identified in non-cultivated plants. MYMIV was shown to occur as two types in Pakistan that show phylogeographical segregation. Additionally, two begomovirus species not considered pathogens of legumes and a betasatellite were isolated. This is of grave concern since it suggests that the presumed genetic isolation of the LYMVs in legumes may be being breached. LYMVs show little, if any, evidence of interspecific recombination with non-legume infecting begomoviruses. Thus, either recombination with non-legume viruses or interaction with betasatellites, which are host range and pathogenicity determining satellites of begomoviruses, could lead to the appearance of more aggressive virus variants/strains affecting legumes.

  3. Progress Toward Poliomyelitis Eradication--Pakistan, January 2014-September 2015.

    PubMed

    Farag, Noha H; Wadood, Mufti Zubair; Safdar, Rana Muhammad; Ahmed, Nabil; Hamdi, Sabrine; Tangermann, Rudolph H; Ehrhardt, Derek

    2015-11-20

    Since Nigeria reported its last case of wild poliovirus type 1 (WPV1) in July 2014, Pakistan and Afghanistan remain the only two countries where WPV transmission has never been interrupted. This report describes actions taken and progress achieved toward polio eradication in Pakistan during January 2014-September 2015 and updates previous reports. A total of 38 WPV1 cases were reported in Pakistan during January-September 2015, compared with 243 during the same period in 2014 (an 84% decline). Among WPV1 cases reported in 2015, 32 (84%) occurred in children aged <36 months, nine (32%) of whom had never received oral poliovirus vaccine (OPV). Twenty-six (68%) of the 38 reported cases occurred in the Federally Administered Tribal Areas (FATA) and Khyber Pakhtunkhwa (KPK) Province. During January-September 2015, WPV1 was detected in 20% (64 of 325) of environmental samples collected, compared with 34% (98 of 294) of samples collected during the same period in 2014. The quality and scope of polio eradication activities improved considerably following the establishment of a national Emergency Operations Center, which coordinated polio eradication partners' activities. All activities are following a National Polio Eradication Emergency Action Plan that includes a rigorous action plan for the polio low transmission season (January-April). The presence of WPV1 in environmental samples in areas where no polio cases are detected highlights the need to improve surveillance for acute flaccid paralysis (AFP). Focused efforts to close remaining immunity gaps by locating, tracking, and vaccinating continually missed children and improving coverage with OPV through the routine vaccination program are needed to stop WPV transmission in Pakistan.

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

    NASA Technical Reports Server (NTRS)

    1984-01-01

    The enormous geologic pressures exerted by continental drift can be very well illustrated by the long northward curving parallel folded mountain ridges and valleys of the coastal Makran Range of Pakistan (27.0N, 66.0E). As a result of the collision of the northward bound Indian sub-continent into the Asian Continent, the east/west parallel range has been bent in a great northward arc and forming the Indus River valley at the interface of the collision.

  5. Human Papillomavirus Genotype Distribution in Invasive Cervical Cancer in Pakistan

    PubMed Central

    Loya, Asif; Serrano, Beatriz; Rasheed, Farah; Tous, Sara; Hassan, Mariam; Clavero, Omar; Raza, Muhammad; De Sanjosé, Silvia; Bosch, F. Xavier; Alemany, Laia

    2016-01-01

    Few studies have assessed the burden of human papillomavirus (HPV) infection in Pakistan. We aim to provide specific information on HPV-type distribution in invasive cervical cancer (ICC) in the country. A total of 280 formalin-fixed paraffin-embedded tissue blocks were consecutively selected from Shaukat Khanum Memorial Cancer Hospital and Research Centre (Lahore, Pakistan). HPV-DNA was detected by SPF10 broad-spectrum PCR followed by DNA enzyme immunoassay and genotyping by LiPA25. HPV-DNA prevalence was 87.5% (95%CI: 83.0–91.1), with 96.1% of cases histologically classified as squamous cell carcinoma. Most of the HPV-DNA positive cases presented single infections (95.9%). HPV16 was the most common type followed by HPV18 and 45. Among HPV-DNA positive, a significantly higher contribution of HPV16/18 was detected in Pakistan (78.4%; 72.7–83.3), compared to Asia (71.6%; 69.9–73.4) and worldwide (70.8%; 69.9–71.8) and a lower contribution of HPVs31/33/45/52/58 (11.1%; 7.9–15.7 vs. 19.8%; 18.3–21.3 and 18.5%; 17.7–19.3). HPV18 or HPV45 positive ICC cases were significantly younger than cases infected by HPV16 (mean age: 43.3, 44.4, 50.5 years, respectively). A routine cervical cancer screening and HPV vaccination program does not yet exist in Pakistan; however, the country could benefit from national integrated efforts for cervical cancer prevention and control. Calculated estimations based on our results show that current HPV vaccine could potentially prevent new ICC cases. PMID:27483322

  6. Future precipitation extremes during summer monsoon in southern Pakistan

    NASA Astrophysics Data System (ADS)

    Zahid, Maida; Lucarini, Valerio

    2016-04-01

    Extreme precipitation events are considered as a hydro-meteorological hazard resulting in colossal damage worldwide. In Pakistan, the extreme precipitation events have increased in the recent decades particularly in the southern part (Sindh province). This region did not receive substantial amount of precipitation earlier, but now experiencing urban flooding almost every year causing loss of life, property, crops and infrastructure. The region lacks the information regarding the recurrence of extreme precipitation events. Therefore, there is a strong need for a reliable information of extremes over the upcoming decades for better regional planning. Although statistical methods based on extreme value theory (EVT) are the most relevant ones to study the extremes, but they are never been applied in Pakistan. To address this shortcoming, we use the peak over threshold (POT) approach to compute the return levels (RLs) of precipitation extremes, and also identify the regions most prone to them. In this study, we analyzed the summer monsoon daily precipitation measured at nine weather stations of Pakistan Meteorological Department over the period 1980-2013. The summer monsoon (JJAS) is preferred for the analysis, because most of the extreme precipitation occurs during this period. We apply POT approach to model the daily precipitation above a selected threshold for each station. Then, we estimate return levels (RLs) of precipitation extremes during summer monsoon in southern Pakistan (Sindh) for the next 5, 25, 50 and 100-years. Lastly, we compare the 5-years with 100-years RLs to indicate the stations most vulnerable to precipitation extremes in future. This work is funded by the Climate KIC, European Institute of Innovation and Technology, Germany.

  7. The Pakistan Himalaya: Tectonics at the NW corner of exposed Indian continental crust (Invited)

    NASA Astrophysics Data System (ADS)

    Dipietro, J. A.

    2009-12-01

    Lithotectonic units in the Himalaya maintain structural continuity from Nepal to Zanskar where they are deformed across a broad, arc-parallel, anticlinorium that plunges northwest such that the Tethyan sequence on the north limb, although truncated by the Indus Suture zone and Ladakh batholith, appears to wrap around the nose of the fold to form the Kashmir Tethys on the south limb. From a wide syn-metamorphic thrust zone in Nepal, the MCT southwest of the Kashmir Tethys narrows to form a late- to post-metamorphic thrust that shallows with the plunge of the anticlinorium. Structural continuity is disrupted by middle Miocene to active transverse fault zones that form the western margins of the Nanga Parbat and Hazara syntaxes (the Raikot-Diamir and Jhelum-Balakot fault zones respectively). It is here that Lesser, Greater, and Tethys Himalayan units lose their identity as defined and understood in the Central Himalaya. Both transverse fault zones are east-side-up and associated with antiforms that bring Lower Proterozoic rock to the surface. The MCT is folded around the nose of the Hazara antiform where it steepens to include a complete Lower Proterozoic to Mesozoic rock sequence in its hanging wall block. The Pakistan Himalaya west of the syntaxis, including the Swat area, forms the NW corner of exposed Indian continental crust. Metamorphism and major deformation are associated with two opposing thrust systems that occurred nearly synchronously prior to and possibly during the metamorphic peak. The earliest is associated with underthrusting beneath southwestward advancing ophiolitic mélange of the Indus suture zone consistent with early fold vergence and stretching lineations in Swat, and with kinematic indicators east of the syntaxis in Zanskar. This was followed by underthusting beneath southeastward advancing Nawagai ophiolitic mélange consistent with kinematic indicators in the West Pakistan fold belt. Both mélange units are metamorphosed with Indian plate

  8. Privatisation in reproductive health services in Pakistan: three case studies.

    PubMed

    Ravindran, T K Sundari

    2010-11-01

    Privatisation in Pakistan's health sector was part of the Structural Adjustment Programme that started in 1998 following the country's acute foreign exchange crisis. This paper examines three examples of privatisation which have taken place in service delivery, management and capacity-building functions in the health sector: 1) large-scale contracting out of publicly-funded health services to private, not-for-profit organisations; 2) social marketing/franchising networks providing reproductive health services; and 3) a public-private partnership involving a consortium of private players and the government of Pakistan. It assesses the extent to which these initiatives have contributed to promoting equitable access to good quality, comprehensive reproductive health services. The paper concludes that these forms of privatisation in Pakistan's health sector have at best made available a limited range of fragmented reproductive health services, often of sub-optimal quality, to a fraction of the population, with poor returns in terms of health and survival, especially for women. This analysis has exposed a deep-rooted malaise within the health system as an important contributor to this situation. Sustained investment in health system strengthening is called for, where resources from both public and private sectors are channelled towards achieving health equity, under the stewardship of the state and with active participation by and accountability to members of civil society. PMID:21111347

  9. Investigation of summer monsoon rainfall variability in Pakistan

    NASA Astrophysics Data System (ADS)

    Hussain, Mian Sabir; Lee, Seungho

    2016-08-01

    This study analyzes the inter-annual and intra-seasonal rainfall variability in Pakistan using daily rainfall data during the summer monsoon season (June to September) recorded from 1980 to 2014. The variability in inter-annual monsoon rainfall ranges from 20 % in northeastern regions to 65 % in southwestern regions of Pakistan. The analysis reveals that the transition of the negative and positive anomalies was not uniform in the investigated dataset. In order to acquire broad observations of the intra-seasonal variability, an objective criterion, the pre-active period, active period and post-active periods of the summer monsoon rainfall have demarcated. The analysis also reveals that the rainfall in June has no significant contribution to the increase in intra-seasonal rainfall in Pakistan. The rainfall has, however, been enhanced in the summer monsoon in August. The rainfall of September demonstrates a sharp decrease, resulting in a high variability in the summer monsoon season. A detailed examination of the intra-seasonal rainfall also reveals frequent amplitude from late July to early August. The daily normal rainfall fluctuates significantly with its maximum in the Murree hills and its minimum in the northwestern Baluchistan.

  10. ASSESSMENT OF PRACTICE AT RETAIL PHARMACIES IN PAKISTAN: EXTENT OF COMPLIANCE WITH THE PREVAILING DRUG LAW OF PAKISTAN.

    PubMed

    Ullah, Hanif; Zada, Wahid; Khan, Muhammad Sona; Iqbal, Muhammad; Chohan, Osaam; Raza, Naeem; Khawaja, Naeem Raza; Abid, Syed Mobasher Ali; Murtazai, Ghulam

    2016-01-01

    The main objective of this study was to assess the practice at retail pharmacies in Pakistan and to compare the same in rural and urban areas. The maintenance of pharmacy and drug inspectors' visit was also assessed. This cross sectional study was conducted in Abbottabad, Pakistan during October-November, 2012. A sample of 215 drug sellers or drug stores was selected by employing convenient sampling method. With a response rate of 91.6%, 197 drug sellers participated in this study. All the drug sellers were male. Overall, 35% (n = 197) of the drug sellers did not have any professional qualification. A majority of the drug sellers were involved in various malpractices like selling of medicines without prescription (80.7%), prescribing practice (60.9%), prescription intervention (62.4%) and selling of controlled substances (66%) without a license for selling it. These malpractices were significantly higher in rural area than that in urban area. PMID:27476300

  11. ASSESSMENT OF PRACTICE AT RETAIL PHARMACIES IN PAKISTAN: EXTENT OF COMPLIANCE WITH THE PREVAILING DRUG LAW OF PAKISTAN.

    PubMed

    Ullah, Hanif; Zada, Wahid; Khan, Muhammad Sona; Iqbal, Muhammad; Chohan, Osaam; Raza, Naeem; Khawaja, Naeem Raza; Abid, Syed Mobasher Ali; Murtazai, Ghulam

    2016-01-01

    The main objective of this study was to assess the practice at retail pharmacies in Pakistan and to compare the same in rural and urban areas. The maintenance of pharmacy and drug inspectors' visit was also assessed. This cross sectional study was conducted in Abbottabad, Pakistan during October-November, 2012. A sample of 215 drug sellers or drug stores was selected by employing convenient sampling method. With a response rate of 91.6%, 197 drug sellers participated in this study. All the drug sellers were male. Overall, 35% (n = 197) of the drug sellers did not have any professional qualification. A majority of the drug sellers were involved in various malpractices like selling of medicines without prescription (80.7%), prescribing practice (60.9%), prescription intervention (62.4%) and selling of controlled substances (66%) without a license for selling it. These malpractices were significantly higher in rural area than that in urban area.

  12. India and Pakistan`s nuclear arms race: Out of the closet but not in the street

    SciTech Connect

    Albright, D.

    1993-06-01

    CIA Director James Woolsey testified before the Senate on February 24, 1993, {open_quotes}The arms race between India and Pakistan poses perhaps the most probable prospect for future use of weapons of mass destruction, including nuclear weapons.{close_quotes} Currently, both countries are dependent on relatively crude nuclear bombs that do not appear to have been deployed. According to US officials, because of fears of accidental nuclear detonation, both sides would only assemble their nuclear weapons when absolutely necessary. Nevertheless, according to Woolsey, both nations {open_quotes}could, on short notice, assemble nuclear weapons.{close_quotes} Each has combat aircraft that could deliver these bombs in a crisis. India and Pakistan continue to improve their nuclear weapons. Unless their programs are stopped, they might succeed in moving from large, cumbersome bombs to miniaturized, easily armed and fuzed weapons able to be permanently deployed on attack aircraft or ballistic missiles, which are being developed or sought by both countries.

  13. Oligocene sivaladapid primate from the Bugti Hills (Balochistan, Pakistan) bridges the gap between Eocene and Miocene adapiform communities in Southern Asia.

    PubMed

    Marivaux, Laurent; Welcomme, Jean-Loup; Ducrocq, Stéphane; Jaeger, Jean-Jacques

    2002-04-01

    A new species of Guangxilemur (Sivaladapidae, Adapiformes) is described from the early Oligocene Chitarwata Formation (Bugti Member) of the Bugti Hills, Sulaiman geological Province, Balochistan, Pakistan. Guangxilemur singsilai n. sp. provides further diagnostic morphological characters from its newly described upper and lower dentitions, confirming its intermediate phylogenetic position between Eocene and Miocene Asian sivaladapid adapiforms. G. singsilai possesses moderately developed shearing and puncturing molar features and maintains lingual cusps on upper molars as in Eocene hoanghoniines; in contrast, it possesses a typical molariform P(4) as in Miocene sivaladapines. The important paleogeographic changes that have affected South Asia during the Tertiary (related to the collision between the Indian and Eurasian Plates) have played a critical role in reforming circulation and climatic differentiation. The presence in Pakistan of an unique and well-diversified Oligocene primate fauna, clearly demonstrates that South Asia maintained favourable environmental conditions during the middle Caenozoic global climatic deterioration that coincides with drastic changes in faunal structure on the whole Holarctic Province, including the extinction of adapiform primates.

  14. South Asia urged to act to fight spread of HIV.

    PubMed

    1997-07-21

    UNAIDS' data indicate that there are 5.3 million people infected with HIV in South Asia and Southeast Asia, approximately 20% of the world's estimated number of adults infected with HIV. South Asia was home to 6% of the world's AIDS cases in 1994, up from 1% in 1993. In the context of this major increase in the number of AIDS cases in the region, UNAIDS, together with the South Asian Association for Regional Cooperation (SAARC) and the European Commission, cosponsored a 2-day meeting in Kathmandu, Nepal, with regional health experts and officials to coordinate efforts with the international community to fight HIV/AIDS. Conference participants developed a plan of action against AIDS in the region. SAARC groups Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka. The level of literacy is very low in the region where many people, who do not know how HIV is transmitted, take no preventive measures.

  15. Child survival and changing fertility patterns in Pakistan.

    PubMed

    Sathar, Z A

    1992-01-01

    Pakistan is a country with high fertility and high infant and child mortality, and declines in total mortality and substantial development initiatives. The discussion considers whether fertility patterns in Pakistan can be related to changes in child mortality, and whether current and future changes in fertility influence child survival favorably. Omran's study linked large family size to child survival. Resources, which are divided, become more important deficits in households below the poverty line: a situation common in Pakistan. High fertility is associated with short birth intervals, which are related to higher infant and child mortality. In Pakistan, the spacing and mortality link was found among both poverty and higher socioeconomic households. There is some support for the notion that it is birth weight and general health that are linked to survival rather than competition for resources. Other studies link the maternal age at birth and birth order with child mortality (Alam and Cleland). Trussel argues for limiting births in high risk ages of under 20 years and over 35 years. The exact casual link is not well documented. Institutional and community factors are also considered important in influencing child survival: sanitation, potable water, access to roads, electricity, health and family planning services, and sewage. Young infants are more vulnerable to these factors. Bangladesh and some Indian states have shown that population programs and raising per captia incomes are necessary to fertility decline. In India, female autonomy, access to education, and more equal income distribution were considered more important than economic development to child survival. In Pakistan, Sathar and Kazi have linked at least 2 years of elementary, maternal education with reductions in child mortality. The pervasiveness of female illiteracy hinders the chances of child survival. Sex preferences also impact on female children. The probably impacts of declines in breast

  16. Climate change and managing water crisis: Pakistan's perspective.

    PubMed

    Hussain, Mumtaz; Mumtaz, Saniea

    2014-01-01

    Climate change is a global phenomenon manifested mainly through global warming. The International Panel on Climate Change (IPCC) has reported its negative consequences on natural resources, anthropogenic activities, and natural disasters. The El Nino and La Nina have affected hydrologic regimes and ecosystems. It has been observed that the average temperature in 1995 was 0.4°C higher than that in 1895. By the end of the 21st century, 10% of the area of Bangladesh is likely to be submerged by the sea. Most of the islands of Pacific Ocean will disappear. A major part of Maldives will be submerged. The sea level is expected to rise by 30-150 cm. Extreme events such as floods, cyclones, tsunamis, and droughts have become regular phenomena in many parts of the world. Other adverse impacts are proliferation of water-borne diseases, sea water intrusion, salinization of coastal areas, loss of biodiversity, eco-degradation of watersheds and global glacial decline, and haphazard snow melts/thaws. In turn, these factors have serious effect on water resources. Pakistan is confronting similar climate change. Meteorological data reveal that winter temperatures are rising and summers are getting cooler. Temperature is expected to increase by 0.9°C and 1.5°C by years 2020 and 2050, respectively. Water resources in Pakistan are affected by climate change as it impacts the behavior of glaciers, rainfall patterns, greenhouse gas emissions, recurrence of extreme events such as floods and droughts. Severe floods have occurred in the years 1950, 1956, 1957, 1973, 1976, 1978, 1988, 1992, 2010, 2011, and 2012. Pakistan has faced the worst-ever droughts during the period from 1998 to 2004. Pakistan has surface water potential of 140 million acre feet (MAF) and underground water reserve of 56 MAF. It is one of the most water-stressed countries in the world. The per capita annual availability of water has reduced from 5140 m3 in 1950 to 1000 m3 now. It is fast approaching towards water

  17. Climate change and managing water crisis: Pakistan's perspective.

    PubMed

    Hussain, Mumtaz; Mumtaz, Saniea

    2014-01-01

    Climate change is a global phenomenon manifested mainly through global warming. The International Panel on Climate Change (IPCC) has reported its negative consequences on natural resources, anthropogenic activities, and natural disasters. The El Nino and La Nina have affected hydrologic regimes and ecosystems. It has been observed that the average temperature in 1995 was 0.4°C higher than that in 1895. By the end of the 21st century, 10% of the area of Bangladesh is likely to be submerged by the sea. Most of the islands of Pacific Ocean will disappear. A major part of Maldives will be submerged. The sea level is expected to rise by 30-150 cm. Extreme events such as floods, cyclones, tsunamis, and droughts have become regular phenomena in many parts of the world. Other adverse impacts are proliferation of water-borne diseases, sea water intrusion, salinization of coastal areas, loss of biodiversity, eco-degradation of watersheds and global glacial decline, and haphazard snow melts/thaws. In turn, these factors have serious effect on water resources. Pakistan is confronting similar climate change. Meteorological data reveal that winter temperatures are rising and summers are getting cooler. Temperature is expected to increase by 0.9°C and 1.5°C by years 2020 and 2050, respectively. Water resources in Pakistan are affected by climate change as it impacts the behavior of glaciers, rainfall patterns, greenhouse gas emissions, recurrence of extreme events such as floods and droughts. Severe floods have occurred in the years 1950, 1956, 1957, 1973, 1976, 1978, 1988, 1992, 2010, 2011, and 2012. Pakistan has faced the worst-ever droughts during the period from 1998 to 2004. Pakistan has surface water potential of 140 million acre feet (MAF) and underground water reserve of 56 MAF. It is one of the most water-stressed countries in the world. The per capita annual availability of water has reduced from 5140 m3 in 1950 to 1000 m3 now. It is fast approaching towards water

  18. Forecasting Extreme Flooding in South Asia (Invited)

    NASA Astrophysics Data System (ADS)

    Webster, P. J.

    2010-12-01

    In most years there is extensive flooding across India, Pakistan and Bangladesh. On average, 40 million people are displaced by floods in India and half that many again in Bangladesh. Occasionally, even more extensive and severe flooding occurs across South Asia. In 2007 and 2008 the Brahmaputra flooded three times causing severe disruption of commerce, agriculture and life in general. Systems set up by an international collaboration predicted these Bangladesh floods with an operational system at the 10 and 15-day horizon. These forecasts determined the risk of flooding and allowed the Bangladeshis in peril to prepare, harvesting crops and storing of household and agricultural assets. Savings in increments of annual income resulted form the forecasts. In July and August 2010, severe flooding occurred in Pakistan causing horrendous damage and loss of life. But these floods were also predictable at the 10-day time scale if the same forecasting system developed for Bangladesh had been implemented. Similar systems could be implemented in India but would require local cooperation. We describe the manner in which quantified probabilistic precipitation forecasts, coupled with hydrological models can provide useful and timely extended warnings of flooding.

  19. Smokeless tobacco consumption in a multi-ethnic community in Pakistan: a cross-sectional study.

    PubMed

    Abbas, S M; Alam, A Y; Usman, M; Siddiqi, K

    2014-06-18

    Smokeless tobacco is commonly used in south Asia. In addition to causing oral and pharyngeal cancers, its harmful effects are comparable to smoking tobacco. A cross-sectional survey with systematic sampling was conducted in 2010-2011 to investigate smokeless tobacco use in a multi-ethnic, semi-urban population in Islamabad, Pakistan (n = 2030). The prevalence of smokeless tobacco use was 16.0% (21.6% among males and 8.8% among females); 51.7% of smokeless tobacco users were also cigarette smokers. The rate of smokeless tobacco use was comparatively high among Pakhtun males (38.2%) and Sindhi females (22.4%). The associations between smokeless tobacco use and ethnicity, age group, income level and cigarette smoking were statistically significant among male smokeless tobacco users. Of the sample 41.4% (840/2030) had inadequate knowledge about the health problems associated with smokeless tobacco. Appropriate interventions are needed to raise awareness of the health risks and to prevent smokeless tobacco use.

  20. Cooperative Monitoring Center Occasional Paper/18: Maritime Cooperation Between India and Pakistan: Building Confidence at Sea

    SciTech Connect

    SIDDIQA-AGHA,AYESHA

    2000-11-01

    This paper discusses ways in which the navies of both India and Pakistan can cooperate on issues of maritime and naval significance. Although the militaries and navies of the two countries have traditionally seen each other as rivals, international economic developments make cooperation imperative. South Asia requires an approach that can alter the exi