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Karachi, Pakistan

Siddique O.,Dow University of Health Sciences | Sundus A.,Dow University of Health Sciences | Faisal Ibrahim M.,Civil Hospital Karachi
Journal of the Pakistan Medical Association

Dengue fever is on the rise in developing nations like India, Pakistan, Sri Lanka and Bangladesh. There is no anti-viral chemotherapy or vaccine for dengue virus and management of the disease is done on supportive measures. The decline in the thrombocyte count leads to dengue haemorrhagic fever accounting for complications and mortality. Oral administration of Carica papaya leaves extract is said to have a positive impact on thrombocyte count. A 23-year-old man was administered a calculated dose for five days. Blood samples were tested for complete blood count before and after the administration of the juice. Thrombocyte count had increased from 28000/micro liter to 138000/micro liter at the end of five days. We present our experience here. Source

Hashmi A.,Medical Center | Soomro J.A.,World Health Organization | Memon A.,Chest Specialist Fatima Bhai Hospital | Soomro T.K.,Civil Hospital Karachi
Journal of Medicine

Objective: The inhalation route is widely used for the treatment of asthma. It is considered that inadequate inhaler technique is the leading cause of therapy failure. To determine the proportion of incorrect inhaler use and associated factors in asthmatic patients compromising quality of life. Methodology: It is a cross sectional study conducted at Specialist Chest Clinic Fatima Bhai Hospital Karachi from September 2010 to March 2011. A sample size of 215 was selected by Non-probability purposive sampling technique. Trained health care workers in presence Chest specialist requested patients to demonstrate their inhaler technique and assessed it according to the checklist. If any of the steps was missing or done incorrectly, it was marked as incorrect technique. Information was also collected through a structured questionnaire on socio-demographic variables such as age, gender, education, duration of asthma, duration of inhaler use, and patient education of inhaler technique. Data was entered and analyzed on SPSS-14. Results: There was an inverse relationship between education level and incorrect inhaler technique (p<0.05). Education of inhaler usage provided by doctors was more effective as compared to education provided by nurses (p<0.038). There was no significant relationship between age, sex, duration of asthma, duration of inhaler use, frequency of inhaler use and incorrect inhaler technique. Conclusion: Quality of life of a large percentage of patients is compromised by incorrect inhaler use and education level of patients had significant relationship with incorrect inhaler technique. Source

Shafique K.,Dow University of Health Sciences | Mirza S.S.,Dow University of Health Sciences | Mughal M.K.,Dow University of Health Sciences | Arain Z.I.,Isra University of Pakistan | And 3 more authors.

Water-pipe (WP) smoking has significantly increased in the last decade worldwide. Compelling evidence suggests that the toxicants in WP smoke are similar to that of cigarette smoke. The WP smoking in a single session could have acute harmful health effects even worse than cigarette smoking. However, there is no evidence as such on long term WP smoking and its impact on chronic health conditions particularly cardiovascular and metabolic conditions. Therefore, we conducted this study to investigate the relationship between WP smoking and metabolic syndrome (MetS). This was a cross-sectional study carried out in Punjab province of Pakistan using the baseline data of a population-based study - Urban Rural Chronic Diseases Study (URCDS). Information was collected by trained nurses regarding the socio-demographic profile, lifestyle factors including WP smoking, current and past illnesses. A blood sample was obtained for measurement of complete blood count, lipid profile and fasting glucose level. MetS was ascertained by using the International Diabetic Federation's criteria. We carried out multiple logistic regressions to investigate the association between WP smoking and MetS. Final sample included 2,032 individuals - of those 325 (16.0%) were current WP smokers. Age adjusted-prevalence of MetS was significantly higher among current WP smokers (33.1%) compared with non-smokers (14.8%). Water-pipe smokers were three times more likely to have MetS (OR 3.21, 95% CI 2.38-4.33) compared with non-smokers after adjustment for age, sex and social class. WP smokers were significantly more likely to have hypertriglyceridemia (OR 1.63, 95% CI 1.25-2.10), hyperglycaemia (OR 1.82, 95% CI 1.37-2.41), Hypertension (OR 1.95, 95% CI 1.51-2.51) and abdominal obesity (OR 1.93, 95% CI 1.52-2.45). However, there were no significant differences in HDL level between WP smokers and non-smokers. This study suggests that WP smoking has a significant positive (harmful) relationship with MetS and its components. © 2012 Shafique et al. Source

Hussain T.,Dow University of Health Sciences | Tauseef A.,Dow University of Health Sciences | Bari A.,Dow University of Health Sciences | Rasheed U.,Dow University of Health Sciences | Hassan J.A.,Civil Hospital Karachi
Journal of the Pakistan Medical Association

Objective: To evaluate awareness amongst general population attending Civil Hospital Karachi regarding risk factors associated with infertility. Methods: A descriptive study was conducted on subjects who were attendants to the patients admitted in Civil Hospital Karachi or had appointment in outpatient department. They were interviewed one-on-one after their verbal consent, through separate questionnaires for each gender, from September 2012 to January 2013. Minimal age of the respondents included was 18 years. Data was entered and analyzed in SPSS (version 20.0). Results: A total of 289 attendants were interviewed, 150 were females, with mean age 38.1±11.3 years, remaining 139 were males having a mean age of 32.5±9.9 years. Correct knowledge about the risk factors causing infertility was found to be limited among people. Only 159 (66.9%) and 142 (49%) of the total respondents recognized obesity and diabetes as a threat. Just 54 (36%) and 72(48%) of females were able to appreciate hirsutism and menorrhagia respectively as cause. Sixty (43%) and 67 (48%) of males considered mumps and smoking respectively as culprits. In contrast to previous researches, men received greater votes for being a probable victim of infertility (55%; 159 of the total respondents). Conclusion: Inadequacy of knowledge about infertility was clearly demonstrated through this study. This lack of knowledge explains why such a strong stigma is attached to infertility in the society. Source

Shafique K.,University of Glasgow | Mirza S.S.,Dow University of Health Sciences | Vart P.,University of Groningen | Memon A.R.,Civil Hospital Karachi | And 3 more authors.
Journal of Inflammation (United Kingdom)

Background: Areca nut, the seed of fruit of an oriental palm, known as Areca catechu, is commonly chewed in many countries. Diabetes, hypertension, cardiovascular diseases, oropharyngeal and oesophageal cancers have been associated with areca nut chewing and the mechanism by which areca nut chewing increases the risk of systemic diseases remains elusive. We hypothesize that systemic inflammation may be elevated among areca nut users, which is linked with many systemic diseases. Therefore, this present study was conducted to examine the systemic inflammation among areca nut chewers and healthy controls. Methods. This was an observational cross sectional study carried out on areca nut chewers and healthy individuals in Karachi, Pakistan. Participants were selected from a region of the city by invitation request sent from door to door. Information was collected regarding the socio-demographic profile and the pattern of use, and a blood sample was obtained to measure the level of C-reactive protein (CRP). We carried out multiple logistic regressions to investigate the association between socio-demographic profile, areca nut chewing and CRP levels. Results: We carried out final analysis on 1112 individuals of which 556 were areca nut chewers and 556 were the age, gender and area matched controls. Areca nut chewers had a significantly higher proportion of men (15.1%, n=84) who had an elevated CRP (>10mg/dl) as compared to controls (5.2%, n=29). Multivariate analyses showed that areca nut chewers had significantly higher odds of an elevated CRP (OR=3.23, 95% CI 2.08-5.02, p value <0.001) as compared to controls. Increase in amount of areca nut consumption had a significant dose-response relationship with systemic inflammation (p for trend <0.001). Further analysis revealed that areca nut chewers with tobacco additives were two times more likely to have an elevated CRP as compared to raw areca nut users. These associations remained unchanged after adjustments for age, BMI and years of full time education. Conclusions: Areca nut chewing has a significant association with systemic inflammation. Further work is required to confirm that systemic inflammation is the main pathway by which areca nut use increases the risk of systemic diseases. © 2012 Shafique et al.; licensee BioMed Central Ltd. Source

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