Sita Road, Pakistan

Dow University of Health Sciences
Sita Road, Pakistan

The Dow University of Health science , is a public research university located in urban metropolitan area of Karachi, Sindh, Pakistan. The university comprises two leading health science research institutes: Medical College and Dow International Medical College.Foundation and establishment in 1945, it is known for its strong emphasis on biomedical, health, and medical research programmes. It is one of the premium institution of higher learning in Pakistan, and ranked among one of the top medical schools by HEC in 2010. The university is named after its founder, Sir Hugh Dow, who laid the foundation of the institution in 1945. The institution offers undergraduate, post-graduate and doctoral programmes in almost all academic disciplines relating to medical science.Major initiatives were personally taken by Ishrat-ul-Ibad who secured its major funding endowment in 2002. The university's objectives are keen towards helping its students to strives to develop better communication skills to communicate with their patients and prepare its students for a meritorious professional career. Wikipedia.

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Sheikh A.,Dow University of Health Sciences
Diabetology and Metabolic Syndrome | Year: 2013

Current gold standard therapeutic strategies for T2DM target insulin resistance or β cell dysfunction as their core mechanisms of action. However, the use of traditional anti-diabetic drugs, in most cases, does not significantly reduce macrovascular morbidity and mortality. Among emerging anti-diabetic candidates, glucagon like peptide-1 (GLP-1) based therapies carry special cardiovascular implications, exerting both direct as well as indirect effects. The direct cardiovascular effects of GLP-1 and its analogs remain the focus of this review. © 2013 Sheikh; licensee BioMed Central Ltd.

Mahmood K.,Dow University of Health Sciences | Naeem M.,Dow University of Health Sciences | Rahimnajjad N.A.,Dow University of Health Sciences
European Journal of Internal Medicine | Year: 2013

Metformin, a biguanide is well known treatment for type 2 diabetes mellitus that has diverse mechanism of actions. Various studies have elucidated the role of this drug in different pathologies. The well-known United Kingdom Prospective Diabetic Study (UKPDS) has observed its survival benefits in a large cohort of individuals. Data has been conclusive that metformin also has beneficial role in lipid disorders as it improves the markers of metabolic syndrome. Studies have also shown the beneficial roles in antipsychotic induced weight gain as well as HIV lipodystrophy syndrome. Evidence is accumulating that metformin also improves the fertility in females with Polycystic Ovarian Syndrome (PCOS). It also delays aging and is effective in aging related disorders and is equally effective in inflammation related disorders at least in different rodent studies. Metformin's major effect has been shown in various cancers ranging from solid to hematological malignancies. Researchers are working to reveal more benefits of this magic drug but it remains an unexplored territory for the medical community. © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Khan M.S.,Dow University of Health Sciences
Global journal of health science | Year: 2014

There are two basic ways of performing coronary artery bypass graft surgery (CABG): on pump CABG and off pump CABG. Off pump CABG is relatively a newer procedure to on-pump CABG and does not require the use of the cardiopulmonary bypass machine. On pump CABG is the more traditional method of performing bypass surgery. However its resultant inflammatory effects cause renal dysfunction, gastrointestinal distress and cardiac abnormalities which have forced the surgeons to look for alternatives to the procedure. An extensive literature search revealed that on pump CABG causes better revascularization as compared to off pump CABG while off pump CABG has a much lower post operative morbidity and mortality especially in high risk patients. We suggest that the technique used should depend on the ease of the surgeon doing the operation as both the methods seem almost equally efficient according to the review.

Hanif H.M.,Dow University of Health Sciences
Journal of the Pakistan Medical Association | Year: 2011

Maternal age at conception has long been demonstrated to have a significant correlation with pregnancy outcome and maternal health. Classically, very young (<20 years old) and old (= or >35 years) women have been classified as high-risk categories for child bearing. Recently, career, education, financial, and other goals have coerced women to delay childbearing all over the world. This trend is also becoming apparent in Pakistan, especially in the upper middle class, wealthy and educated women, as they become increasingly empowered. This review presents the association between maternal age and pregnancy outcome, particularly in the context of statistics of Pakistan, and its possible repercussions. On one hand, physicians need to develop effective counseling strategies for their patients in this regard, and on the other, more studies are required to ascertain the attitudes of Pakistani women, particularly those belonging to the upper and middle classes, regarding delayed childbearing, that can aid physicians in formulating effective counseling strategies.

Muhammad Hanif H.,Dow University of Health Sciences
International Breastfeeding Journal | Year: 2013

Background: Optimal infant and young child feeding practices are crucial to improving the health and nutritional status of children. Bangladesh Breastfeeding Foundation, UNICEF and several other organizations are working in the country for the promotion of healthy feeding practices. This article presents trends in breastfeeding and complementary feeding practices in Bangladesh from 1993-2011, based on data in Bangladesh Demographic and Health Surveys. The following Bangladesh Demographic and Health Surveys were studied: BDHS 93-94, BDHS 96-97, BDHS 99-00, BDHS 04, BDHS 07 and BDHS 11. Values of indicators for infant and young child feeding proposed by WHO, along with their 95% confidence intervals, were calculated, and trends were assessed. Findings: Among the core indicators, early initiation of breastfeeding, exclusive breastfeeding under six months, introduction of solid, semi-solid and soft foods, and consumption of iron-rich foods have improved, while continued breastfeeding at one year does not display a statistically significant development. Of the optional indicators, the prevalence of age-appropriate breastfeeding and children ever breastfed improved, while the prevalence of predominant breastfeeding under six months witnessed a decline. Median duration of breastfeeding declined, and there was no change in the other optional indicators (continued breastfeeding at two years and bottle feeding). Developments in the other optional indicators were not statistically significant. The ratings of early initiation of breastfeeding and complementary feeding have gone up from poor to fair, those of exclusive breastfeeding under six months from fair to good, while those of bottle-feeding are fair. Conclusion: The developments in breastfeeding and complementary feeding practices in the country have been considerable, but there is still substantial scope for improvement. © 2013 Muhammad Hanif; licensee BioMed Central Ltd.

Shahid A.,Dow University of Health Sciences | Khan A.,Dow University of Health Sciences
Journal of the College of Physicians and Surgeons Pakistan | Year: 2013

Objective: To determine the effectiveness of tranexamic acid (TXA) in reducing blood loss during and after caesareansection (CS), as well as its safety.Study Design: A randomized double-blind placebo controlled study.Place and Duration of Study: The Lyari General Hospital, Karachi, from March 2009 till April 2011.Methodology: Women undergoing lower segment caesarean section (LSCS) were enrolled. The patients wererandomized to receive either injection TXA or distilled water just before the surgery. Blood loss was collected andmeasured. First from the time of placental delivery to the end of LSCS and later from the end of LSCS to two hourspostpartum. Haemoglobin, urine analysis, liver and renal functions were tested in both the groups. Mean values blood losswere compared using t-test with significance at p < 0.05.Results: Tranexamic acid significantly reduced the quantity of blood loss from placental delivery to the end of LSCS whichwas 356.44 ± 143.2 ml in the TXA group versus 710.22 ± 216.72 ml in the placebo group (p < 0.001). It also reduced thequantity of blood loss from the end of LSCS to 2 hours postpartum which was 35.68 ± 23.29 ml in the TXA group versus43.63 ± 28.04 ml in the placebo group (p = 0.188), was not significant. No complications or side effects were reported ineither group.Conclusion: Tranexamic acid significantly reduced the amount of blood loss during the LSCS, but it did not reduce theblood loss significantly after the caesarean section. Its use was not associated with any side effects or complication likethrombosis. TXA can be used safely and effectively in women undergoing LSCS to reduce intraoperative blood loss.

Siddiqui S.A.,Dow University of Health Sciences
Annals of Saudi Medicine | Year: 2013

BACKGROUND AND OBJECTIVES: The trial of labor after previous cesarean (TOLAC) is an important strategy to limit repeat cesarean sections and their complications. An unsuccessful TOLAC leads to maternal and neonatal morbidities. The success or failure of TOLAC after the first cesarean is determinant for the subsequent vaginal birth. Limited studies are available from low-income countries, exclusively conducted in women in their second-order birth following the first cesarean section. This study aims at determining the frequency of unsuccessful attempts at vaginal delivery in the second-order term (37-41+6/7 weeks) birth among women with previous cesarean sections and to describe maternal and obstetric factors for unsuccessful laborTOLACs in the same group. DESIGN AND SETTINGS: A cross-sectional study conducted from April to December 2010 at Obstetrics & Gynaecology Unit II, Civil Hospital Karachi. PATIENTS AND METHODS: All eligible patients at term pregnancy in their second-order birth were included. The frequency of unsuccessful attempts at vaginal birth was determined, followed by secondary analysis by calculating odds ratio for maternal and obstetric factors, that is, body mass index (BMI), hight, gestation ≥40 weeks, interdelivery interval, engagement of head in 5th, estimated fetal weight, ruptured membranes, duration of labor ≥7 hours, augmentation of labor, cervical dilatation <4 cm, and vertex station -2 or higher on admission. RESULTS: Out of 122 study subjects, the proportion of unsuccessful vaginal birth after cesarean (VBAC) was 27.9% (n=34). Among maternal and obstetric factors, BMI >25 (AOR, 5.00), gestation ≥40 weeks (AOR, 5.45), cervical dilatation <4 cm (AOR, 5.90), and station of vertex -2 or higher (AOR, 3.83) had highly significant adjusted odds for failed TOLAC. CONCLUSION: With a well-defined protocol, the rates of unsuccessful attempts at VBAC are not high for the second-order birth. The risk of failure can be anticipated by factors such as BMI >25, pregnancy duration ≥40 weeks, cervical dilatation <4 cm, and vertex station -2 or higher on admission.

Triple infection (TI) with HIV-1, HCV, and HBV (TI) is highly prevalent in intravenous drug users (IDUs). These TI patients have a faster progression to AIDS, and even after antiretroviral therapy (ART) the prognosis of their disease is poor. The use of microRNA (miRNA) to silence genes holds potential applications for anti-HCV therapy. We analyzed the role of human miRNAs (hsa-miRs) in TI by computational analyses for HCV, HIV-1, and HBV showing identity to these three viral genomes. We identified one unique miRNA, hsa-miR-3065-3p, that shares significant mutual identity to these three viral genomes (∼61-83%). In addition, hsa-miR-99, hsa-miR-548, and hsa-miR-122 also showed mutual identity with these three viral genomes, albeit at a lower degree (∼52-88%). Here, we present evidence using essential components of bioinformatics tools, and hypothesize that utility of hsa-miR-3065-3p and perhaps miR-548 would be potential antiviral therapeutic agents in the treatment of TI patients because it shows near perfect alignment in the seed region for all three viruses. We also make an argument that current proposed therapy with hsa-miR-122 may not be the optimal choice for HCV patients since it lacks essential gene alignment and may be harmful for the patients.

Hossain N.,Dow University of Health Sciences | Paidas M.J.,Yale University
Seminars in Perinatology | Year: 2013

Disseminated intravascular coagulation in obstetrics is commonly seen associated with massive hemorrhage due to different etiological factors. It may also be seen with intrauterine demise, infections, and hepatic conditions. It is associated with very high maternal and perinatal morbidity and mortality. A battery of laboratory tests (prothrombin time, partial thromboplastin time, thrombin time, and plasma fibrinogen) can be used in the diagnosis, but no single test in isolation is sensitive and specific enough for diagnosis. Cornerstone of management is to identify the underlying pathology for disseminated intravascular coagulation. This chapter looks into molecular basis of obstetric DIC and identifies important laboratory tests, along with management. It also identifies topics of future research in the field of obstetric DIC. © 2013 Elsevier Inc.

Perveen S.,Dow University of Health Sciences
Journal of the College of Physicians and Surgeons Pakistan | Year: 2011

Objective: To determine selected maternal and neonatal adverse outcomes at repeat cesarean delivery compared with repeat vaginal delivery. Study Design: Cross-sectional study. Place and Duration of Study: Lyari General Hospital, Karachi, from January 2005 to December 2008. Methodology: Healthy pregnant women at 28-42 weeks of second singleton pregnancy were selected for study. Those with previous cesarean birth was labelled the exposed group and those with previous vaginal birth were considered the control group. Maternal and neonatal morbidity's attributable to the previous cesarean section was estimated. Potential confounders like persistent medical disorders, previous adverse outcome and trial of scar cases was excluded. Results were presented in frequency and percentage. Effects of outcomes were calculated as odds ratio with 95% confidence interval. SPSS-16 was used for statistical data analysis. Results: A total of 195 mothers at repeat cesarean delivery were compared with 1486 mothers at repeat vaginal delivery. Mothers with previous cesarean birth were at high risk of peripartum hysterectomy and placenta accrete followed by placenta praevia [OR 7.6 (95% CI = 0.48-122.8), 7.6 (0.48-122.8) and 2.5 (0.68-9.6) respectively]. Very preterm birth [OR = 3.86, 95% CI 1.15-12.97)] was the most significant neonatal adverse outcome. Conclusion: Cesarean section in first pregnancy conferred an additional risk in the second pregnancy even after exclusion of known complications of trial of scar. These should be part of overall clinical assessment at the time of first cesarean section.

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