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Husain N.,University of Manchester | Husain N.,Pakistan Institute of Learning and Living | Parveen A.,Pakistan Institute of Learning and Living | Husain M.,Lancashire Care NHS Foundation Trust | And 5 more authors.
Archives of Women's Mental Health | Year: 2011

Depression around childbirth is common in low income countries. The aim of this study was to examine the factors associated with persistence of depression from the antenatal to the postnatal period in urban Pakistan. A total of 1,357 pregnant women in their third trimester attending the antenatal clinic were included in the study. From these, 763 mothers who delivered at the study maternity home were reassessed after 3 months of childbirth. Edinburgh Postnatal Depression Scale (EPDS) was administered to measure depression in both the antenatal and the postnatal periods. Psychological distress, disability and life events experienced by mothers were also measured by using the Self-Reporting Questionnaire (SRQ-20), Brief Disability Questionnaire (BDQ), and Life Events Checklist, respectively. We found 25.8% prevalence rate of antenatal depression and 38.3% persistent depression in a private clinic. Persistently depressed mothers had significantly high psychological distress, more disability, and experienced more stressful life events than the resolved group. Our findings confirm the high rates of depression during pregnancy but we found low rates of persistent depression in this urban population as compared to the previous report. There is a need for further investigation of factors associated with persistent depression in order to develop appropriate interventions. © 2011 Springer-Verlag. Source

Ather M.H.,Aga Khan University | Siddiqui T.,Karachi Medical and Dental College
Arab Journal of Urology | Year: 2014

Context Despite producing some of the leading urologists in the world, urological training in the developing world is marred by inconsistency, and a lack of structure and focus on evidence-based practice. In this review we address these issues from the trainers' perspective. Introduction Teaching the art and science of urological practice is a demanding task. It not only involves helping the resident to develop the depth of cognitive knowledge, but also to have an appropriate surgical judgement, and an ability to act quickly but thoughtfully and, when necessary, decisively. Discussion The surgeon must have compassion, communication skills, be perceptive and dedicated. Most importantly, however, he or she should have the ability to cut and suture. Not all of these can be inculcated in the training programme, even with the best of efforts. The selection of an appropriate candidate therefore becomes an issue of pivotal importance. The changing focus of urological training incorporates research and evidence-based practice as essential components. It is particularly important in the developing world, as there is a dearth of standardised practice models across the healthcare system. Encouraging female residents can be done by improving and tailoring the working conditions. The 'brain drain' is a major problem in the developing world, and bureaucracy and government need to take appropriate measures to provide high-quality healthcare facilities with room for professional growth. Conclusions The future of urology will depend on improved education and training, leading to high-quality urological care, and to developing a service that is patient focused. © 2013 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology. Source

Tariq H.,Dow University of Health Sciences | Khan O.A.,Baqai Medical University | Aftab M.T.,Karachi Medical and Dental College
Pakistan Journal of Pharmaceutical Sciences | Year: 2016

Various Risk factors initiate Submucous fibrosis which may be augmented by NSAIDs. A number of animal studies on their mechanism indirectly support it especially regarding alterations in prostaglandin synthesis. This study has been designed to find association of these drugs with Oral Submucous fibrosis in the presence of risk factors. Newly diagnosed patients of Oral Sub mucous fibrosis were recruited for this study who attended Dental Department of Karachi Medical and Dental College from July 1 till Dec 31,2013.A structured interview and medical record of each patient was used to determine the demographic profile, any addiction, previous and present illnesses and drug (s) used. Through examination of Oral cavity was carried out to access the severity of disease as per modified Khanna & Andrade Classification (1995). Statistical Analysis was done by SPSS 15. Total 102 patients were recruited from dental OPD as per criteria of inclusion. Among these patients 36 (49.31%) were using NSAIDs in which Acetaminophen (30.55%), Acetylsalicylic acid (25.00%) and Diclophenac (19.44%) were 1st, 2nd and 3rd most common drugs. Data shows that 14 patients (28.88%) had mild and 22(61.11%) had sever fibrosis which was significantly high (P<0.05). Mild fibrosis was seen in 05 (45.46%) and Sever fibrosis in 06 (54.54%) out of total 11 patients who were using NSAIDSs since less than or equal to 6 months. Similarly mild fibrosis was seen in 09 (36.00%) and Sever fibrosis in 16 (64.00%) out of total 25 patients who were on NSAIDs since more than 6 months. No statistical significant difference (P>0.05) in severity of fibrosis is seen in patients who were using NSAIDs since less than or equal to 6 months but statistical significant difference (P<0.05) in severity of fibrosis is seen in patients who on these drugs since more than 6 months. Addiction burden was calculated by Average Duration x Average Frequency, which was 92.72 for Pan, 88.88 for Supari and 61.30 for Miscellaneous. No statistically significant difference (P>0.05) was seen in addiction burden of various substances in these patients. An association of NSAIDs with Oral Sub mucous fibrosis exists. The pathology is augmented if these drugs are used in the presence of risk factors. Therefore these drugs should not be prescribed to these patients until a clear benefit is not targeted. Source

Aziz S.,Karachi Medical and Dental College | Hosain K.,Sindh Institute of Urology and Transplant
Journal of the Pakistan Medical Association | Year: 2014

Objective: To determine the frequency pattern of CHO, protein and fat intake in 24 hours by Pakistani school children of different socioeconomic and cultural backgrounds) 6 to 16 years of age. Methods: The cross-sectional study was a multistage stratified sampling, done in a part of nationwide survey funded by the Higher Education Commission, Pakistan (HEC, Ref no: 20-441/R&D/2008). Sample collection of the study was done from 2006-2009, and growth centile charts have already been published (JPMA 2012; 62:367-77). This is the final paper of the completed project and includes data on only the nutritional status. Final statistical analysis of the nutrition aspect was done from 2012 to 2013 and comprised assessment of quality and quantity of CHO, protein and fats consumed by healthy schoolchildren in a 24 hrs recall (breakfast, brunch, lunch, tea time, dinner and bed time). Food records of 11, 237 school children were subjected to United States Department of Agriculture food exchange list. SPSS 18 was used for statistical analysis. Results: The age range of the study subjects was 6-16 years, and they represented different areas of Pakistan. The consumption of CHO was high (range: 60-74%) compared to protein (10-12%) and fat (18-32%). Conclusion: Schoolchildren in Pakistan were found to be taking a deficient amount of protein and fat in their daily diet, while. CHO intake was higher than normal. © 2014 J Pak Med Assoc. All Rights Reserved. Source

Parikh K.C.,Sterling | Oh D.,Korea University | Sittipunt C.,Chulalongkorn University | Kalim H.,National Cardiovascular Center Harapan Kita | And 2 more authors.
Thrombosis Research | Year: 2012

Objectives: The VOICE Asia study aimed to establish the mode of thromboprophylaxis in medical patients admitted to intensive care units (ICU), and to describe the epidemiology of patients at high-risk of venous thromboembolism (VTE) and of patients who were prescribed low molecular weight heparin (LMWH). Methods: This multinational, observational, cross-sectional study recruited medical patients admitted to ICU in whom a decision to give VTE prophylaxis had been taken. The treating physicians decided patient management. We recorded demographics, VTE risk factors, VTE risk assessment, thromboprophylaxis, and compliance to the American College of Chest Physicians (ACCP) guidelines. Results: The study enrolled 2969 patients from 113 centers in 5 Asian countries. The most common VTE risk factors were age > 60 years (57.1%), prolonged immobility (50.6%), respiratory diseases (41.3%), and acute infectious disease (36.2%). There was a wide gap between physicians' assessment of 'very high' risk for VTE (8.4%) and Caprini 'very high' risk stratification (54.9%). 2919 (98.3%) patients received prophylaxis (22.9%-only mechanical, 31.2%-only pharmacological, 44.2%-both, mechanical and pharmacological and 1.7%- no prophylaxis). Early mobilization (44.3%) and LMWH (66.2%, mean duration of prophylaxis-8.6 days) were the most common mechanical and pharmacological prophylaxis, respectively. 80.6% of patients were given thromboprophylaxis as per the ACCP guidelines (and 4.7% per Japanese guidelines). Conclusions: There is substantial underestimation of VTE risk and non-adherence to guidelines for thromboprophylaxis in medical ICU patients in participating Asian countries. This emphasizes the need for increasing awareness about optimum VTE risk assessment and improved implementation of appropriate thromboprophylaxis in at-risk medical ICU patients. © 2012 Elsevier Ltd. All rights reserved. Source

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