DOCSLIB.ORG

JDUHS Volume 4 Issue 13 January to April 2010.FH10

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
JDUHS Volume 4 Issue 13 January to April 2010.FH10 JDUHS Volume 4, Issue 1 January - April, 2010 EDITORIAL BOARD Editor-in-Chief Editor Associate Editors Assistant Editor Masood Hameed Khan Nazeer Khan Mohammad Rafiq Khanani M. Abdul Wahid Usmani Rana Qamar Masood Managing Editor Members Bibliographer Zahid Mirza Nazli Hossain Shahbaz Ahmed S. M. Zahid Azam ADVISORY BOARD National International Abdul Gaffar Billoo Adeel A. Butt (USA) Adnan Ahmed Khan IIyas Kamboh (USA) Aisha Mehnaz Mansour Mohammad Al-Nozha (Saudi Arabia) Dure-Samin Akram Muhammad Sameer Qureshi (UK) Fazal Ghani Nizam Damani (USA) Mohammad Nawaz Anjum Osman Mohammed Ahmed Taha (Sudan) Muhammad Saeed Shafi Sultan Ahmed (USA) Saeed Farooq Sina Aziz Syed Ali Anwar Naqvi Syed M. Wasim Jafri Talat Mirza Waris Qidwai Recognized by the Pakistan Medical and Dental Council. Registration No. IP/036 Indexed in IMEMR, PakMediNet and Global Health The JDUHS is published 4 monthly by the Dow University of Health Sciences Editorial correspondence should be addressed to : The Editor-in-Chief, JDUHS, Dow University of Health Sciences, Baba-e-Urdu Road Karachi-74200, Pakistan. Tel : 9215754-57 Fax : 9215763 E-mail : [email protected], Website : www.duhs.edu.pk Annual subscribtion rates: In Pakistan : Rs. 450, Bangladesh & India: Rs. 600, UK : £ 15, U.S.A and other countries: US$ 15 Published by : The Registrar, Dow University of Health Sciences (DUHS), Karachi-74200, Pakistan i JDUHS Volume 4, Issue 1 January - April, 2010 EDITORIAL Page No. Diarrheal Disease: Major killer of Children, New Development Abdul Gaffar Billoo 1 ORIGINAL ARTICLE Perception of Medical Students on Structured Viva Examination Anila Jaleel and Noreen Jaffrey 4 In an Integrated Undergraduate Curriculum at Ziauddin University Detection of Peripheral Arterial Disease (PAD) in Diabetics using Khatoon Akhtar Bano, Naheed Hashmat , 8 Ankle Brachial Index (ABI) Asia Batool and Shameem Ahmad Siddiqui Phenomena of Physical Activity in with Myocardial Infarction Shazia Azeem and Nazeer Khan 13 Patients of Karachi, Pakistan Morbidity, Co-Morbidity Profile and Disability Status Among Yasmin Mumtaz, Hira Riaz, Muhammad Arsalan, 19 Elderly in Civil Hospital Karachi Sana Akhtar, Hareem Haider and Wajiha Manzoor Current Pattern of Bloodstream Infections in a Tertiary Care Farhan Essa Abdullah, Yasmeen Taj 25 Hospital of Karachi and Clinical Significance of Positive Blood and Shaheen Sharafat Cultures Contusion Index: Its Importance In Management of Traumatic Atiq Ahmed Khan, Muhammad Aslam, 31 Brain Contusions Muhammad Imran, Muhammad Muzaffaruddin, Irfanullah Shah and Junaid Ashraf. CASE REPORT Knotting of Urethral Catheters: a Preventable Complication Muhammad Shahab Athar, Muhammad Sajjad Ashraf, 38 Muhammad Talat Mehmood and Shero Moti Pulmonary Alveolar Microlithiasis Nisar Ahmed Rao and Arsalan Ahmed 40 SHORT COMMUNICATION Frequency of Smoking Among Employees at a Tertiary Care Ashfaq Ahmed Memon, Muhammad Ayaz Mustufa and 43 Children Hospital, Karachi Muhammad Ashfaq ACKNOWLEDGEMENT OF REVIEWERS iii INSTRUCTIONS TO AUTHORS vi ii EDITORIAL Diarrheal Disease: Major killer of Children, New Development Abdul Gaffar Billoo Disease Burden Diarrheal disease is one of the biggest causes of childhood To alleviate the state of child health in resource poor mortality and morbidity in developing countries of the settings in developing countries, the World Health world. Organization (WHO) and the United Nations International Childrens Emergency Fund (UNICEF) presented the Diarrhea accounts for about 1.5 million deaths annually, Integrated Management of Childhood Illness (IMCI) 1 making up about 15 to18% of global under-5 mortality. algorithm in 1995 which is a comprehensive strategy to In the Eastern Mediterranean region, diarrhea accounts treat and prevent childhood illnesses and institute referrals for 17% of under-5 deaths.2 According to the Pakistan on detection of specific danger sings5. Diarrheal disease Demographic and Health Survey 2006-2007, diarrhea is also covered in IMCI,which provides simple guide accounts for 10.9% of deaths under the age of 5.3 Concurrent factors such as malnutrition and poor access lines for assessment and management of diarrhea to to rehydration are responsible for the majority of these improve the effectiveness of community health workers 5 deaths. Malnutrition is concurrently present in 54% of all and primary physicians. diarrhea-related deaths 4 (see Fig. 1). A detailed history and complete physical examination remain vital. The most important aspect of the management This emphasizes the great importance of nutritional status of a patient with diarrhea is to assess and classify the in determining the outcome of illness, particularly in a degree of dehydration. The emphasis is on replacement diarrheal episode. of fluid loss with ORS and homemade fluids with continued feeding. Fluid replacement guidelines are simplified based on whether the patient has NO 18% 25% dehydration, SOME dehydration or SEVERE dehydration, requiring treatment PLAN-A, PLAN-B or PLAN-C respectively.5 These guidelines have resulted in huge reduction in diarrhea related global mortality, from 4.5 deaths associated million to 1.5 million deaths annually, in last two decades. with mainutrition 15% 54% New Developments 1:- Improved Low osmolarity ORS 23% 10% Evidence suggests that efficacy of ORS solution for 4% 5% treating children with acute non-cholera diarrhea is Major causes of death among children under five in developing countries, 2002 improved by reducing its sodium concentration to 75mEq/L from 90 mEq/L, glucose concentration to Acute respiratory infections HIV/AIDS 75mmol/L from 111 mEq/L and total osmolarity to Diarrhoca Perinatal 245 mosm/L from 311 mosm/L. (See Table no. 1).The Malaria Other Measles 245 mosm/L solution also appeared to be as safe and at least as effective as standard ORS for use in children with diarrhea. A systematic review of 15 randomized controlled Correspondence: Dr. Abdul Gaffar Billoo, Professor and Chairman of Paediatrics, trials concluded that in children admitted to hospital with Aga Khan University Hospital, Karachi, Pakistan. dehydration associated with diarrhea, reduced osmolarity E-mail: [email protected] Received: February 26, 2010: accepted: April 15, 2010. rehydration solution is associated with reduced need for Journal of the Dow University of Health Sciences 2010, Vol. 4(1): 1-3 1 Abdul Gaffar Billoo fluids, lower stool volume, and less vomiting compared perspective, use of zinc as adjunct therapy has been shown with standard WHO rehydration solution.6 to have significantly improved the cost-effectiveness of standard management of diarrhea with particular benefitsin 14 With reduced osmolarity ORS having established its role mortality rates in non-dysenteric diarrhea. Zinc has been in improving outcomes in children with diarrhea, the latest demonstrated to be equally useful in the Pakistani WHO guidelines now recommend that countries use the population. A triple-blinded randomized trial conducted in following formulation in place of previously recommended an urban slum in Karachi concluded that daily provision ORS solution (See Table No. 1).Previous formulations of of micronutrients (including zinc) reduced the longitudinal ORS are now to be replaced by the new ones, and to avoid prevalence of diarrhea and thus reduced diarrhea related confusion, the new formulation is now to be simply referred mortality in young children.15 7, 8 to as ORS Based on these findings, WHO and UNICEF(2004) issued a joint statement on the clinical management of 2:- Zinc in treatment of diarrhea diarrhea which recommends that, along with increased fluids, Low Osmolarity ORS , and continued feeding, Most children dying of diarrhea are also malnourished and all diarrheic children be given 20 mg per day of zinc have associated micronutrient deficiency. Children with supplementation for 10-14 days (10 mg per day for marginal nutritional status are at significant risk of infants below six months of age).16 aggravating zinc depletion with diarrheal episodes. 9 Daily losses of zinc in the intestinal fluid during acute diarrhea are as high as 159ug/kg/day compared with 47ug in control CONCLUSION AND group.10 Zinc deficiency also impairs cellular and humoral RECOMMENDATION immune function with zinc supplementation improving immunity. Zinc deficiency also has direct effects on the Diarrhea continues to be a significant cause of morbidity gastrointestinal tract such as impaired intestinal brush border, and mortality in Pakistani children, and reducing incidence increased secretion in response to bacterial enterotoxins 11 of diarrhea would have a significant impact in helping and a breakdown in intestinal permeability reduce child mortality, and in turn, achieving MDG-4. Low osmolarity ORS should replace existing With this biological basis, zinc has been studied in numerous formulations, AS SOON AS POSSIBLE and should be trials and a meeting held in New Delhi in May 2001, which widely distributed in the community. reviewed all studies conducted on effectiveness of zinc concluded that zinc supplementation given during an episode All children with diarrhea should be given ZINK of acute diarrhea significantly reduced the duration and SUPPLEMENTATION along with increased fluid and severity of the episode.12 In six of nine trials that evaluated continued feeding. prevention of diarrhea significantly, analysis demonstrated 18% less diarrhea.13 From a program implementation PREVENTION OF DIARRHEA TO REDUCE THE BURDEN OF THE DISEASE. COMPOSITION OF REDUCED
Load more

Recommended publications
  • Memon Welfare Society Newsletter February 2015
    February 2015 Memon Welfare Society Newsletter إﻧﺎ ﷲ وإﻧﺎ إﻟﻴﻪ راﺟﻌﻮن Issue No. 68 King Abdullah Passed Away Patrons: His Majesty King Salman Bin Abdel Aziz M.Iqbal Advani Dr. Hamid A.Khader Munaf A.S.Bakhshi Mohammed I. Badi Dr. Mohammed Umer Chapra Kaleem A. Naviwala addressing the guests of MASA Grand Dinner. Dr.Iqbal Musani, Office Bearers: former president MASA is sitting with him President: To God We Belong and Indeed to Him Arif A.M. Memon we shall Return,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,. Vice Presidents: Younus Habib Goli & Custodian of the Two Holy Mosques King Abdullah Bin Abdelaziz died on rd Mansoor A.R.Shivani Friday 23 January 2015 following a short illness. Crown Prince Salman Bin Abdelaziz has been named the new king with Prince Muqrin as crown General Secretary: Tayyab K. Moosani prince, according to a Royal Court statement. (Arab News) Joint Secretary: Dear Brothers and Sisters, A.Rashid Kasmani Assalamo Alaikum WRWB Treasurer: th Shoaib Sikander While preparing 68 Issue of MASA Newsletter, we were shocked to lean above mentioned sad and tragic news. We sincerely offer our deepest condolences to each and every Saudi Brothers and share their grief. Let us go through the feelings of couple of great leaders of world which is Member Advisory: in fact feeling of most of the people: Dr.Iqbal Musani Irfan Kolsawala “I am deeply saddened to hear of the death of the Custodian of the Two Holy Mosques, His M.Younus A.Sattar Majesty King Abdullah bin Abdul Aziz Al‐Saud. He will be remembered for his long years of service to the Kingdom, for his commitment to peace and for strengthening understanding M.
    [Show full text]
  • The Pakistan National Bibliography 2002
    THE PAKISTAN NATIONAL BIBLIOGRAPHY 2002 A Subject Catalogue of the new Pakistani books deposited under the provisions of Copyright Law or acquired through purchase, etc. by the National Library of Pakistan, Islamabad, arranged according to the Dewey Decimal Classification, 20th edition and catalogued according to the Anglo American Cataloguing Rules, 2nd revised edition, 1988, with a full Author, Title, Subject Index and List of Publishers. Government of Pakistan, Department of Libraries National Library of Pakistan Constitution Avenue, Islamabad 2003 © Department of Libraries (National Bibliographical Unit) ⎯ 2003. EDITORIAL COMMITTEE Zulfiqar Ahmad Director Muhammad Irshad Sherwani Editor Mazhar Iqbal Jalaly Assistant Editor ISSN 1019-0678 ISBN 969-8014-34-9 Price: Within Pakistan…….. Rs. 1100.00 Outside Pakistan…….US$ 60.00 Available from: National Book Foundation, 6-Mauve Area, Taleemi Chowk, Sector G-8/4, ISLAMABAD P A K I S T A N. (ii) PREFACE The objects of the Pakistan National Bibliography are to list new works published in Pakistan, to describe each work in detail and to give the subject matter of each work as precisely as possible. The 2002 volume of the Pakistan National Bibliography covers Pakistani publications received during the year 2002 in the Delivery of Books and Newspapers Branch of the National Library of Pakistan at Islamabad under the Provisions of Copyright Law: Copy right Ordinance, 1962 as amended by Copyright (Amendment) Act, 1973 & 1992. Those titles which were not received under the Copyright Law but were acquired through purchase, gift and exchange have also been included in the Bibliography. Every endeavour has been made to ensure the accuracy of the information given.
    [Show full text]
  • Perception and Practices of Breastfeeding of Infants 0-6
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by eCommons@AKU eCommons@AKU Department of Paediatrics and Child Health Division of Woman and Child Health January 2011 Perception and practices of breastfeeding of infants 0-6 months in an urban and a semi-urban community in Pakistan: a cross-sectional study Sumera Ali Aga Khan University Syed Faizan Ali Aga Khan University Ayesha Mallick Imam Aga Khan University Samia Ayub Aga Khan University Abdul Gaffar Billoo Aga Khan University Follow this and additional works at: http://ecommons.aku.edu/ pakistan_fhs_mc_women_childhealth_paediatr Part of the Pediatrics Commons Recommended Citation Ali, S., Ali, S., Imam, A., Ayub, S., Billoo, A. (2011). Perception and practices of breastfeeding of infants 0-6 months in an urban and a semi-urban community in Pakistan: a cross-sectional study. Journal of the Pakistan Medical Association, 61(1), 99-104. Available at: http://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_paediatr/23 Students’ Corner KAP Study Perception and practices of breastfeeding of infants 0-6 months in an urban and a semi-urban community in Pakistan: a cross-sectional study Sumera Ali,1 Syed Faizan Ali,2 Ayesha Mallick Imam,3 Samia Ayub,4 Abdul Gaffar Billoo5 Medical Student, Medical College,1-4 Department of Paediatrics,5 The Aga Khan University, Karachi. Abstract Objective: To investigate mother's perception and practices about breastfeeding and their socio-demographic correlate in infants equal to or less than 6 months. Methods: A cross-sectional study was carried out on 200 mother-infant pairs who visited the health care centers, Bilal Colony (semi-urban) and the Aga Khan University (urban), for their well baby follow-ups and vaccination using convenient sampling.
    [Show full text]
  • Who's Who of the Receipiemts of the International Volunteers Day Shield 1998-2016
    Who's Who Of The Receipiemts Of The International Volunteers Day Shield 1998-2016 ABBASI, CV: M.A.; Ph.D. Appointments: Senior Dr. Apa Shamsa. educationist in the Government of Sindh for over forty years. A post-graduate student at the time of Special Assignments: Established Federal Independence, the popular Apa Shamsa of Government’s Community Centers for Women Hyderabad, rendered immense essential services (149 Nos.) and District-level Special Education to the thousands of incoming caravans of harassed institutions. © 2005 refugees in most unusual and critical circumstances traversing from across the new ABBASI, boarders. Along with her equally highly-spirited Dr. Ruby Anwar. brother, the late Kazi Akbar,-[the well-known staunch fighter of the Pakistan Movement] and A dedicated volunteer, Begum Ruby Anwar is his dedicated teams, she remained hectically spiritedly serving the cause of special persons engaged for a very long time in this great for over three decades. Accordingly, established humanitarian mission. the Al-Umeed Rehabilitation Assn., for the Joined the newly-formed APWA and spear-headed education, general and vocational training of the the formation of its Hyderabad District and Sindh mentally retarded children and their ultimate Prov. Branches besides educational, health, placement in the main-stream of life. Membership: incoming generating and other beneficial projects Actively associates with other NGO’s concerned for women in different cities. Held top offices in with the problems of the disabled people. both and is heading the Provincial body for many years. National Honor/Tittle : ’Tamgah-e-Imiaz’ [..2003]. Participated in international conferences on education and welfare of women, besides CV.
    [Show full text]
  • Proceedings of the Conference on Indigenous Philanthropy October 16 & 17, 2000 Islamabad, Pakistan
    Proceedings of the Conference on Indigenous Philanthropy October 16 & 17, 2000 Islamabad, Pakistan AGA KHAN BEVlBfjG9ME!WkETWOIlK Steering Committee The Initiative on Indigenous Philanthropy Dr. Shamsh Kassim-Lakha Convenor, Steering Committee President, Aga Khan University Mr. SyedBabarAli Pro-Chancellor, Lahore University of Management Sciences Advisor, Packages (Pvt.) Ltd. Mr. Mueen Afzal Secretary General Finance and Economic Affairs, Government of Pakistan Mr. Kamal Chinoy Chairman, Aga Khan Foundation (Pakistan) Chief Executive Officer, Pakistan Cables Ltd. Mr. AsifB. Fancy Senior Director, Resource Development & Public Affairs The Aga Khan University Dr. Attiya Inayatullah ; Minister for Women Development, Social Welfare, Special Education and Population Welfare, Government of Pakistan President, International Planned Parenthood Federation Mr. Mahomed J. Jaffer Senior Partner, Orr Dignam & Company, Advocates Mr. Shoaib Sultan Khan Senior Advisor, United Nations Development Programme Chairman, National/Punjab/Sarhad Rural Support Programmes Mr. Khurshid Marker Chairman, Merck Marker (Pvt.) Ltd. Mr. Shaukat R. Mirza Managing Director, Pakistan State Oil Mr. Saeed Ahmad Qureshi Former Deputy Chairman, Planning Commission Secretary General, Government of Pakistan Ms. Sherry Rehman Media Consultant Dr. Sulaiman Sheikh Chief Executive, Sindh Graduates Association Mr. John W. Wall Country Representative Pakistan and Afghanistan, The World Bank Group /0&£p£r^ likeness of those who spend their wealth in the way of Allah is as the likeness of a \C\^ grain which grows seven ears; > \ in every ear a hundred grains, and verily, Allah gives increase manifold to whomever He wills, and Allah is omniscient, knowing. (Al-Baqrah.261) Those who spend their wealth by night arKl ^y daV' secretly and openly, they shall have their reward from their Lord; they shall have no fear, nor shall they grieve.
    [Show full text]
  • FINAL CR BULLETIN English
    IDP IDP IDP CRISIS RESPONSE BULLETIN March 23, 2015 - Volume: 1, Issue: 10 IN THIS BULLETIN HIGHLIGHTS: English News 2-29 Agri-Economy: World Bank approves $187m for Irrigation System 02 Two-Day Training on Disaster Risk Reduction held 02 Women Turn Thar Drought into a Lesson on Sustainability 04 Natural Calamities Section 2-7 Pakistan: Proper Handling of the Dead Eases the Suffering of the 05 Safety and Security Section 8-13 Bereaved Battle for Pakistan: TDPs resettlement won’t be over until Dec 2016 08 Public Services Section 14-29 Insufficient security at Govt schools puts parents on tenterhooks 08 PM Nawaz vows to transform Karachi into ‘crime-free city’ 09 Maps 30-37 Pakistan does not want to be drawn into arms race with India: 10 President United Nation to monitor safety measures at Pakistani schools: Brown 11 Urdu News 55-38 COAS asks nation to join hands in war against terror 11 Employees dismissed to keep Pakistan's nuclear programme safe 12 Natural Calamities Section 55-53 Substandard tap changers may cause havoc to transformers 14 Suspension of mobile phone service perturbs Islooiites 14 Safety and Security section 52-46 APCNGA demands reopening of CNG stations in Punjab 15 Public Service Section 45-38 NTDCL of Pakistan signs 3 deals for 130 MW wind energy purchase 16 PAKISTAN WEATHER MAP WIND SPEED MAP OF PAKISTAN TEMPERATURE MAP OF PAKISTAN POLIO CASES IN PAKISTAN - 2015 MAPS CNG SECTOR GAS LOAD MANAGEMENT PLAN-SINDH VEGETATION ANALYSIS MAP OF PAKISTAN PUNJAB - FIRE INCIDENTS MAP SUICIDE ATTACKS IN PUNJAB (FROM OCTOBER 10,
    [Show full text]
  • Aga Khan University, Report 2012
    Report 2012 x Contents Chancellor’s Message 3 Chairman’s Message 4 From the President 6 Reflections of a Trustee 10 The AKU World 14 Overview: Shaping the Future 16 Innovative Solutions in Unlikely Places 24 Digital Solutions for Village Teachers 27 Broadcast High School 28 Educating Nurses Where They Work 30 Strong Mothers + Healthy Children = A Better World 32 Every Mother, Every Child Counts 35 Charting Growth Curves for Babies 36 Mama Na Mtoto 37 Education for Impact 38 Improving Teaching Practice 40 Expanding Access to Educational Opportunity 42 Building Bridges, Connecting Cultures 45 Acting on Our Values, Leading the Way 46 Fighting for Health in the Flood’s Wake 49 The Care Continuum 50 Bridging the Access Divide 52 Strength Through Collaboration 54 Our Partners 56 In the Spotlight 58 Special Events 60 Some of Our People 62 Awards 67 Campus Expansions 68 Executive Team 74 University Governance 76 University Numbers 80 Financial Highlights 82 Contact Us 86 AKDN 88 x Chancellor’s Message “In too much of the developing world, the capacity to realise the potential of the human resource base is still sadly limited. Too many of those who should be the leaders of tomorrow are being left behind today. And even those students who do manage to get a good education often pursue their dreams in far off places – and never go home again. The result is a widening gap between the leadership these communities need – and the leadership their educational systems deliver. For much of human history, leaders have been born into their roles, or have fought their way in – or have bought their way in.
    [Show full text]
  • Research Reference Guide -..::Health RAB
    Research Reference Guide A Comprehensive Handbook of Clinical Research Compiled by Health RAB & Medical Department PharmEvo Pvt. Ltd. [email protected] www.HealthRAB.org 402,Business Avenue,Block-6,P.E.CH.S Shahrah-e-Faisal ,Karachi-75400,Pakistan. 2 Message from the Chairman Dr. Abdul Gaffar Billoo Chairman, Health Research Advisory Board Aga Khan University Hospital, Karachi Professor, Department of Paediatrics and child Health I feel honored to chair the Health Research Advisory Board, a unique & visionary program, which is developed to promote & establish clinical research in Pakistan. Clinical research has always been very close to my heart simply because it allows us to help our patients effectively through evidence based knowledge and information. The importance of conducting indigenous clinical research cannot be over emphasized. Depending only upon research from western world does not allow us to treat our local population having local illnesses with a local solution. One of the objectives of Health RAB is to educate our clinicians and build their capacity in the field of clinical research. For this very purpose, Health RAB compiled this Research Reference Guide to help our physicians, mainly the younger generation, in understanding and then conducting clinical research in Pakistan. This guide takes us through the subject of clinical research in a simple and categorical manner covering nearly all its various aspects in a concise way. I am very optimistic that this initiative will go a long way not only in serving our patients better, but in creating visionary healthcare leaders in healthcare in Pakistan InshaAllah. 3 Message from the Vice Chairman Prof.
    [Show full text]