1
|
Swed S, Motawea KR, Bohsas H, Alibrahim H, Rakab A, Hafez W, Shaheen N, Almoshantaf MB, Ahmad S, Safdar S, Khairy LT, Bakkour A, Muwaili AHH, Muwaili DHH, Abdelmajid FAA, Ahmad EMS, Patwary MM, Ghaith HS, Albuni MK, Battikh E, Sawaf B, Elsayed M, Elkalagi NKH, Shoib S. Public Attitudes Towards COVID-19, Antibiotic Resistance, Preventive Measures: A Multi Center Cross-Sectional Study in the Arab Countries. J Epidemiol Glob Health 2023; 13:91-104. [PMID: 36820995 PMCID: PMC9947435 DOI: 10.1007/s44197-023-00092-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 01/26/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND AND AIM COVID-19 has shown how crucial awareness of the need to protect public health is to global security. Antibiotic resistance due to antibiotic misuse is seen as a worldwide health issue. Antibiotic use was significant during the COVID-19 epidemic, according to several nations. This research aims to investigate public attitudes on COVID-19, antibiotic resistance, and preventive measures during the COVID-19 pandemic in the Middle East. METHODS An online quantitative cross-sectional study in 17 Arabic nations was carried out between January 3 and March 4, 2022, using a structured questionnaire to evaluate participants' knowledge of COVID-19, their attitudes toward the new standard during the pandemic, and their use of antibiotics, and their resistance to them. The research was available to all Arabic people over 18 nations in the middle east. A convenient snowball sampling technique was used. SPSS version 20.0 was used to analyze the data. To analyze the results, binominal logistic regression was utilized. Statistical significance was defined as a p value of 0.05. RESULTS Of the 6145 responders, 24.1% believed COVID-19 might spread to asymptomatic people, whereas 13.6% thought using antibiotics would accelerate recovery from any illness. Moreover, half of the respondents said antibiotics only work against bacteria (64.6%). 70.8% of participants adopted the necessary safety measures. More than a third of respondents strongly supported placing foreign immigrants in quarantine (33%). However, more than 50% of those surveyed (52.5%) firmly supported using face masks in all public settings. Individuals with a medical education background had 2.6 times more appropriate understanding of antibiotic resistance than others. Furthermore, participants in the 30-49 age range had a better handle on the use of antibiotics and antibiotic resistance than other respondents by 1.1 times. CONCLUSION Arab Health authorities should reconsider this health issue as soon about the inadequate level of awareness toward antibiotic use, resistance, and preventative practices during COVID-19. Many suggested strategies, especially solving the irregular antibiotic prescriptions during a COVID19 pandemic, should be implemented to increase public awareness of COVID19.
Collapse
Affiliation(s)
- Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | | | | | - Amine Rakab
- Assistant Professor of Clinical Medicine, Medicine, Weill Cornell Medical College, Al Rayyan, Qatar
| | - Wael Hafez
- NMC Royal Hospital, 16Th Street, Khalifa City, Abu Dhabi, UAE
- Medical Research Division, Department of Internal Medicine, The National Research Centre, Cairo, Egypt
| | - Nour Shaheen
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | | | | | | | - Agyad Bakkour
- Faculty of Medicine, Albaath University, Homs, Syria
| | | | | | | | | | - Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, 9208 Bangladesh
- Environmental Science Discipline, Life Science School, Kulna University, Khulna, 9208 Bangladesh
| | | | | | - Elias Battikh
- Department of Internal Medicine, Damascus University, Damascus, Syria
| | - Bisher Sawaf
- Department of Internal Medicine, Syrian Private University, Damascus, Syria
| | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Leimgrubenweg 12-14, 89075 Ulm, Germany
| | | | - Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir India
| |
Collapse
|
2
|
Ahmad S, Ahmad S, Ahmad U, Cheema HA, Iqbal N, Shahid A, Malik B, Siddiqui A, Jaffar H, Ghani U, Sarfraz W, Shelar V, Rahir U, Zubair M, Ali NN, Safdar S, Essar MY, Abadeen ZU. An assessment of publishing practices and barriers faced by medical students to conduct research: A cross‐sectional study from Pakistan. Health Sci Rep 2022; 5:e831. [PMID: 36110346 PMCID: PMC9464460 DOI: 10.1002/hsr2.831] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 01/25/2023] Open
Abstract
Background Pakistan being a low‐ and middle‐income country, its institutes are substantially deficient in scientific and technological aspects and share limited research contributions to the world repositories. Therefore, there is a rising concern to reflect on the history and status of publishing attitudes among medical students in Pakistan and to highlight and address the barriers that they are facing. Methods A study was conducted aiming to determine the experience, motivation, and attitude of medical students in regarding publishing practices throughout Pakistan in several medical colleges. A multivariable logistic regression model was used to find the independent predictors of students publishing a research article. Forward selection was used to arrive at the final stepwise logistic regression. Odds ratio (OR) and 95% confidence interval (CI) were calculated. p < 0.05 was considered significant for all statistical tests. Results From a sample size of 1225 participants, only 6.6% of students had published an article in our study. Of these, 59% were males and 31.3% were in final year. Males were more likely to publish articles than females (OR = 2.69, 95% CI: 1.37–5.26) and final‐year students were more likely to publish articles than first‐year students (OR = 7.48, 95% CI: 1.34–41.81). Students that had the knowledge that performing research is the way through which they will be judged for jobs had significantly higher odds of getting an article published (OR = 16.21, 95% CI: 3.65–71.88). Additionally, students who had been taught how to write a paper and those who knew the process of submitting an article were more likely to get published than the others. Conclusion Our study has successfully highlighted the status of publishing among medical students in Pakistan. Our findings serve as an eye opener and call to action for authorities to address the grievances of students in terms of barriers, lack of mentorship, and lack of research teaching. We hope our findings can guide a strong policy change to facilitate the next generation of passionate researchers.
Collapse
Affiliation(s)
- Shoaib Ahmad
- Department of General Medicine Punjab Medical College Faisalabad Pakistan
| | - Shkaib Ahmad
- Department of General Medicine DG Khan Medical College DG Khan Pakistan
| | - Unaiza Ahmad
- Department of General Medicine Punjab Medical College Faisalabad Pakistan
| | | | - Nida Iqbal
- Department of General Medicine Mohtarma Benazir Bhutto Shaheed Medical College Azad Jammu and Kashmir Pakistan
| | - Abia Shahid
- Department of General Medicine King Edward Medical University Lahore Pakistan
| | - Badar Malik
- Department of General Medicine Punjab Medical College Faisalabad Pakistan
| | - Amna Siddiqui
- Department of General Medicine Karachi Medical and Dental College Karachi Pakistan
| | - Huda Jaffar
- Department of General Medicine Dow Medical University Karachi Pakistan
| | - Usman Ghani
- Department of General Medicine Punjab Medical College Faisalabad Pakistan
| | - Waqar Sarfraz
- Department of General Medicine Punjab Medical College Faisalabad Pakistan
| | - Vrushali Shelar
- Department of General Medicine Saratov State Medical University Saratov Russia
| | - Ufaq Rahir
- Department of General Medicine JSS Medical College Mysuru India
| | - Maryam Zubair
- Department of General Medicine University of Tripoli Tripoli Libya
| | | | - Sifwa Safdar
- Department of General Medicine Allama Iqbal Medical College Lahore Pakistan
| | | | - Zain Ul Abadeen
- Department of General Medicine Punjab Medical College Faisalabad Pakistan
| |
Collapse
|
3
|
Ahmad S, Yaqoob S, Safdar S, Cheema HA, Islam Z, Iqbal N, Tharwani ZH, Swed S, Ijaz MS, Rehman MU, Shahid A, Tahir U, Ahmad S, Bilal W, Essar MY, Iqbal S, Choudry ZA. Burnout in health care workers during the fourth wave of COVID-19: A cross sectional study from Pakistan. Ann Med Surg (Lond) 2022; 80:104326. [PMID: 35958288 PMCID: PMC9357282 DOI: 10.1016/j.amsu.2022.104326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/30/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022] Open
Abstract
Objective To assess the burnout among the healthcare workers during the fourth wave of COVID-19. Methods In this cross-sectional study, burn out was measured in health care professionals using the MBI scale inventory during the fourth wave of COVID-19. Age, gender, marital status, having children, hospital, job type, experience, and workload, as well as the severity of burnout in each subscale, were all measured. We used the chi-square test to detect the difference between the level of burnout and other demographic variables, and a multiple logistic regression test was used to define the predicted correlation between the high level of burnout and the risk factors. Odds ratios and corresponding 95% confidence intervals (CI) were reported. A p-value of less than 0.05 indicated a statistically significant outcome. Results Out of 776 healthcare workers who participated in our study, 468 (63.2%), 161 (21.7%) and 112 (15.1%) participants experienced low, moderate and high levels of emotional exhaustion, respectively. For the depersonalization subscale, 358 (48.3%), 188 (25.4%) and 195 (26.3%) people suffered from low, moderate, and high levels of depersonalization, respectively while 649 (87.6%), 40 (5.4%) and 52 (7.0%) respondents had low, moderate and high levels in the personal accomplishment subscale, respectively. Conclusion During the fourth wave of COVID-19, the healthcare workers reported increased level of burnout overall possibly due to the long term physical and mental impacts that the pandemic has had over the time. Moreover, healthcare workers in Pakistan were more prone to burnout as compared to other countries. Higher levels of burnout were observed in the fourth wave of COVID-19, possibly due to the long term physical and mental impacts that the pandemic has had over time. Healthcare workers in Pakistan were more prone to burnout as compared to other countries. This study yielded key findings that have important implications for preventing and reducing burnout in hospital settings.
Collapse
Affiliation(s)
- Shoaib Ahmad
- Punjab Medical College, Faisalabad, Pakistan.,DHQ Teaching Hospital, Faisalabad, Pakistan
| | | | | | | | - Zarmina Islam
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Pakistan
| | - Nida Iqbal
- Mohtarma Benazir Bhutto Shaheed Medical College, Mirpur AJK, Pakistan
| | - Zoaib Habib Tharwani
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Pakistan
| | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | | | - Abia Shahid
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | | | - Shkaib Ahmad
- Dera Ghazi Khan Medical College, DG Khan, Pakistan
| | - Wajeeha Bilal
- Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Pakistan
| | | | - Saleem Iqbal
- Department of Surgery, Allied Hospital Faisalabad, Pakistan
| | | |
Collapse
|
4
|
Ali K, Iqbal A, Bukhari SM, Safdar S, Raiz A, Ali W, Hussain A, Javid A, Hussain M, Ali MM, Mahmud A, Iqbal MJ, Nasir MF, Mubeen I, Kanwal S, Sughra F, Khattak A, Saleem M. Amelioration potential of Moringa oleifera extracts against sodium arsenate induced embryotoxicity and genotoxicity in mouse (Mus musculus). BRAZ J BIOL 2021; 83:e248022. [PMID: 34468531 DOI: 10.1590/1519-6984.248022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/09/2021] [Indexed: 11/21/2022] Open
Abstract
Previous studies have suggested that arsenic crosses the placenta and affects the fetus development. The study under consideration aims to show comparative ameliorative effect of Moringa oleifera leaf and flower extracts against sodium arsenate induced fetus toxicity of mice. Pregnant mice (N=44) were kept in lab and divided into eleven group from (A to K) and were orally administered the doses 6 mg/kg, 12 mg/kg for sodium arsenate, 150 mg/kg and 300 mg/kg for Moringa oleifera leaf extracts (MOLE) and 150 mg/kg and 300 mg/kg for Moringa oleifera flower extracts (MOFE) comparing with control. The investigation revealed evident reduction in the fetuses weight, hind limb, fore limb, tail and snout length, crown rump and head circumferences well as malformations in tail, feet, arms, legs, skin and eyes in the negative control group (only administered with sodium arsenate). Co-administration of sodium arsenate with MOLE and MOFE ameliorate the reversed effect of sodium arsenate on the shape, length, body weight and DNA damage of fetus significantly at 95% confidence interval. However, Moringa oleifera leaf extract showed more significant results in comparison to Moringa oleifera flower extract. Hence concluded that Moringa oleifera leaf extract ameliorated the embryo toxic effects of sodium arsenate and can be used against environmental teratogens.
Collapse
Affiliation(s)
- K Ali
- University of Veterinary & Animal Sciences, Department of Wildlife & Ecology, Lahore, Pakistan
| | - A Iqbal
- University of Veterinary & Animal Sciences, Department of Wildlife & Ecology, Lahore, Pakistan
| | - S M Bukhari
- University of Veterinary & Animal Sciences, Department of Wildlife & Ecology, Lahore, Pakistan
| | - S Safdar
- University of Veterinary & Animal Sciences, Department of Wildlife & Ecology, Lahore, Pakistan
| | - A Raiz
- Department of Zoology, GC Women University, Faisalabad, Pakistan
| | - W Ali
- University of Veterinary & Animal Sciences, Department of Wildlife & Ecology, Lahore, Pakistan
| | - A Hussain
- University of Veterinary & Animal Sciences, Department of Wildlife & Ecology, Lahore, Pakistan
| | - A Javid
- University of Veterinary & Animal Sciences, Department of Wildlife & Ecology, Lahore, Pakistan
| | - M Hussain
- University of Veterinary & Animal Sciences, Department of Wildlife & Ecology, Lahore, Pakistan
| | - M M Ali
- University of Veterinary & Animal Sciences, Institute of Biochemistry and Biotechnology, Lahore, Pakistan
| | - A Mahmud
- University of Veterinary & Animal Sciences, Department of Poultry Production, Lahore, Pakistan
| | - M J Iqbal
- Bahauddin Zakariya University, Department of Zoology, Multan, Pakistan
| | - M F Nasir
- Bahauddin Zakariya University, Department of Zoology, Multan, Pakistan
| | - I Mubeen
- Government College University, Department of Zoology, Lahore, Pakistan
| | - S Kanwal
- University of Okara, Department of Zoology, Okara, Pakistan
| | - F Sughra
- University of Education, Department of Zoology, Division of Science & Technology, Lahore, Pakistan
| | - A Khattak
- Department of Bioinformatics, Shaheed Benazir Bhutto Women University, Peshawar, Pakistan
| | - M Saleem
- Department of Zoology, Virtual University of Lahore, Lahore, Pakistan
| |
Collapse
|
5
|
Safdar S, Cramb R, Dawson C. Effect of PCSK9 inhibition with alirocumab on lipoprotein(a) in patients with high risk of cardiovascular disease. ATHEROSCLEROSIS SUPP 2017. [DOI: 10.1016/j.atherosclerosissup.2017.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
6
|
Abstract
Diaphragmatic paralysis is an unusual and often underrecognized cause of dyspnea. We present a case of bilateral diaphragmatic paralysis with no identifiable etiology. Our patient is a 73-year-old female with a history of smoking who presented with dyspnea and orthopnea. She was treated for obstructive lung disease with no improvement in dyspnea despite adequate therapy. She had pulmonary function tests (PFTs) that revealed marked decrease in vital capacity and was unable to perform lung volume maneuvers supine due to marked dyspnea. The maximal inspiratory pressure was 37 in the upright position and decreased to 27 in the supine position. She was given a presumptive diagnosis of idiopathic bilateral diaphragmatic dysfunction. Given the history, physical exam, and PFT findings, we felt that the patient did not need further invasive testing. The patient was treated with noninvasive mechanical ventilation due to hypercapnia and her symptoms improved.
Collapse
Affiliation(s)
- D MacBruce
- Department of Internal Medicine, Newark, NJ, An Affiliate of New York Medical College, NY, USA; Department of Pulmonary and Critical Care Medicine, Saint Michael's Medical Center, Newark, NJ, An Affiliate of New York Medical College, NY, USA
| | - S Safdar
- Department of Internal Medicine, Newark, NJ, An Affiliate of New York Medical College, NY, USA; Department of Pulmonary and Critical Care Medicine, Saint Michael's Medical Center, Newark, NJ, An Affiliate of New York Medical College, NY, USA
| | - K Katpally
- Department of Internal Medicine, Newark, NJ, An Affiliate of New York Medical College, NY, USA; Department of Pulmonary and Critical Care Medicine, Saint Michael's Medical Center, Newark, NJ, An Affiliate of New York Medical College, NY, USA
| | - Hamid Shaaban
- Department of Internal Medicine, Newark, NJ, An Affiliate of New York Medical College, NY, USA; Department of Pulmonary and Critical Care Medicine, Saint Michael's Medical Center, Newark, NJ, An Affiliate of New York Medical College, NY, USA
| | - M Adelman
- Department of Internal Medicine, Newark, NJ, An Affiliate of New York Medical College, NY, USA; Department of Pulmonary and Critical Care Medicine, Saint Michael's Medical Center, Newark, NJ, An Affiliate of New York Medical College, NY, USA
| |
Collapse
|
7
|
Boardman R, Trofe J, Alloway R, Rogers C, Roy-Chaudhury P, Cardi M, Safdar S, Groene B, Buell J, Hanaway M, Thomas M, Alexander W, Munda R, Woodle ES. Early steroid withdrawal does not increase risk for recurrent focal segmental glomerulosclerosis. Transplant Proc 2005; 37:817-8. [PMID: 15848542 DOI: 10.1016/j.transproceed.2004.12.065] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
UNLABELLED Experience with early corticosteroid withdrawal (CSWD) in renal transplant recipients with focal segmental glomerulosclerosis (FSGS) has not been previously reported. Since corticosteroids are used to treat primary FSGS, concern exists as to whether early CSWD regimens will be associated with an increased risk of FSGS recurrence posttransplant. The purpose of the present study was to evaluate the results of early CSWD in FSGS recipients and compare these results to a historic control group of FSGS patients who underwent renal transplantation under corticosteroid-based immunosuppression. METHODS Forty-three patients with FSGS underwent renal transplantation with early CSWD. Results in these patients were compared to FSGS patients that underwent renal transplantation with chronic corticosteroid therapy. All rejection episodes were biopsy proven with grading by Banff criteria. Statistical analyses included Student's t test and chi square tests. RESULTS Results in 43 patients with a median follow-up of 569 days were analyzed and compared to control patients. There was no significant difference in recurrent FSGS, time to recurrence, or graft loss. CONCLUSION CSWD does not increase risk for recurrence of FSGS. These observations indicate that ECSW can be achieved in FSGS patients, thereby affording them the benefits of steroid elimination.
Collapse
Affiliation(s)
- R Boardman
- University of Cincinnati, Cincinnati, Ohio 45249, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Safdar S, Omair A, Faisal U, Hasan H. Prevalence of hypertension in a low income settlement of Karachi, Pakistan. J PAK MED ASSOC 2004; 54:506-9. [PMID: 15552283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To assess the prevalence of hypertension in a low-income community in Karachi. METHODS Cross sectional survey, through multi-stage sampling of 857 adult subjects in 405 households was conducted between April and September 2002. RESULTS The overall prevalence of hypertension was 26% (95% C.I. 23, 29), the prevalence among males (34%) was higher than females (24%). The mean age of participants was 35 +/- 14 years, the prevalence of hypertension increased with age. Proportionately there were more cases of hypertension among male participants over 35 years of age as compared to female participants of the same age (p < or = 0.001). Fifty-eight percent of hypertensives were unaware of their hypertension. None of the hypertensive subjects who were aware of their condition had blood pressure under 140/90 mmHg. Stratified analysis revealed significant risk factors for hypertension. Hypertension was 1.7 (OR 95% C.I. 1.14, 2.42) times more common among males then females. Males were 1.7 (OR 95% C.I. 1.06, 2.6) times less likely to have been aware of their hypertension status. Age analysis revealed that the prevalence of hypertension increased with age and hypertensive subjects were 5.6 (OR 95% C.I. 3.9, 8.1) times more likely to be over 35 years of age. CONCLUSION There is a need to control hypertension and prevent its complications through effective community interventions. The survey results indicate high prevalence and poor control of hypertension in the community, but more research is required to understand the reasons behind this phenomena.
Collapse
Affiliation(s)
- S Safdar
- Department of Community Health Sciences, Jinnah Medical and Dental College, Karachi
| | | | | | | |
Collapse
|
9
|
Trofe J, Roy-Chaudhury P, Gordon J, Mutema G, Cavallo T, Cardi M, Austin J, Goel S, Rogers C, Boardman R, Clippard M, Alloway R, Alexander J, Metze T, Goodman H, Hanaway M, Munda R, Buell J, Peddi R, Safdar S, Wadih G, Huang S, Fidler J, Khalili K, Woodle E. Study 3: early steroid cessation-avoidance regimens are associated with a lower incidence of polyomavirus nephropathy compared with steroid-based immunosuppression in kidney transplant recipients. Transplant Rev (Orlando) 2003. [DOI: 10.1016/j.trre.2003.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
Shaikh I, Omair A, Inam SNB, Safdar S, Kazmi T, Anjum Q. National Polio Day campaign in a squatter settlement through medical students. J PAK MED ASSOC 2003; 53:98-101. [PMID: 12779022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To provide maximum polio vaccination coverage to under-five (<5) year children of a squatter settlement through Ziauddin Medical University (ZMU) medical students. SETTING ZMU has established a Primary Health Care Program in a squatter settlement, which is predominantly inhabited by migrants from North Western Province of Pakistan and Afghanistan. The total population is approximately 20,000 and the proportion of <5 year children is nearly 19%. METHODOLOGY ZMU started Oral Polio Vaccination (OPV) campaigns from 1996; up to 1999. The OPV campaigns were confined to the National Immunization Days (NIDs). A different strategy of "door-to-door" OPV services by medical students was undertaken in 1997. In December 1999 the polio vaccination coverage of <5-year children was evaluated through duster sampling. This paper describes the steps for improving OPV coverage in Sikanderabad. RESULTS The estimated number of <5 year children in the area is 4,600. In a duster sample survey after the 1999 NID campaign out of 620 under 5 year children living in 429 households, 529 (85%) received OPV, with a 95% CI for OPV coverage of 82 to 88%. The coverage before the campaigns initiated by ZMU was 52%. CONCLUSION The results indicate that the polio coverage of <5-year children has risen with the change in strategy. Door-to-door coverage strategy with the help of medical students proved effective in providing vaccination. No case of suspected poliomyelitis has been reported from the area since October 1999.
Collapse
Affiliation(s)
- I Shaikh
- Department of Community Health Sciences, Ziauddin Medical University, Karachi
| | | | | | | | | | | |
Collapse
|
11
|
Alexander JW, Stanley LL, Ofstedal TL, First MR, Cardi MA, Safdar S, Mendoza NC, Munda R, Fidler JP, Buell JF, Hanaway MJ, Woodle ES. Transplantation without steroids. Transplant Proc 2002; 34:2076-8. [PMID: 12270319 DOI: 10.1016/s0041-1345(02)02857-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J W Alexander
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Trofe J, Cavallo T, First MR, Weiskittel P, Peddi VR, Roy-Chaudhury P, Alloway RR, Safdar S, Buell JF, Hanaway MJ, Woodle ES. Polyomavirus in kidney and kidney-pancreas transplantation: a defined protocol for immunosuppression reduction and histologic monitoring. Transplant Proc 2002; 34:1788-9. [PMID: 12176577 DOI: 10.1016/s0041-1345(02)03078-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Jennifer Trofe
- Department of Surgery, Division of Transplantation, The University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267-0558, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Safdar S, Inam SNB, Omair A, Ahmed ST. Maternal health care in a rural area of Pakistan. J PAK MED ASSOC 2002; 52:308-11. [PMID: 12481662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
OBJECTIVE The need for effective strategies for delivery of healthcare to rural women is paramount and requires a study of maternal perceptions and experiences of the healthcare system. METHOD This article describes knowledge, attitudes and practices regarding obstetric healthcare in a rural area of Pakistan. This is a cross sectional survey of a rural area of district Hyderabad, Pakistan. A multistage sample of 1,150 households was drawn from a population of 247,257 living in 30,653 households. Structured KAP questionnaires regarding maternal health were administered to male and female respondents in study household. RESULTS A total of 1,178 married women and 1,146 married men were interviewed. The mean age of female respondents was 29 +/- 6 years. At the time of the interview 20% women were pregnant. Sixty-one percent women received antenatal care during their last pregnancy. The most frequent antenatal care providers were female doctors (55%). Majority (67%) of women had delivered at home with the assistance of traditional birth attendants (TBAs). Overall less than 40% of respondents could correctly identify signs of obstetric complications. Thirty-eight percent women experienced obstetric complications during their last pregnancy. Estimated annual maternal mortality ratio (MMR) was 689/100,000 live births. CONCLUSION Women have inadequate access to obstetric care due to limited healthcare options and poor knowledge of obstetric complications. This can be corrected by improving services and increasing overall maternal health awareness in the community.
Collapse
Affiliation(s)
- S Safdar
- Department of Community Health Sciences, Ziauddin Medical University, Karachi
| | | | | | | |
Collapse
|
14
|
Inam SN, Safdar S, Omair A. Health in Pakistan: challenges and opportunities for academia. J PAK MED ASSOC 2001; 51:170-1. [PMID: 11467236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
|
15
|
Adkins D, Brown R, Trinkaus K, Maziarz R, Luedke S, Freytes C, Needles B, Wienski D, Fracasso P, Pluard T, Moriconi W, Ryan T, Hoelzer K, Safdar S, Rearden T, Rodriguez G, Khoury H, Vij R, DiPersio J. Outcomes of high-dose chemotherapy and autologous stem-cell transplantation in stage IIIB inflammatory breast cancer. J Clin Oncol 1999; 17:2006-14. [PMID: 10561251 DOI: 10.1200/jco.1999.17.7.2006] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the disease-free survival (DFS) and overall survival (OS), prognostic factors, and treatment-related mortality of women with stage IIIB inflammatory breast cancer (IBC) treated with combined modality therapy (CMT) and high-dose chemotherapy (HDCT) with autologous stem-cell transplantation. PATIENTS AND METHODS Between 1989 and 1997, 47 consecutive patients with stage IIIB IBC were treated with CMT and HDCT and were the subject of this retrospective analysis. Chemotherapy was administered to all patients before and/or after definitive surgery. Neoadjuvant and adjuvant chemotherapy was administered to 33 and 34 patients, respectively, and 20 patients received both. All patients received HDCT with autologous stem-cell transplantation, and 41 patients received locoregional radiation therapy. Tamoxifen was prescribed to patients with estrogen receptor (ER)-positive cancer. RESULTS The mean duration of follow-up from diagnosis was 30 months (range, 6 to 91 months) and from HDCT was 22 months (range, 0.5 to 82 months). At 30 months, the Kaplan-Meier estimates of DFS and OS from diagnosis were 57.7% and 59.1%, respectively. At 4 years, the Kaplan-Meier estimates of DFS and OS from diagnosis were 51.3% and 51.7%, respectively. In a multivariate analysis, the only factors associated with better survival were favorable response to neoadjuvant chemotherapy (P =.04) and receipt of tamoxifen (P =.06); however, the benefit of tamoxifen was only demonstrated in patients with ER-positive breast cancer. At last follow-up, 28 patients (59. 6%) were alive and disease-free. Seventeen patients (36.2%) developed recurrent breast cancer. Seventeen patients died: 15 from disease recurrence and two (4.2%) from treatment-related mortality due to HDCT. CONCLUSION In this analysis, the early results of treatment with CMT and HDCT compare favorably with other series of patients with stage IIIB IBC treated with CMT alone. These outcomes must be confirmed with longer follow-up and controlled studies.
Collapse
Affiliation(s)
- D Adkins
- Division of Bone Marrow Transplantation, Washington University School of Medicine, St Louis, MO 63110-1093, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Khoury H, Adkins D, Zehnbauer B, Goodnough L, Brown R, Safdar S, DiPersio JF. Essential thrombocythemia after allogeneic bone marrow transplantation for chronic myelogenous leukemia. Bone Marrow Transplant 1998; 22:107-9. [PMID: 9678805 DOI: 10.1038/sj.bmt.1701292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Allogeneic transplant recipients are at high risk of developing secondary malignancies as a late complication of therapy. We report a case of essential thrombocythemia occurring 8 years following bone marrow transplantation (BMT) for chronic myelogenous leukemia.
Collapse
Affiliation(s)
- H Khoury
- Washington University School of Medicine, Division of Bone Marrow Transplantation and Stem Cell Biology, St. Louis, MO 63110, USA
| | | | | | | | | | | | | |
Collapse
|
17
|
Iqbal M, Rasool MI, Safdar S, Sohail S. Anal eroticism: self introduced foreign bodies in the rectum. J PAK MED ASSOC 1988; 38:223-4. [PMID: 3149316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|