Displaying publications 1 - 20 of 44 in total

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  1. bte Abdul Rashid NH, Yunus MR, bte Baki MM, bte Ami M, Athar PP
    J Pak Med Assoc, 2012 May;62(5):466-9.
    PMID: 22755311
    To determine the frequency of stomal recurrence in patients following total laryngectomy in our center and to compare the frequency of previously reported risk factors such as preoperative tracheostomy, subglottic invasion and the level of lymph node metastases, with the rest of the world.
  2. Zahid M, Khan AH, Yunus ZM, Chen BC, Steinmann B, Johannes H, et al.
    J Pak Med Assoc, 2019 Mar;69(3):432-436.
    PMID: 30890842
    In spite of the efforts and interventions by the Government of Pakistan and The World Health Organization, the neonatal mortality in Pakistan has declined by only 0.9% as compared to the global average decline of 2.1% between 2000 and 2010. This has resulted in failure to achieve the global Millennium Development Goal 4. Hypoxic-ischaemic encephalopathy, still birth, sepsis, pneumonia, diarrhoea and birth defects are commonly attributed as leading causes of neonatal mortality in Pakistan. Inherited metabolic disorders often present at the time of birth or the first few days of life. The clinical presentation of the inherited metabolic disorders including hypotonia, seizure and lactic acidosis overlap with clinical features of hypoxic-ischaemic encephalopathy and sepsis. Thus, these disorders are often either missed or wrongly diagnosed as hypoxicischaemic encephalopathy or sepsis unless the physicians actively investigate for the underlying inherited metabolic disorders. We present 4 neonates who had received the diagnosis of hypoxic-ischaemic encephalopathy and eventually were diagnosed to have various inherited metabolic disorders. Neonates with sepsis and hypoxic-ischaemic encephalopathy-like clinical presentation should be evaluated for inherited metabolic disorders.
  3. Thaver I, Ahmad AM, Ashraf M, Asghar SK, Mirza MS
    J Pak Med Assoc, 2020 Dec;70(12(A)):2092-2101.
    PMID: 33475578 DOI: 10.47391/JPMA.1218
    OBJECTIVE: To investigate the effect on maternal and infant health of iron plus folate and multiple micronutrient supplements, along with deworming and health education session provided to pregnant women in rural, nonagrarian and food-insecure areas.

    METHODS: The quasi-experimental study was conducted in Tharparker and Umerkot districts, Sindh, Pakistan, in 2013-14, and comprised pregnant women in their earlier weeks of pregnancy. The enrolment and follow-up phase entailed 3 visits to each subject. Areas covered by lady health workers were designated as intervention areas, and those with non-LHW population were labelled as non-intervention areas.

    RESULTS: Of the 1204 subjects, 600(49.8%) were in the intervention group and 604(50.2%) were in the nonintervention group. By the end of the follow-up phase, significantly more women had increased number of meals in the intervention group compared to the non-intervention group (p<0.001). There was a significantly higher increase in mean haemoglobin levels and body mass index of women in the intervention arm after 3 and 6 months of interventions (p<0.05). Significantly higher mean birth weight was recorded in intervention areas compared to nonintervention areas (p<0.05).

    CONCLUSIONS: Community-based provision of multiple micronutrients to women along with deworming, health education and dietary counselling significantly reduced the prevalence of anaemia and reduced the incidence of low birth weight.

  4. Taqi M, Razak IA, Ab-Murat N
    J Pak Med Assoc, 2019 Jul;69(7):950-954.
    PMID: 31308560
    OBJECTIVE: To assess and compare the dental caries status among children using two methods..

    METHODS: The cross-sectional study was conducted in October-November 2017 at five government and two private schools in Bhakkar, Punjab, Pakistan. It comprised children aged 11-12 years. World Health Organisation standards and the modified International Caries Detection and Assessment Systems methods were used were used to determine the dental caries status of each subject. Results of the two methods were compared at all cut- offs where appropriate, using SPSS 17.

    RESULTS: Of the 183 subjects, 101(55.2%) were boys. Those aged 12 years were 112(61.2%) while 71(38.8%) were aged 11 years. There was no statistically significant difference in values of the Decayed Missing and Filled Surface / Decayed Missing and Filled Teeth index as well as the prevalence of dental caries between two methods (p>0.05 each). Intra-examiner reproducibility was higher with the World Health Organisation method compared to the other index used (p<0.05).

    CONCLUSIONS: Modified International Caries Detection and Assessment Systems method can be used in epidemiological surveys as it was found to provide results similar to the World Health Organisation criteria at cut-off point 2.

  5. Taqi M, Razak IA, Ab-Murat N
    J Pak Med Assoc, 2018 Oct;68(10):1483-1487.
    PMID: 30317346
    OBJECTIVE: To estimate the frequency and pattern of sugar intake among Pakistani school going children and its association with early carious lesion and caries history.

    METHODS: The cross-sectional study was conducted from January to May 2016 in seven schools of Bhakkar district in the Punjab province of Pakistan, and comprised of school children aged 11-12 years. Diet diaries were used to assess the frequency of sugar intake while caries was assessed using the Modified International Caries Detection and Assessment System. Bivariate analysis was used to assess the association of sugar consumption and early carious lesion with selected sociodemographic variables, and regression analysis was performed to evaluate the factor that matters most in caries occurrence.

    RESULTS: Of the 226 subjects, 115(51%) had early carious lesion. Mean frequency of sugar intake was 5.2±3.2 times per day. Children who consumed sugar between main meals (p=0.01) and within two hours before bedtime (p=0.04) had significantly higher history of having caries. Cariogenic intake before bedtime was significantly associated with overall caries risk (p=0.02).

    CONCLUSIONS: The frequency of sugar intake among the subjects was slightly higher than the recommended level. .

  6. Sharif F, Mahmood F, Azhar MJ, Asif A, Zahid M, Muhammad N, et al.
    J Pak Med Assoc, 2019 May;69(5):632-639.
    PMID: 31105281
    OBJECTIVE: To compare the occurrence, distribution and management of clefts of lip and palate in local patients with the available data from India and China.

    METHODS: The retrospective study was conducted at the Interdisciplinary Research Centre in Biomedical Materials, COMSATS University Islamabad, Lahore Campus, Lahore, Pakistan, and comprised data related to a three-month period from January to March 2015 at two medical centres in Lahore. Data from Pakistani centres was analysed based on province, gender, age and clefts of lip and palate conditions and Spearman's correlation matrix.

    RESULTS: Of the 1574 cases, 1061(67.4%) were from Punjab, 361(23%) Khyber Pakhtunkhwa, 85(5%) Sindh and 67(4.2%) were from Azad Jammu and Kashmir. The incidence of clefts of lip and palate was higher in males than females. There was higher awareness of the need for timely management in new borns with clefts of lip and palate. Some patients seeking secondary treatment were also being surgically corrected. There is no national registry of children born with cleft defect, making it difficult to assess the full scale of the problem..

    CONCLUSIONS: Based on available data, it is likely that there are many adults who have not been treated when younger..

  7. Shaikh BT, Azmat SK, Mazhar A
    J Pak Med Assoc, 2013 Apr;63(4 Suppl 3):S67-72.
    PMID: 24386733
    The population of the world reached seven billion in 2012. Pakistan's population stands at more than 180 million, is growing rapidly, and has the highest unmet need for family planning (FP) in isolated rural areas. The low usage of contraception in the rural areas of Pakistan correlates with the level of isolation, poverty, illiteracy, and to a large extent, religious misinterpretations/misconceptions. Almost 25% of couples who desired FP services were not receiving them for a variety of reasons of which religion could be one, especially in the rural remote areas where the media is still not reaching and influencing mind-sets. In this scenario, the role of social marketing in bringing about attitudinal and behavioural change among users in underserved areas and gatekeepers and opinion makers in society must not be neglected. The work in promoting FP, contraception and birth spacing requires authentic evidence from similar sociocultural contexts and this endeavour of compiling case studies from various Islamic countries on their FP initiatives is a good step. Governments around the world, including many in the Islamic world, support FP programmes to enable individuals and couples to choose the number and timing of their children.
  8. Sattar MU, Palaniappan S, Lokman A, Shah N, Riaz Z, Khalid U
    J Pak Med Assoc, 2021 Jul;71(7):1730-1735.
    PMID: 34410236 DOI: 10.5455/JPMA.22992
    OBJECTIVE: To investigate the effects of design parameters on the user experience of virtual reality medical training.

    Methods: The quantitative study was conducted at Punjab (Pakistan) from July 2018 to October 2018, and comprised final year students from eight medical colleges in Pakistan. Each respondent was given to experience laparoscopy operation in text, video and virtual reality-based learning methodologies. User experience and usefulness was assessed against a pre-validated scale and compared with the three learning methodologies.

    RESULTS: Of the 87, students, 50(57.5%) were male and 37(42.5%) were female. The overall mean age was 22.5±4 years. Result of virtual reality was better than others (p<0.05). Data was analysed using SPSS 20.

    CONCLUSIONS: Virtual reality-based learning provided better user experience than traditional learning methodologies.

  9. Salman M, Khan AH, Syed Sulaiman SA, Hughes JD, Khan JH, Shehzadi N, et al.
    J Pak Med Assoc, 2021 May;71(5):1384-1387.
    PMID: 34091619 DOI: 10.47391/JPMA.1162
    Objective: To investigate the prevalence and severity of lower urinary tract symptoms among calcium channel blocker users, and the impact on patients' quality of life.

    METHODS: The cross-sectional study was conducted at one hospital and 2 community pharmacies in Lahore, Pakistan, from November 2017 to July 2018, and comprised patients using calcium channel blockers. Data was collected using standardised scales to assess lower urinary tract symptoms and quality of life. Data was analysed using SPSS 22.

    RESULTS: Of the 410 subjects, 315 (76.8%) were males. The overall median age was 50.84 years, IQR 19 with 126 (30.7%) aged 41-50 years. Of the total, 108 (26.3%) patients were on calcium channel blockers alone, while the rest were taking it in combination with other drugs. Prevalence of lower urinary tract symptoms was 307 (74.9%); mild 103 (25.1%), moderate 201 (49.1%) and severe 106 (25.9%). The symptoms were significantly associated with reduced quality of life (p<0.05).

    Conclusion: Majority calcium channel blockers users had clinically significant lower urinary tract symptoms which significantly reduced patients' quality of life.

  10. Raja NS
    J Pak Med Assoc, 2003 Aug;53(8):373-4.
    PMID: 14558747
  11. Qamar Z, Haji Abdul Rahim ZB, Chew HP, Fatima T
    J Pak Med Assoc, 2017 Jan;67(1):116-120.
    PMID: 28065967
    Dental enamel, an avascular, irreparable, outermost and protective layer of the human clinical crown has a potential to withstand the physico-chemical effects and forces. These properties are being regulated by a unique association among elements occurring in the crystallites setup of human dental enamel. Calcium and phosphate are the major components (hydroxyapatite) in addition to some trace elements which have a profound effect on enamel. The current review was planned to determine the aptitude of various trace elements to substitute and their influence on human dental enamel in terms of physical and chemical properties.
  12. Naqvi AA, Hassali MA, Aftab MT
    J Pak Med Assoc, 2019 Mar;69(3):389-398.
    PMID: 30890833
    OBJECTIVE: The study aimed to evaluate literature on rheumatoid arthritis disease in Pakistani patients, to have an understanding about its epidemiology, clinical aspects and socio-economic determinants.

    METHODS: The review study was conducted from December 2017, to May 2018. An online search was conducted in international and local health databases using appropriate search keywords as well as scanning reference lists of related articles. Literature published after year 2000 that reported epidemiological, demographic, clinical and socioeconomic data of Pakistani rheumatoid arthritis patients was included. Meta-analysis was performed where possible. This systematic review was registered on the international prospective register of systematic reviews PROSPERO (CRD42018090582).

    RESULTS: Of the 334 research articles found, 29 (8.7%) were selected. Patients were mostly females, but no study explored impact of disease on household and family role functioning of rheumatoid arthritis-affected women in Pakistan. Most patients were uneducated (55%) and unemployed; had low disease knowledge (N = 149, 74.5%) and poor adherence to disease-modifying anti-rheumatic drugs (N = 23, 23%). Point prevalence of rheumatoid arthritis reported from Karachi was high at 26.9%. Moderate disease activity, i.e., 4.5}0.7 and mild functional disability (N = 66, 51.6%) were seen in RA patients. Almost half (N = 799, 46.9%) had comorbidities. Almost a fifth proportion of RA patients had dyslipidaemia as a comorbidity (N = 134, 16.77%) and higher cardiovascular risk score as modifiable risk factor. Undiagnosed depression (N = 134, 58.3%) and low bone mineral density (N = 93, 40.6%) were reported in RA patients. Direct monthly treatment cost of disease was significantly high considering patients' socio-economic status, i.e., USD 16.47 - 100.68. Most commonly used drug was methotrexate.

    CONCLUSIONS: There is a paucity of data on Pakistani rheumatoid arthritis patients' demographic and socio-economic parameters, especially the gender element.

  13. Naqvi AA, Hassali MA, Aftab MT, Nadir MN
    J Pak Med Assoc, 2019 Feb;69(2):216-223.
    PMID: 30804587
    OBJECTIVE: The study aimed to perceived barriers to medication adherence in patients with chronic illnesses..

    METHODS: A qualitative study was conducted in a tertiary care hospital in Karachi in September 2017, using grounded theory and inductive approach. Interviews were conducted using a checklist in Urdu language from patients of chronic illnesses determined based on medicines dispensed from the out-patient pharmacy in hospital. Interviews were recorded, transcribed verbatim, translated in English and validated. The translated quotations were analysed using a qualitative analysis software, and thematic analysis was conducted. Codes were generated and analysed by semantic linkages and network analysis using ATLAS.ti qualitative research software.

    RESULTS: Of the 16 patients interviewed, 8(50%) were males and 8(50%) were females. Barriers to medication adherence identified were patient behaviour (intentional and un-intentional non-adherence), comorbidity and pill burden, cost-related non-adherence, and low patient knowledge. The last barrier was associated with the rest.

    CONCLUSIONS: Counselling has the potential to increase patient knowledge regarding medication use, and active pharmacist-physician collaboration can improve medication adherence..

  14. Nabi FG, Sundaraj K, Lam CK
    J Pak Med Assoc, 2021 Jan;71(1(A)):41-46.
    PMID: 33484516 DOI: 10.47391/JPMA.156
    OBJECTIVE: Breath sound has information about underlying pathology and condition of subjects. The purpose of this study was to examine asthmatic acuteness levels (Mild, Moderate, Severe) using frequency features extracted from wheeze sounds. Further, analysis was extended to observe behaviour of wheeze sounds in different datasets.

    METHODS: Segmented and validated wheeze sounds was collected from 55 asthmatic patients from the trachea and lower lung base (LLB) during tidal breathing maneuvers. Segmented wheeze sounds have been grouped in to nine datasets based on auscultation location, breath phases and a combination of phase and location. Frequency based features F25, F50, F75, F90, F99 and mean frequency (MF) were calculated from normalized power spectrum. Subsequently, multivariate analysis was performed.

    RESULTS: Generally frequency features observe statistical significance (p < 0.05) for the majority of datasets to differentiate severity level Ʌ = 0.432-0.939, F(12, 196-1534) = 2.731-11.196, p < 0.05, ɳ2 = 0.061-0.568. It was observed that selected features performed better (higher effect size) for trachea related samples Ʌ = 0.432-0.620, F(12, 196-498) = 6.575-11.196, p < 0.05, ɳ2 = 0.386-0.568.

    CONCLUSIONS: The results demonstrated dthat severity levels of asthmatic patients with tidal breathing can be identified through computerized wheeze sound analysis. In general, auscultation location and breath phases produce wheeze sounds with different characteristics.

  15. Mushtaq K, Ashraf M, Thaver IH
    J Pak Med Assoc, 2020 Dec;70(12(B)):2460-2463.
    PMID: 33475564 DOI: 10.47391/JPMA.770
    This descriptive cross-sectional research study was conducted to determine the characteristics of the women who intend to use a modern family planning method. For this 154 women were selected in a small village and faceto- face interviews were conducted. The findings indicate that 86 (56%) women intended to use a contraceptive method. The regression model showed that women who had the knowledge about different methods, those who had previously ever used family planning method and those who had never used any traditional method are more likely to adopt modern contraceptive methods.
  16. Mubarak N, Raja SA, Khan TM, Zin CS
    J Pak Med Assoc, 2021 Mar;71(3):950-965.
    PMID: 34057955 DOI: 10.47391/JPMA.058
    Medicine use review is a tool to improve medication adherence and safety. Current narrative review was planned to explore global policies and practices of medicine use review by community pharmacists in chronic diseases and its impact and way forward for low- and middle-income countries. Key words, such as ″medicine use review″, ″medication therapy management″ and ″community pharmacy″ were used for search on PubMed and CINAHL databases for articles published from 2004 to 2019. Medicine use review has opened an avenue of ongoing collaboration between community pharmacists and general practitioners. High-income countries have witnessed a gradual yet cautious adoption of these services through effective policy shift. In terms of practices and impact, the situation in high-income countries was promising where on an average ″type-II″ medicine use review was widely in practice and had improved clinical, humanistic and economic outcomes in chronic disease. However, in low- and middle-income countries, a paucity of effective policies was noted. Nevertheless, an emergent recognition of the potential of community pharmacists to contribute to the management of chronic diseases was evident.
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