Displaying publications 41 - 60 of 452 in total

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  1. Ullah S, Daud H, Dass SC, Fanaee-T H, Kausarian H, Khalil A
    PMID: 32098247 DOI: 10.3390/ijerph17041413
    The number of tuberculosis (TB) cases in Pakistan ranks fifth in the world. The National TB Control Program (NTP) has recently reported more than 462,920 TB patients in Khyber Pakhtunkhwa province, Pakistan from 2002 to 2017. This study aims to identify spatial and space-time clusters of TB cases in Khyber Pakhtunkhwa province Pakistan during 2015-2019 to design effective interventions. The spatial and space-time cluster analyses were conducted at the district-level based on the reported TB cases from January 2015 to April 2019 using space-time scan statistics (SaTScan). The most likely spatial and space-time clusters were detected in the northern rural part of the province. Additionally, two districts in the west were detected as the secondary space-time clusters. The most likely space-time cluster shows a tendency of spread toward the neighboring districts in the central part, and the most likely spatial cluster shows a tendency of spread toward the neighboring districts in the south. Most of the space-time clusters were detected at the start of the study period 2015-2016. The potential TB clusters in the remote rural part might be associated to the dry-cool climate and lack of access to the healthcare centers in the remote areas.
    Matched MeSH terms: Pakistan/epidemiology
  2. Ullah S, Daud H, Dass SC, Fanaee-T H, Khalil A
    PLoS One, 2018;13(6):e0199176.
    PMID: 29920540 DOI: 10.1371/journal.pone.0199176
    Identifying the abnormally high-risk regions in a spatiotemporal space that contains an unexpected disease count is helpful to conduct surveillance and implement control strategies. The EigenSpot algorithm has been recently proposed for detecting space-time disease clusters of arbitrary shapes with no restriction on the distribution and quality of the data, and has shown some promising advantages over the state-of-the-art methods. However, the main problem with the EigenSpot method is that it cannot be adapted to detect more than one spatiotemporal hotspot. This is an important limitation, since, in reality, we may have multiple hotspots, sometimes at the same level of importance. We propose an extension of the EigenSpot algorithm, called Multi-EigenSpot that is able to handle multiple hotspots by iteratively removing previously detected hotspots and re-running the algorithm until no more hotspots are found. In addition, a visualization tool (heatmap) has been linked to the proposed algorithm to visualize multiple clusters with different colors. We evaluated the proposed method using the monthly data on measles cases in Khyber-Pakhtunkhwa, Pakistan (Jan 2016- Dec 2016), and the efficiency was compared with the state-of-the-art methods: EigenSpot and Space-time scan statistic (SaTScan). The results showed the effectiveness of the proposed method for detecting multiple clusters in a spatiotemporal space.
    Matched MeSH terms: Pakistan/epidemiology
  3. Ullah MZ, Awais MM, Akhtar M, Anwar MI, Navid MT, Khan I, et al.
    Trop Biomed, 2018 Dec 01;35(4):1028-1040.
    PMID: 33601850
    Toxoplasmosis is a protozoal infection of zoonotic potential with worldwide geographical distribution which affects nearly all warm-blooded animals including mammals and birds. Keeping in view, this study was conducted to determine the seroprevalence of toxoplasmosis along with associated risk factors and its haematological impacts in small ruminants of district Multan, Pakistan. In this study, a total of 250 sera samples collected from sheep (n=125) and goats (n=125) from three tehsils of Multan were examined using commercially available Latex agglutination test kit for the presence of anti-T. gondii antibodies. The haematological profiles of Toxoplasma seropositive and seronegative animals were determined by using automated haematology analyser. Overall seroprevalence of toxoplasmosis in small ruminants was 42.80% with a higher prevalence rate (44.80%) in sheep as compared to goats (40.80%). Sex, existence of co-morbid conditions, feeding pattern and presence of pet cats and dogs were identified as significant (P<0.05) risk factors associated with the presence of antibodies against toxoplasmosis. The breed was found to be a significant (P=0.026) risk factor for the seroprevalence of toxoplasmosis in goats but not in sheep. Haematological analysis revealed significantly altered leukocytic counts (P<0.05) in seropositive sheep and goats as compared to seronegative ones. Our findings showed that small ruminants of the Multan District in Pakistan are toxoplasma seropositive and may pose a serious threat of public health concern in the region.
    Matched MeSH terms: Pakistan
  4. Ullah AR, Hussain A, Ali I, Samad A, Ali Shah ST, Yousef M, et al.
    Pak J Med Sci, 2016 May-Jun;32(3):688-93.
    PMID: 27375715 DOI: 10.12669/pjms.323.9978
    The current study aims to explore the factors associated with outcome among patients with severe sepsis and septic shock admitted to the intensive care unit, Northwest General Hospital and Research Centre, Peshawar, Pakistan.
    Matched MeSH terms: Pakistan
  5. Ul Mustafa Z, Salman M, Aldeyab M, Kow CS, Hasan SS
    SN Compr Clin Med, 2021 May 28.
    PMID: 34095752 DOI: 10.1007/s42399-021-00966-5
    The discovery of different antimicrobial agents has revolutionized the treatment against a variety of infections for many decades, but the emergence of antimicrobial resistance require rigorous measures, even amid the coronavirus disease 2019 (COVID-19) pandemic. This retrospective study aimed to examine the consumption of antibiotics in patients with COVID-19 admitted into the five hospitals in the province of Punjab, Pakistan. We collected data on the consumption of antibiotics, classified using the World Health Organization (WHO) AWaRe (Access, Watch, and Reserve), within two months-August and September, 2020, and the corresponding months in 2019. Consumption of antibiotics was presented as daily define dose (DDD) per 100 occupied bed-days. Eight different classes of antibiotics were prescribed to patients with COVID-19 without culture tests being performed, with the prescribing of antibiotics of the Watch category was especially prevalent. The consumption of antibiotics was higher during the COVID-19 pandemic compared to the pre-pandemic period: the consumption of azithromycin increased from 11.5 DDDs per 100 occupied bed-days in 2019 to 17.0 DDDs per 100 occupied bed-days in 2020, while the consumption of ceftriaxone increased from 20.2 DDDs per 100 occupied bed-days in 2019 to 25.1 DDDs per 100 occupied bed-days in 2020. The current study revealed non-evidence-based utilization of antibiotics among patients with COVID-19 admitted into the hospitals in Pakistan. Evidently, the current COVID-19 pandemic is a public health threat of notable dimensions which has compromised the ongoing antimicrobial stewardship program, potentially leading to the emergence of antimicrobial resistance among pathogens.
    Matched MeSH terms: Pakistan
  6. Ul Mustafa Z, Batool A, Ibrar H, Salman M, Khan YH, Mallhi TH, et al.
    Expert Rev Anti Infect Ther, 2024 Apr;22(4):229-240.
    PMID: 38146949 DOI: 10.1080/14787210.2023.2299387
    INTRODUCTION: Previous studies in Pakistan have shown considerable over prescribing of antibiotics in patients hospitalized with COVID-19 despite very low prevalence of bacterial infections. Irrational use of antibiotics will worsen antimicrobial resistance (AMR).

    METHODS: Retrospective analysis of medical records of patients in the COVID-19 wards of three tertiary care hospitals to assess antibiotic use during the sixth COVID-19 wave.

    RESULTS: A total of 284 patients were included, most were male (66.9%), aged 30-50 years (50.7%) with diabetes mellitus the most common comorbidity. The most common symptoms at presentation were cough (47.9%) and arthralgia-myalgia (41.5%). Around 3% were asymptomatic, 34.9% had mild, 30.3% moderate, and 23.6% had severe disease, with 8.1% critical. Chest X-ray abnormalities were seen in 43.3% of patients and 37% had elevated white cell counts, with 35.2% having elevated C-reactive protein levels. Around 91% COVID-19 patients were prescribed antibiotics during their hospital stay, with only a few with proven bacterial co-infections or secondary bacterial infections. Most antibiotics were from the 'Watch' category (90.8%) followed by the 'Reserve' category (4.8%), similar to previous COVID-19 waves.

    CONCLUSION: There continued to be excessive antibiotics use among hospitalized COVID-19 patients in Pakistan. Urgent measures are needed to address inappropriate prescribing including greater prescribing of Access antibiotics where pertinent.

    Matched MeSH terms: Pakistan/epidemiology
  7. Ul Haq N, Saeed S, Iqbal Q, Naseem A, Razaq G, Farooqui M
    Value Health, 2015 Nov;18(7):A865.
    PMID: 26534631 DOI: 10.1016/j.jval.2015.09.516
    Objectives: The current study aimed to determine the prevalence of Complementary and Alternative Medicines (CAM) and its types used in diabetes patients in Quetta, Pakistan.
    Methods: A cross-sectional study was undertaken with diabetes patients, attending different government and private hospitals and clinic of Quetta city, Pakistan. A self-administered questionnaire containing 16 questions (5 questions related with disease and remaining questions were for information regarding CAM use). Descriptive statistics were applied to evaluate the patient’s demographics. Inferential statistics were used to fine the association between demographics characteristics and CAM (p<0.05).
    Results: A total of 500 questionnaires were distributed and 451 were returned (with response rate of 90.2%). Out of 451 patients 148 (32.8%) used CAM for the diabetes treatment, out of which 87 (58.8%) were females and 61 (41.2%) were males. Most of the participants were uneducated 51 (34.5%) and belongs to large families 89 (60.1%). Fifty (33.8%) participants were using mind body intervention, followed by alternative medical system (33.1%) and herbal products (31.8%) respectively for treatment of diabetes. Type of family, monthly income and per month medicine cost were significant associated (p<0.05) with CAM use.
    Conclusions: The current study indicated that diabetes patients used mind body intervention, alternative medical system and herbal products are the most common CAM type used for diabetes control. Further research is recommended to evaluate the diabetes control in patients with CAM used.
    Matched MeSH terms: Pakistan
  8. Udry JR, Cliquet RL
    Demography, 1982 Feb;19(1):53-63.
    PMID: 7067870
    Recent work with samples of black and white urban American women showed a clear behavioral sequence relating age at menarche to age at first intercourse to age at first birth. This paper shows that the linking of ages at menarche, intercourse, marriage, and first birth is a pattern which occurs in very diverse cultures. We present confirmatory data from the United States, Belgium, and Pakistan, and from Malay and Chinese women in Malaysia. We interpret our findings as indicating a biological process leading to (a) social interpretations of readiness for reproduction, and (b) persisting biological differences between early and late maturing women.
    Matched MeSH terms: Pakistan
  9. Uddin GA, Alam K, Gow J
    Environ Sci Pollut Res Int, 2019 May;26(13):13159-13172.
    PMID: 30903468 DOI: 10.1007/s11356-019-04791-1
    The relationship between national income growth and the environment of 14 Asian economies over a 50 year period is examined using the Environmental Kuznets Curve (EKC) hypothesis. Ecological Footprint (EF) measures environmental impacts and gross domestic product (GDP) measures economic growth. It is hypothesised that increased rates of economic growth come at a cost to the natural environment. The EKC hypothesis has been mainly tested in the literature by cross-sectional or panel data methods. In this study, it is tested using time series analysis through initially examining the relationship between EF and GDP using linear, quadratic and cubic estimating OLS regression functions. In the second stage, the long-run relationship between EF and GDP is investigated using an augmented error correction trend model. There is a statistically significant cointegrated long-run relationship between the variables in most of the countries. The EKC hypothesis is supported in the case of India, Nepal, Malaysia and Pakistan with the other countries exhibiting a positive linear relationship between the two variables. Almost all error correction terms are correct in sign and significance that implies that some percentage of disequilibria in EF in the previous year adjusts back to the long-run equilibrium in the current year. Based on the long-run relationship, it is apparent that rapid economic growth has had an impact on the environment and the ecosystems of these countries over the last 50 years. Despite that, until now, not many of them have taken sufficient steps to reduce their EF or to improve their bioproductive capacity.
    Matched MeSH terms: Pakistan
  10. Tinker H
    Dev Dig, 1979 Oct;17(4):116-24.
    PMID: 12336016
    Matched MeSH terms: Pakistan
  11. 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.

    Matched MeSH terms: Pakistan/epidemiology
  12. Thaver I, Ashraf M
    J Pak Med Assoc, 2017 Apr;67(4):651.
    PMID: 28420937
    Matched MeSH terms: Pakistan
  13. Thatte U, Hussain S, de Rosas-Valera M, Malik MA
    Value Health, 2009 Nov-Dec;12 Suppl 3:S18-25.
    PMID: 20586975 DOI: 10.1111/j.1524-4733.2009.00622.x
    This paper discusses national programs implemented in India, Pakistan, Malaysia, and Philippines to generate and apply evidence in making informed policy decisions on the approval, pricing, reimbursement and financing of medicines, diagnostics, and medical devices.
    Matched MeSH terms: Pakistan
  14. Tharwani ZH, Bilal W, Khan HA, Kumar P, Butt MS, Hamdana AH, et al.
    Inquiry, 2023;60:469580231167024.
    PMID: 37085986 DOI: 10.1177/00469580231167024
    Over the years, several developing countries have been suffering from high infant and child mortality rates, however, according to the recent statistics, Pakistan falls high on the list. Our narrative review of copious research on this topic highlights that several factors, such as complications associated with premature births, high prevalence of birth defects, lack of vaccination, unsafe deliveries, poor breastfeeding practices, complications during delivery, sudden infant death syndrome (SIDS), poor socioeconomic conditions, and a struggling healthcare system, have influenced these rates. Bearing in mind the urgency of addressing the increased infant and child mortality rate in Pakistan, multiple steps must be taken in order to prevent unnecessary deaths. An effective initiative could be spreading awareness and education among women, as a lack of education among women has been indirectly linked to increased child mortality in Pakistan across many researches conducted on the issue. Furthermore, the government should invest in healthcare by hiring more physicians and providing better supplies and improving infrastructure, especially in underdeveloped areas, to decrease child mortality due to lack of clean water and poor hygiene. Lastly, telemedicine should be made common in order to provide easy access to women who cannot visit the hospital.
    Matched MeSH terms: Pakistan/epidemiology
  15. Thai VN, Dehbandi R, Fakhri Y, Sarafraz M, Nematolahi A, Dehghani SS, et al.
    Biol Trace Elem Res, 2021 Sep;199(9):3497-3509.
    PMID: 33180263 DOI: 10.1007/s12011-020-02476-2
    The contamination of seafood like narrow-barred Spanish mackerel (Scomberomorus commerson) fillets by potentially toxic elements (PTEs) has converted to worldwide health concerns. In this regard, the related citations regarding the concentration of PTEs in fillets of narrow-barred Spanish mackerel were collected through some of the international databases such as Scopus, Cochrane, PubMed, and Scientific Information Database (SID) up to 10 March 2020. The concentration of PTEs in fillets of narrow-barred Spanish mackerel fish was meta-analyzed and the health risk (non-carcinogenic risk) was estimated by the total target hazard quotient (TTHQ). The meta-analysis of data indicated that the rank order of PTEs in fillet of narrow-barred Spanish mackerel was Fe (10,853.29 μg/kg-ww) > Zn (4007.00 μg/kg-ww) > Cu (1005.66 μg/kg-ww) > total Cr (544.14 μg/kg-ww) > Mn (515.93 μg/kg-ww) > Ni (409.90 μg/kg-ww) > Pb (180.99 μg/kg-ww) > As (93.11 μg/kg-ww) > methyl Hg (66.60 μg/kg-ww) > Cd (66.03 μg/kg-ww). The rank order of health risk assessment based on the country by the aid of TTHQ for adult consumers was Malaysia (0.22251) > Philippines (0.21912) > Egypt (0.08684) > Taiwan (0.07430) > Bahrain (0.04893) > Iran (0.03528) > China (0.00620) > Pakistan (0.00316) > Yemen (0.00157) > India (0.00073). In addition, the rank order of health risk assessment based on the country by the aid of TTHQ for child consumers was Malaysia (1.03838) > Philippines (1.02257) > Egypt (0.40523) > Taiwan (0.34674) > Bahrain (0.22832) > Iran (0.16466) > China (0.02892) > Pakistan (0.01474) > Yemen (0.00731) > India (0.00340). Therefore, the children in Malaysia and the Philippines were at considerable non-carcinogenic risk. Hence, approaching the recommended control plans in order to decrease the non-carcinogenic risk associated with the ingestion of PTEs via the consumption of narrow-barred Spanish mackerel fish fillets is crucial.
    Matched MeSH terms: Pakistan
  16. Teh CS, Chua KH, Thong KL
    Int J Med Sci, 2014;11(7):732-41.
    PMID: 24904229 DOI: 10.7150/ijms.7768
    The incidence of enteric fever caused by Salmonella enterica serovar Paratyphi A (S. Paratyphi A) is increasing in many parts of the world. Although there is no major outbreak of paratyphoid fever in recent years, S. Paratyphi A infection still remains a public health problem in many tropical countries. Therefore, surveillance studies play an important role in monitoring infections and the emergence of multidrug resistance, especially in endemic countries such as India, Nepal, Pakistan and China. In China, enteric fever was caused predominantly by S. Paratyphi A rather than by Salmonella enterica serovar Typhi (S. Typhi). Sometimes, S. Paratyphi A infection can evolve into a carrier state which increases the risk of transmission for travellers. Hence, paratyphoid fever is usually classified as a "travel-associated" disease. To date, diagnosis of paratyphoid fever based on the clinical presentation is not satisfactory as it resembles other febrile illnesses, and could not be distinguished from S. Typhi infection. With the availability of Whole Genome Sequencing technology, the genomes of S. Paratyphi A could be studied in-depth and more specific targets for detection will be revealed. Hence, detection of S. Paratyphi A with Polymerase Chain Reaction (PCR) method appears to be a more reliable approach compared to the Widal test. On the other hand, due to increasing incidence of S. Paratyphi A infections worldwide, the need to produce a paratyphoid vaccine is essential and urgent. Hence various vaccine projects that involve clinical trials have been carried out. Overall, this review provides the insights of S. Paratyphi A, including the bacteriology, epidemiology, management and antibiotic susceptibility, diagnoses and vaccine development.
    Matched MeSH terms: Pakistan
  17. Tariq W, Asar MAT, Tahir MJ, Ullah I, Ahmad Q, Raza A, et al.
    Front Public Health, 2022;10:1036800.
    PMID: 36684982 DOI: 10.3389/fpubh.2022.1036800
    BACKGROUND: Telemedicine is the provision of healthcare services through information and communication technology with the potential to mobilize all facets of the health sector to prevent the spread of COVID-19, provide quality healthcare, protect patients, doctors, and the public from exposure to disease, and reduce the burden on the healthcare system. This study aims to identify knowledge, perceptions, willingness to use, and the impact of the COVID-19 pandemic on telemedicine awareness.

    METHODS: A cross-sectional study was conducted from 27 May 2020 to 17 June 2020 using the convenient sampling technique in the general population of Pakistan. Data were collected by designing an online questionnaire consisting of demographic information, knowledge, attitude perceptions, barriers, utilization, and the impact of the COVID-19 pandemic on telemedicine.

    RESULTS: Of the 602 participants included in the study, 70.1% had heard about telemedicine, 54.3% had a good understanding of the definition of "telemedicine," 81.4% had not used telemedicine in the past, 29.9% did not know that telemedicine was available before the COVID-19 pandemic, and 70.4% responded that the COVID-19 pandemic had changed their attitudes toward telemedicine. Gender (p = 0.017) and family income (p = 0.027) had a significant association with the perception of the benefits of telemedicine.

    CONCLUSION: The knowledge and usage of telemedicine are lacking due to inadequate awareness and technology. The need of the hour is to maximize the application of telemedicine to overcome the deficiencies of the healthcare system. Hence, it is essential to increase awareness through various means and develop an appropriate infrastructure to attain maximum benefits from telehealth services.

    Matched MeSH terms: Pakistan/epidemiology
  18. 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.

    Matched MeSH terms: Pakistan
  19. 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. .

    Matched MeSH terms: Pakistan/epidemiology
  20. Taqi M, Razak IA, Ab-Murat N
    Pak J Med Sci, 2017 Jul-Aug;33(4):948-952.
    PMID: 29067071 DOI: 10.12669/pjms.334.13106
    OBJECTIVE: To estimate the percentage of children with low, moderate and high caries risk; and to determine the predictors of caries risk amongst 11-12 year old Pakistani school children.

    METHODS: Subjects' caries risk was assessed using the Cariogram programme. The survey was done among school children in Bhakkar district of Punjab, Pakistan. Caries and plaque level were assessed using the DMFT and Sillnes and Loe indices respectively, while diet content and frequency were assessed using a three-day diet diary.

    RESULTS: A total of 226 children participated in this study, giving a response rate of 75%. Most subjects (39.8%) were in the low risk category with DMFT score of 0. The overall mean DMFT score was 1.49 (±0.63). Linear and multiple regressions were performed to evaluate the predictability of caries risk. Previous experience of dental caries was found to be the most relevant predictor of caries risk (40%).

    CONCLUSION: The levels of caries risk amongst Pakistani 11-12 year old school children were generally low. Past caries experience was the most significant factor in predicting future caries lesion in this sample population.
    Matched MeSH terms: Pakistan
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