Volume 5            Issue 1            March 2017


To Identify the Non-Biological Causes of Child Mortalities in Developing Countries, Social Autopsy Tools Should Be Based On “The Pathway to Survival Conceptual Framework”
Muhammad Bilal Siddiqui1,2, 3, Chiu Wan Ng4 and Wah Yun Low5
1. Centre of Maternal and Child Health Research” (CoMCHR) at Advanced Educational Institute of Research Centre (AEIRC), Karachi, Pakistan.
2. Child Registry of Pakistan (CROP), Karachi, Pakistan.
3. Department of Community Health Sciences, Hamdard University, Karachi, Pakistan.
4. Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur,Malaysia.
5. Health Research Development Unit, Faculty of Medicine, University of Malaya.
Corresponding Author

Since a large proportion of child deaths occur due to preventable diseases in developing countries, estimating the cause of death (CoD) is very important for such prevention. Verbal Autopsy (VA) has given us tremendous amount of valuable data on the cause of death; however, VA data is primarily limited to assigning only biological cause of death (BCoD) to the unregistered child mortalities. Apart from gaining the information on BCoD, knowing the social or non-biological determinants (NBDs) linked with health care seeking behavior, health care delivery and access to health care to any child is of utmost importance. This knowledge potentially may help us to develop interventions targeting effects of different barriers affecting the timely and appropriate health delivery to the needy, thereby may help us by armoring us with new and more advanced information to prevent the child mortalities and improving the child survival estimates in developing geographies, which have huge inconsistencies related to social determinants of health. The concept of capturing NBDs and relating them with the death incidents in children have been backed in the literature1-10.

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Frequency of Raised Urinary Trypsinogen-2 in Acute Pancreatitis
Mansab Ali1, Syed Mehsam1, Adeel Hussain1, Shahid Rasul1, Sughra Parveen1,
Ahson Memon2, Peer Asad Aziz3 and Hamid Ali3
1. Jinnah Postgraduate Medical Centre, Karachi Pakistan
2. Tabba Heart Institute
3. LUMHS, Hyderabad
Corresponding Author

Objectives To determine the frequency of raised Urinary Trypsinogen-2 in diagnosed patients of acute pancreatitis. Methodology Settings Patients in emergency refer to General Surgery ward-3 Jinnah Post Graduate and Medical Centre Karachi. Duration Six months, started from 20-01-2012 to 19-07-2012. Study Design Cross sectional descriptive study. Subjects and Methods All cases of Acute Pancreatitis diagnosed by Upper Abdominal Pain, Raised Serum Amylase and/or Serum Lipase and Abdominal CT Scan findings, were included in the study. Urinary Trypsinogen-2 dipstick test was done. All patient related data including age, gender, sex and raised Urinary Trypsinogen-2 or normal, was recorded. Data analysis was done on SPSS version 10. Frequency and percentage was calculated for gender and raised trypsinogen-2. Age and gender wise stratification was done to see the effect of these variables on outcome. Results Mean age of the patients was 38.14 ±7.42 years. The minimum age was 24 years, while the maximum age was 63 years. Raised urinary trypsinogen-2 level was present in 55 (65.5%) patients. Stratification of age group shows, that 40 (66.7%) patients in age group ≤ 40 years had raised urinary trypsinogen-2. Stratification of gender showed significant association with raised urinary trypsinogen-2 level (p-value 0.010). Conclusion The frequency of raised Urinary Trypsinogen-2 in diagnosed patients of acute pancreatitis was found to be high.

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Sickle Cell Anemia; 3 Years Clinical Experience in Bisha, Saudi Arabia (2010-2013)
Yahya Aziz1, Warda Musharraf1, Syed Ibrar Hussain Shah2 and Muhammad Tayeb2
1. Department of Medicine, Hamdard University Hospital, Karachi, Pakistan.
2. Department of Medicine, King Abdullah Hospital, Bisha, KSA.
Corresponding Author:

Objective Three-year clinical experience of patients diagnosed with Sickle cell disease in Bisha, South Western region of Saudi Arabia is analyzed. Methodology A retrospective analysis was done on data recruited from 2011 to 2013 of all the patients presented with sickle cell anemia. The demographic data, clinical presentation, course of disease, complications and chronic conditions were collected. The descriptive percentage of data with years of presentation and its incidence rate per 100 person-years were also taken with the cause mortality. Results Total 386 patients were analyzed, among them 45.2% were females and 54.8% were males. According to our study, the sickle cell crises included as acute chest syndrome (26%), pulmonary hypertension (21%), Splenomegaly (7%), septicemia (11%), acute Vaso-occlusive crisis (10%), and other sickle cell crisis (2-10%) of patients. It was also found that about 48% of patients suffered from 1 or more irreversible organ damage. The survival rate of male and female are not significant, however total 82 patients died of sickle cell anemia. Conclusions Sickle cell disease represents high mortality in Saudi Arabia, comprising distinctive diseases characteristic in different regions. The qualitative and quantitative study of genetic and environmental factors in relation to disease complications need to be done.

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Comparative Results of Repair of Ischemic Mitral Regurgitation (IMR): Conventional Against Trans-Septal Approach
Ahson Memon1, Junaid Ansari1, Ghufranullah Khan1, Khalid Rasheed1, Ali Shan1, Imran Ali1, Peer Asad Aziz3 and Hamid Ali3
1. Tabba Institute of Heart, Karachi, Pakistan
2. LUMHS, Hyderabad
Corresponding Author:

Objective Ischemic mitral regurgitation is common and increases mortality, even when mild. (American Heart Association) AHA and European association have both stressed the need of mitral valve repair in patients with moderate or more regurgitation. The aim of this study was to compare the results with the conventional and right atrial trans-septal approach of mitral valve repair in Ischemic Mitral Regurgitation (IMR). Methodology A total of 308 consecutive patients underwent mitral valve repair for IMR, between January 2012 and December 2013 at Tabba Heart Institute. Patients who had at least moderate mitral regurgitation or more mitral regurgitation underwent mitral regurgitation repair. The final decision of mitral valve repair was taken after the intra operative trans-esophageal echocardiography (TEE). Result Total number of patients included in study was222, out of those 153 (69.9%) patients underwent conventional approach and 69 (31.1) patients underwent trans-septal approach. Total 88.2% patients got off bypass in normal sinus rhythm in conventional approach group, as compared to 82.1% in trans-septal group. 11.8% and 17.9% patients got off by pass on pacing in conventional and trans-septal approach respectively. 3 patients developed junctional rhythm and 5 patients developed complete heart block in post-operative period in trans-septal approach. Conclusion Right Atrial Trans-septal technique is a good alternative approach that can be used in relatively small atria. It not only provides an excellent exposure to the mitral valve, there also seems to be no associated rhythm disturbances encountered as well.

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Diffused Scanning, Blind Stick & Rehabilitation
Salma Tariq
College of Biomedical Engineering, Ziauddin University, Karachi, Pakistan
Corresponding Author:

Objective Pakistan is a developing country and strive to provide cost effective solutions for rehabilitation and aid of visionless individuals with innovative technologies. The purpose of this study is to design and study the blind stick prototype implanted with modern technology. Method Its significant characteristics is embedded photo-electric sensor that uses diffuse-reflective scanning to sense hindrance and feedback it to the high quality buzzer which can be heard easily furthermore it operates by only rechargeable 9V battery. This will enable the blind individuals to sense and detect the obstacle from 5mm to 127 mm distance with simplicity. Result This prototype was used by a blind person in hall with obstacles. Results were tremendous and promising as the blind individual crossed the hall without tripping even a single time. Conclusion It is portable, light weight, user friendly and extremely cost effective that is 4.77$ (500 Pakistan Rupees) only. It can be used not only in Pakistan but in other least developed countries as well. Blind as well as partially blind person can use it for walking in designated place independently.

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Effectiveness of Aromatherapy on Physical Vitals of Exercising Females
Alvira Ali1, Faizan Mirza2 and Sadaf Ahmed1, 2
1. Advance Educational Institute and Research Center
2. University of Karachi, Pakistan
Corresponding Author

Objective Aroma or scent therapy is one of the traditional treatments, which is presumed to be helpful in supporting and balancing the mind, body and soul. It is a complementary therapy that has been clinically proven to be beneficial in improving various attributes of life. The aim of the study was to evaluate the effectiveness of aromatherapy on the physiological vitals of the healthy females. Methodology an observational study has been conducted to determine the effectiveness of Aromatherapy on Vitals and Physical Factors. This study targeted to recruit a small set of healthy females for the study. All the readings were collected at room temperature, between the months of November 2015 to January 2016. The recordings were compared by the two-tailed test, with probability taken as 1, to detect the influence of aromatherapy on physiological workings of the healthy human body that has been exposed to the physical strain due to the moderate level of exercise. The test involved the comparative analysis of the physiological vitals of those females who exercised regularly; their vitals were evaluated after a course of physical activity in two sets i.e. with and without aromatherapy. Result The result showed a significant difference in the pre and post status mainly in the readings for the cardiac output, pulse rate and body temperature, increases after physical activity of average intensity and is further supported by the aromatherapy. Conclusion The study came to the conclusion that aromatherapy has beneficial influences on the rate of body metabolism.

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Knowledge of Nursing Students Regarding Housing Characteristics and Its Evaluation
Arif Ali, Abdur Rasheed, Fauzia Imtiaz, Mudassir Hussain, Muhammad Arsalan
Dow University of Health Sciences
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Objective The purpose of this research study is to assess the knowledge of housing characteristics and associated health problems in nursing students of Dow University of Health Sciences (DUHS). Moreover, nursing students’ knowledge about housing condition and public health risks were also analyzed. Methodology The study was conducted at Institute of Nursing, DUHS, Karachi. In 2012, 90 nursing students were asked to participate in this study with their consents. A teaching session was conducted as a part of this study that lasted for two hours. At the end of teaching session students were requested to fill out the questionnaire about their housing condition and health related problems along with a feedback of the session. Results The study highlighted that on average, participants had been living in the same housing for the last one year, with median and inter-quartile range of 12 and 16 months respectively. Twelve participants (13%) mentioned that they had suffered from diarrhea or vomiting during last three months, and 7.6% participants reported that their housing conditions were affecting their respiratory health. A large number of participants (89.1%) and (87.2%) did not find any visible mold in their house/hostel or kitchen respectively. Almost 61% and 80% participants reported about the mechanical ventilation and window in the bathroom respectively. Conclusion Reduction in dampness results in improvement of various health symptoms. House dust mite can be controlled through constant mechanical ventilation. The majority of the participants showed willingness towards such seminars and discussions for their future classes.

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Optimizing CRISPR Cas9 Genome Editing System: A Review
Meen Bahadur Budhthoki1, Puja sharma2, Saima khan3, Saroj Singh1, Fu Chao1, Li Yong1
1. Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Stomatology, Chongqing Medical University, China
2. Department of Periodontics, The Affiliated Hospital of Stomatology, Chongqing Medical University, China
3. Institute of Life Sciences, Chongqing Medical University, Chongqing, China.
Corresponding Author:

CRISPR Cas9 is highly advanced genome editing technology extensively used for the modifications of genetic components in various sectors of living organisms. This technology has been adapted from the prokaryotic immune system, where it plays a vital role in protecting bacteria and archaea from virus attacks. This robust technology has currently been proven efficient in selective and precise editing, the genome of different living organisms for different purposes ranging from therapeutic, diagnostic to programmable gene regulation. This technology has been continuously upgraded, enhancing its performance thus reducing unfavorable outcomes. Customizing this technology is not a piece of cake. Hundreds of thousands of experiments have been conducted all around the world to optimize this highly intellectual technology to make it an error prone programmable technology to serve each and every living kind. In this review, we have summarized the modifications that have been made in different components of CRISPR cas9 system, engineering of CRISPR Cas9 for specific purposes, different external factors that has to be considered to obtain the best possible outcome minimizing the hazards.

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