Volume 3            Issue 2            July 2015

Responsibility, Prevalence and major factors of infertility, A cross-sectional study in Karachi.

Ayesha Khan,  Neelam Barkat, Sidra Afzal & Shehla.

Al-Hafeez fertility and Medical Center

Civil hospital Karachi

Dow University of Health Sciences


A cross-sectional study was conducted to target the infertile couples visiting to private and government hospitals in Karachi from 2012 to 2014. The aim of the study is to know the higher prevalence of infertility among the married couples and to determine the major factors causing infertility. Detailed evaluation had been made to assess each cause. Likewise, in females, we analyze menstrual history, parity, past surgical history, family history and body weight, years of marriage, complete hormonal profile and ultrasonic measurements. On the other hand, in males; we conduct complete analysis of semen, coital frequency, addiction to any substance and medical history. Overall 475 infertile couples were targeted in the study, in which 175 pairs were included, who full fills all the inclusion criteria, i.e. with complete medical investigations and excluded the remaining with incomplete reports in females and in males who denied semen evaluation. The included couples are divided into four groups in order to determine the responsibility of childlessness between the two, a) female, b) male, c) both and d) unexplained infertility. Our study concludes that in the Karachi the majority of females are responsible for unproductiveness up to 41.1% rather than the male up to 25%, whereas 16.5% both the couples are involved in it and 17% has unexplained screened problems. Moreover, our study further explores the occurrence of primary infertility which is twice, i.e. 71.1% than secondary infertility, i.e. 22.8% in Karachi city. However, the major female factor is PCOS which is observed in more than half of the females in both primary and secondary incidents. While, lower sperm count, inefficient sperm motility and higher rate of abnormal sperm are the key male factors.


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Student abuse in medical colleges of Karachi, a descriptive Cross-sectional study.

Warda Musharraf, Dr. Kiran Khan, Asma Pervaiz, Saba Younis, Sana Shiekh, Hina Rahim & Sara Zehra

Hamdard College of Medicine and Denistry

Assistant Professor Department of Community Health and Science, Hamdard College of Medicine and Dentistry


Background: Medical students are suspected to be the most compassionate, warm hearted and devoted students to their profession. In the process of cultivating future doctors any bad impact to their personalization may lead to a decrease in self-esteem, spirits and positive mood. Objective: The following study is conducted to make an estimation of different types of abuse that medical students are facing in Medical universities of Karachi. Furthermore, this study also intends to analyze which type of abuse is more prevalent and if the universities have a complaint department for taking a proper action against abuse or not. Methodology: A descriptive cross sectional study was conducted in private and government medical colleges of Karachi, Sindh Pakistan, in the months of June and July 2014. Data collection was based on random data sampling comprising of 250 subjects, which included male and female students between the ages of 20-25 years.Results: According to our study’s findings, about 47.47% of abuse is seen in medical colleges of Karachi. Among those who had faced bullying or harassment, 38.44% reported that they had experienced verbal abuse, 54.76% reported academic abuse, 6.9% faced physical abuse, and 18.56% faced sexual abuse. There was no reported harassment cell found in medical colleges of Karachi and hence, no one has ever taken authority. Conclusion: Therefore, it has been concluded that mistreatment and abuse are common occurrences in our medical colleges. This has found to be very adverse for learning, determination and the self-confidence of our medical students and for a futuristic personality of a doctor as well.


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Epidemiology of Hand Injury in Children

Aftab Ahmed, Syed Muhammad Mustahsan, Syed Hasan Mustafa Rizvi & Muhammad Tahir Mehboob

Liaquat National Hospital & Medical College

Jinnah Postgraduate Medical Centre


Objective: To study the types and presentation of hand injuries in children. Method and Materials: A prospective study was done at the emergency department of Jinnah Postgraduate Medical Centre from 24th October, 2014 to 30th December, 2014 (a duration of six weeks). The data was collected on 50 out-patient children but we also followed the in-patient to find the outcome of their injuries. A self-designed questionnaire was administered and was filled by the parents of the participants. The questionnaire was explained in a one to one meeting by our volunteers. The volunteers were encouraging and friendly. Results: The most common reason of hand injury in our settings was due to road traffic accidents (34%); followed by the second reason, a fall of an object on the hand. In most of the cases, 68% of the participants involved the right hand whereas in 32% of the participants, the left hand was involved. The most common bone to be fractured in children was the scaphoid with the 1st metacarpal bone. Conclusion: The goal of the study was to find out the various modes of presentation and types of the hand injuries in the accident and emergency department and to emphasize the regions commonly injured during a hand trauma. Better understanding of the type and manner of hand injuries will lead the physicians to emphasize on the areas more commonly injured and take suitable measures for their treatment accordingly. The rising number of hand injuries and knowledge about their pattern encourages the authorities to take suitable action and measures for its prevention and treatment which has been an area of neglect.


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Health Issues confronting Muslims on Hajj

Murtaza Ali Gowa, Syed Ali Ammar, Ahmed Ali, Syed Muhammad Kashif Kazmi, Rana Farrukh, Ali Abbas Mohsin Ali & Syed Muhammad Mustahsan

Sultan Qaboos Hospital, Oman

National Institute of Cardiovascular Disorders, Karachi

Doctors Clinic, Dubai

Ziauddin Medical University Hospital, Karachi

Jinnah Postgraduate Medical Centre, Karachi


Objective: To determine the prevalence of health issues among hajj pilgrims and the factors associated with them. Method: An observational study conducted during hajj (Year 2011) using a questionnaire which was filled by pilgrims on their visit to the health clinics conducted by the Imamia Medics International. Results: During the period, pilgrims presented complaints related to the respiratory system 52.5%(n=394) followed by musculoskeletal system 29.6%(n=222), gastrointestinal system 15.5%(n=116), skin problems 5.9%(n=44), central nervous system 3.1%(n=23), cardiovascular system 2.9%(n=22), reproductive system 2.7%(n=20), urinary tract problems 2.3%(n=17)  were dealt with. Out of 750, 17.9% (n=134) were diabetic and 26.4% (n=198) were hypertensive. Amongst the total, 24.8% (n=186) were vaccinated against hepatitis while 35.7% (n=268) were vaccinated against pneumonia. An astonishingly high percentage of the pilgrims had no prior immunization to both hepatitis and pneumonia. Conclusion: This data tries to emphasize awareness regarding the importance of vaccination and the potential problems which are faced by diabetic, hypertensive and older population which can help to improve the health condition of hajj pilgrims and can lessen the burden faced by concerned authorities.


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A Cross-sectional study: Head Injury in Children of Karachi

Aftab Ahmed, Syed Muhammad Mustahsan, Fateeha Tariq, Syed Muhammad Ali Abidi, & Muhammad Owais Aslam

Liaquat National Hospital & Medical College, Karachi

Jinnah Postgraduate Medical Centre, Karachi

King Edward Medical University, Lahore


A cross-sectional study was conducted to determine the prevalence, causes and outcome of head injury in children at Neurosurgery Department of Jinnah Postgraduate Medical Centre from 1st December, 2013 to 1st February, 2014. A total of 37 patients under the age of 12 years, presented with head injuries to the emergency department, were included in the study. A self-designed questionnaire was filled for these children after getting the oral consent from their parents. The questionnaire comprised a complete detail on the causes of head injury, clinical presentation on reaching the hospital, X-rays and Computed Tomography (CT) scans of the children and their reports. SPSS version 20 was utilized as an analytical tool. The mean age of patients was 6.93 years ± 3.02. Out of these 37 patients, 54.1% were males and 45.9% were females. Road traffic accidents accounted for most of cases (48.6%) with marked peak observed in boys as compared to the girls. Majority had a good Glasgow Coma Scale (GCS) score (43.2%) whereas a depressed fracture was found to be the dominant feature (21.6%) on X-rays. Additionally, 29.7% of children had intracranial hemorrhage while 32.4% also acquired other injuries. In total 29.7% were offered surgical intervention with majority (83.8%) landing in neurosurgical ward. As head injury in childhood is an important issue, keeping in view the lack of research in this field we need to properly highlight the burden of such injuries in childhood so that all the concerned governing authorities should take every possible step in preventing as well as managing this devastating health concern.

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Hospital induced psychological distress among patient attendants at Liaquat University Hospital, Jamshoro

Aatir H. Rajput, Ali Raza Shaikh & Kainat Ali Panhwar

Liaquat University of Medical & Health Sciences, Jamshoro


Background: Existing literature on interpersonal affairs amid health professionals and patients has proliferated since the 1960s, highlighting the importance of health professionals of all sorts. Here, in the clinical setup of Liaquat University Hospital, we have another important relationship that is crucial to a patient’s health care plan, is an adjunct to the health care professionals and contributes significantly more to the patients care. This relationship, often taken for granted by the health authorities, is that of a patient and a family member voluntarily staying with the patient at the hospital (commonly termed as attendant). Objective: This study hopes to unearth the major problems (particularly hospital induced psychological distress) faced by attendants and inquire what major complaints they have against the health care setup, health professionals and the hospital. Methodology: This cross-sectional observational study was conducted from May to July 2013. A data sample of 150 patient attendants at Liaquat University Hospital, Jamshoro was chosen by purposive sampling. The data was collected by self-administered structured questionnaire and was analyzed using SPSS v.16.0 and MS Excel. Results: 66% of the patient attendants were males while 34% were females. The most common attendants were sons (22%), mothers (17.3%) and brothers (12%). The most common complaint of the patients was that the attendants had no proper place to stay even if their stay was necessary. The attendants complained of inadequate sleep, health worries, anxiety, depressed mood, agitation, reduced appetite and weight loss due to improper food. Conclusion:  We conclude, on the basis of our findings, that an important asset is being mistreated by our healthcare system and this mistake demands to be corrected on a priority basis. Steps should be taken to solve their problems so that they may continue to play their positive role.

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Impact of Media on Social Behavior of Individuals Living in Karachi

Fauzia Imtiaz, Noor Ellahi & Yawar Hasan Zaidi

Dow University of Health Sciences.

Princeton University

Islamic division, National Bank of Pakistan


Today the world is known as a global village where information is easily accessible. Media plays a vital role in providing information, education and entertainment to the population. Media updates people about the current situations through their news channels which are providing the most up to date news within no time through live evidences and substantiations. Several studies have proved the impact of media directly on the acute stress response to collective trauma. Media coverage of collective traumas may trigger sociological distress in individuals outside the directly affected community. Objective: To determine the effect of media on Social behavior of the population of Karachi Methodology: It’s a cross sectional questionnaire based study conducted in different areas of Karachi during, November 2014 to Feb 2015. The questionnaire includes demographic information, the type of media used for obtaining information and the impact of news on the social life of individuals. Results: Among the participants 46.6% were males and 53.4% were females. Television is the type of media that was used by most (442) of the population. Results showed that 31.9% showed no effect on their social life whereas 24.4% avoided the place/public transport for a few days, 18.6% didn’t go out at night, 17.3 avoided travelling alone and 7.8% of participants were afraid to go out. Conclusion: Television is the source of information for most people, beside the exaggeration in telecasting the news people continues their work. Their social life is not affected anymore which causes them to become immune to the environment they are facing.


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Association of Chemical stress with Type I & II diabetes

Shamoon noushad, Hamza Akhtar, Safdar Ali, Zafar Iqbal Abbassi, Sadaf Ahmed, Soobhi Mehdi , Kaneez Fatima & Samina Saleem

Advance Educational Institute & Research Centre

Shaheed Motharma Benazir Bhutto Medical College Layari

Koohi Goth Women Hospital

Patel Hospital

Baqai Medical University


Background Diabetes mellitus is characterized by absolute or relative deficiencies in insulin secretion or insulin action correlated with chronic hyperglycemia and other disturbances in carbohydrate, lipid and protein metabolism results in weakening immunity. In addition, various biochemical disorders associated with diabetic vascular complications, such as hyperlipidemia and oxidative stress frequently co-exist with diabetes mellitus. Previous studies have also suggested that these and additional factors might involve with increasing chemical stress in diabetic patients. Material and methods The questionnaire based survey was conducted including both close & open ended questions along with the assessment of chemical stress using Sadaf Stress Scale (SSS) version 2 among diabetic patients. This study was conducted in tertiary care hospitals of Karachi from October 1st till November 10th, 2014.  Data was analyzed and plotted using SPSS version 20.0. Results This study showed that 28% of diabetic patients were in severe chemical stress. However, the various symptoms of severity included body temperature alterations (50%), feeling of dehydration (56%) and shortness of breath (63%) were obtained. Conclusion It is concluded that the diabetes patient with type 2 diabetes are at higher risk of developing chemical stress that may indicate multiple metabolic and as indicated by prominent symptoms that can be a oxidative alterations on sequence of increase use of medications and altered glucose metabolism.

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A Systematic Literature Review to Highlight the Causes and Destructive Impact of Stigmatization on Health Status of Mentally Challenged Clients in Developing Countries

Ashraf.A.Karani & Salima.A.Karani

Baqai Medical University, College of Nursing

Aga Khan Univeristy


Introduction: Mental illness is a major obstacle of the health care system throughout the world. The solutions and knowledge about mental health issues have increased many folds over time. However, in many parts of the world, the stigma is still attached to the mental illness. It is felt that it will bring a bad name to the family if any of the family members are mentally unstable. Purpose: This paper aims to highlight major causes, probable consequences and suggest recommendations to demark stigmatized mentally ill patients in the developing world. Method: A systemic review of 25 pieces of literature from recent scholar articles (2008- 2014) was conducted to study the impact of stigmatization on mentally ill patients. Result: The findings suggest that the most significant causes of the stigma in the socio-cultural domain are society’s pre-conceived ideas, lack of knowledge, and myths that authenticate this stigma surrounding the mental illness. Moreover, the vicious cycle of stigmatization on patients’ lives and the attitude of health care providers are also among the very important aspects highlighted in some studies. The impact manifested was even more devastating including under or over diagnosed mental illness, delay in health seeking behavior and poor prognosis in community as well as hospital setting. Recommendation: It is essential to address these issues and arrange awareness sessions in order to improve the quality of life.


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Sensitivity pattern of Salmonella species in different age groups

Farzeen Zehra, Syeda Mehak Fatima & Fatima Syedain

Jinnah Sindh Medical University

Dr. Essa Laboratory and Diagnostic Centre


Objective: To determine the current efficacy of antibiotics used in treatment of enteric fever, with respect to age, in a laboratory setting. Study Design: A cross-sectional study. Methodology: A retrospective study was done on 105 specimens that were collected at Dr. Essa Laboratory and Diagnostic Centre from January 2012-December 2013. These specimens were inoculated into blood cultures bottles having Oxoid and incubated. Positive specimens were then cultured on EMB, CLED and chocolate agar. These sub cultures were incubated at 37°C for about two days.With AP120E screening was done of suspected colonies. They were then processed. Identified isolates were confirmed by specific agglutination antisera. Kirby–Bauer disc diffusion method was used to confirm anti-microbial suspects by Mueller-Hinton agar (Oxoid), using eleven antibiotics  which were  Amoxicillin , Ciprofloxacin , Aztreonam , Cefixime , Cefotaxime , Ceftriaxone , Co-trimaxole, Enoxacin , Fosfomycin, Sparfloxacin , and Ofloxacin. Results: The  overall sensitivity profile shown by these antibiotics against Salmonellae species is as follow : Amoxicillin (0 ) , Aztreonam (47.6%) , Cefixime (98.1%) , Cefotaxime (98.1%) , Ceftriaxone (97.1%) , Ciprofloxacin (85.7%) , Co-trimoxazole (64.8%) , Enoxacin (28.6%) , Fosfomycin (85.7%) , Ofloxacin (94.3%) , Sparfloxacin (30.5%). Conclusion: Third generation cephalosporins (Cefixime, Cefotaxime, Ceftriaxone) have maximum sensitivity profile among all age groups, rendering them most suitable for empirical treatment.


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volume 3 issue 2