Welcome to Journal Of Pakistan Medical Association

 Supplement Vol:63, No:1 January, 2013

Editorial >>

The Growing Threat of HIV, TB and TB-HIV Co Infection in Pakistan

Arshad Altaf, Sharaf Ali Shah, Sten Vermund,

The estimated population of Pakistan is around 176 million people. The countryis placed at a strategic hinge and shares its borders with South Asia, Central Asia, China and Middle East. As a result of the global economic turmoil and internal governance issues, the economyis in tatters which has a....

Commentary >>

Commentary on Tuberculosis and HIV/AIDS in Pakistan: Success in disease control and prevention demands serious quality improvement research and programmatic efforts

Sten H. Vermund, Arshad Altaf, Ghulam Nabi Memon, Mohammad Ashraf Memon, Rafiq Khanani, Holly Cassell, Nikhat Iftikhar, Ejaz Qadeer, Sharaf Ali Shah,

The authors recognize the contributions of the late Dr. A.S. Mujeeb as a pioneer in HIV/AIDS research, teaching, and service. He co-conceptualized this series of reprints for the local Pakistani audience through the JPMA. This work is supported by the Vanderbilt-CIDRZ AIDS International Training ....

Harm Reduction Journal >>

High risk behaviors of injection drug users registered with harm reduction programme in Karachi, Pakistan

Arshad Altaf, Sharaf Ali Shah, Najam A Zaidi, Nadeemur-Rehman, Norman Wray,

Background: Surveillance data of Sindh AIDS Control Programme, Pakistan suggest that HIV infection is rapidly increasing among IDUs in Karachi and has reached 9% in 2004-5 indicating that the country has progressed from nascent to concentrated level of HIV epidemic. Findings of 2nd generat....

Tropical Doctor January >>

HIV transmission among drug users in Larkana, Pakistan

Nadeem-ur-Rehman, Faran Emmanuel, Saeed Akhtar,

During a routine surveillance programme, 17 of183 drug users in Larkana, Pakistan,were found to be HIV positive.To investigate the factors to this rapid transmission of HIV, a case--control study was conducted. Cases were HIV seropositivemale drug dependants, while controls were drug dependants w....

Southeast Asia Journal of Tropical Medicine and Public Health; Jul 2008; 39, 4. >>

Risky sexual behavior, knowledge of sexually transmitted infections and treatment utilization among a vulnerable population in Rawalpindi, Pakistan

Naeem Hassan Saleem, Alix Adrien, Ali Razaque,

As a part of a second generation surveillance, we investigated the sociodemographics, risky sexual behavior, knowledge of HIV and sexually transmitted infections (STIs) and treatment seeking behavior among a vulnerable population. A cross-sectional study preceded by mapping, was conducted in Rawa....

Sex Transm Infect 2009 >>

Protecting the unprotected: mixed-method research on drug use, sex work and rights in Pakistanís fight against HIV/AIDS

S Mayhew, M Collumbien, A Qureshi, L Platt, N Rafiq, A Faisel, N Lalji, S Hawkes,

Objectives: To investigate the nature and extent of human rights abuses against three vulnerable groups (injecting drug users (IDUs) and male and female sex workers), to understand the social and sexual linkages between them and to examine how protecting their rights could enhance the impa....

HIV and other sexually transmitted infections among men, transgenders and women selling sex in two cities in Pakistan: a cross-sectional prevalence survey

S Hawkes, M Collumbien, L Platt, N Lalji, N Rizvi, A Andreasen, J Chow, R Muzaffar, H ur-Rehman, N Siddiqui, S Hasan, A Bokhari,

Objectives: The extent and possibilities of spread of the HIV epidemic are not fully understood in Pakistan. A survey was conducted among men, women and transgender populations selling sex in Rawalpindi (Punjab) and Abbottabad (North West Frontier Province) in order to inform evidence-base....

Sex Transm Infect 2008 >>

Variations in the population size, distribution and client volume among female sex workers in seven cities of Pakistan

J F Blanchard, A Khan, A Bokhari,

Objectives: To describe the size and distribution of female sex worker (FSW) populations and the distribution of client-FSW encounters in seven major cities of Pakistan.
Methods: Mapping of FSWs was done using a two-stage process of identifying and validating locations where ....

International Journal of STD & AIDS 2008 >>

Correlates and prevalence of HIV and sexually transmitted infections among Hijras (male transgenders) in Pakistan

A A Khan, N Rehan, K Qayyum, A Khan,

This study explored the role of Hijras (male transgenders) as a core group in Pakistan\'s HIV epidemic. Four hundred and nine Hijras underwent detailed behavioural and biological assessment. Our subjects were young (median age: 24 years), debuted sex early and used alcohol and drugs. Sex with m....

BMJ Open 2011 >>

Condom use during commercial sex among clients of Hijra sex workers in Karachi, Pakistan (cross-sectional study)

Anees ur Rehman Siddiqui, Han-Zhu Qian, Arshad Altaf, Holly Cassell, Sharaf Ali Shah, Sten H Vermund,

Objective: To describe the prevalence and predictors of condom use and sexual risk in the male clients of Hijra sex workers (HSWs) in Karachi, Pakistan.
Design: Cross-sectional study.
Setting: Karachi, Pakistan.
Participants: Clients of HSWs were r....

J Ayub Med Coll Abbottabad 2009 >>

Prevalence of HIV in pregnant women identified with a risk factor at a tertiary care hospital

Ghazala Mahmud, Shazra Abbas,

Background: HIV is an epidemic quite unlike any other, combining the problems of a lifelong medical disease with immense social, psychological, economic and public health consequences. Since we are living in a global village where human interactions has become fast and frequent, diseases l....

Retrospective audit of patients treated for MDR-TB in re-treatment category

Waseem Saeed, Arshad Naseem, Jamal Ahmed,

Objective: To determine the efficacy of our modified anti-tuberculosis regimen in adult patients with multi-drug-resistant tuberculosis (MDR-TB) in the re-treatment category.
Methods: Retrospective chart review of 176 patients in re-treatment category with diagnosis of MDR-TB....

Knowledge, attitude and practice of private practitioners regarding TB-DOTS in a rural district of Sindh, Pakistan

Mubashir Ahmed, Zafar Fatmi, Sajid Ali, Jamil Ahmed, Naseem Ara,

Background: Tuberculosis is prevailing in both urban and rural areas of Pakistan. Knowledge, attitude and practice (KAP) of private practitioners (PPs) regarding tuberculosis management have been reported only in urban areas of Pakistan. This survey was conducted for the first time in a ru....

Frequency of anti-tuberculous therapy-induced hepatotoxicity in patients and their outcome

Sumbal Tariq, Tahir Saleem Khan, Saqib Malik, M. Shamim Anwar, Abdul Rashid,

Background: Tuberculosis (TB) is a very common droplet infection especially in the northern areas. If untreated, the disease may be fatal within 5 years in more than half of cases. To study the frequency of anti-tuberculous therapy (ATT) induced hepato-toxicity was the subject of the prese....

JCPSP 2007 >>

Frequency of dual tuberculosis/human immunodeficiency virus infection in patients presenting at tertiary care centers at Karachi

Abdul Rauf Memon, Muhammad Ashraf Memon, Arshad Altaf, Sharaf Ali Shah, Bader Faiyaz Zuberi, Rashid Qadeer, Salahuddin Afsar,

Objective: To determine the frequency of dual infection of Tuberculosis and Human Immunodeficiency Virus (HIV) and document the sexual practices of infected patients.
Design: Cross-sectional study.
Place and Duration of Study: Medical Unit-IV of Civil Hospital, ....

BMC Research Notes 2011 >>

Delay in diagnosis of tuberculosis in Rawalpindi, Pakistan

Muhammad AN Saqib, Irum N Awan, Syed KA Rizvi, Mirza I Shahzad, Zahid S Mirza, Sabira Tahseen, Imran H Khan, Azra Khanum,

Background: Delay in diagnosis and treatment of tuberculosis (TB) may enhance the chances of morbidity and mortality and play a key role in continuous transmission of the bacilli. The objective of this study was to describe health care seeking behavior of suspected TB patients and initial ....

J Pak Med Assoc 2009 >>

Treatment outcome of multi-drug resistant tuberculosis in a tertiary care hospital in Karachi

Nisar Ahmed Rao, Muhammad Irfan, Zeeshan Mahfooz,

Objective: To assess the outcomes of pulmonary multidrug-resistant tuberculosis (MDR-TB) patients treated at Ojha Institute of Chest Diseases (OICD), a reference hospital for TB in Karachi, Pakistan.
Methods: Clinical study for the period 1996-2006, with follow-up until June ....

Public private mix model in enhancing tuberculosis case detection in District Thatta, Sindh, Pakistan

Jameel Ahmed, Mubashir Ahmed, A Laghari, Wasdev Lohana, Sajid Ali, Zafar Fatmi,

Objectives: To enhance the TB case detection through Public Private Mix (PPM) model by involving private practitioners in collaboration with National TB Control Program, (NTP) in district Thatta.
Methods: Private practitioners (PPs) of district Thatta involved in treatment of....

Emerging Infectious Diseases >>

Extensively Drug-Resistant Tuberculosis, Pakistan

Rumina Hasan, Kauser Jabeen, Asho Ali, Yasraba Rafiq, Rabia Laiq, Babar Malik, Mahnaz Tanveer, Zahra Hasan, Ramona Groenheit, Solomon Ghebremichael, Sven Hoffner,

Frequency of extensively drug-resistant tuberculosis in Pakistan increased from 1.5% in 2006 to 4.5% in 2009 (p<0.01). To understand the epidemiology, we genotyped selected strains by using spoligotyping, mycobacterial interspersed repetitive units-variable number of tandem repeats, and IS6110....

Am J Trop Med Hyg 2009 >>

Multilevel modeling of household contextual determinants of tuberculin skin test positivity among contacts of infectious tuberculosis patients, Umerkot, Pakistan

Saeed Akhtar, Suresh K. Rathi,

This cross-sectional study sought to identify household contextual determinants that might be associated with Mycobacterium tuberculosis infection as assessed by tuberculin skin test (TST) positivity among familial contacts of index patients of infectious pulmonary tuberculosis (TB) while control....

J Pak Med Assoc 2010 >>

Extrapulmonary Tuberculosis: A retrospective review of 194 cases at a tertiary care hospital in Karachi, Pakistan

Subash Chandir, Hamidah Hussain, Naseem Salahuddin, Mohammad Amir, Farheen Ali, Ismat Lotia, Amir Javed Khan,

Objective: To describe the types and treatment outcomes of the extra-pulmonary tuberculosis (EPTB) cases in a tertiary care hospital in a high burden tuberculosis country.
Method: A retrospective case series study was conducted at Liaquat National Hospital (LNH), the largest ....

Integration of informal medical practitioners in DOTS implementation to improve case detection rate

Huma Qureshi, Ambreen Arif, Ejaz Alam, Najma Qadir,

Objective: To integrate informal registered medical practitioners (IRMP) in Directly Observed Therapy Short Course (DOTS) implementation to improve case detection rate.
Methods: This interventional study was conducted in the settlement area of Malir district whereas New Karac....

Am J Trop Med Hyg 2011 >>

Short Report: Gender Differences in Tuberculosis Notification in Pakistan

Andrew J. Codlin, Saira Khowaja, Zhongxue Chen, Mohammad H. Rahbar, Ejaz Qadeer, Joseph B. McCormick, Ismat Ara, Susan P. Fisher-Hoch, Aamir J. Khan,

Worldwide, the male to female ratio of new smear-positive tuberculosis (TB) cases is approximately two to one. However, in Pakistan, this is not the case. Rates of notified TB cases are 20-30% higher in young females compared with males, and female rates remain high regardless of increasing age. ....

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