No abstract available.
Pakistan* ; Public Sector* ; Transfusion Reaction*

BACKGROUNDIt is a common practice in developing countries that medical/infectious waste openly dumped with municipal solid waste. This paper presented a generation and characterization study of hospital waste. Determination of the waste composition is a basic step for selecting the most efficient treatment method of hospital waste.

METHODSStratified random sampling was used to collect the samples of general as well as medical wastes for seven days. Medical waste was sorted into 10 categories whereas general waste was classified into 11 categories. Incineration was observed thoroughly for observing flaws in the incineration process. Data was analyzed by using SPSS software version 16.0.

RESULTSThe studied hospital produced an average 297 kilograms of medical waste daily and it comprises plastics (71.0%), glass (13.9%), papers etc. (3.8%), cotton/dressings (5.7%), masks/gloves/sheets (0.3%) diapers (0.4%), wasted machines used in operation theaters (2.0%) and blades (0.1%). Laboratories, cancer ward, nursery ward, OPD and emergency ward are the largest infectious waste producing departments in the hospital. The hospital produced an average 3 511 kilograms of general waste daily in which organics constitute (44.3%), diapers etc. (42.8%), demolition materials (3.7%), plastic waste mixing medical plastic waste (2.5%), miscellaneous (2.14%), cloth/clothes (1.6%), cardboard (1.3%), papers (0.8%), cotton dressings (0.28%), glass (0.27%) and iron materials (0.18%). Other alarming facts are: medical waste is recycled in study area, after incineration of hospital waste, ash simply dumped in the premises of the hospital without any liner system.

CONCLUSIONSThe studied hospital produces 10% of infectious waste and 90% of general waste. The largest components of the infectious waste are plastic and glass. Organics and diapers are major components of the general waste coming from different sites of the hospital. Lack of training, inadequate knowledge regarding to the composition of the infectious waste and risks associated with the waste are the major issues which must be addressed and resolved.

OBJECTIVETo determine the present status of plant communities and their possible association with the habitat in Malam Jabba, Swat, Pakistan.

METHODSA study on the phytoecology was conducted in various ecologically important sites of Malam Jabba, Swat, Pakistan from 2002 to 2004. The altitude of these sites ranged from 1 200 m to 3 200 m. Quadrat method was used for evaluation of plants communities and the data on these attributes was converted to relative values. The plant communities were named after 3 leading species with highest importance values. Biological spectrum of the flora based on the life form was prepared by following Raunkiar's life form classes.

RESULTSThe floristic composition and structure of the study area were found to be 200 species belonging to 75 families. Asteraceae, Lamiaceae and Poaceae were important families in the study area. The biological spectrum showed that therophytic and hemicrytophytic life form and micro-nonophyllous leaf sizes were dominant in the area. The air and soil temperatures were decreasing with increasing elevation. Both the air and soil temperatures were relatively higher in south slopes than on the northeast slopes. The vegetation analysis of the area indicated eleven plant communities around the area. The present vegetation is the relics of moist temperate coniferous forest in the area. The communities reflect highly deteriorated conditions. Both the structure and composition of the surrounding vegetation were associated with the types of habitats.

CONCLUSIONSThe conservation of the remaining populations of the reported communities will be best achieved by proper time of sustainable harvesting. It is only possible with the participation of local communities.

Pakistan is ranked 9th in terms of flood-affected countries worldwide. In the summer of 2010, the northern province of Khyber-Pakhtunkhwa received more than 312 mm of rain in a 56 hour period. This resulted in over 1 600 deaths across the region. In addition, over 14 million people were directly affected by this record-breaking deluge. Flood affected regions serve as ideal breeding grounds for pathogens, leading to the spread of diseases. The poor standards of hygiene in camps set up for individuals displaced by the floods also contribute to this. It is essential that those involved in relief efforts are aware of the epidemiology of diseases that have historically seen a sudden upsurge after natural disasters. Keeping this in mind, we conducted a simple review of literature. An extensive literature search was conducted using the PubMed data base and online search engines. Articles published in the last 20 years were considered along with some historical articles where a background was required. Seven major diseases were identified to increase substantially in the aftermath of natural disasters. They were then classified into acute and sub-acute settings. Diarrhea, skin & eye infections and leptospirosis were identified in the acute setting while malaria, leishmaniasis, respiratory infections and hepatitis were identified in the sub-acute setting.
Communicable Diseases ; epidemiology ; Floods ; Humans ; Pakistan ; epidemiology

BACKGROUND AND OBJECTIVES: Tinnitus is characterized as a perception of numerous auditory sounds in absence of external stimulus. Tinnitus can have a considerable consequence on a person’s quality of life, and is considered to be very complicated to quantify. The aim of this study was to investigate the reliability and validity of Urdu translation of the Tinnitus Handicap Inventory (THI) in Pakistan. It was designed to assess the presence of various auditory sounds without the external stimulus. Scale consisted of 25 items having three subscales functional, emotional, and catastrophic. SUBJECTS AND METHODS: The study comprised into two stages, preliminary and main studies. The results of preliminary study revealed that the overall scale had high internal consistency [alpha coefficient of Urdu version of THI (THI-U)= 0.99, alpha coefficient of English version of THI=0.98]. The overall scale had test-retest correlation over a fifteen days period of interval (0.99). Main study was performed on 110 tinnitus patients. The results of main study showed that the internal consistency and reliability of Urdu version was (α=0.93). The THI-U and its subscales demonstrated good internal consistency reliability ( α =0.81 to 0.86). RESULTS: High to moderate correlations were noted between tinnitus symptom ratings. A confirmatory factor analysis was used to validate the three subscales of THI-U, and high inter-correlations were found between the subscales also results revealed that a three-factor model for the THI-U was most tenable. The results displayed that the confirmatory factor analysis confirmed to validate the three subscales of THI-U. CONCLUSION: THI-U might present important information about precise facets of tinnitus distress along with diagnostic interviews in clinical practice.
Humans ; Pakistan ; Quality of Life ; Reproducibility of Results ; Tinnitus

Harappan Civilization is well known for highly sophisticated urban society, having been flourished in extensive regions of northwestern part of Pakistan and northeastern part of Afghanistan as its heyday around 4500 years ago. Most archaeologists agree on the periodization of this civilization as three different phases (Early, Mature and Late), which represent its cultural process of origin, development and decline. From the Harappan sites, one can note that there were about more than fifty burial sites discovered so far related with the civilization. In this article, we are trying to introduce the brief picture of the Harappan burials from the archaeological as well as anthropological perspectives.
Afghanistan ; Anthropology ; Archaeology ; Burial* ; Civilization* ; Humans ; India* ; Pakistan

We are living in a time of unprecedented increase in knowledge and rapidly changing technology. Such biotechnology especially when it involves human subjects raises complex ethical, legal, social and religious issues. The establishment of newborn screening programmes in developing countries poses major challenges as it competes with other health priorities like control of infectious diseases, malnutrition and immunization programmes. Despite this, it is imperative that the importance of newborn screening programmes is recognised by developing countries as it has been proven through decades of experience that it saves thousands of babies from mental retardation, death and other serious complications. Pakistan has an estimated population of 167 million inhabitants, 38.3% of whom are under 15 years of age. Pakistan lacks a national programme for newborn screening. However, as individual practice at the local level, Aga Khan University Hospital (AKUH) and a few other hospitals are doing newborn screening for congenital hypothyroidism. The main hurdle in the implementation of newborn screening in Pakistan is the lack of good infrastructure for health. Eighty percent of deliveries take place at home. Moreover, little resources are available for children identified with a genetic condition due to the non-existence of genetic and metabolic services in Pakistan. In a 20-year audit of congenital hypothyroid screening at AKUH we found 10 babies with congenital hypothyroidism. However due to missing data links spanning several years, we were unable to calculate its true incidence during this period. In order to estimate the incidence of congenital hypothyroidism (CH) we reviewed in detail data over 10 months in 2008, a period where there was better compliance for repeat thyroid stimulating hormone (TSH) testing, and found 2 babies with CH. This gave an estimated incidence of 1 in 1600 live births.
Congenital Hypothyroidism ; diagnosis ; Hospitals ; Humans ; Infant, Newborn ; Neonatal Screening ; Pakistan

The goal of this study was to assess student perceptions of a variety of instructional practices and attitudes toward class attendance. Data were obtained and analyzed by administering a questionnaire to students of the Shifa College of Medicine, Pakistan in 2011 and 2012. The subjects positively assessed most instructional practices, and in particular felt that teaching sessions conducted in small groups were more valuable than formal lectures in large groups. Students did not like having to give presentations, quizzes, panel discussions, and journal club. A positive correlation was found between the perceived importance of attendance and levels of academic motivation. Of the students surveyed, 11.8% were against mandatory attendance, saying that it reduced motivation and that attendance should be optional. In conclusion, the students had a positive perception of a range of instructional practices, and felt especially positively about practices that involve student activity in small groups. Programmatic improvement in instructional practices might increase class attendance.
Choice Behavior ; Humans ; Learning ; Lectures ; Motivation ; Pakistan* ; Students, Medical*

Advertising as Topic ; Drug Industry ; Drug Prescriptions ; Pakistan ; Periodicals as Topic

Drug Utilization ; Humans ; India ; Pakistan ; Psychotropic Drugs ; therapeutic use