1.
Pillars of Epidemiology
by Prof. Dr. Muhammad Athar Khan.
Edition: 1st edMaterial type: Publisher: Pakistan: UVAS LAHORE; 2013Availability: Items available for loan: UVAS Library [Call number: 614.4 Athar 30073 1st 2013 Epidemiology] (3).
2.
Descriptive Epidemiological Study Of Cancer Patients Registered At Mayo Hospital, Lahore
by Tamseela Naseem | Prof. Dr. Muhammad Athar Khan | Dr. Mansur-ud-Din Ahmad.
Material type: ; Format:
print
; Literary form:
drama
Publisher: 2011Dissertation note: The objective of this study were to report the distribution and pattern of various cancers in Mayo
hospital of Lahore over a period of last 5 years and to determine the age and gender distribution
of the various reported Cancer cases in the above mentioned teaching hospital of Lahore. This
research project was planned to study the epidemiology of various types of cancer among
population of Pakistan. For the design of study a descriptive study based on passive surveillance
system was planned. The data of cancer patients were collected from the Mayo Hospital a
Teaching Hospital of Lahore. To meet the objective of this study we took data from Mayo
Hospital, based on previous five years (from 2006-2010). Data was entered and analyzed through
SPSS version 16 by researcher herself. Quantitative variable like age was presented in form of
mean ± SD with respect to type of cancer and year. The qualitative variable like gender, type of
cancer etc were presented in form of frequency tables and appropriate charts. Chi square analysis
was used to see the association between qualitative attributes. Analysis of variance was used to
see the mean age of different types of carcinomas. Independent sample t-test was used to see the
mean age in different gender. In this study there were total 12096 cancer patients registered at Mayo
hospital Lahore in period of last five years from 2006 to 2010. Out of which, 2305(19.1%),
2182(18.0%), 2293(19.0%), 2315(19.1%) and 3001(24.8%) patients were registered in 2006, 2007,
2008, 2009 and 2010, respectively. Out of total 12096 cancer patients, there were 5766(47.87%)
males and 6330(52.13%) females. Of the 12096 patients diagnosed with malignant cancers, nearly
11827 (98.5%) belonged to the province of Punjab and approximately 45 (0.4%) to the NWFP, 111
(0.9%) belonged to Azad Jammu Kashmir, 27 (0.2%) belonged to Karachi and 13 (0.1%)
belonged to Quetta. There were 2988 patients of breast and female genital carcinomas registered, out of which 592 patients were registered in 2006, 487 patients were registered in 2007, 583 were in 2008, 611 in 2009 and 715 were registered in 2010. Registered patients with carcinoma of digestive organs were 2071 in which there were 374 were in 2006, 385 were in 2007, 374 in 2008,418 in 2009 and 520 in 2010. Lymphoid heamatopietic were 1589 in which 293 were from 2006,322 were from 2007,302 were from 2008, 284 were from 2009 and 388 were from 2010.
Availability: Items available for loan: UVAS Library [Call number: 1370,T] (1).
3.
Descriptive And Therapeutic Trial Of Iron Supplements (Standard Drug And Herbal) In Anemic Pregnant Women
by Maria Ikram | Prof. Dr. Muhammad Athar Khan | Dr. Mansur-ud-Din Ahmad.
Material type: ; Format:
print
Publisher: 2011Dissertation note: This study was carried out in two phases; in first phase descriptive epidemiologic study was done in pregnant females living around district Okara. List of a total 101154 pregnant females was obtained from Health office OKARA. Hemoglobin level of each subject was assessed and prevalence of anemia in pregnant women was observed 42.15%. From village 1141., 88 44%) pregnant women were enrolled, from 25 GD village 74(37%) pregnant women were enrolled and from 36/2L village 38 (19%) pregnant women were enrolled. in phase II, experimental epidemiological study was conducted to compare the efficacy Sharbat- e-Iolad (Treatment groups) with Ascifer (standard group). Sample Size of 200 patients was enrolled with 100 subjects in each group. SPSS 16.0.2 was used for data entry and analysis. Mean ± S.D was used to present the data. Two way repeated measures ANOVA was used to see the effects of treatments in the significance of Hemoglobin levels at different follow ups. Mean age of the mothers in group A was 27.16 ± 4.97 years and in group B it was 26.07 ± 4.78 years. The age range of the patients was 17 to 38 years. Mean Hb level in Group-A was 6.89 & 6.87 in Group-B at base line. Mean Hb level after first follow up (after 3 weeks from base line) in Group-A mean Hb level was 7.34 and in Group-B it was 7.26. After second follow up (after 6 weeks) mean Hb level in Group-A was 8.81 and in Group-B it was 8.50. In both Groups Hb level was significantly improved (p-value = 0.000). I-Ib level was significantly improved in both study groups with equal effects. In future any of the treatment may be used for the treatment of anemia but Sharbt-e-Folad is recommended due to its cheap cost and accessible availability in rural areas.
Availability: Items available for loan: UVAS Library [Call number: 1371,T] (1).
4.
Epidemiological Trends, Clinical Profile And Risk Factors Associated With Crimean Congo Hemorrhagic Fever In Quetta, Balochistan
by Khushal Khan Kasi | Prof. Dr. Muhammad Athar Khan | Prof. Dr. Mansur-ud-Din Ahmad.
Material type: ; Format:
print
; Literary form:
not fiction
Publisher: 2012Dissertation note: Crimean congo hemorrhagic fever (CCHF) is an important disease in suburbs of Quetta in
particular, and other cities of Balochistan in general. The cases of this disease are brought to the
public hospital for treatment purposes. The study was carried out to understand the descriptive
nature of the disease with respect to geographic, temporal and personal distribution. The second
part of study comprised of cross sectional as well as case-control study for the identification of
different risk factors in patients as compared to their control admitted in the same hospitals. The
highest numbers of CCHF cases were from Quetta i.e. 35, 82 cases were male and 19 cases of
female, small scale sheep and goat farmer has highest number of cases i.e, 59. Mean age for male
patients was 30.82±15.47 years, while for female patients mean age was 29.17±16.40 years with
a p-value= 0.685. Mean platelet count for male and female patients was 450n.29±35934.14 and
35388.89±18081.96 respectively with a p-value= 0.270. Mean Hemogobin level for male and
female patients was 11.52±2.78 and 9.80±3.23 respectively, and with a p-value=O.023. Among
the patients, 5 patients were positive for IgG and IgM antibodies, 9 patients were having A+
blood group, 44 with B+, 16 with 0+, 1 with AB+ and 29 was not reported, 21 patients died and
the remaining patients discharged, and the highest number of cases were between April and
September. A significant association exist between platelet count with respect to cases who
suffered from CCHF (p-value= 0.000), male were 1.157 times more prone to CCHF as compared
to female (OR=1.157), (p-value=0.629) and (CI=0.641-2.089), and animals at home have has
more susceptibility to CCHF cases (OR=3.538), (p-value=O.OOO) and (CI=2.219-5.642).
Availability: Items available for loan: UVAS Library [Call number: 1377,T] (1).
5.
Socio-Demographical And Epidemiological Risk Factors Associated With The Diseases Of Senior Citizens of Jhelum City
by Muhammad Shahzad Ashraf | Prof. Dr. Muhammad Athar Khan | Dr. Mansur-ud-Din Ahmad.
Material type: ; Format:
print
Publisher: 2011Dissertation note: Research on geriatric diseases is scarce in Pakistan. This endeavor was planned to establish a baseline data for common geriatric diseases found in lhelum, Pakistan. This study reveals the prevalence of geriatric diseases in elderly people in lhelum, Pakistan. Our first objective was to collect and interpret the baseline data about prevalent diseases among the old aged people. Our second objective was to describe the socio- demographic and epidemiological risk factors associated with the diseases of elderly population of lhelum city. In order to study the risk factors associated with geriatric diseases, a geographical cluster of lhelum was selected. The study area was Tehsil lhelum which comprises of 400,000 individuals. Tehsil lhelum is further divided into 16 union councils. In this epidemiological study, multistage sampling was performed. At first step by purposively sampling, union council number 14 of Tehsil lhelum was selected which was comprising of all socioeconomic classes of our community. At second step, by using random sampling technique, home-to-home visits were done. The data was collected on pre-tested questionnaire. The data was collected by face-to-face interviews. The pre- tested questionnaire contained variable factors and questions regarding age, gender, socio economic status, education level, exercising, smoking, marital status, walk before the age of 60 years, walk after the age of 60 years, present and past employments, financial status, use of edible oils in the past, number of children and social life. Futhermore, Information was collected regarding working of different body systems like Central Nervous system, Cardio-vascular system, Digestive system, Urogenital system, Respiratory system, ENT system, Musculo-skeleton system etc. Along with system-information, name of disease of the impaired system was also asked. The collected data was analyzed by using SPSS-version 16. This present interview based study reflects the prevalence of geriatric morbidities in geriatric population of Jhelum city. In the current study, impairment of digestive system (28%), cardio-vascular system (23%) and musculo-skeletal system (21 %) was on the top of the list. Impairment of digestive system was found in a good proportion among senior citizens followed by Cardio-vascular system, musculoskeletal system, centra nervous system, respiratory system, uro-genital system and E.N.T. system. Diabetes mellitus, blood pressure related problems and arthritis are the most frequent diseases. So, vwe should try to educate the people about these diseases. As compared to other studies around the globe, our geriatric population is possessing comparatively better health. Walk before the age of 60 years and walk after the age of 60 years is helpful for health. The people who used to walk more than five kilometers usually remained healthier in theelderly. Economic status, use of edible oils and social life is also associated with health of elderly people. So, there is need to promote the habit of walk in the elderly population and in young population. Disease prevention is the most cost-effective method for the maintenance of optimal level of health in elderly population. We should understand that many of the geriatric diseases are preventable. Preventive measures can be applied during the various stages of disease progression in order to either slow or stop the process of disease.
Availability: Items available for loan: UVAS Library [Call number: 1404,T] (1).
6.
Epidemiology Of Major Transbuondary Diseases Of Livestock In Nomads Herds Of District Buner
by Farman Ali | Prof. Dr. Muhammad Athar Khan | Prof. Dr. Mansur-ud-Din Ahmad.
Material type: ; Format:
print
; Nature of contents: ; Literary form: Publisher: 2011Dissertation note: The research project was carried out in the livestock of nomads in District Bunere to study the epidemiology of major trans-boundary livestock diseases including foot and mouth diseases 9FMD) in buffaloes and cattle and Peste des Petite Ruminants (PPR) and Contagious Caprine Pleuropneumonia (CCPP) in sheep and goats. A questionnaire was designed for collecting data regarding morbidity, mortality & case fatality rate in different seasons in the animals of nomads migrate from Afghanistan to Pakistan. Serosurveillance was also conducted by collecting 600 blood samples from the apparently healthy sheep and goats, cattle and buffaloes in the summer season. A total number of 100 nomads were interviewed by systematic random sampling method and sera were collected to test the antibodies against FMDV and PPRV. The serum samples in labeled eppendorph tubes were stored in deep freezer till the sent to lab in ice container. These samples were transported to National Veterinary Laboratory Islamabad, where cattle and buffalo's sera were examined by using 3ABC-ELISA & sheep and goat's sera were analyzed by C-ELISA to detect antibody ofPPRV, respectively. Similarly 60 nasal swabs of sheep and goats collected and examined in Veterinary Research Institute Lahore, by culturing method. The data were collected and analyzed statistically by using SPSS (16.00). Means, Chi square values, P-Vlues and percentages were calculated. The overall prevalence of CCPP was 18.3% while individually 3.3% in sheep and 15 % in goats. The prevalence in goat (15%) was higher than that
of sheep (3.3%) with insignificant difference and no significant association between CCPP
disease and species of sheep/goat of nomads. Similarly age wise prevalence of CCPP in young (sheep and goats) was 10% which was higher than that of adult (8.3%) with significant association between CCPP disease and age of sheep and goat. Similarly gender wise prevalence was 6.66% in male and 11.6% in female (sheep and goats) with no significant association between CCPP disease results and gender of sheep and goats. The peculiar signs of CCPP were recorded retrospectively, including pneumonic coughing, mucopurulent nasal discharges, fever and abortion in sheep and goats in autumn season in Pakistan and in winter season in Afghanistan respectively. The 10.5% mortality rate, 82% morbidity rate and 12.8% case fatality rate of CCPP in autumn season were recorded in sheep respectively. While 92% morbidity, 12.5% mortality and 13.5% case fatality rate were recorded in goats in autumn, respectively. The mortality, morbidity and case fatality rate were 6.5%, 66%, and 9.8% in sheep in winter season. Similarly mortality, morbidity and case fatality rate in goats due to CCPP in winter season were8%, 89.5% and 8.97%, respectively. The prevalence in both the species were higher in autumn season than that of winter season and zero prevalence were recorded in rest of the seasonsretrospectively. The night stay with crowding of livestock near streams and springs,
night fog, morning dew, cold seasons and common travelling and grazing premises were recorded as risk factors for CCPP.
The serosurveillance for FMD was conducted and overall seroprevalence of FMD was 32% and individually 12% in buffaloes and 20% in cattle respectively with no significant association and both the species were equally susceptible to FMDV. Gender wise seroprevalence in male and female cattle and buffaloes were 12% and 34 % respectively with no significant association between FMDV antibodies and gender of the animals. Age wise seroprevalence of FMD in adult cattle and buffaloes was higher (24%) than that of young (8%) cattle and buffaloes with a significant association between the age of cattle, and buffaloes and FMDV antibodies. The survey results indicated that all the cattle and buffaloes were in mixed herds and the peculiar signs including stomatitis, lameness, abortion, fever and dysphonia were recorded retrospectively. The mortality rate was 0% in cattle herds of all ages and in both the genders while the morbidity rate was 52.5%. The death rate of l.1%, 75.5% attack rate and 1.41% case fatality rate in buffaloes were recorded retrospectively in the humid rainy season of late summer in Shangla, Besham & Chitral districts.
The serosurveillance for PPR in sheep and goats was conducted by using competitive ELISA, dand 42% overall seroprevalence while individually 27% in goats and 14.8% in sheep were recorded with a significant association. Gender wise seroprevalence of 38.8% in females and .3.2% in males of sheep and goats with significant difference and with a significant association to PPRVantibodies were recorded. The age wise seroprevalence of37.8% and 4.2% in adult and in young of both the species with a significant association to PPRV antibodies were recorded. No clinieal signs of PPR were observed by nomads because the infection was subclinical and survived previously because they had not practiced vaccines for last many years. Zero % morbidity and mortality rates were therefore recorded retrospectively in sheep and goat flocks. The four routes at the border areas of Khyber Pakhton Khwa were recorded for the seasonal and cyclieal entrance of livestock of nomads, which act as abridge for diseases transmission between Afghanistan & Pakistan. The outbreaks of CCPP occurred in winter season in Afghanistan and in autumn season in Pakistan (Gilgith, Chitral, Kohistan, Besham, Shanglapar and Buner). Also the FMD
outbreaks occurred in Buner and Shangla in late summer while the PPR was subclinical and animals survived. Cross borders as well as district wise trade and movement restrictions are of utmost importance for control the diseases. Similarly serosurveillance of the disease in
the local and as well as in nomad's livestock's population necessean appropriate scheduled vaccination.
Availability: Items available for loan: UVAS Library [Call number: 1408,T] (1).
7.
Assessment Of Knowledge And Practice Of Food Handlers About Food Safety In University Hostel Kitchen Employees
by Qurra-Tul- Ain | Prof. Dr. Mansur-ud-Din Ahmad | Prof. Dr. Muhammad Athar Khan.
Material type: ; Format:
print
Publisher: 2011Dissertation note: Cigarette butts are found at crime scenes as potential evidence. Saliva is present on the cigarette butts that can be detected and DNA can be isolated from nucleated cells present in saliva for quantification and typing. In past, research has declared that cigarette butts are useful source for saliva detection, DNA extraction and profile generation. Difference of saliva accumulation on cigarette butt paper and filter was compared in the present study. On smoked cigarette butts, gender based comparison of saliva detection and DNA quantification was performed.
Agarose gel assay was used for amylase enzyme detection. All samples showed positive results for saliva detection. Cigarette butt filter and filter paper were processed separately and analyzed. Results showed more saliva detected at cigarette butt paper. Then gender based comparison on cigarette butt samples smoked by males and females was done for salivary amylase. By using student t-test, no significant difference was found on basis of gender. For extraction of DNA, phenol chloroform extraction method was used. Quantifiler® Human DNA Quantification kit was used through RT-PCR for quantification of DNA isolated from cigarette butt papers. SDS software analyzed the data and gave results of quantified DNA in ng/µL. Gender based comparison in DNA quantity was done by using statistical method. SPSS software was used for statistical analysis. Pearson correlation value was calculated between detected saliva and quantified DNA of samples. Weak positive results of correlation were obtained between saliva and DNA.
Availability: Items available for loan: UVAS Library [Call number: 1424,T] (1).
8.
Clinico-Epidemiological Study Of Toxocariasis In Pet Cats In Lahore
by Shakera Sadiq Gill | Prof. Dr. Mansur-ud-Din Ahmad | Prof. Dr. Muhammad Athar Khan.
Material type: ; Format:
print
; Literary form:
drama
Publisher: 2012Dissertation note: The study was conducted at the pet clinic UVAS to check the prevalence of Toxocara Cati in pet cats and awareness of the pet owners about the zoonosis. Prevalence of Toxocara was checked by conventional laboratory techniques. A survey was conducted to check the awareness of zoonotic diseases among the pet owners using a questionnaire. A total of 40% were found to be infected with Toxocara cati.
Overall high prevalence was recorded in cats less than one year of age which was significant. There was also significant difference of prevalence among cats in which deworming was not done as compared to the dewormed cats. Prevalence was also high in cats in which the fecal consistency was not normal. There was no significant difference in prevalence of Toxocara between male and female cats. There was also no significant difference of prevalence among the different breeds of cats.
The results of the survey revealed that out of the total of 100 pet owners only 39% had idea of pet zoonosis, while the majority of the owners had awareness about rabies. Only 18 % of the owners were informed by the veterinarians. The total of 98% suggested that the vet should inform the owners about pet zoonosis. Among the total 56% replied that they will leave their pet if a zoonotic problem was diagnosed the remaining were not willing to leave their pets even if a zoonotic problem diagnosed.
Most cases of human toxocariasis and zoonotic hookworm infections are preventable by simple measure such as careful personal hygiene, eliminating intestinal parasites from pets through regular deworming and not allowing the children to play in potentially contaminated environments. Despite the fact that some of the pet owners dispose of their pet feaces however,, owners should be educated on proper disposal methods of pet feaces. Disposal methods like using pet feaces as garden manure, can predispose children playing in the lawn to infective eggs and larvae.
Availability: Items available for loan: UVAS Library [Call number: 1428,T] (1).
9.
Epidemiological, Haematological And Biochemical Risk Factors Of Parturient Haemoglobinuria In Buffaloes
by Altaf Mahmood | Prof. Dr. Muhammad Athar Khan | Prof. Dr. Muhammad Arif Khan.
Material type: ; Format:
print
; Literary form:
drama
Publisher: 2011Dissertation note: Parturient haemoglobinuria is disease of economic importance which affects a considerable number of buffaloes every year in India, Pakistan and Egypt. It is a non infectious hemolytic syndrome characterized by intravascular haemolysis, hypophosphataemia, haemoglobinaemia, haemoglobinuria and anaemia. The exact pathogenesis is not known and diversified etiological factors have been associated with this disease in different parts of the continent. Information on multidimensional etiological aspects of this buffalo syndrome is quite scanty. The present study was therefore carried out in district Chakwal for assessment of disease burden (parturient haemoglobinuria), its distribution and quantification of associated epidemiological, haematological and biochemical risk factors in order to suggest control measures and future research priorities.
Active surveillance was conducted in eight randomly selected villages of district Chakwal from April 2010 . March 2011. All breeding age buffaloes (1938) of these selected villages were taken as sampling frame whereas one breeding age buffalo was taken as sampling unit. Parturient haemoglobinuria appeared as number one disease among all problems of breeding age buffaloes with respect to mortality rate (1.03%) and proportional mortality rate (20%) whereas it appeared as 8th and 7th disease respectively with respect to incidence (3.97%) and case fatality (25.97%) rates.
Case-Control study was conducted for quantification of epidemiological risk factors associated with disease by analyzing the data of 180 case-control pairs for various 162
hypothesized risk factors. . 7 months pregnancy, . 3 lactation number, . 60 days postpartum period, . 7 years age, previous history of haemoglobinuria and ingestion of cruciferous plants were recorded as significant (P . 0.05) risk factors with odds ratios of 15.80, 6.39, 6.23, 5.56, 3.41 and 2.51 respectively. Clinical trial was conducted on 30 haemoglobinuric buffaloes randomly divided into three groups with 10 animals in each group to compare and assess the recovery rates of three different treatment packages against parturient haemoglobinuria. The highest recovery rate (100%) was recorded for combined therapy of sodium acid phosphate and blood transfusion followed by sodium acid phosphate with antifibrinolytic drug tranexamic acid (70%) and tranexamic acid with Novacoc injection (50%). Cross-sectional epidemiological study was conducted on haemoglobinuric (n = 30) and healthy (n = 60) buffaloes for quantification of haematological and biochemical risk factors associated with parturient haemoglobinuria. Red cell count (. 5 ~ 106 /ƒÊl), haemoglobin (. 8g / dl), haematocrit . 25%, mean corpuscular volume (. 50fL), mean corpuscular haemoglobin (. 20pg) and erythrocyte sedimentation rate( . 80mm / 1st hour) were recorded as significant (P . 0.05) haematological risk factors with odds ratios of 26, 17.81, 28.95, 21, 12.25 and 26 respectively whereas billirubin unconjugated (. 0.2mg /dl), billirubin total ( . 0.3mg /dl), phosphorous (. 2.5mg /dl), molybdenum (. 70ƒÊg /dl) and selenium (. 15 ƒÊg /dl) were recorded as significant (P.0.05) biochemical risk factors with odds ratios of 26.55, 26.55, , 7.50, 11 respectively.
Experimental study was conducted to determine the effect of orally administered gossypol on haematological and biochemical parameters of eight female rabbits of six 163
months age purchased from local market and maintained at university of veterinary and animal sciences from February 2011 . April 2011 under optimum conditions. The cotton seed cake containing free gossypol contents of 0.25% was fed to rabbits @ 4 grams per kg per day in addition to their routine diet including good quality fresh vegetables (cucumbers, spinach, cabbage & carrots) and clean water ad-libitum. Blood samples of each rabbit were collected after every 15 days interval and analyzed for haematological and serum biochemical parameters. Significant (P.0.05) decrease was recorded in total erythrocyte count, haemoglobin concentration, haematocrit, mean corpuscular volume and serum inorganic phosphorous whereas significant increase was recorded in mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red cell distribution width, total leukocyte count, lymphocytes and monocytes from 0 . 60th day with the passage of time whereas non significant (P.0.05) difference was recorded with respect to granulocytes and serum calcium concentration.
Availability: Items available for loan: UVAS Library [Call number: 1429,T] (1).
10.
Sero And Viro Surveillance Of Influenza Virus Sero Types Circulating In Equine Species
by Muhammad Sajid | Prof. Dr. Mansur-ud-Din Ahmad | Prof. Dr. Muhammad Athar Khan.
Material type: ; Format:
print
; Literary form:
drama
Publisher: 2011Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1526,T] (1).
11.
Epidemiological And Molecular Profile Of Hepatitis-C Viral Infection Among Different Groups Of Population In And Around Lahore, Pakistan
by Dr. Abdul Majeed Akhter | Prof. Dr. Muhammad Athar Khan | Prof. Dr. Azhar Maqbool.
Material type: ; Format:
print
; Literary form:
drama
Publisher: 2012Dissertation note: Hepatitis C is an infectious disease affecting primarily the liver, caused by the hepatitis C virus (HCV). The infection is often asymptomatic, but chronic infection can lead to scarring of the liver and ultimately to cirrhosis, which is generally apparent after many years. In some cases, those with cirrhosis will go on to develop liver failure, liver cancer or life-threatening esophageal and gastric varices.
The present project was carried out to study the prevalence of laboratory based confirmed patients of Hepatitis-C in various public, private hospitals and in high risk groups among the population of Lahore metropolitan and its distribution and pattern with respect to person, time and place. Second part of the project was designed to study the risk factors of Hepatitis-C patients from out patient departments of various public and private hospitals of Lahore. Individuals at high risk from different organizations and occupations across the city population of Lahore metropolitan were also included in the study. The third part of the project was designed to investigate the distribution of genotypes of Hepatitis-C virus among patients through RT-PCR and theireffect on viral load, various haematological and biochemical parameters.
Project-I
Study-1: To estimate the prevalence of hepatitis C in various public and private hospitals of Lahore Metropolitan among different groups a total of 1399 individuals were tested to estimate the hospital based prevalence of HCV. Out of these 233 individuals produced positive result for Hepatitis-C virus infection. The overall hospital based prevalence was estimated to be 16.66% during the year 2009. The current study revealed that the highest prevalence was estimated in Dialysis patients and Organ recipients (41.17%) followed by General Patients of age > 12 years (14.60%) and pregnant women (10.84%). It was further observed that the least affected group was the Children of age ? 12 years (3.85%).
Study-2: The results of estimated prevalence of Hepatitis C virus infection in high risk groups from the population in and around Lahore revealed that the highest prevalence was estimated in patients with HIV/AIDS (36.36%) followed by injecting drug users (36.09%), blood donors (17.78%), long rout truck drivers (14.70%), house hold and direct contact personal (14.6%) and prisoners (14.28%). It was also find out that the less affected groups were police department (10.66%), staff nurses and other health care workers (9.87%) and barbers and beauticians (6.97%) while doctors and dental surgeons were least affected (1.32%) among the high risk groups.
Study-3: To find out the pattern and distribution of HCV patients with respect to person place and time a total of 924 patients were selected from the registry of Provincial Hepatitis Control Cell Lahore through systematic random sampling. Out of these, 154 fulfilled the inclusion criteria. Among these, 90 were male and 64 were females. Average age of male and female patients was 35.88±10.49 and 37.78±9.12 years, respectively. The age difference between male and female patients was statistically non-significant (P-value>0.05). It was further observed that 147 patients were Punjabi and 7 were from other provinces. Moreover, It was found that the highest number of patients was observed during the month of December (n=18) followed by November, 2008 (n=15), March (n=15) and July, 2009 (n=14) while the least number of patients were observed during the months of September, 2008 and May, 2009 (n=10).
Project-II
To study the risk factors associated with HCV infection an analytical cross sectional study was conducted.
Study-1: Lower socio economic class, place of birth (hospital), delivery assisted by whom and breast feeding were significantly associated with HCV infection in children of age ? 12 years. The mean age of reactive and non-reactive general patients was significantly associated (P=0.012) with anti-HCV status. Marital status (OR=2.042), socioeconomic status, blood donation (OR=2.15), prescription by doctor or non-doctor (OR=2.664), route of drug administration, relative having hepatitis and towel sharing (OR=1.987) were also significantly associated (P<0.05) risk factors for HCV infection. The mean age of reactive and non-reactive pregnant women was 27.55±3.43 and 25.37±4.24 years, respectively. Educational level (OR=3.093) and occupational status (OR=2.228) were the important risk factors associated with HCV infection. Tattoo on the body (OR=11.833), comb sharing (OR=20.86) and razor sharing (OR=4.786) were significantly associated (P<0.05) with HCV infection. Pregnant women who gave the history of dental procedures and tooth brush sharing were 3.15 and 4.12 times more prone to get HCV infection, respectively. In 205 patients having dialysis and organ recipients 41.17% patients were reactive for Anti-HCV. Blood transfusion, glass sharing and qualification of the patients were significant factors in this group.
Study-2: In case of doctors/dental surgeons a significant association was observed with history of blood transfusion and duties in medical and surgical wards. The nurses who worked in surgical wards, visited beauty salons were significantly associated (P<0.05) with HCV infection. Among health care workers age, gender and other factors did not have any significant influence on the reaction of HCV. Among blood donors female to male ratio was 1:16.5. It was found that the occupational status (p=0.002), place of surgical treatment (p=0.035), history of blood transfusion (p=0.000), ever pricked by sharps (p=0.045), habit of injecting drugs (p=0.04) and glass sharing (p=0.017) were significantly associated with occurrence of hepatitis C in blood donors. In long route truck drivers geographical status, surgical procedure, dental treatment and family history were significantly associated (P<0.05). Among the injecting drug users, demographic factors like marital (P=0.007) and educational status (P=0.000) were found to be significantly associated with HCV infection. Furthermore, the behavioral factors; use of injectable drugs with reused syringes (P=0.003), sharing of syringes in groups (P=0.004), place of shaving (P=0.000), use of disinfected ustra (razor) (P=0.003) and razor sharing (P=0.000) were significantly associated with anti-HCV status for IDUs. Among HIV/Aids patients a statistically significant (P<0.05) difference was present among the ages of reactive and non reactive patients. Comb sharing has also a positive effect of HCV but all other factors were not contributing in this group. In Police personals odds ratio for married persons was higher (9.57) but statistically insignificant. The mean age for reactive persons was 39.75±8.24 years. A non-sexual contact with HCV patient and spoon sharing were significantly associated. In prison inmates skin infection and sexual involvement were significantly associated (P<0.000) with HCV infection. In the group of 43 barbers/beauticians age, working shift, tattoo on body (OR=19.5), injecting drugs (OR=19.5) and pre-testing for HCV (OR=19.5) were significantly associated with HCV infection. In house hold and direct contact group previous history of accidents and family history of HCV (OR=18.36) were significantly associated with HCV infection.
Project-III
A molecular epidemiological study was conducted in which the HCV reactive patients as tested by ELISA test were subjected to viral load and genotyping through RT-PCR. The positive cases of Project-I were included in this project. In the present study 558 patients were reactive for Anti-HCV. Out of these, 34 (6.09%) patients had Type-1 genotype, 67 (12%) patients were accounted for Type-2 and 410 (73.47%) patients were positive for Type-3. Multiple genotypes were seen in 19 (3.4%) patients, 9 (1.61%) patients had un-type able genotype whereas in 19 (3.4%) patients genotype could not be detected. According to the distribution of genotype-1, 1a was present in 30 (88.23%) while 1b was seen in 4 (11.76%) patients. In patients of Type-2 genotype, 2a and 2b were present in 54 (80.59%) and 13 (19.40%) patients, respectively. In patients having Type-3, 3a and 3b were identified in 353 (86.09%) and 57 (13.90%) patients, respectively. Furthermore, Bilirubin, ALT, AST, ALPT, viral load, Hb, TLC, DLC, Platelet and ESR were statistically same in all genotype.
Availability: Items available for loan: UVAS Library [Call number: 1529,T] (1).
12.
Epidimiological Investigation Of Dengue Virus Maintenance Host In Lahore
by Mesam Abbas | Dr.Muhammad Hassan Mushtaq | Prof. Dr. Muhammad Athar Khan.
Material type: ; Format:
print
Publisher: 2012Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1553,T] (1).
13.
Epidemiology Of Endo And Ecto Parasites Of Small Ruminants And Its Effect On Their Hematology Profile In District Bannu
by Niomat Ullah Khan | Prof. Dr. Muhammd Sarwar Khan | Prof. Dr. Muhammad Athar Khan.
Material type: ; Format:
print
; Literary form:
not fiction
Publisher: 2013Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1607,T] (1).
14.
A Case Control Study To Determine The Risk Factors Of Tuberculosis In Dairy Animals In Peshawar City And Its Suburbs
by Atta Ullah | Prof. Dr. Muhammad Athar Khan | Dr. Muhammad Hassan Mushtaq.
Material type: ; Format:
print
Publisher: 2013Dissertation note: Tuberculosis is chronic infectious disease of animals and human beings, which is characterized by progressive emaciation, nodules formation in lungs and involvement of local lymph nodes. Tuberculosis is caused by mycobacterium species and it is endemic in Pakistan. In the world ranking regarding tuberculosis patients, Pakistan is on 6th position.
A case control study was conducted in Peshawar city and its suburbs in order to determine the risk factors of tuberculosis in dairy animals. Prevalence of tuberculosis in dairy animals recorded in this study was 18.27%. A total of 750 dairy animals were included in the study in which 250 were positive cases and 500 were controls on the basis of tuberculin skin test. Controls were divided into two groups, group 1(animals above 1 year of age) group 2(animals under 1 year of age). All these animals were selected from civil veterinary hospital Peshawar and veterinary teaching hospital (University of Agriculture Peshawar); and villages located on ring road of Peshawar city.
Data was collected from the owner on pre designed questionnaire to determine different risk factors associated with tuberculosis and it was analyzed by using SPSS 16.0. The calculated odds ratio in descending order were 2.70 for rotational grazing practice, 2.52 for keeping donkey with dairy animals, 2.22 for not having own bull for breeding, 2.05 for keeping animals inside the shed at night, 2.02 for living in rural geographical environment, 1.87 for low socio-economic status, 1.65 for not using tap water, 1.59 for herd size more than 16-30 animals, 1.47 for non lactating animals, 1.47 for illiterate owners, 1.42 for contact with wild animals, 1.30 for keeping old animals within the herd, 1.25 for using fertilizer on crops that offer to animals, 1.22 for cattle, 1.17 for dung disposal weekly and 0.45 for deworming practice in dairy animals. Odds ratio more than 1 was considered being a risk factor while less than 1 was being considered as a health promoting factor. P-value < 0.05 was considered as significant.
Tuberculosis is disease of zoonotic importance, and its incidence increasing day by day both in humans and animals. Therefore further research is the need of time to control and eradicate this disease globally.
Availability: Items available for loan: UVAS Library [Call number: 1627,T] (1).
15.
Community Trials Of Haemorrhagic Septicemia Vaccines In District Mardan, Khyber Pakhtunkhwa
by Muhammad Imran | Prof. Dr. Muhammad Athar Khan | Dr. Muhammad Hassan Mushtaq.
Material type: ; Format:
print
; Literary form:
drama
Publisher: 2013Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1649,T] (1).
16.
Seroprevalence Of Brucellosis In Camels Of District Muzaffargarh, Punjab
by Sami Ullah | Dr. Muhammad Hassan Mushtaq | Prof. Dr. Muhammad Athar Khan.
Material type: ; Format:
print
Publisher: 2013Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1760,T] (1).
17.
Epidemiological Intelligence On Distribution & Dynamics Of Main Transboundary Diseases Of Ruminants In The Central Districts Of Punjab
by Muhammad Akram | Prof. Dr. Muhammad Athar Khan | Prof. Dr. Muhammad Sarwar Khan.
Material type: ; Format:
print
Publisher: 2007Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1844,T] (1).
18.
Comparative Impact Of Dairy Farming On Health Status Of Farm Workers And Non Farmers Of Lahore
by Farwa Amjad | Prof. Dr. Muhammad Athar khan | Dr. Saima | Ms. Shakera Sadiq.
Material type: ; Format:
print
; Literary form:
not fiction
Publisher: 2013Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1971,T] (1).
19.
Seroprevalence Of Brucella Canis In Dogs In Disteict Lahore0
by Muhammad Adnan aslam | Prof. Dr. Mansur ud din ahmad | Prof. Dr. Muhammad Athar khan.
Material type: ; Format:
print
; Literary form:
not fiction
Publisher: 2014Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1994,T] (1).
20.
Retrospective Study Of Fatal Dengue Hemorrhagic Fever In Lahore City
by Shumaila Abdusattar (2012-VA-523) | Prof. Dr. Mansur-ud-din Ahmad | Prof. Dr. Muhammad Athar Khan | Dr. Jawaria Ali Khan.
Material type: ; Literary form:
not fiction
Publisher: 2014Dissertation note: Dengue fever is one of the most common mosquito-borne viral diseases of human beings. It has become a major reason for public health concern internationally over the recent years because of disease morbidity and mortality. Globally around 2.5 billion people are living in areas where dengue viruses can be transmitted. Spread of mosquito vectors & viruses in geographical distribution are two main reasons of rise in incidence and prevalence of dengue fever & appearance of dengue hemorrhagic cases. Urban areas of the tropics have been identified to be highly endemic. According to estimates made by WHO around 50–100 million infections of dengue are prevalent every year globally. (Deen et al. 2006) In Pakistan first dengue outbreak was reported in Karachi in 1994 as environmental conditions are conducive to Aedes mosquito breeding. Economic and security related migration introduced virus to Lahore as well. According to Punjab Health Department 590339 suspected cases were reported in Lahore & 21685 confirmed by serology. It has been observed that 5-10% of these cases develop DHF.(Mahmood et al. 2013)
Dengue is mainly transmitted by mosquito vector i.e. Aedesaegypti and can also be transmitted by A.albopictus to a lesser extent. Virus that causes dengue has four different types that are closely related to each other.Infected female mosquitoes transmit this virus to human beings through bite.An infected mosquito can transmit this virus to humans for the rest of its life. Symptoms of dengue range from very mild fever to very high fever including intense headache, retro-orbital pain, muscular and joint pain, and rashes. There is no vaccine or any specific medicine to treat dengue. Patients having dengue fever are advised to take rest and drink ample fluids. They are advised to use paracetamol in order to reduce high grade fever or visit the physician if fever persists. Recovery from infection by one provides lifelong immunity against that serotype but confers only partial and transient protection against subsequent infection by the other three. There have been enough proofs showing that subsequent infection increases the risk of severity of disease which can result in DHF (WHO).
Leaking of plasma, fluid accumulation, respiratory distress, and intense bleeding and organ impairment makes severe dengue a fatal complication. Warning signs includes decrease in temperature (below 38°C/ 100°F), severe abdominal pain, rapid breathing, bleeding gums, malaise, and restlessness,continuous vomiting and hematemesis. These can occur three to seven days after first symptom recognition. In order to prevent complications and minimize the risk of death adequate and timely health care is required in next 1-2 critical days.(Halstead 1980)
In 1950s when dengue epidemics occurred in the Philippines and Thailand then Dengue hemorrhagic fever was first identified. Till 1970 nine countries had encountered epidemic DHF and this number has increased more than four times and keeps on rising. Today rising number of DHF cases are causing increased dengue outbreaks in the Americas, and in Asia, where all four dengue viruses are endemic. DHF has turn out to be a prominent reason of hospitalization and demise among kids in several states.In Asia, widespread DHF has enhanced geologically from Southeast Asian regions to west China. Various regional states of the South and Central Pacific have encountered significant or slight DHF outbreaks.In previous twenty years deterrence and management has come to be more immediate with the escalating geographical spreadof dengue and dengue hemorrhagic fever and higher ailment occurrence (Gubler 2002).
In the absence of bleeding or organ manifestation, DHF is medically challenging to diagnose, and the numerous etiologic agents can barely be distinguished by clinical tests. The specified diagnosis of DHF depends mainly on laboratory testing.(Drosten et al., 2002)
Availability: Items available for loan: UVAS Library [Call number: 2211,T] (1).
21.
Relationship Of Parent’s Level Of Education And Socio-Demographic Variables With Child’s Immunization Status: A Cross-Sectional Study In The Rural Areas Of District Layyah
by Abida Zahoor (2012-VA-573) | Prof. Dr. Mansur-ud-Din Ahmad | Prof. Dr. Muhammad Athar Khan | Prof. Dr. Masood Rabbani.
Material type: ; Literary form:
not fiction
Publisher: 2015Dissertation note: Immunization is a very important element of public health. It is the process whereby a person is made immune or resistant to an infectious disease, generally by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infections. It prevents against various communicable diseases such as Tuberculosis, Tetanus, Pertussis, Diphtheria, Poliomyelitis, Hepatitis B and Measles.
A cross-sectional study was conducted on 200 parents having at-least one child under five years of age. Data was collected from the rural areas of district Layyah. The purpose of the study was to investigate the relationship between parent’s level of education and child’s immunization status on one hand and the effect of sociodemographic variables on child’s immunization status on the other hand. In this study, it was concluded that there was a significant association between parent’s level of education and the socioeconomic variables with child’s immunization status.
Low rate of parent’s literacy, especially health literacy, poor socioeconomic status, large population size, parent’s refusal, difficulty in accessing immunization services and lack of health facilities were identified as the main barriers to immunization completion. As parent’s level of education is considered to be the corner stone in the progress of modern nation so education is a very important element as educated parents play a significant role in achieving the health of their children. It was concluded that there was a significant association between literacy status of parents, income status of parents and the immunization status of children. The immunization status of children in the rural areas can be improved by higher household income, literacy, better
Summary
41
health knowledge, exposure to media, maternal empowerment and mother’s participation in decision-making process. The policy makers should stress on the education of the people especially female education. Health awareness campaigns should be carried out so that parents can gain the benefits of vaccination.
6.1 Hypothesis
Ho: there is no significant relationship between parent’s level of education and child’s immunization status.
H1: Parent’s level of education has significant relationship on child’s immunization status
6.2 Methodology A cross-sectional study of six months duration from July 2016 to December 2016 was conducted in the rural areas of district Layyah in which parents of children under 5 years of age were interviewed about the immunization status of their children. Convenient sampling technique was used to collect the data. Data was collected from 200 parents living in the rural areas of district Layyah. The collected data was analyzed by using SPSS version 16.0.
6.3 Statistical Design
The dependent variable “child’s vaccination” and independent variables “parent’s educational level, household income, parent’s occupation and family composition” were analyzed by using SPSS version 16 and Microsoft Excel. Data entry and analysis was done on SPSS-16. Chi-square test was used for statistical testing. A p-value of <0.05 was considered significant. Frequencies and percentages of categorical variables were calculated. Cross
Summary
42
tabulations were done among dependent and independent variables. Chi-square test was applied on different sociodemographic factors and child’s immunization status to define the significant associations.
6.4 Study Outcomes It is concluded that there is a significant association between literacy status of parents, income status of parents and the immunization status of children. The major benefit of this study is that, the research findings can be used to assess the relationship of parent’s education with child’s immunization status and to find out those factors which are the main hindrance in child’s vaccination coverage. It will also provide new dimensions for further research related to child immunization and the health managers will find new facts and figures that will help them to make national decisions with the certainty of success. Availability: Items available for loan: UVAS Library [Call number: 2654-T] (1).
22.
Epidemiology Of Influenza Virus H5n1 In Islamabad Capital Territory
by Zahida Fatima (2005-VA-246) | Prof. Dr. Muhammad Athar Khan | Dr. Khalid Naeem | Prof. Dr. Mansur Ud Din Ahmad | Prof. Dr. Khushi Muhammad.
Material type: ; Literary form:
not fiction
Publisher: 2016Dissertation note: The poultry sector in Pakistan is the second largest industry that contributes to the national gross domestic products (GDP) and remains a major source of nutrition (protein and energy) for human population in Pakistan. Highly Pathogenic Avian Influenza (HPAI) outbreaks due to H5N1 virus in poultry have been recorded in over 62 countries, indicating the contagious nature of the disease and its potential to infect various avian species. These HPAI outbreaks in poultry have lead to killing/culling of around 120 million birds in various countries. During 2009, the Avian Influenza continues to occur in poultry in China, Hong Kong, India, Egypt, Nepal, Bangladesh and Canada . In Pakistan, an HPAI outbreak due to H7N3 virus was first observed in 1994-95 and those due to H9N2 virus in broiler and layer chickens were recorded between late 1990’s and early 2000. During the period between 2006 and 2008, poultry heavily suffered due to multiple outbreaks caused by H5N1 virus.
The country experienced several and severe HPAI subtype H5N1 outbreaks during 2006-2008 in commercial poultry farms mostly, causing mass economic losses. In Pakistan all the four poultry production system exists being identified by FAO. The present study was conducted in peri-urban areas of ICT Islamabad, capital of Pakistan. The objectives of the present study were to investigate the outbreaks due to HPAIV H5N1 in 2006-2007 in ICT and identify the pattern and trends of these outbreaks. For this purpose descriptive epidemiological study was conducted and data was collected on a predesigned questionnaire regarding farm demography, culling, morbidity and mortality. The result statistical analysis showed a significantly (P< 0.05) higher morbidity, mortality, case fatality and culling rate in layers farms than breeders and broilers respectively. Layers and breeders of old ages were mostly affected with having higher mortality and culling in comparison to younger age layer and breeder commercial farms. The mean morbidity and mortality rates ranged 57–95% and 5-43% correspondingly.
After the HPAIV H5N1 first reported outbreak in Pakistan in 2006 culling strategy was adopted after devastating outbreaks regularly reported from throughout the country. The reasons behind these emerging epidemics were unknown and several hypotheses were given birth after these outbreaks. Knowledge regarding potential risk factors responsible for HPAIV H5N1 epidemics in commercial poultry farms in Pakistan was lacking. Therefore we conducted a longitudinal cross sectional survey (1:1 matched case control study) to identify potential risk factors at farm level responsible for 2006-2007 HPAIV H5N1 infection in poultry in ICT. Information on farm characteristics, biosecurity practices and farm management were collected. Logistic regression model on data was used to unveil the potentially associated risk factors with cases (farms confirmed HPAI H5N1 Positive). Several candidate variables were studied and investigated for association. The results multivariable logistic regression showed that farm location such as in urban area (P<0.05: OR=18.50), wild birds entry (P<0.05: OR= 12.66) and farms situated in highly dense poultry populated area (P<0.05:OR=4.50) were found significantly associated with outbreaks of HPAIV H5N1 infection in commercial poultry farms during 2006-2007 epidemics in the study area.
Live bird markets (LBMs) are essential for poultry marketing in developing countries like Pakistan. One year active disease surveillance for influenza viruses in avian species in LBMs in ICT area was conducted in 2011. LBMs in Pakistan are typically urban that brings together many avian species produced by different suppliers. Which make LBMs in Pakistan a potential source of HPAIV viruses as well as other emerging poultry pathogens i.e. new castle disease virus,infectious bronchitis etc. The results of the present surveillance data showed that seroconversion against H5N1 and H9N2 is present in LBMs bird species which were isolated from different samples like serum, cloacal, nasal samples and organ samples.This indicates the continuous threat of AIV viruses circulating in the live bird markets set up of Pakistan.
Findings of these studies will help to tailor control and prevention measure against devastating outbreaks in future regarding the local circumstances of commercial poultry farms as well as in LBMs. These studies also succeeded to unveil the true reasons behind these devastating outbreaks and their higher impact on poultry industry. Such type of surveillance programs will be useful in future to investigate several emerging diseases and outbreaks in Pakistan and other developing countries. Availability: Items available for loan: UVAS Library [Call number: 2700-T] (1).
