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Biomedical subjects

J A Razzak

Publications and source records attributed to J A Razzak.

6 recordsLinked to original sources
PubMed2004

Injuries among children in Karachi, Pakistan--what, where and how.

OBJECTIVES: To describe the epidemiology of injuries among children in Karachi, Pakistan. STUDY DESIGN: Retrospective case series. METHODS: Data on children aged < or =15 years who were injured between October 1993 and January 1996 were extracted from the logs of the main provider of emergency medical transportation, and were classified according to the World Health Organization's basic data set for information on injuries. RESULTS: We identified 1320 cases of injuries in children < or =15 years old. The major causes were: motor vehicle crashes (MVC) (80%), falls other than from vehicles (5%), burns (5%) and drowning (3%). One in six of these children (15%) died either at the scene of the accident or during transportation to the hospital. The majority of deaths were either due to MVCs (67%) or drowning (18%) Large vehicles (buses, minibuses and trucks) were involved in 54% of all childhood road traffic injuries. Almost one-third (33%) of burns took place in the kitchen at home, and half (51%) of all drowning cases occurred in the sea. CONCLUSIONS: The majority of children transported by the ambulance service were male and were victims of MVCs. Prevention efforts aimed at stricter enforcement of driving laws and family/child education geared towards pedestrian safety could potentially reduce morbidity and mortality. This study also highlights the role of the prehospital transport system in injury surveillance.

Accidental Falls↗
PubMed2002

Patterns of violence in Karachi, Pakistan.

OBJECTIVES: Government reports on violence in developing countries are almost universally based upon police data, which are typically incomplete and unreliable. Violence in Karachi was evaluated using ambulance service, not police, records. SETTING: Karachi, Pakistan. METHODOLOGY: The study was based on a case series of persons suffering from intentional injuries and transported by Edhi, the largest emergency service in Karachi, between October 1993 and January 1996. Main outcome variables were injury and death rates. RESULTS: Edhi Ambulance Service transported 4,091 intentionally injured persons during the 29 month period from October 1993 to January 1996. Ninety five per cent (n=3,864) were males; 74% (n=2,823) were 20 to 40 years of age, and 2,400 (58%) died before reaching the hospital. Firearms were the most common mode of injury (n=3,396, 83%). Forty six per cent (n= 1,828) of violent injuries occurred in four neighborhoods of Karachi--22% in Korangi (n= 884) and 8% each in Orangi (n=337), Malir Colony (n=307), and Nazimabad (n=300). On the 32 days when a political strike was called, more people were injured (mean = 10.4 v 5.0 persons, p=0.01) and killed (mean 6.6 v 3.9 persons, p<0.01) compared with days without a political strike. CONCLUSION: Violence is a major public health problem in Karachi, affecting predominantly wage earners. At least some of the violence is rooted within the political system. Detailed study of the causes of violence that explains the role that political and ethnic tensions play, may suggest strategies to lessen the toll of violence.

Adult↗
PubMed1998

Estimating deaths and injuries due to road traffic accidents in Karachi, Pakistan, through the capture-recapture method.

BACKGROUND: Road traffic accidents (RTA) are an important yet preventable cause of death and disability in developing countries like Pakistan. Yet accurate epidemiological data on injuries in developing country injuries is often difficult to obtain. We applied the capture-recapture method to estimate the death and injury rates due to RTA in Karachi. METHODS: We applied the two-sample capture-recapture method using traffic police records as one source of capture and the logs of a non-government ambulance service as the second capture source for the same 10 months and 20 days for which 1994 data were available. We generated a conservative adjusted estimate of injuries and deaths by considering entries in the two sources as matched if they reported the same date, time, and place, and at least one of the other matching variables, of name, vehicle registration number, vehicle types or patient outcome. We then compared the estimated rates with the police rates. RESULTS: In 1994 police reported 544 deaths and 793 injuries due to RTA while ambulance records noted 343 deaths and 2048 injuries. The capture-recapture analysis estimated at least 972 (95% CI: 912-1031) deaths and 18,936 (95% CI: 15,507-22,342) injuries attributable to RTA during the study period. Official sources counted only 56% of deaths and 4% of serious injuries. The estimated rates for the year 1994 were 185 injuries and 11.2 deaths per 100,000 population. CONCLUSION: Road traffic injuries and deaths in Karachi are a much more substantial health problem than is evident from official statistics.

Accidents↗
PubMed1994

Laparoscopic appraisal of infertility and pelvic pain in Pakistani women: a 5 years audit.

Five hundred and nine Laparoscopic examinations performed between 1987-91, (147 procedures for evaluation of gynaecologic pelvic pain and 313 for infertility) revealed ectopic pregnancy (27%), twisted ovarian cyst (18%) and acute pelvic inflammatory disease (14%) in cases of acute gynaecologic pain, and endometriosis (17%) and chronic pelvic inflammatory disease (16%) in chronic pelvic pain. Adhesions (20%), tubal block (15%), endometriosis (9%) and polycystic ovary (7%) were common findings in cases of infertility. These data support the usefulness of this minimally invasive procedure in accurate diagnosis of gynaecological disorders and provides insight into the spectra of diseases seen in Pakistani women with pelvic pain and infertility.

Acute Disease↗
PubMedDate not supplied

Emergency medical services and cultural determinants of an emergency in Karachi, Pakistan.

OBJECTIVES: The study was conducted to understand the prehospital system in Karachi, the mode of transport that adult inpatients use to reach the emergency departments (EDs), and the barriers to the use of ambulances. METHODS: The study consisted of two parts. The first part involved interviewing the administrators of major ambulance services in Karachi. The second part consisted of a structured interview of randomly selected adult inpatients admitted to one government and one private hospital. RESULTS: Seven ambulance service administrators were interviewed. The interviews revealed that ambulances in Karachi are mainly involved in transporting patients from hospital to hospital or to home. A large number of calls are for transporting dead bodies. A total of 92 patients were interviewed (58 male, 34 female). Admission complaints included abdominal pain (22), blunt trauma (11), penetrating trauma (3), chest pain (6), shortness of breath (4), hematemesis (3), acute focal weakness (4), high fever (4), and other (32). The most common mode of transport to the ED was taxi (53, 58%), followed by private car (21, 23%). Specific reasons for not using ambulances included a perception that the patient was not sick enough (34, 45%), slow response of the ambulance services (17, 23%), not knowing how to find one (8, 11%), and the high cost (6, 8%). CONCLUSION: In case of a medical emergency, most people in Karachi do not use ambulances. The reasons for this low usage include not only poor accessibility, but also cultural barriers and lack of education in recognition of danger signs.

Administrative Personnel↗