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Biomedical subjects

N Rehan

Publications and source records attributed to N Rehan.

At least 19 recordsLinked to original sources
PubMed2006

Profile of men suffering from sexually transmitted infections in Pakistan.

BACKGROUND: To evolve effective prevention and efficient treatment strategies for sexually transmitted infections (STIs) in a country, comprehensive understanding of the prevalent STI and their modes of transmission is needed. The aim of this present study was to generate such data for Pakistan. METHODS: The study was conducted between June 1999 and September 1999 in four provincial capitals. In each city, data was collected from one or more teaching hospitals and a number of general practitioners. During this period, 465 men suffering from STIs were interviewed. RESULTS: The mean age of study population was 31.9 +/- 8.6 years, 60% were married, 58.3% urbanites, 81.7% living with their families and 83.3% smokers. Only 10.5% were drug addicts. Out of 465 cases, 27.5% cases had gonorrhea, 31.6% syphilis, 17.2% chancroid, 18.3% herpes, 5.2% chlamydial infections while only one case (0.2%) was HIV positive. Most men (55%) acquired the infection heterosexually, 11.6% through homosexuality, 18.4% through bisexual relations and 2 men (0.5%) reported bestiality. Among 78.1% of those contracting the infection heterosexually, the source of infection was a sex worker. None acquired infection through his wife. The knowledge about STIs was very poor. Wrong notions were prevalent. CONCLUSIONS: The pattern of STIs is different from developed countries. Those acquiring STIs in Pakistan were older, married and living with their families whereas in developed countries most men acquiring STIs are younger, unmarried and living alone.

Journal Article↗
PubMed2003

Perceptions of menopause among rural women of Lahore.

OBJECTIVE: The present study was undertaken to document the perceptions of Pakistani women regarding menopause. DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: The study was conducted in the suburb of Lahore from 1st July 2000 to 31st August 2000. SUBJECTS AND METHODS: The data were collected from a rural population of 28,419 individuals living in 20 villages outside Lahore. A systematic random sample of 130 women was drawn from those 1337 women, who had reached natural menopause. In-depth interviews were conducted in local dialect. RESULTS: The age of the population ranged from 42 to 80 years with a mean of 59.8+/-7.4 years. The mean age at menopause was 49.0+/-3.6 years. Majority of the women (82.3%) considered menopause as a positive change. According to 71.6% women, their relationship with the family had either improved or there was no change. There was an increase in libido among 70.5% women, decrease in libido among 5.7% and no change among 23.8% women. However, 16.9 % women reported dyspareunia. Seven percent of the women suffered a fracture after menopause. None of the study subjects reported postmenopausal bleeding. Three women (2.3%) had cardiac ailments. The proportion of women showing a positive attitude towards menopause was significantly higher (p<0.005) among our study subjects as compared to those from India, Thailand, USA and Australia. CONCLUSION: The majority of study subjects did not consider menopause as a negative milestone, loss of time, a partial death or a disease as seen in many western populations. On the contrary menopause is regarded as a natural phase in a woman's reproductive life

Aged↗
PubMed2001

Epidemiology of cigarette smoking in Pakistan.

AIMS: To study the prevalence of smoking among Pakistani population with particular reference to regional differences and correlates of cigarette smoking. DESIGN: Cross-sectional survey based on representative national sample. SETTING: Data collected through National Health Survey of Pakistan 1990-94. PARTICIPANTS: 13,104 individuals (6337 males and 6767 females), aged > or = 8 years. OUTCOME MEASURES: Prevalence and correlates of smoking. FINDINGS: Based on weighted estimates, the overall prevalence of cigarette smoking was 14.2% (95% CI: 13.6-14.8) in individuals aged > or = 8 years and 19.4% (95% CI: 19.08-19.72) among those aged > or = 15 years. The highest prevalence was seen in the province of Sindh (16.1%) and the lowest in North Western Frontier Province (7.1%). Nearly a quarter of males (25.4%) were smokers while only 3.5% of females smoked (p < 0.001). The smoking was slightly more prevalent in urban areas (15.2%) compared to rural areas (13.7%). This pattern was consistent in all provinces except the province of Sindh. The highest prevalence of cigarettes smoking among males (48.6%) was seen in those aged 25-44 years. After this age, there was a decline in smoking among males in Punjab and North Western Frontier Province, whereas the other two provinces, Sindh and Balochistan, did not show any such trend. CONCLUSION: Smoking is common in Pakistan. There is no clear policy on tobacco control in Pakistan.

Adolescent↗
PubMed2001

Characteristics of Pakistani women seeking abortion and a profile of abortion clinics.

A study of the characteristics of Pakistani women seeking abortion and a profile of abortion clinics was conducted in 32 abortion clinics in three provincial capitals of the country. All 452 women who had their pregnancies terminated between October and December 1997 were interviewed. Except for 39 women (8.6%), all study subjects were married. A majority of the women (36.6%) were aged >35 years, 61.0% had given birth to > or =5 children, and 40.2% were illiterate. The predominant reasons for abortion were "too many children" (64.4%), contraceptive failure (20.3%), premarital affairs (8.6%), medical reasons (5.4%), and extramarital affairs (1.3%). Nearly two thirds of the abortions were induced by inadequately trained persons. Only 22% of the abortion clinics met the World Health Organization (WHO) standards required for safe termination of pregnancy. At all these clinics, the procedure used to terminate the pregnancy was dilatation and curettage (D&C). Only one clinic was using manual vacuum aspiration (MVA). Induced abortion seems to be fairly common among married women of high parity, advanced age, and low educational status. Keeping in view the large number of terminations, new medical and surgical techniques of pregnancy termination should be introduced to those already providing abortion services.

Abortion, Therapeutic↗
PubMed2000

Prevalence and determinants of caesarean section in a teaching hospital of Pakistan.

A retrospective analysis of 10 863 caesarean sections was carried out at a teaching hospital in Pakistan to examine the factors responsible for the high caesarean section rate. The caesarean section rate (CSR) during the study period (1985-1996) was 24.1/100 births and 78% of the caesareans were emergency procedures. The caesarean section rate was significantly higher among primigravida (27.26%) compared with 22.31% in multipara (P<0.01). Even for each indication, the frequency of caesarean section was higher among prinigravida (P<0.05). The three leading indications were dystocia (6.32%), repeat section (5.8%) and fetal distress (3.5%). Specific socio-demographic and child bearing patterns of our women, flaws in antenatal surveillance, ineffective working of the referral chain and departmental polices regarding management of cases with dystocia, Previous, abdominal delivery and fetal distress seem to be the major underlying causes of the high CSR.

Journal Article↗
PubMed2000

Norplant: reasons for discontinuation and side-effects.

OBJECTIVE: To study the side-effects and reasons for the discontinuation of Norplant. METHODS: The study was based on the analysis of the medical records of 265 Norplant users, who obtained Norplant from two clinics of the Family Planning Association of Pakistan and who were followed for 5 years. RESULTS: The most common reason (29.4%) for the discontinuation of Norplant was menstrual disturbances, followed by medical problems (4.1%), desire for more children (3.1%) and family problems (3.1%). The major side-effects were weight gain, breast tenderness, headache and dizziness. Only 7.7% of users mentioned any change in sexual behavior and 69.6% of the complaints leading to Norplant removal developed within 6 months of insertion. CONCLUSION: The extent and nature of the side-effects experienced by Pakistani women using Norplant are similar and comparable to those reported from other countries.

Activities of Daily Living↗
PubMed1999

Efficacy and continuation rates of Norplant in Pakistan.

A total of 265 women who had the Norplant system inserted were followed for 5 years. The present study is based on 11,435 women-months of use, describing the continuation rates and efficacy of Norplant among these women. The 5-year cumulative continuation rate was 45.7 per 100 continuing users. The continuation rates were age-dependent. The women > or = 35 years of age consistently maintained higher continuation rates at all time intervals as compared with those of younger women. During 5 years of follow-up, five women became pregnant. Three pregnancies occurred in year 2, one in year 3, and one in year 5. The 5-year cumulative pregnancy rate was 2.5 per 100 continuing users. The weight of the user did not influence the pregnancy rate. The continuation rates, as well as the pregnancy rates, are comparable to those reported from other countries in the region.

Adult↗
PubMed1999

Norplant: users' perspective in Pakistan.

Five hundred and eighteen Norplant acceptors (260 ever-users and 258 current users) were interviewed to assess their perceptions about Norplant. The mean age of the acceptors was 32.6+/-5.7 years (mean +/- SD). The mean parity was 4.3 and many of the users (40.2%) were illiterate. The most common reason to choose Norplant was its long duration of action (70.1%) followed by doctor's advice (10.4%) and use by other women (10.1%). Norplant was recommended by family planning workers in 35.3% cases, doctors in 29.2% cases and friends in 17.4% cases. Advertisement did not play any role in the women's choice of Norplant. In 77.3% cases, the decision to use Norplant was a joint decision. Only 15% of the users had fears/anxieties before insertion. Most of these women (44%) were concerned about possible ill-effects of Norplant on their health rather than efficacy. The social acceptance of Norplant was very high (76%) and more than half of the users (52.5%) were satisfied with the method. Among current users, 83.9% wanted to continue Norplant for 5 years. Only 39 users (15.1%) intended to discontinue. The main reason for discontinuation was menstrual disturbance (69.2%), followed by weight gain (12.7%). The study suggests that long duration of effective action and high social acceptance are likely to make Norplant a popular method among Pakistani women.

Adult↗
PubMed1996

Tumor size and prognosis in aggressively treated osteosarcoma.

PURPOSE: The aim of this retrospective analysis was to investigate the prognostic significance and optimal measures of tumor size in osteosarcoma treated with intensive neoadjuvant chemotherapy. PATIENTS AND METHODS: Initial anterior-posterior (AP) and lateral x-ray films of 128 patients treated within the trials Cooperative Osteosarcoma Study (COSS)-80, -82, and -86, were evaluated for the following three tumor diameters: length, width, and depth. Metastasis-free survival (MFS) analyses were performed in univariate and multivariate models with one, two, and three dimensions of the tumor as absolute or relative measures (tumor length, referred to bone length, plane and volume to body-surface area). RESULTS: Univariate analyses of MFS showed a high prognostic significance of all absolute measures. Relative measures, at best, showed a comparable predictive value. Cox regression analysis indicated the high prognostic significance of absolute tumor volume (ATV; P < .0001) and histologic response (P < .0001). None of 19 patients with an ATV < or = 70 cm3 and only four of 53 with an ATV < or = 150 cm3 relapsed, while in patients with an ATV more than 150 cm3, the relapse rate remained 40% to 60%, irrespective of further increase in volume. CONCLUSION: Initial tumor size is an important and easily obtainable prognostic factor in osteosarcoma and may serve as a basis for risk-adapted therapy. It is best represented by the absolute three-dimensional measure ATV. There is a cut-off point regarding the incidence of metastases at a tumor volume of approximately 150 cm3 as calculated from two-plane x-ray films.

Adolescent↗
PubMed1996

Sero-prevalence of HIV: six years' experience at Shaikh Zayed Hospital, Lahore.

Sero-prevalence of HIV was tested among 16,170 individuals. They included 215 patients with sexually transmitted diseases (STD), 77 I/V drug users, 21 commercial sex workers, 987 patients on haemodialysis, 119 subjects referred for HIV testing, 12,482 voluntary blood donors, 360 ante-natal attenders, 73 tuberculosis patients, 674 Pakistanis travelling abroad and 1162 persons who had received multiple blood transfusions. Ten persons were seropositive (0.06%). All of them came from the 119 subjects, suspected to be suffering from AIDS. The predominant mode of transmission was heterosexual (50%), blood transfusion (30%), homosexual (10%) and vertical (10%). All cases acquired infection outside the country. Comparisons have been made with other national studies.

Adult↗
PubMed1994

Semen characteristics of fertile Pakistani men.

Semen characteristics were studied among 200 fertile Pakistani men aged 24 to 48 years. Each subject had fathered at least two children. The mean +/- SD values of volume, sperm density, motility percentage, grade of motility and percentage of oval sperms were 3.11 +/- 1.2 ml, 58.21 +/- 26.41 million/ml, 61.2 +/- 21.3%, 3.01 +/- 0.94 and 70.2 +/- 15.36% respectively. There was no deteriorating effect of age on semen quality except some decrease in semen volume. The comparison has been made with studies from other countries.

Adult↗
PubMed1994

Use of Norplant in Pakistan: two years experience.

The acceptability and efficacy of norplant (levonorgestrel sub- dermal implants) was assessed over a period of two years among 445 married women aged 19 to 45 years. Twenty women were lost to follow-up while the remaining 425 were regularly followed-up. At the end of two years, 388 women were still continuing with norplant (91.2%). During this period, there was only one pregnancy (0.26%). There was no significant change in mean systolic or diastolic blood pressure. However, there was a significant increase (P < 0.001) in mean weight and decrease (P < 0.001) in the mean duration of menstrual cycle. Thirty-seven women (8.7%) got the implant removed. The major reason for removal (67.6%) was menstrual disturbances. Nine acceptors (18.59%) developed side effects, which were related to the type of symptoms often associated with steroid contraception. These findings are similar to those reported from other countries. The high efficacy (99.74%) and acceptability (continuation rate of 91.29%) as well as long acting (5 years) nature of norplant suggest that this method of contraception can safely be promoted in Pakistan.

Adult↗