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Biomedical subjects

S Safdar

Publications and source records attributed to S Safdar.

10 recordsLinked to original sources
PubMed2005

Early steroid withdrawal does not increase risk for recurrent focal segmental glomerulosclerosis.

UNLABELLED: Experience with early corticosteroid withdrawal (CSWD) in renal transplant recipients with focal segmental glomerulosclerosis (FSGS) has not been previously reported. Since corticosteroids are used to treat primary FSGS, concern exists as to whether early CSWD regimens will be associated with an increased risk of FSGS recurrence posttransplant. The purpose of the present study was to evaluate the results of early CSWD in FSGS recipients and compare these results to a historic control group of FSGS patients who underwent renal transplantation under corticosteroid-based immunosuppression. METHODS: Forty-three patients with FSGS underwent renal transplantation with early CSWD. Results in these patients were compared to FSGS patients that underwent renal transplantation with chronic corticosteroid therapy. All rejection episodes were biopsy proven with grading by Banff criteria. Statistical analyses included Student's t test and chi square tests. RESULTS: Results in 43 patients with a median follow-up of 569 days were analyzed and compared to control patients. There was no significant difference in recurrent FSGS, time to recurrence, or graft loss. CONCLUSION: CSWD does not increase risk for recurrence of FSGS. These observations indicate that ECSW can be achieved in FSGS patients, thereby affording them the benefits of steroid elimination.

Adrenal Cortex Hormones↗
PubMed2004

Prevalence of hypertension in a low income settlement of Karachi, Pakistan.

OBJECTIVE: To assess the prevalence of hypertension in a low-income community in Karachi. METHODS: Cross sectional survey, through multi-stage sampling of 857 adult subjects in 405 households was conducted between April and September 2002. RESULTS: The overall prevalence of hypertension was 26% (95% C.I. 23, 29), the prevalence among males (34%) was higher than females (24%). The mean age of participants was 35 +/- 14 years, the prevalence of hypertension increased with age. Proportionately there were more cases of hypertension among male participants over 35 years of age as compared to female participants of the same age (p < or = 0.001). Fifty-eight percent of hypertensives were unaware of their hypertension. None of the hypertensive subjects who were aware of their condition had blood pressure under 140/90 mmHg. Stratified analysis revealed significant risk factors for hypertension. Hypertension was 1.7 (OR 95% C.I. 1.14, 2.42) times more common among males then females. Males were 1.7 (OR 95% C.I. 1.06, 2.6) times less likely to have been aware of their hypertension status. Age analysis revealed that the prevalence of hypertension increased with age and hypertensive subjects were 5.6 (OR 95% C.I. 3.9, 8.1) times more likely to be over 35 years of age. CONCLUSION: There is a need to control hypertension and prevent its complications through effective community interventions. The survey results indicate high prevalence and poor control of hypertension in the community, but more research is required to understand the reasons behind this phenomena.

Adult↗
PubMed2003

National Polio Day campaign in a squatter settlement through medical students.

OBJECTIVE: To provide maximum polio vaccination coverage to under-five (<5) year children of a squatter settlement through Ziauddin Medical University (ZMU) medical students. SETTING: ZMU has established a Primary Health Care Program in a squatter settlement, which is predominantly inhabited by migrants from North Western Province of Pakistan and Afghanistan. The total population is approximately 20,000 and the proportion of <5 year children is nearly 19%. METHODOLOGY: ZMU started Oral Polio Vaccination (OPV) campaigns from 1996; up to 1999. The OPV campaigns were confined to the National Immunization Days (NIDs). A different strategy of "door-to-door" OPV services by medical students was undertaken in 1997. In December 1999 the polio vaccination coverage of <5-year children was evaluated through duster sampling. This paper describes the steps for improving OPV coverage in Sikanderabad. RESULTS: The estimated number of <5 year children in the area is 4,600. In a duster sample survey after the 1999 NID campaign out of 620 under 5 year children living in 429 households, 529 (85%) received OPV, with a 95% CI for OPV coverage of 82 to 88%. The coverage before the campaigns initiated by ZMU was 52%. CONCLUSION: The results indicate that the polio coverage of <5-year children has risen with the change in strategy. Door-to-door coverage strategy with the help of medical students proved effective in providing vaccination. No case of suspected poliomyelitis has been reported from the area since October 1999.

Child, Preschool↗
PubMed2002

Maternal health care in a rural area of Pakistan.

OBJECTIVE: The need for effective strategies for delivery of healthcare to rural women is paramount and requires a study of maternal perceptions and experiences of the healthcare system. METHOD: This article describes knowledge, attitudes and practices regarding obstetric healthcare in a rural area of Pakistan. This is a cross sectional survey of a rural area of district Hyderabad, Pakistan. A multistage sample of 1,150 households was drawn from a population of 247,257 living in 30,653 households. Structured KAP questionnaires regarding maternal health were administered to male and female respondents in study household. RESULTS: A total of 1,178 married women and 1,146 married men were interviewed. The mean age of female respondents was 29 +/- 6 years. At the time of the interview 20% women were pregnant. Sixty-one percent women received antenatal care during their last pregnancy. The most frequent antenatal care providers were female doctors (55%). Majority (67%) of women had delivered at home with the assistance of traditional birth attendants (TBAs). Overall less than 40% of respondents could correctly identify signs of obstetric complications. Thirty-eight percent women experienced obstetric complications during their last pregnancy. Estimated annual maternal mortality ratio (MMR) was 689/100,000 live births. CONCLUSION: Women have inadequate access to obstetric care due to limited healthcare options and poor knowledge of obstetric complications. This can be corrected by improving services and increasing overall maternal health awareness in the community.

Adolescent↗
PubMed1999

Outcomes of high-dose chemotherapy and autologous stem-cell transplantation in stage IIIB inflammatory breast cancer.

PURPOSE: To evaluate the disease-free survival (DFS) and overall survival (OS), prognostic factors, and treatment-related mortality of women with stage IIIB inflammatory breast cancer (IBC) treated with combined modality therapy (CMT) and high-dose chemotherapy (HDCT) with autologous stem-cell transplantation. PATIENTS AND METHODS: Between 1989 and 1997, 47 consecutive patients with stage IIIB IBC were treated with CMT and HDCT and were the subject of this retrospective analysis. Chemotherapy was administered to all patients before and/or after definitive surgery. Neoadjuvant and adjuvant chemotherapy was administered to 33 and 34 patients, respectively, and 20 patients received both. All patients received HDCT with autologous stem-cell transplantation, and 41 patients received locoregional radiation therapy. Tamoxifen was prescribed to patients with estrogen receptor (ER)-positive cancer. RESULTS: The mean duration of follow-up from diagnosis was 30 months (range, 6 to 91 months) and from HDCT was 22 months (range, 0.5 to 82 months). At 30 months, the Kaplan-Meier estimates of DFS and OS from diagnosis were 57.7% and 59.1%, respectively. At 4 years, the Kaplan-Meier estimates of DFS and OS from diagnosis were 51.3% and 51.7%, respectively. In a multivariate analysis, the only factors associated with better survival were favorable response to neoadjuvant chemotherapy (P =.04) and receipt of tamoxifen (P =.06); however, the benefit of tamoxifen was only demonstrated in patients with ER-positive breast cancer. At last follow-up, 28 patients (59. 6%) were alive and disease-free. Seventeen patients (36.2%) developed recurrent breast cancer. Seventeen patients died: 15 from disease recurrence and two (4.2%) from treatment-related mortality due to HDCT. CONCLUSION: In this analysis, the early results of treatment with CMT and HDCT compare favorably with other series of patients with stage IIIB IBC treated with CMT alone. These outcomes must be confirmed with longer follow-up and controlled studies.

Adult↗