Journal of the College of Physicians and Surgeons Pakistan, Mar 1, 2011
Objective: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual... more Objective: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual behaviors and methods of contraception, among college/university students of Karachi, Pakistan. Study Design: Cross-sectional observational study. Place and Duration ...
The aim of the study was to determine the functional status and level of physical activity and th... more The aim of the study was to determine the functional status and level of physical activity and their association with depression in the elderly population (age 60 and above) in Karachi, Pakistan. This was a cross-sectional study. Subjects were recruited through multi-stage cluster sampling technique. Questionnaire-based interviews were conducted from July to September 2008. Functional status and physical activity were assessed using activities of daily living (ADL) and physical activity questionnaires, respectively. Depression was evaluated using the 15-item geriatric depression scale (GDS). Both mean ADL score (9.9±0.2 vs. 9.6±0.2) as well as time spent in physical activity/week (377.3±26.9min vs. 251.7±15.4min) was higher in men than women, respectively. Subjects spending more than 310min (>5.2h) per week in physical activity were 60% less likely to be depressed compared to those who spent less than 120min (<2h) per week (Adjusted OR=0.4, 95% CI=0.2-0.7). A one unit increase in ADL score showed a 10% decrease in depression after adjusting for other variables (Adjusted OR=0.9, 95% CI=0.8-0.9). We found a strong association between depression and time spent in physical activities as well as activities of daily living. Our results indicate the potentially important positive role of higher functional status and physical activity in prevention of depression in the elderly in Karachi.
About a million people die by suicide each year worldwide. 1 Most research information on suicide... more About a million people die by suicide each year worldwide. 1 Most research information on suicide comes from high-income countries. Few countries outside the Western world report suicide data to the World Health Organization regularly. 2 Prominent among those that do not report are most of the 57 countries with a majority Muslim population, including those with populations in excess of 100 million people, namely Indonesia, Pakistan and Bangladesh. 3 Pakistan is the sixth most populous country in the world (population 162 million). 4 Overall, 97% of the population are Muslims, 65% people live in rural areas and a third are below the poverty line. The literacy rate is around 35-40%. Official unemployment stands at 12% of the eligible workforce. Health spending is less than 1% of the annual budget; mental health does not have a separate budget.
Background: Depression in elderly is a major global public health concern. There has been no popu... more Background: Depression in elderly is a major global public health concern. There has been no population-based study of depression in the elderly in Pakistan. The aim of the study was to estimate the prevalence of depression and its association with family support of elderly (age 60 years and above) in Karachi, Pakistan. Methods: A population based cross-sectional study was carried out in Karachi from July-September 2008. Questionnaire based interviews were conducted with individuals (n = 953) recruited through multi-stage cluster sampling technique, using the 15-item Geriatric Depression Scale (GDS). Results: Prevalence of depression was found to be 40.6%, with a higher preponderance in women than men (50% vs. 32%). Elderly currently not living with their spouses were 60% more depressed than those living with their spouses (Adjusted OR = 1.6, 95% CI = 1.3-2.1). Elderly who did not consider their children as future support were twice as likely to be depressed as those considering their children to be old age security (Adjusted OR = 2.1, 95% CI = 1.4-3.1). An increase in one male adult child showed 10% decrease in depression after adjusting for other variables (Adjusted OR = 0.9, 95% CI = 0.8-0.9). Conclusion: A relatively high prevalence of depression was found in the elderly in Karachi. There appeared to be a strong association between depression and family support variables such as living with spouse, considering children as future security and number of male adult children in the sample studied. Mental wellbeing of the elderly in Pakistan needs to be given consideration in the health policy of the country. In collectivistic societies like Pakistan family support plays an important part in mental health of the elderly that needs to be recognized and supported through various governmental and non-governmental initiatives.
Asian and Pacific census forum / East-West Population Institute, 1982
The authors "focus primarily on voluntary, peacetime migration [in Pakistan], both internal ... more The authors "focus primarily on voluntary, peacetime migration [in Pakistan], both internal and international, and attempt to analyze some of its possible socioeconomic consequences." The importance of the role of migration in urban population growth is discussed, with attention to implications for social and economic development. The impact of large-scale emigration of workers to the Middle East is also assessed. The analysis is based on data from the 1951, 1961, 1972, and 1981 censuses as well as from secondary sources.
JPMA. The Journal of the Pakistan Medical Association, 1993
The Maternal and Infant Mortality Survey (MIMS) was conducted in eight squatter settlements of Ka... more The Maternal and Infant Mortality Survey (MIMS) was conducted in eight squatter settlements of Karachi. The female mortality rate was 151.0 per 100,000 women aged 10-49 years and the maternal mortality ratio was 281 per 100,000 livebirths. The leading causes of deaths among women were complications of pregnancy (28.1%), infectious diseases (24.8%), cardiovascular diseases (20.7%), neoplasia (10.7%) and trauma (10.7%). Hemorrhage (47.1% of all maternal deaths), tuberculosis (40.0% of all infectious disease deaths), oropharyngeal cancer (23.1% of all neoplastic deaths), and burns (61.5% of all trauma deaths) were among the major causes identified. Maternal deaths were associated with young age and nulliparity (p-value < 0.01), and a higher proportion occurred in the hospital or on the way to the hospital as compared to non-maternal deaths.
Background: As part of the mid-term evaluation of a Women's Health Care Project, a study was cond... more Background: As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan.
Objective: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual... more Objective: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual behaviors and methods of contraception, among college/university students of Karachi, Pakistan. Study Design: Cross-sectional observational study. Place and Duration ...
Background: During the 1980s, approximately three million people migrated from Afghanistan to Pak... more Background: During the 1980s, approximately three million people migrated from Afghanistan to Pakistan and sought refuge in several cities including the city of Karachi. After the initial settlement of the refugees, the international organizations transitioned the health care of these refugees to the two local non-profit service agencies in Karachi. One of these agencies subsidized health care to the refugees under their care and the other agency encouraged the refugees under their care to utilize governmental and non-governmental private health resources at the disposal of general public. Our objective was to measure the effect of health subsidy on the uptake of contraception among Afghan refugee women and compare them to the group of Afghan women without such a subsidy.
International Journal of Gynecology & Obstetrics, 2009
conditions (pooled odds ratio, 0.50; 95% confidence interval, 0.29-0.86; P = 0.012 with DerSimoni... more conditions (pooled odds ratio, 0.50; 95% confidence interval, 0.29-0.86; P = 0.012 with DerSimonian-Laird's model). Metaregression analysis revealed that a heterogeneity involving year of publication, taxane use, and optimal cytoreduction rate was influencing the median overall survival significantly (P = 0.002, P = 0.007, and P = 0.012, respectively). However, the 'betweenstudies' variation of the number of NAC cycles was not influencing survival (P = 0.701). Conclusion: The current meta-analysis showed that NAC helped the gynecologic oncologist achieve an increased rate of optimal cytoreduction.
Karachi is the only mega city in the world with persistent poliovirus transmission. We determined... more Karachi is the only mega city in the world with persistent poliovirus transmission. We determined routine childhood immunization rates in Karachi and identified predictors of vaccine completion. A population-based cross-sectional survey was conducted in Karachi between August and September 2008. Data on demographics, socioeconomic, and DTP3 vaccination status in children 12 to 23 months old were collected. Logistic regression was used to identify predictors of vaccination completion. Overall, 1401 participants were approached; 1391 consented to participate. Of these, 1038 (75%) were completely vaccinated. Punjabi families had the highest DTP3 coverage (82%), followed by Urdu-speaking families (79%). Pashtun (67%) and Bengali (48%) families had the lowest vaccine coverage. Children of mothers with ≥ 12 years of schooling (OR = 25.4; 95% CI = 5.7-113.1) were most likely to be vaccinated. A quarter of study participants were unvaccinated. Targeted strategies for boosting DTP3 rates in communities with low immunization coverage are essential for polio eradication in Karachi.
Journal of the College of Physicians and Surgeons Pakistan, Mar 1, 2011
Objective: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual... more Objective: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual behaviors and methods of contraception, among college/university students of Karachi, Pakistan. Study Design: Cross-sectional observational study. Place and Duration ...
The aim of the study was to determine the functional status and level of physical activity and th... more The aim of the study was to determine the functional status and level of physical activity and their association with depression in the elderly population (age 60 and above) in Karachi, Pakistan. This was a cross-sectional study. Subjects were recruited through multi-stage cluster sampling technique. Questionnaire-based interviews were conducted from July to September 2008. Functional status and physical activity were assessed using activities of daily living (ADL) and physical activity questionnaires, respectively. Depression was evaluated using the 15-item geriatric depression scale (GDS). Both mean ADL score (9.9±0.2 vs. 9.6±0.2) as well as time spent in physical activity/week (377.3±26.9min vs. 251.7±15.4min) was higher in men than women, respectively. Subjects spending more than 310min (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;5.2h) per week in physical activity were 60% less likely to be depressed compared to those who spent less than 120min (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;2h) per week (Adjusted OR=0.4, 95% CI=0.2-0.7). A one unit increase in ADL score showed a 10% decrease in depression after adjusting for other variables (Adjusted OR=0.9, 95% CI=0.8-0.9). We found a strong association between depression and time spent in physical activities as well as activities of daily living. Our results indicate the potentially important positive role of higher functional status and physical activity in prevention of depression in the elderly in Karachi.
About a million people die by suicide each year worldwide. 1 Most research information on suicide... more About a million people die by suicide each year worldwide. 1 Most research information on suicide comes from high-income countries. Few countries outside the Western world report suicide data to the World Health Organization regularly. 2 Prominent among those that do not report are most of the 57 countries with a majority Muslim population, including those with populations in excess of 100 million people, namely Indonesia, Pakistan and Bangladesh. 3 Pakistan is the sixth most populous country in the world (population 162 million). 4 Overall, 97% of the population are Muslims, 65% people live in rural areas and a third are below the poverty line. The literacy rate is around 35-40%. Official unemployment stands at 12% of the eligible workforce. Health spending is less than 1% of the annual budget; mental health does not have a separate budget.
Background: Depression in elderly is a major global public health concern. There has been no popu... more Background: Depression in elderly is a major global public health concern. There has been no population-based study of depression in the elderly in Pakistan. The aim of the study was to estimate the prevalence of depression and its association with family support of elderly (age 60 years and above) in Karachi, Pakistan. Methods: A population based cross-sectional study was carried out in Karachi from July-September 2008. Questionnaire based interviews were conducted with individuals (n = 953) recruited through multi-stage cluster sampling technique, using the 15-item Geriatric Depression Scale (GDS). Results: Prevalence of depression was found to be 40.6%, with a higher preponderance in women than men (50% vs. 32%). Elderly currently not living with their spouses were 60% more depressed than those living with their spouses (Adjusted OR = 1.6, 95% CI = 1.3-2.1). Elderly who did not consider their children as future support were twice as likely to be depressed as those considering their children to be old age security (Adjusted OR = 2.1, 95% CI = 1.4-3.1). An increase in one male adult child showed 10% decrease in depression after adjusting for other variables (Adjusted OR = 0.9, 95% CI = 0.8-0.9). Conclusion: A relatively high prevalence of depression was found in the elderly in Karachi. There appeared to be a strong association between depression and family support variables such as living with spouse, considering children as future security and number of male adult children in the sample studied. Mental wellbeing of the elderly in Pakistan needs to be given consideration in the health policy of the country. In collectivistic societies like Pakistan family support plays an important part in mental health of the elderly that needs to be recognized and supported through various governmental and non-governmental initiatives.
Asian and Pacific census forum / East-West Population Institute, 1982
The authors "focus primarily on voluntary, peacetime migration [in Pakistan], both internal ... more The authors "focus primarily on voluntary, peacetime migration [in Pakistan], both internal and international, and attempt to analyze some of its possible socioeconomic consequences." The importance of the role of migration in urban population growth is discussed, with attention to implications for social and economic development. The impact of large-scale emigration of workers to the Middle East is also assessed. The analysis is based on data from the 1951, 1961, 1972, and 1981 censuses as well as from secondary sources.
JPMA. The Journal of the Pakistan Medical Association, 1993
The Maternal and Infant Mortality Survey (MIMS) was conducted in eight squatter settlements of Ka... more The Maternal and Infant Mortality Survey (MIMS) was conducted in eight squatter settlements of Karachi. The female mortality rate was 151.0 per 100,000 women aged 10-49 years and the maternal mortality ratio was 281 per 100,000 livebirths. The leading causes of deaths among women were complications of pregnancy (28.1%), infectious diseases (24.8%), cardiovascular diseases (20.7%), neoplasia (10.7%) and trauma (10.7%). Hemorrhage (47.1% of all maternal deaths), tuberculosis (40.0% of all infectious disease deaths), oropharyngeal cancer (23.1% of all neoplastic deaths), and burns (61.5% of all trauma deaths) were among the major causes identified. Maternal deaths were associated with young age and nulliparity (p-value < 0.01), and a higher proportion occurred in the hospital or on the way to the hospital as compared to non-maternal deaths.
Background: As part of the mid-term evaluation of a Women's Health Care Project, a study was cond... more Background: As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan.
Objective: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual... more Objective: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual behaviors and methods of contraception, among college/university students of Karachi, Pakistan. Study Design: Cross-sectional observational study. Place and Duration ...
Background: During the 1980s, approximately three million people migrated from Afghanistan to Pak... more Background: During the 1980s, approximately three million people migrated from Afghanistan to Pakistan and sought refuge in several cities including the city of Karachi. After the initial settlement of the refugees, the international organizations transitioned the health care of these refugees to the two local non-profit service agencies in Karachi. One of these agencies subsidized health care to the refugees under their care and the other agency encouraged the refugees under their care to utilize governmental and non-governmental private health resources at the disposal of general public. Our objective was to measure the effect of health subsidy on the uptake of contraception among Afghan refugee women and compare them to the group of Afghan women without such a subsidy.
International Journal of Gynecology & Obstetrics, 2009
conditions (pooled odds ratio, 0.50; 95% confidence interval, 0.29-0.86; P = 0.012 with DerSimoni... more conditions (pooled odds ratio, 0.50; 95% confidence interval, 0.29-0.86; P = 0.012 with DerSimonian-Laird's model). Metaregression analysis revealed that a heterogeneity involving year of publication, taxane use, and optimal cytoreduction rate was influencing the median overall survival significantly (P = 0.002, P = 0.007, and P = 0.012, respectively). However, the 'betweenstudies' variation of the number of NAC cycles was not influencing survival (P = 0.701). Conclusion: The current meta-analysis showed that NAC helped the gynecologic oncologist achieve an increased rate of optimal cytoreduction.
Karachi is the only mega city in the world with persistent poliovirus transmission. We determined... more Karachi is the only mega city in the world with persistent poliovirus transmission. We determined routine childhood immunization rates in Karachi and identified predictors of vaccine completion. A population-based cross-sectional survey was conducted in Karachi between August and September 2008. Data on demographics, socioeconomic, and DTP3 vaccination status in children 12 to 23 months old were collected. Logistic regression was used to identify predictors of vaccination completion. Overall, 1401 participants were approached; 1391 consented to participate. Of these, 1038 (75%) were completely vaccinated. Punjabi families had the highest DTP3 coverage (82%), followed by Urdu-speaking families (79%). Pashtun (67%) and Bengali (48%) families had the lowest vaccine coverage. Children of mothers with ≥ 12 years of schooling (OR = 25.4; 95% CI = 5.7-113.1) were most likely to be vaccinated. A quarter of study participants were unvaccinated. Targeted strategies for boosting DTP3 rates in communities with low immunization coverage are essential for polio eradication in Karachi.
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