New typhoid protecting vaccine found

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

An emergency vaccination campaign in Sindh following the outbreak of typhoid in the province has found the typhoid conjugate vaccine to be effective in preventing new cases of the disease. 

The researchers of a recent event at Aga Khan University (AKU), Karachi, revealed that over 10,000 cases of extensively drug resistant (XDR) typhoid, a strain of the disease resistant to an unprecedented range of antibiotics, have been reported since 2016 in Karachi and Hyderabad which led to the launch of an emergency vaccination campaign in January 2018 in the worst affected areas of Hyderabad which saw 207,000 children between 6 months and 10 years of age receive the new vaccine. 

At the same time as the campaign, researchers set up a surveillance system in the same area over an 18-month period to screen a cohort of over 20,000 children, who received the vaccine, to detect cases of typhoid. They found that 9 out of 10 children in the cohort, or 89 per cent, did not contract the disease. 

“The results of the vaccine’s effectiveness are in line with a study in Nepal. This strengthens the case for the national rollout of the vaccine,” Dr Farah Qamar, an associate professor in paediatrics and child health at AKU, remarked.

During the event, Dr Farah Qamar spoke about how lessons from the Hyderabad campaign had been applied in Lyari, Karachi, and during the Sindh-wide rollout, conducted in November 2018, which aimed to reach over 10 million children during a three-week period. 

A mop-up campaign is now being planned in Sindh in March 2020 to immunize children between the age of 9 months and 15 years missed during the previous drive. 

The researchers noted that parents, whose children haven’t receive the vaccine, are keen to participate in the forthcoming immunization campaign. 

The speakers at the event revealed that cases of typhoid were being reported in parts of the Punjab province such as Lahore and Multan. The province is yet to launch the vaccine. 

The Punjab EPI Director, Dr Muhammad Saeed Akhtar, informed that cases of XDR typhoid and multi-drug resistant typhoid had been noticed to date.

“The Punjab government plans to include the vaccine in its routine immunization programme between September and October 2020. We will study the lessons learned from the Sindh campaign in order to ensure the success of our drive,” he shared. 

Dr Anita Zaidi, director of vaccine development, surveillance, and enteric and diarrheal diseases at the Bill and Melinda Gates Foundation, expressed her support for efforts to generate evidence of the efficacy for this vaccine against typhoid fever. 

She added that a strategy to combat typhoid requires an integrated approach that covers access to clean water, improved sanitation, and immunization. 

During the event, the researchers from the AKU explained how their collaboration with the health authorities in Hyderabad helped trace the cause of the outbreak. 

“Our research involved geographic mapping which highlighted how the majority of typhoid cases were reported around sewage lines. Household water samples also tested positive for contamination showing that the drinking of contaminated water was the most likely cause for the outbreak,” Dr Momin Kazi, an assistant professor (research) in paediatrics and child health at AKU, mentioned. 

The research and policy advocacy efforts supporting the vaccine’s launch were backed by a team at AKU including Professor Rumina Hasan, Professor Zahra Hasan and Dr Sadia Shakoor from the department of pathology and microbiology, Dr Farah Qamar, Dr Tahir Yousafzai and Dr Momin Kazi from the department of paediatrics and child health at AKU.  

The control and prevention of water-borne diseases such as typhoid is a global health priority with targets under goal 3 of the Sustainable Development Goals calling for the eradication of such diseases by 2030.

Nisar Memon regrets lack of governance

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

Senator Nisar Memon, a former federal minister, has regretted the lack of governance at the top, believing that it’s about time to let the youth take leadership of country which will also help achieve happiness with them taking ownership of challenges.

“Of course, we have governance. The Constitution of Pakistan and all state institutions govern the 219.4 million people. Is it effective, decisive and sustainable? Even if one wishes to look optimistically, it is difficult to give an affirmative answer,” he wrote in a recently published newspaper article. 

“If governance was effective by this multi-party conglomeration in Islamabad, it would be visible in all walks of life. The conduct of parliamentary affairs, the quality of debates, government response to private bills and answers to members questions, the handling of Ordinances for converting them to bills, the absence of relevant government ministers during debates, and the language used by government leaders provoking harsher response from opposition benches; all point to an ineffective governance,” he observed.

“Let’s see the governance effectiveness in its economic policies. It would have been visible in results of economic policies which in nineteen months have brought unprecedented hardships to all sections of society due to increasing prices, Pakistan Bureau of Statistics reports the food and beverages prices increased by 23.6% in January 2020; non-availability of essential food items; reduction in earnings making goods and service out of their reach; the rising inflation of 14.56%; and the lack of jobs. All these confirm ineffective governance,” Senator Nisar Memon pointed out. 

“The effectiveness of governance could not have been out of sight of citizens if speedy and affordable justice was provided at the doorstep of citizens. The pending cases, 1.9 million according to Law and Justice Commission of Pakistan, due to lack of enough courts is causing hardship to people. The free education committed in the Constitution is yet to be provided, the poor quality of education in government schools, and the inadequacy of curriculum to prepare them to participate and contribute to economy of the country is yet another consideration,” he explained. 

“The level of basic health facilities and the medical services is forcing citizens to go for private medical services at huge costs and burden, it is reported in November 2019, in private hospitals a normal delivery package costs Rs. 200,000-300,000 and average cost of a private room between Rs. 8000-15,000 per day without healthcare facilities. The utility service bills include innumerable and unclear taxes and these days the jacked up wrong bills are adding insult to injury,” he added. 

He didn’t mince words in stating that all the economic hardships have reportedly increased the societal pressures leading to suicides, crime rate and terrorism. 

"The effective governance requires unity in rank and file of all institutions, which too is wanting. The burden of which lies on government leadership which must plan meticulously by taking all pros and cons of policies before launching them and then have patience and firmness to see them through,” he reckoned. 

The former federal minister emphasized that governance can be effective and decisive if coupled with sustainability. “In 2016, we committed to 17 Sustainable Development Goals (SDG) of UN and government will be better advised to tune itself to achieve them in the interest of its own people. The government talks of mafias who must be defeated at all cost. The fast eroding value system can be addressed by the trust in capability and capacity of government and by isolating unprincipled corrupt interest groups from government. Even the perception will affect the governance with its far-reaching impact on lives of people,” he thought. 

“The government cannot be at war internally and externally all the time. Creating crises to cover up deficiencies leads to question: do we have governance? The internal strength of governance is likely to provide impetus in resolution of external issues,” he advised. 

“Our tremendous resources must be mobilized by developing indigenous economic systems and not by representatives of the outside forces. Our youth, with 49.2% being female population, is our strength if harnessed by human resource development and providing them the opportunities,” he continued. 

“It is time to let the youth take leadership of country; this will also help achieve happiness with them taking ownership of challenges. Are people happy? It can be measured not by economic indicators alone but by social indicators as practiced for years in a small country like Bhutan,” he reminded. 

“The drifting away from Quaid’s guiding principles is yet another challenge to governance. The independence and security can be assured if sovereignty in governance is kept in focus while framing all our policies like: foreign, defence, economic, social, judicial and we replace the colonial laws and colonial way of life in the interest of our country and its citizens. A sovereign Pakistan’s vision will be the one to unite the nation towards making the country and institutions strong by protecting, preserving and developing Pakistan for all its citizens,” he concluded.

Sindh Minister vows to protect rights of minorities

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

The Sindh Minister for Information, Local Government, Housing, Town Planning, Religious Affairs, Forest and Wildlife, Syed Nasir Hussain Shah, vowed to protect the rights of the minorities.

Having participated in the ongoing religious festival in Swami Narayan temple in Karachi, the provincial minister expressed his solidarity with the religious minorities and categorically acknowledged that the role and contribution of the members of the minorities in the development and progress of the country was commendable. 

“Following the teachings of Quaid-e-Azam Muhammad Ali Jinnah, the Pakistan People’s Party (PPP) government has always remained committed towards protecting the rights of the minorities,” he remarked on the occasion. 

“The Sindh government would continue to do so under the guidance and leadership of the PPP Chairman, Bilawal Bhutto Zardari. It was the government of the PPP which always reserved seats for the members of the minorities more than any other political party in the country,” Nasir Hussain Shah added. 

He recalled that the PPP, through plenty of legislations, had protected the rights of the minorities in the province with the Sindh Child Marriage Restraint Act being another example. The Minister vowed that the Sindh government would continue to introduce whatever legislation needed for the protection of the members of the minorities. 

Nasir Hussain Shah announced that the Sindh government would make available 10,000 copies of Bhagavad Gita for the members of Hindu community soon. 

A Hindu delegation led by Pandit Shayam Nand and Ram Yoga Das, who came from Australia to attend the festival, also met with Syed Nasir Hussain Shah and his delegation that included special coordinator to Sindh Chief Minister, Shahzad Memon, Dr Lal Chand Ukrani and Chairman DMC South Malik Fayaz.

Healthcare workers bring about meaningful reduction in blood pressure

By Abdul Qadir Qureshi

(Pakistan News & Features Services)

A multi-country research study in Pakistan, Bangladesh and Sri Lanka, has found that a low-cost, multi-component intervention helped deliver a clinically meaningful reduction in blood pressure levels among patients living with high blood pressure, or hypertension, as well as better control of the condition.

Published in the New England Journal of Medicine, the multi-country intervention trial, Control of Blood Pressure and Risk Attenuation of Bangladesh, Pakistan, Sri Lanka (COBRA-BPS), evaluated the effectiveness of a range of interventions consisting of home visits by community healthcare workers to monitor blood pressure (BP) and provide lifestyle coaching, coupled with physician training and coordination with the public health care infrastructure among 2,550 individuals with hypertension living in 30 rural communities in the three South Asian countries over two years.

At the end of the study, the decline in mean systolic BP was 5 mmHg greater in the intervention group versus the control group, which received the usual care. Reduction in mean diastolic BP and BP control (<140/90 mmHg) was also better in the intervention group. The intervention also increased adherence to anti-hypertensive medications and lipid-lowering medicines, and improved some aspects of self-reported health. Additionally, there was a suggestion of a reduction in deaths in the intervention group.

“A sustained 5 mm Hg reduction in systolic BP at a community level translates into about a 30 per cent reduction in death and disability from cardiovascular disease,” Professor Tazeen H. Jafar from Duke-NUS Medical School, Singapore, who is the principal investigator of the three-country study, remarked.

“Our study demonstrates that an intervention led by community health workers and delivered using the existing healthcare systems in Bangladesh, Pakistan, and Sri Lanka can lead to clinically meaningful reductions in BP as well as confer additional benefits all at a low cost,” the professor added.

Uncontrolled hypertension is a major risk factor for cardiovascular and kidney diseases, and a leading cause of premature death globally leading to adverse economic consequences.

In Pakistan one in three adults suffered from high blood pressure, according to a 2016 study by the Pakistan Health Research Council. The control and prevention of non-communicable diseases (NCDs) such as hypertension is a global health priority with targets under goal 3 of the Sustainable Development Goals calling for a one-third reduction in deaths caused by such diseases by 2030.

Hypertension is a lifestyle disease and can be prevented and controlled by changing dietary and living habits. Risk factors that can cause hypertension include an unhealthy diet, being overweight or obese, physical inactivity and a sedentary lifestyle, smoking, psychosocial stressors, and excess alcohol consumption.

Aga Khan University’s Dr Imtiaz Jehan, the study’s country principal investigator in Pakistan and a co-author, said: “Uncontrolled hypertension, a lack of public awareness of the disease and its contributing risk factors, as well as inadequate anti-hypertensive medicine use are alarmingly high in Pakistan.”

“Controlling BP through lifestyle modifications and antihypertensive therapy can be the single most important way to prevent rising rates of cardiovascular disease and deaths in Pakistan. This trial seems timely to furnish evidence regarding sustainable and low-cost pragmatic solutions for effective BP control that can be integrated into our public primary healthcare system of lady health workers as well as referrals to basic health units through standardised training and task shifting,” Dr Imtiaz Jehan added.

Aga Khan University’s Dr Aamir Hameed Khan, the study’s co-investigator in Pakistan and a co-author highlighted the need to create a mechanism for refresher trainings for public and private sector physicians in order to effectively manage and control hypertension. He noted that the trainings provided through the trial were well received by physicians and local authorities. 

“The public health implications of our findings are significant. A low-cost programme like ours could be adapted and scaled up in many other settings globally, using the existing healthcare infrastructure to reduce the growing burden of uncontrolled hypertension and potentially save millions of lives, as well as reduce suffering from heart attacks, strokes, heart failure and kidney disease,” Professor Jafar added.

A formal cost-effectiveness analysis is currently underway by Professor Eric Finkelstein, a health economist at Duke-NUS and the Duke Global Health Institute. Early estimates by the study group suggest that scaling up the COBRA-BPS intervention nationally in the three countries would cost less than US$11 per patient annually.

This is the first multi-country trial of its kind and a model of South-South collaboration. While there are differences in the health systems and some population characteristics in the countries involved, BP control rates are uniformly poor in all of them. Nonetheless, the study found that similar results were achieved in all three countries with the standardized strategies, suggesting that the intervention has validity in different settings.  

The COBRA-BPS study is led by Professor Tazeen Jafar and her team at Duke-NUS Medical School in Singapore in partnership with Dr Imtiaz Jehan from Aga Khan University, Pakistan; Dr Aliya Naheed from the International Centre for Diarrhoeal Diseases Research, Bangladesh; and Prof Asita de Silva from the University of Kelaniya, Sri Lanka, leading the trial as country principal investigators in the three countries respectively. 

The study is funded by the Joint Global Health Trials scheme, which included the Medical Research Council, the UK Department for International Development (DFID), the National Institute for Health Research (NIHR), and the Wellcome Trust.

AKU Surgical Conference calls for systemic approach to reduce injury deaths

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

The experts, while speaking at the inaugural session of the 5th AKU Annual Surgical Conference, having the theme Trauma: Striving for Change, reckoned that thousands of injury deaths every year in Pakistan could be averted by taking safety measures on one side and by adopting a systematic approach to improve trauma care on the other side. 

A systematic approach ensures that life-saving interventions are performed in a timely manner and that no life-threatening conditions are missed, the speakers at the event, organized by the Aga Khan University (AKU), noted. 

As per the World Health Organization (WHO) guidelines, such an approach could consist of emergency care in the form of first aid being provided by a trained bystander, who can also call an ambulance, equipped with necessary life support and at least two personnel, one to monitor and manage the patient and the other to drive. Ambulance personnel should be able to communicate to a relevant hospital prior to arrival, if needed. 

During the handover, the ambulance provider should share critical information with hospital personnel, who then triage patients to different areas based on the seriousness of their condition. 

Research from the conference was published in a special supplement of the Journal of the Pakistan Medical Association (PMA). 

During the event, Professor Syed Ather Enam, chair of the Department of Surgery at AKU, referred to a case report of a two and half-year old boy, who sustained three gunshots at point-blank range. 

The child was unresponsive when the terrified family brought him to the emergency department of the Aga Khan University Hospital after trying two nearby hospitals. 

When the patient did not respond to initial resuscitation efforts, a team of paediatric, cardiothoracic and orthopaedic surgery, and paediatric anesthesiology specialists was taken on board and he was moved to the operating room immediately. 

“Today, he is a healthy four-and-a-half-year old schoolgoing child. There could be thousands of people who were not lucky like him. That’s because our hospitals lack multidisciplinary teams of specialists and the emergency care system as a whole is short of fully equipped ambulances and trained bystanders,” Professor Enam said. 

The AKU’s Annual Surgical Conference brought together national and international experts with expertise in pre-hospital care, mass casualty, rehabilitation, prevention and disaster management. 

“Since blood loss is the leading cause of preventable death following injury, rapid control of bleeding at the scene of an event can be lifesaving, especially if bystanders can step in to help before emergency responders arrive,” Eileen Bulger, a professor of surgery at the University of Washington, remarked. 

On the second day of the conference, the AKU’s upcoming Centre of Excellence for Trauma and Emergencies, and partners will launch a national life-saving initiative focused on bystander training in life support. Emergency care is essential to many targets of the United Nations’ Sustainable Development Goals. Under SDG 3, good health and wellbeing: Post-crash emergency care and rehabilitation has been estimated to play a role in preventing 40 per cent of road traffic deaths. 

"Also, timely emergency care access is critical to effective universal health coverage. Emergency care can also contribute to efforts to achieve targets under 10 more SDGs by addressing non-communicable diseases, obstetric complications, child health issues, and injuries related to disasters and violence,"Hasan Badre Alam, a professor of surgery at the University of Michigan, informed.

The AKU Vice Provost Anjum Halai, Medical College, Dean, Adil Haider, and chair of the event’s organizing committee Hasnain Zafar also spoke at the conference. 

The Annual AKU Surgical Conference, organized by the Department of Surgery at the AKU in Karachi, offered unparalleled hands-on and didactic learning opportunities, timely discourse on the most relevant surgical practices and research and networking with peers. The last year’s conference had focused on the global surgery.

Idarae Ilm Dost making its presence felt

By Abdul Qadir Qureshi 
(Pakistan News & Features Services)

Idarae Ilm Dost, a forum founded by Shabbir Ibne Adil and like-minded contemporaries, has started making its presence felt by holding programmes regularly. 

The latest event was organized at the KMC Officers Club, located at Kashmir Road, on February 14 in which the accomplishments and contributions of the legendary quartet of Hakim Muhammad Said, Mirza Ghalib, Ibne Insha and Josh Meleehabadi were recalled by various eminent personalities. 

Although none of the high ranking officials of the Karachi Metropolitan Corporation (KMC) was present on the occasion, there were quite a few worthy intellectuals brightening the premises of the KMC Officers Club. 

The initiatives of Shabbir Ibne Adil and his group of friends augur well for the literary minded community of the metropolis, which has witnessed a dearth of such activities over the years.

Shabbir Ibne Adil, who has had successful career at the Pakistan Television (PTV), deserves to be complimented for devoting his energies towards this cause and it’s being hoped that he will continue working towards goals despite the mixed response he’s likely to receive for the obvious reasons. 

In an era when reading books is on the way to extinction due a combination of factors, it’s incredibly gladdening to find the likes of Shabbir Ibne Adil trying their level best to remind people about its innumerable virtues. 

The intentions of Idarae Ilm Dost look absolutely inspirational and one hopes that the execution will also be generally right although the presence of a few individuals with dubious reputation makes people skeptical about it. 

It remains to be seen if Shabbir Ibne Adil and his team will be able to overcome the people with vested interests, who have been engaged in blocking healthy traditions.

AKU surgery conference begins on Feb 14

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

The 5th AKU (Aga Khan University) Annual Surgical Conference from February 14 to 16 in Karachi will focus on how these precious lives can be saved by following a systematic approach for improving trauma care, training and research. 

As injury kills more people every year than HIV, TB and malaria combined, and the overwhelming majority of these deaths occur in low- and middle-income countries, the theme of this year’s conference is 'Trauma: Striving for Change' will enable the experts and participants to deliberate on those burning issues. 

The conference will bring together national and international experts with expertise in pre-hospital care, mass casualty, rehabilitation, prevention and disaster management. 

On the second day of the conference, the AKU’s upcoming Centre of Excellence for Trauma and Emergencies, and partners will launch a national life-saving initiative focused on trauma care.

Innovative solutions proposed to boost emergency preparedness at schools

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

The students, teachers, engineers and experts from different walks of life gathered to design cost-effective and locally-relevant solutions to enhance the ability of schools to manage natural and man-made disasters, during a three-day hackathon at Aga Khan University’s Institute for Educational Development. 

The participants at the event noted that the rare nature of emergencies such as fires, floods and other safety hazards meant that public and private sector schools were unprepared and ill-equipped to deal with such crises. 

Unfortunately, such one-off events can have a disproportionate, and often catastrophic, impact on a school’s operations and stakeholders. That’s why emergency response trainings, safety drills and other means of ensuring emergency preparedness need to be a regular part of a school’s strategic planning and processes, the speakers pointed out. 

The experts added that mitigation measures were often taken in the aftermath of disasters as they called on schools to adopt a forward-thinking approach that considered all possible risks in their environment as well as the processes needed to effectively manage a disaster. 

One of the three winning teams at the event, BVS School Team, highlighted the problem of fires caused by short circuits in computer labs, classrooms and staff rooms. 

They noted that the simple, preventive step of installing a carbon dioxide chamber inside electrical switchboards could stop a potential fire at its source and reduce the threat of loss of life and property. Other teams at the event identified the way safety drills were conducted as being a problem. 

“The customary drills that happen in my school are casually planned. There is no seriousness exhibited on the part of student body or administration. It’s critical that the mindset changes before any calamity strikes again,” Ahsan, a high school student taking part in the hackathon, remarked. 

Team Zords proposed the use of virtual reality (VR) technology to ensure active participation in safety drills. They stated that VR provided an immersive experience for trainees which enhanced the retention of key concepts. The team called on schools to prepare tailored sessions and a ‘safety curriculum’ that would enable them to impart safety drills in a more engaging manner. 

The final winning team at the event, ER Tales, also selected the problem of a lack of attention during drills leading to ineffective response during emergencies and disaster situations. 

They suggested the use of pictorial storybooks as a supplement to drills. The use of stories centered on safety would build interest in the subject and drills could then be used to assess the level of knowledge and ability to effectively respond to a situation. 

During the hackathon, Zara Qadir, a primary school teacher, shared an instance of the impact of effective security drills. 

She recalled hearing a siren in class and seeing her students spring into action to shut the windows and switch off the lights before they all hid under their desks. Zara mistook the siren, which was for an intruder alert, for a fire alarm. 

When she asked students to leave the room to head for the fire assembly point, they responded that they were supposed to hide and stay invisible in order to stay safe. 

“The purpose of our hackathons is not only to mobilise people within the organization, but also to demonstrate the event’s ability to engage the external community in the innovation process. The school preparedness for emergencies hack is a classic example of that democratisation of the innovation process,” Dr Asad Mian, founder of AKU’s Critical Creative Innovative Thinking Forum (CCIT) and chair of emergency medicine at the University, observed. 

"We are thrilled to see the energy and creativity the participants have poured into this hackathon. Creating safe schools is not an afterthought now: it is a priority and the community is working together to design solutions to help schools prepare for emergencies,” Azra Naseem, one of the event’s co-organizers, a faculty member at AKU’s Institute for Educational Development and associate director of the Blended Learning Network at AKU, added. 

The event was organized by AKU's Institute for Educational Development and CCIT forum in collaboration with the University’s departments of emergency medicine, and safety and security.

AKU’s CIME becomes South Asia’s first simulation-based educational institution

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

The Aga Khan University’s Centre for Innovation in Medical Education (CIME) has become South Asia’s first simulation-based educational institution to be accredited by the US-based Society for Simulation in Healthcare (SSIH). 

The University’s CIME was judged to meet the highest standards in simulation-based education by the SSIH which has accredited over 170 centres in 19 countries around the world. The accreditation means that CIME will join a global community of practice bringing the latest advances in the field to Pakistan. 

The simulation-based education represents a significant advance on traditional classroom and theory-based instruction. 

Designed to be an immersive ‘real world’ experience, simulation, in the field of healthcare, enables medical and nursing trainees and professionals to practice key skills and techniques, using virtual reality and high-fidelity patient mannequins, in a risk-free environment before working with patients. 

The CIME Director Charles Docherty, Dr Robert J Buchanan, Professor in Teaching and Technology, received the award during a ceremony in San Diego. In his speech at the event, he noted: “Healthcare is both an art and a science. While textbooks and teachers can teach concepts, simulation-based education augments the academic experience by challenging students to apply their knowledge and inter-personal skills in realistic settings.” 

“The result is that students feel more confident when they begin practicing as they are already familiar with the equipment to be used and the processes to be followed. This leads to a much better experience for students and patients,” he added. 

As a pioneer in healthcare simulation in Pakistan, the 80,000 square feet CIME is Pakistan’s only facility that enables aspiring doctors, nurses, dentists and allied health professionals to work collaboratively on a range of challenging, technology-enhanced patient scenarios. 

“The CIME was founded with the vision of introducing state-of-the-art learning technologies to raise overall standards of healthcare education across Pakistan. There are simulation centres around the world that have been operating for decades without achieving accreditation from the SSIH. We are very proud that CIME has been able to achieve this distinction within two years of its formal inauguration,” the AKU President, Firoz Rasul, remarked. 

The CIME runs over 200 simulation-based courses, ranging from basic life-support to complex birth scenarios that have improved the skills of thousands of healthcare professionals to date. 

“We’re pleased to recognize Aga Khan University’s Centre for Innovation in Medical Education for meeting the highest standards in the practice of simulation in healthcare. The Aga Khan University now joins the ranks of over 170 institutions from 19 countries,” Kristyn Gadlage, Director of accreditation at the Society for Simulation in Healthcare, announced. 

The CIME is open to students from other universities and healthcare institutions across Pakistan and is currently working with public sector bodies in the country as well as centres in Kenya, Uganda and Egypt on initiatives to raise the standard of simulation-based healthcare education.

Eminent cardiologists speak at Pulse 2020

By Abdul Qadir Qureshi
(Pakistan News & Features Services)

Dietary practices are a major risk factor for cardiovascular diseases and diabetes in Pakistan because health practitioners have difficulty translating international recommendations according to local diet. In the absence of any national data on dietary consumption, health practitioners are unaware of what people are consuming. 

There is a need for an operational policy and an action plan to promote healthy eating and active lifestyle, the speakers noted at the First Cardiovascular Conference ‘Pulse 2020’ held at Aga Khan University (AKU), Karachi. 

Cardiovascular diseases are the number one cause of death in Pakistan, according to the Global Burden of Disease Study 2017, and the country has committed to reducing the burden of such diseases by a third by 2030 under goal 3 of the sustainable development goals. 

The experts at the three-day conference stressed that the epidemic poses many challenges in the country due to the high cost of diagnosis and treatment and lack of prevention knowledge among patients. 

“Health is a partnership between a patient and his/her doctor, so empowerment has to happen from both ends. Right choices in dietary practices need to be picked by patients and advised by health professionals,” Dr Saira Bukhari, an assistant professor of cardiology in the department of medicine, remarked. 

There have been well-designed studies in the last few years which have found that diets which are inclined towards one set of nutrients as opposed to others don’t work and do more harm than good. 

“Such dietary practices are in contradiction to how the human body functions. It is all about having a diet of moderation,” Dr Romaina Iqbal, associate professor and section head for non-communicable diseases, NCDs, in the department of community health sciences at the AKU, added. 

Dr Romaina Iqbal recommended eating a balanced diet composed of complex carbohydrates, a variety of nutrients along with 150 minutes of moderate-intensity physical exercise for adults of all ages. 

The speakers noted that numerous dietary plans catch media’s attention and people adopt them. The experts stressed that health practitioners need to introduce the language of prevention with patients. 

The knowledge of symptoms of cardiovascular diseases such as chest pain, shortage of breath, unusual heart beat and loss of consciousness are some of the indicators that patients should be informed about. 

Dr Saira Bukhari said that ideas promoting stereotypical notions of age and health such as how cholesterol and blood pressure numbers should be at a particular age should be discouraged. 

“Patients need to be enabled to make informed choices of their health because every delayed intervention increases the chance of heart attacks and even stroke,” she added. 

The keynote speaker, Dr Faiez Zannad, a cardiologist and clinical pharmacologist at Université de Lorraine in France, reckoned that the global progress in treating heart failure has been spectacular in the last 25 years with mortality declining three fold in dedicated clinical trials, pointing out that evidence from global clinical trials show income inequality as a factor determining clinical outcomes in heart failure. 

“It is desirable that patients and investigators from Pakistan get involved in global trials and join the efforts of knowledge production,” he said. 

Two other keynote speakers who spoke at the conference included Dr Jospeh Kisslo, professor of medicine at Duke University Medical Center and Eric Velazquez, professor of medicine at Yale University. 

The conference was held in collaboration between AKU’s section of cardiology and department of medicine, the Association of Pakistani-descent Cardiologists of North America, the Pakistan Hypertension League and the Pakistan Aspirin Foundation. The event was attended cardiologists, postgraduate students, nurses, nutritionists and other healthcare professionals.