Internship Report Al-Khidmat Foundation Pakistan

1.1: Non-profit organization

A non-profit organization (NPO) is one which is not driven by profit but by
dedication to a given cause that is the target of all income beyond what it takes to run
the organization. Non-profit organization are often used for trusts, cooperatives,
advocacy, environmental and religious groups. The mission of every NGO is to serve
humanity. The term NGO (non-government organization) are also often used
interchangeably but they are different. NGOs are separate from government and require
no government council but depend on the government for funding. However, most
NGOs are non-profit organization.

1.2: Profile of the organization

Al-Khidmat Foundation Pakistan is one of the leading, non-profit

organizations, fully dedicated to humanitarian services. Al-Khidmat workers and
volunteers continue to work tirelessly for relief of affected people across Pakistan
and worldwide. Their services include Rescue and Relief, Rehabilitation and
Development, Education, Healthcare, Community Services, Microfinance and
Orphans Care Program.

It was authoritatively enrolled in 1990 as an NGO having 4500 paid

employees and 5500+ registered volunteers. AKFP having 12 departments in their head
office. Al-Khidmat Foundation Pakistan is a continuation of a half a century old
tradition of relief and philanthropic work. Its services actually started with the creation
of Pakistan. With the vision of “SERVE TO HUMANITY” Al Khidmat Foundation
Pakistan registered on 1990, as an NGO under the Societies ACT. Al khidmat founded
on a principle to serve humanity without considering anyone’s religion, color, caste, or
race.

Al-Khidmat Foundation Pakistan being non-political, non-governmental and non-

profit organization is committed to serving humanity especially vulnerable and orphans
without any kind of discrimination to contribute in their well-being of health, education,
financial sustainability, livelihood, shelter, availability of clean water, mosques, savage
of disaster and other aspects of life and for welfare of its employees by means of
resource mobilization and developing partnership with

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Figure 1.1: Building of Al-Khidmat Foundation

NGOs, other concerned public & private organizations, supporting, engaging in and
during useful programs and doing all such acts, deeds and things required to
achieves above with integrity.

Division of AKFP

There are following divisions of Al-Khidmat foundation

• AJK
• Quetta
• Karachi
• Punjab
1.2.1: Magnitude of AKFP

Al-Khidmat Foundation, the largest organizational set-up running in

multidimensional areas in Pakistan and around the world. With Presidents motto’s
others that whilst passing the life, don’t let to live with hardships and difficulties, yet
extend your every possible assistance to others, in case, any assistance is sought from
you, to live with happiness and ease. Al-Khidmat foundation services is an open book
that has many remarkable chapters, one of them is offering supporting system to the
handicapped like wheel chairs, crutches, and so on, family planning counselling,
maternity services, national and international relief efforts during the disasters to
provide relief to the victims of natural calamities.

AKFP strongly believes in protecting basic human rights without any discrimination of
color, caste, and creed. “Service for humanity” that is spanned over years, thus our

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efforts and services are greatly liked and commended by all schools of thought, across
Pakistan and many parts of the world.

1.3: PROJECTS

1.3.1: Orphan care program

Orphans are those helpless souls who endure the greatest suffering on earth as a
result of the lack of adequate parental care. Being the most suffering group in
society, they require a lot of assistance to get their lives back to normal. people who
step up to support these orphans may lessen the severity of their danger and receive
the finest rewards in the hereafter, Pakistan is home to more than 4.6 million orphan
children, the bilk of them are under the age of 17, according to the United Nations.
Social depravity affects a substantial section of the society, and it need to be
urgently addressed.

Figure 1.2: Region wise Beneficiaries

Al-Khidmat Foundation Pakistan is currently sponsoring over 12,000 orphan children

through the Orphan Care program. With just PKR 3,500 per month, you can also
sponsor an orphan to transform the child’s life for good. Al-Khidmat Foundation
Pakistan is here to facilitate you in this outstanding journey. Keeping in view the plight
of orphans in Pakistan, Al-Khidmat Foundation Pakistan has been working for the cause
of orphans through its “Orphan Care Program”. Al-Khidmat OCP focuses on the
education and social uplifting of the orphans with two different approaches.

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1.3.2: Clean water

Pakistan is on its way to become a water deficient country as it already stands at
30th position among the most water-deficient countries of the world. Safe drinking
water is one of Pakistan’s most immediate and crucial problems that demands earliest
actions to taken for its resolution.

Figure 1.3: Servile wise Beneficiaries

AKFP is practically active to ensure the provision of clean drinking water by installing
hand-pumps in arid lands, drilling water-wells in remote water-scarce areas, installing
water-filtration plants in cities, and supplying water to homes in villages through its
water schemes. Alkhidmat clean water program takes every possible measure according
to the needs of the water-scarce regions to implement its mission.

Though its urban and rural network, Al-Khidmat has set up a number of water
desalination projects in the urban centers and well-water facility and community hand
pumps in rural areas. At the same time, al-khidmat organizes programs on intake of
clean and safe water and holds awareness drives on waterborne diseases as well.

1.3.3: Mawakhat program

Mawakhat brought great benefits for both the Muhajirs and Ansars as Allah
blessed both of them with plenty of affection between both and increased the utility of
their shared wealth (Barkah). With the sense of gratitude, Muhajirs loved and respected
Ansars and worked hard to earn their livelihood and Ansars respected their efforts and
appreciated them to excel and prosper. Al-Khidmat Mawakhat Program was initiated
with the objective of providing interest-free microcredit to the poor and needy to help
them start a business, earn a respectable income and improve their standard of living.
Al-Khidmat Mawakhat program is dedicated to improving the lives of the poor; those

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who are financially unstable and are in seek of an opportunity to find their way for a
respectful earning. This program is truly based on the Islamic values that provide the
poor with interest-free loans so that they may acquire a livelihood, skill to earn and
support their needs to reach their full potential. The program is based on the principle
of Qarze-e-Hasna, helping someone in need with an interest-free loan.

Objectives of Mawakhat program:

• To provide interest-free microfinance services to poor families enabling them

to become self-reliant.
• To promote interest-free loans (Qarz-e-Hasna) as a viable model and a broad-
based solution for poverty alleviation.
• To provide social guidance, capacity building, and entrepreneurial training.
• To transform beneficiaries of the Al-Khidmat Mawakhat Program into future
Donors.
• To contribute towards the establishment of a socially responsible community
through awareness, enrolment, and training.
• To institutionalize the spirit of brotherhood.

1.3.4: Community Services

Pakistan is facing multifarious social problems for year ranging from poverty to civic
ignorance and lack of basic facilities of life. People face severe problems in terms of
health and economy. The country stands at 152th position in Human Development
Index (HDI) and almost 51%of Pakistan’s population is deprived of basic necessities
(health, education etc.).

Figure 1.4: Community Services

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“The best amongst you is the one who helps others”

These projects include the distribution of ration bags, Eid gifts, Ramadan
Packages, clothes distribution, collecting funds for treatments as well as
marriages of the needy and other such services in the times of need. Our
community services can help many different groups of people: children, senior
citizens, people with disabilities, even animals and the environment.

• Qurbani
Pakistan is a Muslim country as Islam is the official religion. The majority of the
people are Muslims and fortunately, all of them are practicing Muslims.
Unfortunately, a large number of the population lives below the poverty level while
another major portion belongs to the lower middle class. In such a crucial
circumstances people can’t afford Qurbani (slaughtering a cattle) on the occasion
of Eid-ul-Adha. The price of meat in Pakistan has multiplied to such a magnitude
that a common man can’t even think to buy meat for his family.

Al-Khidmat Qurbani program ensures the provision of Qurbani meat to the

rightful poor and needy in the country. Al-Khidmat arranges for the procurement of
healthy animals and their slaughtering on international standards and then
distributes the meat among the poor and needy all across Pakistan. If you want to
share the happiness of Eid –e- Qurban with the poor and needy Muslims, you can
donate for the cause online. Al-Khidmat Qurbani project is run at the same time in
all provinces of Pakistan.
• Ramadan package
Ramadan is one of the most blessed months of the year as the holy Quran was revealed
in this month. It is the ninth month in the Muslim lunar calendar. Healthy adult Muslims
fast in Ramadan from dawn until dusk. This includes abstaining from eating, immoral
acts, and anger. Other acts of worship such as prayer, reading the Quran and charity are
also encouraged during Ramadan. During the holy month, we, the Muslims would wake
up early to eat a pre-dawn meal Suhoor, and they break their fast with a meal referred
to as an Iftar.

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It is common for rich people to host large Iftars, especially for the poor and needy as
this month spreads the message of self-restraining and understanding the real meaning
of life.

Figure 1.5: Rashan Bags

A large number of affording and rich people can’t manage to host such Sahoor and
Iftaar while most of them don’t have access to reach the poor and needy in this month.
Al-Khidmat, on their part, does the duty and arranges for Iftaar and Sahoor of poor and
deserving people across Pakistan throughout the month.
If you want to serve the cause of humanity and share the blessings of Ramadan with
our poor and needy Muslims brothers and sisters, you can send your donations to Al-
Khidmat Foundation Pakistan.

1.3.5: Disaster Management

The term "disaster" conjures up countless images of danger in the imagination

of the listener. It brings to mind the tragic 2005 earthquake that struck Pakistan's
northern regions, killing thousands of people and displacing millions more others. A
devastating flood also devastated a sizable portion of Pakistan in 2010. The amount of
human suffering in Pakistan has been significantly increased by sporadic acts of
terrorism, accidents, and other tragedies. Al-Khidmat Foundation Pakistan has been
working hard in the area of disaster management because it is dedicated to its goal of
serving humanity, and the team's services during floods, earthquakes, and other
calamities are recognized as badges of honour. "The person who helps others is the best
of you all”.

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1.3.6: Education

Education is the only solution for humanity to prosper. With an aim to help
every child to get an education. AKFP has taken lead among all its competitor by
providing education through free schooling and rehabilitation support to the poor and
needy children. Al-khidmat’s helpful undertakings encircle all matter and issues related
to education in Pakistan. There are a lot of unfortunate students in Pakistan, particularly
in the country's distant, rural, and slum areas, whose families are unable to pay for their
school uniforms, bags, books, shoes, and other supplies. Al-Khidmat regularly provides
these impoverished children with school supplies.

Figure 1.6: Education

Alkhidmat helps street and deserving children by giving them free school
supplies, uniforms, and books. It also awards Alfalah scholarships to gifted
students. managing 72 madras under its auspices that provide quality education
on contemporary lines and in compliance with Islamic principles. Students from
other cities can also use the hostel facilities.

• Child protection center

The project intents to give street kids access to official and informal
education, leisure activities, health and hygiene campaigns, psycho-social
counselling and other services in order to encourage them to attend school and
further their education. Instead of living in landfills and dumpsites, the
beneficiaries are given a safe area to live in and educational assistance. When this
project is finished, street children will be able to live independency and normally.

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There are numerous Child Protection Centers in Pakistan thanks to the Al-
khidmat Foundation Pakistan.

Figure 1.7: Child Protection Center

• Schools
The project aims to provide street children with formal & informal education,
recreational activities, health & hygiene campaigns, psycho-social counselling
and to convince them to go to school and pursue their education. The
beneficiaries are assisted in terms of education and they are provided a protective
environment to live in instead of the dumpsites and landfills. The completion of
this project will enable street children to be self-reliant and have a normal life.
Al-Khidmat Foundation Pakistan has established many Child Protection Centers
across Pakistan.
• Scholarship program

Al-Falah Scholarship Program frequently collaborates with the talent Scholarship

Program in its administration. Al-Falah Scholarship Scheme has been in operation for
16 years, and many outstanding but disadvantaged students have been given out by the
Al-Khidmat Foundation Pakistan to deserving students.

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Figure 1.8: Scholarship Program

• Skill Development
Al-Khidmat skill Development Center is a unique initiative wherein unemployed
youth are given free training in various technical professions such as tailoring, generator
repair, carpentry, electric work etc. The intention is to establish the youths on their feet
and make them financially independent.

Figure 1.9: Skill Development

1.3.7: Healthcare Services

The World Health Organization (WHO) has enlisted Pakistan among 57

countries with Critical health workforce deficiency while the country is placed at
122nd position in terms of quality of healthcare facilities. Unfortunately, Pakistan
stands high in the list of top countries with extreme infant mortality.

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Figure 1.10: Health care

Alkhidmat Health Foundation is leading this Project. AHF has a network of 40

hospitals ,63 medical center, 40 pharmacy, 426 medical camps and 131 laboratory
of collection center.

Alkhidmat foundation helps the underprivileged patients. Its diagnostic

centers provides more reliable and authentic reports, with the help of its latest
imported diagnostic equipment in its diagnostic centers and qualified medical
staff. Alkhidmat foundation is operating 119 diagnostic laboratories and collection
centers all over the country. Alkhidmat laboratories have latest and digital
machinery to perform PCR, X-RAY,MRI ,hepatitis ,HIV and many other tests.
Collection centers and instant reports with free of cost services to deserving people
makes its difference. Alkhidmat foundation have 45 laboratories across Punjab
with Annually ten thousand free tests for the deserving and poor patient.

• Diagnostic Center

Diagnosis is a process of identifying a medical condition or disease by its

symptoms, and from the results of various diagnostic procedures, by using techniques
such as biochemical, radiological, magnetic resonance and ultrasound. The
consequential conclusion is known as [Link] is a growing need of diagnostic
services in Pakistan as public-sector facilities are either very poor or nonexistent. Most
equipment and services at public hospitals are primitive and often non-functional, as
such diagnostic results at these facilities are questionable. Diagnostic Services and
Clinical Laboratories have become an extremel profitable business, especially in

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remote and rural areas of Pakistan while in public sector the diagnostic services are
very poor. Al-Khidmat Foundation Diagnostic Network through its Diagnostic centers
provides more reliable and authentic reports with the help of its latest imported
diagnostic equipment in its diagnostic centers and qualified medical staff. Al-Khidmat
Foundation Pakistan has always been striving to serve the poorest segment of the
society. Keeping in the view the situation of poor infrastructure of health sector in
Pakistan, we have started a number of projects to improve the situation by provision of
facilities for the general public, regardless of their socio-economic status.

Figure 1.11: Diagnostic Center

1.4: ALKHIDMAT LAB LAHORE

AKL is working under the umbrella of Alkhidmat Health Foundation, a sub
department of Alkhidmat Foundation Pakistan. It is registered with Punjab Health Care
Commission (PHC). It has a blood bank that is a licensed Blood Bank from PBTA. It
is also running a Thalassemia Care Center where thalassemia care is given free of cost
that include Treatment, Blood Transfusion, Diagnostic Follow-up and Entertainment.
Thalassemia Care Center and Blood Bank is strictly under the supervision of
Hematologist.

1.5 Other Services

To provide credible diagnostic services includes

• Chemical Pathology
• Hematology

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• Microbiology
• Biochemistry
• Histo-pathology
• Blood banking
• Molecular Biology

1.6: Vision

Serving the humanity through quality diagnostic services for maximized

healthcare outcome always, everywhere, for all.

1.7: Mission

Affordable, reputable and quality diagnostic services across Pakistan without any
discrimination.

1.8: AIM

• To provide most efficient care treatment in all field specially thalassemia diseases.
• To create awareness in the public about thalassemia and all types of diseases.

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2.1: Organization Structure

Figure2.1: Organizational Structure

2.2: Departments
2.2.1: VOLUNTEER MANGEMENT
o Established in 2015
o 35 partnerships
o Volunteer Team
o Ambassador Team
2.2.2: INFORMATION COMMUNICATION TECHNOLOGIES:

o Provide world wide access

o Working Human Resources
o Qurbani Management
o Domain server
o Exchange server
o Call center

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o Software server

2.2.3: MONITRING AND EVALUTION

o Establish in December
o Data monitoring
o Conducting surveys
o Practical work
2.2.4: FINANCE

o Two types of audits

o Three types of reports
o Detailed discussion of annual report
o Difference between profit motivated firms and NGO’s
o Steps in the accounting cycle
o How to generate a voucher?
2.2.5: AUDIT AND COMPLIANCE

o Two types of standards:

o Accounting standards
o Auditing standards
o Function of the department
o Legal compliance
Society’s act 1860
Social Security
o Pakistan Center of Philanthropy (PCP)

2.2.6: HUMAN RESOURCE

Function of human resource

• Planning for organization, Jobs and people strategic Human Resource Job
Analysis

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• Acquiring Human Resource Equal Employment Opportunity Recruitment

Selection Orientation
• Rewarding Employees Compensation and benefits Performance Appraisal
• Building Performance Training Human Resource Development
• Maintaining Human Resource Safety and Health Labor Relation Employment
Transition
• Managing multinational Human Resource
Evaluation

Human Resource (HR) plans need to be updated on a regular basis. It is important

to establish the information necessary to evaluate the success of the new plan.
Benchmarks need to be selected and measured over time to determine if the plan is
successful in achieving the desired objectives.

Positives

• Profitability rate is satisfactory

• Co-operation between employees and friendly environment
• Strong Liquidity Position

Practical Work

Arranging all the files alphabetically.

HR Manual

Responsibilities of HR

File management

Scanning

Data Entry

2.2.7: MASS MEDIA

o Awareness and fundraising

o Review of Annual Report
o Video Editing
o Workshop

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2.2.8: HEALTH

o Seven working areas

o Learnings
o Duties of pharmacist
o Stages to bleed a donor

2.2.9: Foreign Desk

o This department deals with the receiving of the national and international
receiving of donors.
o They have good relation with their donors so that they are known globally.

2.3: Administration

o Backbone of an organization
o Major responsibilities
o Practical experience

Organization and tagging of files

o Learning file Management of a department

2.4: Volunteers

Volunteers play a key role in any social welfare organization and we value the
time of volunteers. Your time is valued here at AL-Khidmat and we strive to provide
you the experience you will cherish for the rest of your life. We give you the chance to
work foe the humanity by directly involving yourself in our organizational operations.
We know that your time can change the lives of millions of people around the globe.

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Figure2.2: Volunteers

2.5: Events

Various types of recreational activities are conducted for youth and the staff of
Al-Khidmat Foundation. Some of are given below:

o Al-Khidmat Youth Gathering.

o Youth, Culture and peace.
o Leaders Arena.
o Annual Educational Kit Distribution.
o Go green Pakistan.
o Annual health Screening for orphan.
o Spreading happiness.
o International Youth Gathering

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3.1: Introduction to Thalassemia:

Thalassemia is an inherited blood disorder that causes your body to have less
hemoglobin than normal. Hemoglobin enables red blood cells to carry oxygen.
Thalassemia is a genetic disorder in which the patient is dependent on regular
blood transfusion to live. It has emerge as a huge public health problem
worldwide. Thalassemia is an inherited disease of the blood. It cannot be
developed from contact with other people or from the environment. This situation
affects the ability of the blood to carry oxygen to all parts of the body.

3.2: Types of thalassemia

The types of thalassemia described with the help of hemoglobin. It distributes it

into two parts.

• Alpha thalassemia
• Beta thalassemia (Minor, Major)

3.2.1: Alpha thalassemia

Alpha thalassemia is a blood disorder that reduce the production of hemoglobin.

hemoglobin is the protein in red blood cells that carries oxygen to cells throughout the
[Link] people with the characteristic features of alpha thalassemia, a reduction in the
amount of hemoglobin prevents enough oxygen from reaching the body’s tissues.
Affected individuals also have a shortage of red blood cells, which can cause pale skin,
weakness, fatigue, and more serios complications.

Two types of alpha thalassemia can cause health problems. The more severe type is
known as hemoglobin Bart hydrops fetalis syndrome, which is also called HB Bart
syndrome or alpha thalassemia major. The milder form is called HbH disease.

Hydrops fetalis, a condition in which an excessive amount of fluid accumulates in the

body prior to birth, is a feature of Hb Bart syndrome. Severe anemia, enlarged liver and
spleen (hepatosplenomegaly), heart problems, and abnormalities of the urinary system
or genitalia might also be additional indications and symptoms. The majority of babies
with this syndrome are stillborn or pass away shortly after birth due to these

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catastrophic health issues. For pregnant women, Hb Bart syndrome can potentially
result in major consequences like preeclampsia, which is a dangerously high blood
pressure condition accompanied by swelling, preterm delivery, and irregular bleeding.

Figure 3.1: Red Blood Cell

HbH disease causes mild to moderate anemia, hepatosplenomegaly and yellowing of

the eyes and skin. Some affected individuals also have bone changes such as
overgrowth of the upper jaw and an unusually prominent forehead. The features of HbH
disease usually appear in early childhood and affected individuals typically live into
adulthood.

3.2.2: Beta thalassemia

Beta thalassemia is an inherited blood disorder characterized by reduced levels of

functional hemoglobin. Hemoglobin is found in red blood cells it is the red, iron-rich,
oxygen-carrying pigment of the blood. A main function of red blood is to deliver
oxygen throughout the body. Beta thalassemia is caused by damaged or missing genes.
Tow specific genes are involved.

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Figure3.2: Gene Mutations

• Beta thalassemia major

There are two damaged genes. This is the most severe form of this disorder.
People with this condition will need frequent blood transfusion. They may not
live a normal lifespan.
• Beta thalassemia minor or trait
Only one gene is damaged. This causes less severe anemia. People with this
type have a 50% chance of passing the gene to their children. If the other parent
is not affected, the children will also have this form of disorder. This type is
further divided into:

▪ Thalassemia minima: There are few or no symptoms.

▪ Thalassemia intermedia: This causes moderate to severe anemia.

People with beta thalassemia trait usually do not have any symptoms. The might
have a very mild anemia. children with beta thalassemia intermedia or major may not
show any symptoms at birth, but usually develop anemia in the first 2 years of life.
Signs of anemia in beta thalassemia intermedia or major may include extreme tiredness,
pale skin, shortness of breath, a fast heartbeat, moodiness or irritability, slow growth,
change in the shape of bones in the face and head. People with beta thalassemia
intermedia or major also buildup extra iron in the body, either from the disease itself or
from frequent blood transfusions. Extra iron can damage the heart, liver and endocrine.

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3.3: Symptoms

There are several types of thalassemia. The signs and symptoms depend upon the
type. Thalassemia signs and symptoms can include:

▪ Fatigue
▪ Pale or yellow skin
▪ Weakness
▪ Facial bone deformities
▪ Slow growth
▪ Abdominal Pain
▪ Dark urine

Some babies show signs and symptoms of thalassemia at birth; other develop them
during the first two years of life. Some people who have only one affected
hemoglobin gene don’t have thalassemia symptoms.

3.4: Causes

▪ Thalassemia is caused by mutation in the DNA of cells that makes

hemoglobin. The substance in red blood cells that carries oxygen throughout
your body. The mutation associated with thalassemia are passed from
parents to children.
▪ Hemoglobin molecules are made of chains called alpha and beta chains that
can be affected by mutation.
▪ In alpha thalassemia, the severity of thalassemia you have depends on the
number of gene mutations you inherit from your parents.

3.5: Risk factors

Factors that increase your risk of thalassemia include:

• Family history of thalassemia

Thalassemia is inherited that is, passed from parents to children through
mutated hemoglobin genes.

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▪ Ancestry
Thalassemia occurs most often among people of Italian, Greek, Middle
Eastern, Southern Asian and African descent.

3.6: Complication:

Possible complication of moderate to severe thalassemia include:

• Iron overload:
People with thalassemia can get too much iron in their bodies, either
from the disease or from frequent blood transfusions. Too much iron can
result in damage to your heart, liver and endocrine system, which
includes hormone-producing glands that regulate processes throughout
your body.
• Infection:
People with thalassemia have an increased risk of infection. This is
especially true if you’ve had your spleen removed.
• Bone deformities:
Thalassemia can make your bone marrow expand, which causes your
bones to widen. This can result in abnormal bone structure, especially in
your face and skull. If Bone structure expansion also makes bones thin
and brittle, increasing the chance of broken bones.
• Heart problem:
Congestive heart failure and abnormal heart rhythms can be associated
with severe thalassemia.
• Slowed growth rates:
Anemia can both slow a child’s growth and delay puberty.
3.7: Diagnosis

Most children with moderate to severe thalassemia show signs and symptoms with in
their first two years of life. If your doctor suspects your child has thalassemia, he or
she can confirm a diagnose with blood tests.

Blood tests can reveal the number of red blood cells and abnormalities in size, shape
or color. Blood tests can also be used for DNA analysis to look for mutated genes.

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• Complete Blood Count (CBC) that includes measures of hemoglobin and the
quantity and size of red blood cells. People with thalassemia have fewer
healthy red blood cells and less hemoglobin than normal. They may also have
smaller-than-normal red blood cells.
• Hemoglobin electrophoresis is used to diagnose beta thalassemia.
• Genetic testing is used to diagnose alpha thalassemia.
• Reticulocyte count (a measure of young red blood cells) may indicate that
your bone marrow is not producing enough red blood cells.

What food are best for thalassemia?

It is recommended that patients going through blood transfusion should opt for a low
iron diet. Avoiding iron-fortified foods like cereal, red meat, green leafy vegetables &
Vitamin C-rich foods is the best option for thalassemia patients.

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4.1: Role of statistics in Diagnostic lab

Statistics has a very important role in epidemiological and clinical research and
therefore there is strong need for good statistical input. Statistical should be involved at
al l stages of the clinical research from designing the experiment, data collection, data
analysis interpretation to finally writing the report. Statistician’s help in making valid
diagnose, prognostic or therapeutic decision and help policy planners to plan monitor
and evaluate public health initiatives. In the view of statisticians should pursue
opportunities available to gain experience in the field of medical search.

4.2: Internee activities

My university “Lahore College For Women University, Lahore, LCWU”

recommended me to join “Alkhidmat Foundation Pakistan” for internship. Then
I was referred to the Diagnostic Lab of Alkhidmat Foundation Pakistan in
Lahore that is Alkhidmat Lab Lahore (AKL). I worked in the department of
blood bank according to my internship requirements.
Alkhidmat Blood bank is a reputable and well-established blood bank in Lahore
that collect blood, store blood and ensures safe blood supply. I do my internship
in its Thalassemia Care center. The thalassemia care center deals with the
thalassemia patients and provide them all the facilities free of cost that include
Blood Transfusion, Blood tests, Medicines, entertainment, different programs
on national days etc. I feel honored to get a chance to work at this lab. All the
staff members are very cooperative. Mam Mehak Khalid (in-charge of blood
bank) was my mentor and provided me all opportunities to conduct research
there.

4.2.1: Selection of topic

During the first week on internship, my instructor assigned me a topic. We

immediately started working on the given topic and my topic was “Thalassemia
patient”.

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4.2.2: Method of data collection

In the second week of my internship, I was assigned to collect data in the

diagnostic lab for thalassemia patients. By gathering data on various factors
such as height, weight, gender, blood group, and age, I can gain an
understanding of the characteristics and demographics of thalassemia patients.
In which we compile the data of patient height, weight, gender, blood group and
age. Then entered all the data into excel sheet for further processing via
statistical tools. Overall, during the internship, I observed that statistic
department has many responsibilities. They are responsible to summarize and
record the data of lab such as number of new born births and deaths, number of
doctors, number of all the staff members, number of lama’s in all the
departments, number of died patients, number of patients received, admitted and
discharged as well. The assistant of Mam Mehak prepared the report of this data
on MS Excel and Mam teaches us the format of final report.
[Link] LAB
This lab was established in 2015 near Suraiya Azim Hospital, Lahore. It
specifically deals with thalassemia patients with special equipment. With
equipments that are commonly used by Agha Khaan lab and Shokhat Khanam.
This is a great success to have all these equipments in a very short time.
Key Points
• Safe blood provision
• Patient and donor requirement area
• Work station
• Donor bleed area
• Packed red cells
• Fresh frozen blood bottles
• Bags (single, double and triple) these bags are for platelets
• Water bath (37degree)

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About Thalassemia patients

There are 150 registered patients

Days for bleeding (Thursday, Tuesday, Saturday)

HIMS is an online software for data checking of patients.

Also do awareness programs.

4.3: ANALYSIS OF THALASSEMIA

Total 280, consisting male and female patients of thalassemia were included in this
study. The data of patient have been collected form AL-khidmat foundation and it has
been analyzed. Data were collected, managed, entered, and analyzed by statistical
package of social sciences (SPSS) software.

4.4: Descriptive analysis

Descriptive analysis helps to describe, show or summarize data in a meaningful way.

It is used to visualize data in summarizing form rather than showing it in raw form
which is difficult to understand. Descriptive statistics includes frequency table, graphs,
and averages. When we use descriptive statistics it is useful to summarize our group of
data using a combination of tabulated description, graphical description and discussion
of the results.

Table 4.1: Descriptive Analysis

Categories Frequency Percentages

Gender:
Male 159 56.8
Female 121 43.2
Blood group:
A-ve 32 11.4
A+ve 41 14.6
AB-ve 31 11.1
AB+ve 19 6.8
B-ve 36 12.9
B+ve 76 27.1
O-ve 20 7.1

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O+ve 25 8.9
Age:
Less than 10 years 116 41
10-15 63 22
16-20 45 16
More than 20 56 20
years
Weight in Kg:
Less than 20 55 19.6
21-30 92 32.9
31-40 43 15.4
More than 40 90 32.1

Based on the information provided, it can be concluded that in the sample, there is a
higher proportion of male patients compared to female patients. Specifically, 56.8% of
the patients in the sample are male.

Additionally, it can be inferred that in the sample, there is a higher proportion of patients
with blood group B+ve compared to other blood groups. Specifically, 27.1% of the
patients in the sample have blood group B+ve.

These conclusions are based on the given percentages and indicate the distribution of
gender and blood groups within the sample population.

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Figure: 4.1 gender

Figure: 4.2 Blood group

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Figure4.3: Age

Figure4.4: Weight

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4.5: Assessment of Anthropometric parameter:

Demographics (age, gender and transfusion) and anthropometric parameters

(weight, height and body mass index BMI) were collected. The BMI of each participant
was calculated. BMI was measured depending on height(m) and weight(kg) were
BMI=weight/(height).The height , weight and BMI Z-scores was considered by
standard growth chart calculations provided by the World Health
Organization(WHO).This study comprised 280 thalassemia patients, 159(56.8%) males
and 121(43.2%) females. Based on the results of the T-test of independence, we found
a significant difference in height and weight between genders in our dataset of major
thalassemia patients.

Characteristics Age BMI Height Weight Height z- Weight z-

/years (kg/m^2) (cm) (kg) score score

Total Mean±S. 13.44±7.1 22.98±7.29 120.89±29. 33.05±13. 30.6±15. 33.2764±13.

D 01 4 47 4 1 47
Minimu 1 3.9 39.62 6 1.2 6.23
m
Maximu 30 70.03 170.69 60 5.0 60.23
m

Gender Male 13.70±6.9 22.249±6.5 123.93±29. 33.57±13. 0.1029±1 0.038±0.987

41 04 47 29 .0
Female 13.09±7.3 23.95±8.14 116.91±29. 32.36±13. - -
21 3 12 72 0.135±0. .0509±1.018
98

Significan NS NS NS NS 0.006* 0.003**

ce

Table 4.2: Demographic characteristics of study parameters among participants

4.6:BMI
Based on a person’s weight and height, the body mass index calculates their
estimated level of body fat. Body mass index is a simple index of weight-for-height that
is commonly used to classify overweight and obesity in adults. It is defined as a

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person’s weight in kilograms divided by the square of his height in meters (kg/m2). BMI
is one method used to estimate the total amount of body fat.

𝒘𝒆𝒊𝒈𝒉𝒕(𝒌𝒈)
BMI=(𝒉𝒆𝒊𝒈𝒉𝒕(𝒎))𝟐

Table 4.3: BMI

Category BMI range-kg/m2

Underweight Less than 20
Normal From 20.0 to 24.99
Overweight Form 25-29.99
Obese Over 30

Figure 4.5: BMI

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The graph represent the BMI ranges for thalassemia patients. According to this
information mostly patients are underweight.

Table 4.4: Correlations between various pairs of variables

[Link] Variables Correlation

1 Age vs. Weight 0.886
2 Age vs. Height 0.86
3 Height vs. Weight 0.81
4 Hemoglobin vs. RBC 0.97
5 Hemoglobin vs. Calcium -0.078
6 Hemoglobin vs. Age 0.17
7 RBC vs. WBC 0.085

To determine the linear dependence between the variables, the coefficient of correlation
is computed between several pairs of variables. The correlation between age and
weight, age and height, height and weight and hemoglobin and RBC (Red Blood Cells)
are highly linear correlated as likely (0.886,0.86,0.81and 0.97). They all have a positive
relation means one variable is increased (decrease0 by increasing (decreasing) the value
of other variable.

4.7: Multiple linear Regression Technique:

In statistics, Linear regression is an approach for modeling the relationship

between a scalar dependent variable y and one or more explanatory variables (or
independent variables) denoted X. The case of one explanatory variable is called
simple linear regression. For more than one explanatory variable, the process is called
multiple linear regressions.
In linear regression, the relationships are modeled using linear predictor
functions whose unknown model parameters are estimated from data. Such models are

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called linear model. A linear regression line has an equation of the form Y=a+bX,
where X is the explanatory variable and Y is the dependent variable. The slope of the
line is b, and a is the intercept.

Given a variable y and a number of variables X1,…,Xp that may be related to y, linear
regression analysis can be applied to quantify the strength of the relationship between
y and the Xj, to assess which Xj may have no relationship with y at all, and to identify
which subsets of the Xj contain redundant information about y. Thus the model takes
the form:

Y=Xβ+ε

Where:
Y = Dependent variable

β = vector of the coefficient of independent variables

X= vector of explanatory or independent variables

ε = Error term

4.7.1: Assumption of Multiple linear regression:

There are certain assumptions under which the multiple linear regression
analysis is valid. The assumptions or diagnostics are discussed one by one.

• Normality of Response variables:

One of the main assumptions of multiple linear regression is that error terms
are normally distributed.

This assumption can best be checked with histogram and a fitted normal curve or a Q-
Q-Plot. Normality can be checked with a goodness of fit test, e.g., the Kolmogorove-
smirnof test.

The following are used in this study are:

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o Normal probability Plot

o Histogram

The normal probability plot is a graphical technique to identify substantive departures

from nomality. This includes identifying outliners, skewness, kurtosis, a need for
transformations, and mixtures. Normal probability plots are made of raw data, residuals

from model fits, and estimated parameters. In a normal probability plot (also called a
“normal plot”), the sorted data are plot vs. value selected to make the resulting image
look close to a straight line if the data are approximately normally distributed.
Deviations from a straight line suggest departures from normality.

A histogram is a graphical representation of the distribution of numerical data. It

is an estimate of the probability distribution of a continuous variable (quantitative
variable) and was first introduce by Karl Pearson. Histogram give a rough sense of the
density of the underlying distribution of the data, and often for density estimation:
estimating the probability density is always normalized to 1.

• Linearity:

Linear regression is the most basic and commonly used predictive analysis.
Regression estimates are used to describe data and to explain the relationship between
one dependent variable and one or more independent variables.

At the center of the regression analysis is the task of fitting a single line through
a scatter plot. The simplest form with one dependent and one independent variable is
defined by the formula

y = c +b*x, where y = estimated dependent, c = constant, b = regression coefficients,

and x = independent variable.

• Homoscedasticity:

In statistics, a sequence or a vector of random variables is homoscedastic, if

all random variables in the sequence or vector have the same finite variance. This is
also known as homogeneity of variance. The complementary notion is called
heteroscedasticity.

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Hetroscedasticity is present if the size of the error terms are differs across values of
an independent variable. Hetroscedasticity is a violation of this assumption.

By graphical method we can decide or observe that our data is homoscedastic. it is

worth plotting *ZRESID (y-axis) & *ZPRED (x-axis), because this plot is useful to
determine whether the assumption of random errors are means homoscedastic have
been met or not. The graph of *ZRESID & *ZPRED should look like a random array
of dots evenly diapered around zero. If the graph punnels out, then the

Chances are that there is Hetroscedasticity in the data and then different transformation
are used to make the variance constant.

• Multicollinearity:

In statistics, multicollinearity is a phenomenon in which two or more

predictor variables in a linear regression model are highly correlated, meaning that one
can be linearly predicted from the others with a substantial degree of accuracy.

That is, a linear regression with correlated predictors can indicate how well the entire
bundle of predictors predicts the outcome variable, but it may not give valid results
about any individual predictor, or about which predictors are redundant with respect to
other. In the presence of high multicollinearity, the confidence intervals of the
coefficients tend to become very wide and the statistics tend to be very small. It
becomes difficult to reject the null hypothesis of any study when multicollinearity is
present in the data under study. If the multicollinearity is present in the data, this means
that the coefficients are unstable due to the presence of multicollinearity.
Multicollinearity can also be detected with the help of tolerance and its reciprocal,
called variance of inflation factor (VIF). If the value of tolerance is less than 0.2 or 0.1
and, simultaneously, the value of VIF 10 and above, then the multicollinearity is
problematic.

1
VIF= (1−𝑅2)

Where; Rj2 is the coefficient of determination obtained from regression xj on the other
regressor.

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Diagnostic Checks:
Some assumptions of simple linear regression are verified and diagnostics are
checked. So, the quality of proposed model may be improved and consequently a final
model would be achieved.

Normality Analysis:

One of the main assumption in multiple linear regression in that Error term must be
normally distributed.

There are different methods that are used for testing this assumption.

Following two are used in this study:

Histrogram:

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The histogram shows that the RBC of patient is almost normally distributed with
mean 3.80 and standard deviation = 0.995.

Normal P-P plot

Hence, it can be said that the Normal P-P plot shows that both the graphs is almost
normally distributed.

Homoscedasticity (constant variance):

In Multiple linear regression, an important assumption is that the response variable

should have a constant variance. For this purpose, we regress residual on the predicted
values.

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The above figure doesn’t show any pattern therefore there is no heteroscedasticity in
the data. Hence it can be concluded that there is a fixed or constant variance in the
response variable.

Multicollinearity:
The most widely used diagnostics for multicollinearity is Variance Inflating
Factor (VIF). The value of VIF should be as low as possible for the indication of
absence of multicollinearity.
A value of VIF should more than 10 shows a serious problem of multicollinearity.
i.e., All explanatory variables are linearly independent.

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Model fitting:

Table 4.5: Multiple Linear Regression ANOVA

ANOVA Explained
variation
Model Sum of Mean F Sig. R2 Adj R2
squares Df Square
Regression 2.691 3 0.897 3.487 0.016 0.037 0.026
Residual 70.996 276 0.257 - - - -
Total 73.687 279 - - - - -

Table 4.6: Coefficient

Model Collinearity statistics

Un-standardized
Coefficient

Variance β [Link] T Sig Tolerance VIF

Constant 2.670 0.164 16.251 - - -
Age 0.004 0.011 0.400 0.689 0.155 6.456
Height -0.036 0.065 -0.552 0.581 0.236 4.231
Weight 0.007 0.005 1.454 0.147 0.205 4.887

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Interpretation of Regression Coefficient:

Interpretation of each coefficient of regressor involved in the final model is

independently given below:

Age:

The unstandardized coefficient B1 for age is 0.004. This means that for every one unit
increase in age, the model predicts a 0.004 unit increase in RBC count, assuming all
other variables are held constant. In other words, the model suggests that in thalassemia
patients, as age increases there is a small increment in RBC count, taking into account
the other variables as constant in the model.

Height:

The coefficient -0.036 indicates that there is a negative impact of growth on RBC count
in thalassemia patients. This means that thalassemia patients who have a lower blood
production rate will be having their RBC count reduced as their height and growth
increase. Therefor, the negative coefficient suggests that the presence of the disease is
associated with a decrease in RBC count.

Weight:

The unstandardized coefficient β3 for weight is 0.007. This means that assuming all
other variables are held constantst, for every one unit increase in weight, the model
predicts a 0.007 unit increase in RBC count. In other words, as weight increases, the
model suggests that there will be a small increment increase in RBC count in
thalassemia patients. This indicates that weight has a positive association with RBC
count, meaning that higher weight is associated with small increase in RBC count.

Final model:

RBC = 2.670 + 0.004 age -0.036 height + 0.007 weight

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4.8: One way ANOVA:

One-way ANOVA is a statistical approach used to compare the mean value of samples
to assess whether they are substantially different. Also, the approach uses only one
independent variable.

The basic purpose of using one-way anova is to check whether the average blood
transfusion quantities for all blood groups are similar or different.

4.8.1: Assumptions of one-way analysis of variance:

For applying ANOVA, we have to check its assumptions which is commonly use
are following:

o Data samples should be taken from the normally distributed population.

o Samples should be selected randomly to ensure that observations in one sample
do not depend on the observations in other samples. In essence, samples should
be independent.
o The dependent variable should be continuous.
o The variance of data belonging to different groups should be the same.

Diagnostic check:

Although the transfusion reliability in our dataset of major thalassemia patients shows
some degree of normality, it does not necessarily imply that its distribution is
completely normal. Further analysis and consideration of additional statistical tests
are recommended to confirm the distribution's normality.

Hypothesis:

H0: µ1=µ2=…=µ8

H1: At least one of the mean is different.

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Level of significance:

α=0.05

Calculation:

Table 4.7: One Way ANOVA

ANOVA
Sum of Df Mean square F Sig
squares
Between 352036.285 7 50290.898 1.460 0.182
groups
Within 9367629.086 272 34439.813
groups
Total 9719665.371 279

Interpretation:

Based on the statement provided, if the p-value is 0.182 and it is greater than the
significance level of 0.05, the null hypothesis is not rejected. In this case, the null
hypothesis would state that the transfusion quantity has the same effect on all the blood
groups. Therefore, it can be interpreted that there is not enough evidence to suggest that
the transfusion quantity has a significant effect on the different blood groups. In other
words, the results indicate that the transfusion quantity does not have a differential
impact on the various blood groups being studied.

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Graphical representation:

Figure4.6:Mean Plot

Interpretation:
Based on the statement provided, it appears that despite the expectation of similar
transfusion quantities for all blood groups, the graphical representation of the data
shows that the blood group AB- has a significantly higher requirement for blood
transfusion, while the blood group O+ has a relatively lower requirement.

This suggests that there may be a significant difference in the transfusion needs among
the blood groups in the study. It is important to further investigate the reasons behind
these differences. Factors such as the presence of certain medical conditions or the
compatibility of blood types may contribute to the varying transfusion requirements
observed.

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In summary, the graphical representation indicates that there are distinct differences in
the required blood transfusion quantities among the different blood groups studied.
Further analysis and investigation are necessary to understand the underlying factors
contributing to these differences.

___________________________________________________________________

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5.1: Conclusion and summary:

It’s really great honour for me to present this report that is carrying
complete information about Al-Khidmat Foundation. I am glad to have undergone this
internship because it taught me a few important things and also got me to explore my
own interests. I while doing this internship really enjoyed there a lot as it was very good
experience and that was my first step towards the progress of learning in practical
world. The purpose of this program is to give practical exposure about our studies. It is
also helpful for understanding the organizational environment that how to deal with
professional persons. For the purpose, I got the chance to do internship in AKFP. This
project has been worked out primarily to consider the brief knowledge about
organization and implementations, which we get the hands-on experience about the
training that we have gain during our internship.

Besides, being to the point, this project is comprehensive also, since it includes
different chapter. In chapter 1 we discuss the history and their departments in detailed
second chapter describes the registrations of patients and hospitals performance.
Further we discuss the analytical and descriptive study and in the last we discuss
recommendations and conclusions.

5.2: Recommendations:

After spending six weeks at Al-khidmat foundation Pakistan, interacting with the
employs getting their views, observing the organizational structure an design, I have
come up with the following suggestions that in my view will definitely improve a few
weakness observed in the organization by me.

• Staff behavior towards the patients should be friendly.

• All the employees in the organization should be insured job security so that
there is no pressure on the employees while performing their tasks.

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• Patients Care Office (thalassemia center) should be available in the hospital

during his/her duty hour.
• Management should provide excessive waiting area so that every citizen should
get relaxing environment, because at the particular were so exhausted that they
need good environment.

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References:

o Saad, B. H., Abdul-AM, A. H. H., Hussein, A. M. B., & Mazin, J. M.

(2021). The study of serum ferritin level as a predictor of growth
retardation in thalassemia-major. Archivos Venezolanos de
Farmacologia y Terapeutica, 40(5), 492-501.
o Aydinok, Y. (2012). Thalassemia. Hematology, 17(sup1), s28-s31.
o Brancaleoni, V., Di Pierro, E., Motta, I., & Cappellini, M. D. (2016).
Laboratory diagnosis of thalassemia. International journal of
laboratory hematology, 38, 32-40.
o Ahmad, S. (2021). How Islamic Social Finance Contribute to the
Sustainable Development Goals: An Impactful Story of Al-Khidmat
Foundation Pakistan. Islamic Wealth and the SDGs: Global Strategies
for Socio-economic Impact, 197-216.
o Kerlinger, P. (1973). Correlation and Multiple Regression
Analysis. Foundations of. Holt, Rinehart and Winston, Inc. New York.
o Maqsood, A., & Iftikhar, S. (2019). Analysis of Thalassemia Patients
Data Using Statistical Methods. International Journal of Scientific &
Engineering Research, 10(6), 936.
o Indrayan, A., & Satyanarayana, L. (2006). Biostatistics for medical,
nursing and pharmacy students. PHI Learning Pvt. Ltd..
o Ross, A., & Willson, V. L. (2017). One-way anova. In Basic and
advanced statistical tests (pp. 21-24). Brill.
o Factors Impacting Quality of Life in Thalassemia Patients; Results from
the Intercontinenthal Collaborative Study | Blood | American Society of
Hematology ([Link])
o Risk Factors of Thalassemia | Hematology-Oncology Associates of
CNY ([Link])

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