Prevalence and characteristics of abnormal papanicolaou smear in central Saudi Arabia

To assess the prevalence and characteristics of abnormal pap smear in the central region of Saudi Arabia. In this retrospective case control study conducted in the Departments of Obstetrics and Gynecology, and Histopathology at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, all pap smears screened for Saudi women between 2008 and 2011 were reviewed. Approximately 5000 pap smears are screened annually at King Abdulaziz Medical City utilizing the Bethesda III System [2001]. All abnormal smears patients' data were collected and compared to the data of randomly selected 200 normal smears' patients. Abnormal pap smear prevalence was found to be 4.3% [841/19,650 Saudi patients were found with atypical epithelial cells abnormalities]. Its prevalence in the years 2008 was 5.7%, 2009 was 4.9%, 2010 was 4.2%, and 2011 was 2.5%. Abnormal smear patients have lower parity [p=0.001], and were less likely to use intra-uterine devices [p=0.03] compared with normal smear patients. Presence of abnormal cervical appearance was associated with increased epithelial cell abnormalities [p=0.045]. The only positive history that has characterized patients with epithelial cell abnormalities was their previous history of abnormal pap smear [p=0.001]. Squamous cell abnormalities were identified in 91% of the patients [767/841], and glandular cell abnormalities were identified in 9% of the patients [74/841]. Prevalence of abnormal pap smears in central Saudi Arabia is relatively low, while advanced glandular abnormalities prevalence was observed to be high

Census survey for a primary health care programme

Objectives: To describe the process of gathering information from a census survey as a preliminary step for supporting the working of a primary health care center. It also presents briefly the results of the survey and its broader implications on the health needs of the local population

Methods: A questionnaire was used to obtain basic information regarding the ethnicity / area of origin, number of household members and their breakdown according to gender, age and marital status. The medical students of different batches were involved in the data collection process, as part of their Survey Methodology course of Community Health Sciences [CHS] in first year

Results: Data was obtained from 2,033 houses, having a total population of 16,118 persons. Fifty three per cent of the population was under fifteen years, 42% were between 15-49 and 5% were over 50 years of age. The overall percentage of males was 52% and females 48%. Approximately 79 percent people were Pushto speaking

Conclusion: Sikanderabad is a typical slum settlement, with an emigrant population being mostly of Pathan and Afghan refugees. The fertility rate in Sikanderabad is much higher than that of Karachi. This highlights the need for education and availability of family planning facilities. At the same time, due to the fact that there is a major portion of the population aged under five years, so facility for treating children must be appropriately provided. The Primary Health Care center established in Sikanderabad is based on the above information. The emphasis is on maternal and childcare, including antenatal and postnatal care; family planning and nutritional counseling

National Polio Day Campaign in a squatter settement through medical students

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

Evaluation of vitamin a supplementation in gulshan-e-sikandarabad

Vitamin A deficiency [VAD] causes blindness of 250,000 to 500,000 children annually, around the world. It also increases the risk of morbidity and mortality due to other diseases. Pakistan is categorized in the 'Severe Sub-Clinical Deficiency' group. A mass supplementation program has been started in 1999. AIM: To determine the coverage of vitamin A supplements in children under five years of age, and to assess the incidence of symptoms related to hypervitaminosis A. SETTING: Block I-A of Gulshan-e-Sikanderabad. METHODOLOGY: A survey was conducted, using the fourth year MBBS students of Ziauddin Medical University [ZMU], under faculty supervision. A pre-tested structured questionnaire was used to assess coverage and symptoms of toxicity. Data was obtained on 489 children. The coverage of polio and vitamin A supplementation was 88% and 74.8%, respectively. In all 15 children [4.4%] experienced symptoms of toxicity related to vitamin A supplementation. Although vitamin A supplementation can save lives, it is only a short term measure. What is needed is a multi-strategy approach including short and long term strategies