Estimation of body mass index in students of a public sector medical college in Pakistan

To determine the BMI status of the students of Dow Medical College and to calculate frequency of different BMI categories. A cross-sectional questionnaire based study was carried out in Dow Medical College, Dow University of Health Sciences, Karachi. Body weight and height were measured and body mass index [BMI] values were calculated by dividing weight with [height]2. Overweight and obesity were defined using WHO international standard BMI cut-offs. The overall prevalence of underweight students was 29.9% out of which 9.6% fell under the category of severely underweight [BMI of < 16.5]. In overweight category there were 8%. The frequency of students falling in Obese Class I, II and III was 2.7%, 0.6% and 0.0% respectively. It was found that more female students compared to male students were underweight. In the overweight and obese categories there was a preponderance of male students. A positive correlation was found between perception of obesity amongst parents and overweight obese students. According to this study, underweight, especially in girls, should be considered a serious health problem among adolescent students which needs to be addressed. Obesity on the other hand does not seem to be a major issue amongst them

Clinical scoring system: a valuable tool for decision making in cases of acute appendicitis

OBJECTIVE: Decision making in cases of acute appendicitis poses a clinical challenge specially in developing countries where advanced radiological investigations do not appear cost effective and so clinical parameters remain the mainstay of diagnosis. The aim of our study was to devise a scoring system from our local database and test its accuracy in the preoperative diagnosis of acute appendicitis. METHODS: Clinical data from 401 patients having undergone appendectomy were collected to identify predictive factors that distinguished those with appendicitis from those who had a negative appendectomy. Ten such factors were identified and using Bayesian probability a weight was assigned to each and the results summated to get an overall score. A cut-off point was identified to separate patients for surgery and those for observation. The scoring system was then retrospectively applied to a second population of 99 patients in order to compare suggested actions [derived from the scoring system] to those actually taken by surgeons. The sensitivity, specificity and accuracy for the level of decision was then calculated. Of the 99 patients, the method suggested immediate surgery for 65 patients, 63 of whom had acute appendicitis [3.1% diagnostic error rate]. Of the 33 patients in whom the score suggested active observation, 18 had appendicitis. The accuracy of our scoring system was 82%. The method had a sensitivity of 78%, specificity 89% and a positive predictive value of 97%. The negative appendectomy rate determined by our study was 7% and the perforation rate 13%. Scoring system developed from a local database can work effectively in routine practice as an adjunct to surgical decision making in questionable cases of appendicitis