Adult mortality in medical, sociodemographic and healthcare perspective

Statistics on causes of deaths can help in determining the pattern and burden of disease and devise measures for planning and controlling unwanted deaths. To assess the pattern of mortality in adult patients in a public sector tertiary care hospital at Rawalpindi during the year 2005. This retrospective study was done through search of hospital records of all deaths in adults during the year 2005 in a public sector tertiary care hospital. Information on pertinent variables was obtained on a proforma. Cause of death in each case was ascertained as it was documented. Important Lab. Investigations, where available were also recorded. Diseases were grouped according to World Health Organization classification [International Classification of Diseases-10]. Causes deaths were analyzed under various medical, sociodemographic and healthcare parameters according to available records. A total of 529 adult deaths occurred during study period. The mean age of the deceased was 54 years. There were 58% males with 13% being unmarried. More than 75% cases belonged to lower socioeconomic status while 55% belonged to urban areas. Almost all [97%] were admitted through casualty department. Hospital stay was less than one hour in 34% and 1-7 days in 52% cases. Death due to diseases of circulatory system was ranked first [33%]. A total of sixty deaths occurred due to liver diseases and hepatitis C virus was positive in 39 [64%] cases. Proportion of female who died of hypertensive disorders was significantly high [p < 0.01]. Both infectious and non infectious diseases are bringing a major death toll in our health setting with circulatory system and liver disease as the leading causes of death in adults. Adult mortality can be reduced by controlling infectious and non infectious diseases

Knowledge about leprosy in doctors of teaching hospitals of Rawalpindi

To assess the knowledge of doctors about leprosy. This was a qualitative study. Specially designed questionnaire based interviews were carried out in three teaching hospitals [Holy Family Hospital, Rawalpindi General Hospital and District Head Quarter Hospital of Rawalpindi Medical College] over 2 months [May-June 2008]. Doctors were interviewed irrespective of their qualification and experience using convenience sampling. A total of 136 doctors were included in the study, out of which 96 were simple MBBS, 34 had done FCPS-I and 6 were FCPS-II. Of the total 68 doctors, 38.2% had seen a case of leprosy whereas 61.8% had never examined a case of leprosy. Majority knew the commonly used drugs for leprosy and only 2.9% did not know them. Eighty two percent doctors knew the management of a suspected case of leprosy. Doctors had adequate knowledge about leprosy that was independent of their qualification and experience. Though leprosy has been eradicated from Pakistan but students and doctors still need to educated on this subject to keep them abreast about the subject

Assessment of pregnancy outcome with and without antenatal care

Women with poor attendance for antenatal care, have an increased risk of poor pregnancy outcomes. Antenatal care is an effective method of preventing adverse outcomes in pregnant women and their babies. To assess and compare the pregnancy outcome in women with and without antenatal care and to see its effects on maternal and infant morbidity and mortality. A descriptive observational study was carried out in Allied hospitals [Holy Family Hospital, Rawalpindi General Hospital and District Head Quarter Hospital of Rawalpindi Medical College] for a period of 2 months in 2008. All women coming to labor rooms, wards and emergency department of these hospitals for delivery were included in the study. Women who had at least 3 antenatal visits were categorized as [with antenatal care], while those with less than 3 antenatal visits as [without antenatal care]. A total of 170 mothers were seen at these hospitals in 2 months. Of the total, 137 [80%] received antenatal care and 33 did not. Of those who received antenatal care, 85% were immunized and 15% mothers who did not receive antenatal care were also immunized. Majority of women with antenatal care have had regular monitoring of blood pressure, weight monitoring, blood and urine tests during pregnancy. Forty seven percent mothers with antenatal care had spontaneous vaginal delivery with episiotomy as compared to 57.6% mothers without antenatal care who were delivered by caesarean section. Ninety seven percent and 85% newborns were delivered alive in the two groups respectively. Among mothers who received antenatal care, 87% had satisfactory pregnancy outcome and 13% had unsatisfactory outcome. Pregnancy outcome in women taking antenatal care is far better and healthy than those without antenatal care. Awareness about the effectiveness of antenatal care in safe mother and child delivery should be enhanced through various methods including media

Breast feeding patterns in some lactating mothers of Rawalpindi

The purpose of the study was to assess present patterns of breast feeding [BF] to identify such determinants that can be positively modified in the present socioeconomic scene of the nation. It was a descriptive cross sectional study. This study was done in Rawalpindi city from March 2004 to December 2004. Mother's perceptions [n=501] for breast feeding [BF] were examined through a descriptive cross-sectional study using convenient sampling technique m urban area of Rawalpindi city National [BF] policy guidelines were used as a basis of assessment. Lactational practices were not optimum in majority [87.42%] and in all socioeconomic strata In general no significant association was found between Literacy and economic strata and the pattern of [BF] of the study population [P> 0.1 and > 0.05 respectively] However, practice of additional food intake during Lactational period was significantly associated with right breast feeding practices in the population studied [P < 0.05 and odd's ratio 72] In 29.2% cases qualified health care providers including specialist in obstetrical care promoted formula milk feeding Insufficient information, Ineffective motivation about BF of masses and inappropriate healthcare practices, were major factors responsible for inadequate [BF] practices in the community studied. The issue can be addressed by enhancing health education to potential mothers, sensitizing males and effective monitoring of health care practices

study on knowledge of diseases causation among adults of an urban slum of Multan

A cross-sectional study with descriptive and analytical components was carried out at Basti Oddan, an urban slum of Multan city. The concept of disease causation regarding tuberculosis, hepatitis B and malaria among 320 adults was assessed utilising a pre-tested questionnaire. Data was entered and analysed using SPSS software, 11[th] version. Running and tabulation of all the variable frequencies were done as part of data management. Tables were used to present the data. Chi -square test was used as the test of significance. Level of significance was set at 0.05. The overall knowledge of disease, causation was poor i.e. less than 50%. Respondents with better educational status had better concept of causation regarding three common communicable diseases. The association between economic status and concept of disease causation was variable i.e. no significant association between economic status and awareness of tuberculosis causation. However a positive association between economic status and awareness regarding hepatitis B and malaria was noted. It is concluded that there is great need to improve the educational status of the people otherwise any health improvement program is unlikely to succeed