Preventable Lifestyle Risk Factors for Non-Communicable Diseases in the Pakistan Adolescents Schools Study 1 (PASS-1) / 예방의학회지

OBJECTIVES: The rising burden of preventable risk factors for non-communicable diseases (NCDs) among adolescents is a major public health challenge worldwide. We identified the preventable risk factors for NCDs in adolescents. METHODS: In a school-based study, pre-tested structured questionnaires were completed by 414 adolescents (14 to 17 years) at six schools in three cities in Pakistan. The chi-squared test and adjusted odds ratio (aOR) with 95% confidence interval (CI) were calculated in a multinomial logistic regression analysis. RESULTS: Over 80% of the adolescents had unhealthy diets, and 54% were physically inactive. Most adolescents were exposed to passive smoking, and 14% were also current smokers. More than one-third of participants chewed betel nut, and one-quarter used oral tobacco. More girls were physically inactive (OR, 4.07; 95% CI, 2.69 to 6.17), whereas a greater proportion of boys were current smokers (OR, 2.17; 95% CI, 1.19 to 3.91), exposed to passive smoking (OR, 2.57; 95% CI, 1.72 to 3.83), and using betel nut (OR, 2.03; 95% CI, 1.34 to 3.06). Only 3.1% of the participants were without any preventable lifestyle risk factor for NCDs, and over 80% had > or =2 factors. Co-existence of risk factors was independently associated with fathers being blue-collar workers (aOR, 3.57; 95% CI, 1.07 to 11.92) and parents not treating their child fairly (aOR, 5.05; 95% CI, 1.29 to 19.78). CONCLUSIONS: Most of the adolescents studied had preventable risk factors for NCDs. These results warrant comprehensive and integrated interventions to prevent lifestyle risk factors, and parents are front-line stakeholders.

audit of the quality of care indicators for the management of diabetes in family practice clinics in Karachi, Pakistan

Management of diabetes is a painstaking and careful approach. This study was aimed to evaluate the quality of care for the management of diabetes provided by family practitioners to their patients having diabetes. This is a retrospective audit of medical records conducted in a tertiary care teaching hospital of private sector in Karachi for one month. For this study, 150 medical records of patients with type 2 diabetes that visited family practice clinics for their diabetes care were examined. A total of 88 patient's medical records were selected and analyzed who attended the studied clinics for at least one year and had minimum of four out-patient visits. Majority [68%] of the audited medical records were of females. Of the total medical records analyzed, only one-quarter of the cases qualified the criteria of 'excellent' or 'good' diabetes care. Monitoring of body weight of the patient was only one indicator which was according the recommendations in 100% case at every visit. The other nearest quality of care indicator documented was blood glucose advice at every visit in 79.5% [95% CI: 71.1-87.9] of cases. Physical activity advised/reinforced at every visit was least observed [27.3%; 95% CI: 18.0-36.6]. In addition, blood sugar control was reported in less than a quarter [23.9%] with 95% CI of 15.0-32.8. This work has identified a big gap in the management of type 2 diabetes provided by family practitioners. In addition, majority of the patients found to have poor glycemic control. Interventions are suggested to improve the quality of diabetes care. More such audits and research are recommended at the larger scale

Assessment of knowledge, beliefs and practices of our population regarding effects of viewing a solar eclipse

To assess the prevalence of knowledge, beliefs and practices of people coming to The Aga Khan University Hospital, about viewing a solar eclipse. A cross-sectional survey was conducted at The Aga Khan University Hospital, Karachi from January 2000 to April 2000. A self-administered questionnaire was filled by the patient or attendant who were aged 18 and above. Total of 202 respondents were interviewed. The data was analyzed by Epi Info. Mean age of respondents was 35.8 years. Overall, awareness regarding the harmful effects to their eyes by viewing an eclipse directly was 83.2%. Females were more knowledgeable. Majority had obtained information from TV. One third thought it was safe to view the eclipse through binoculars or through smoked glasses. Half of the respondents thought the same about photographic films and sunglasses. Viewing an eclipse by a pregnant mother had an adverse effect on the fetus and on herself was thought to be 50% and 45% respectively. Use of knife or scissors by pregnant females at the time of solar eclipse was thought to be harmful for the fetus and to herself by 41% and 38% respectively. Majority knew that viewing a solar eclipse could be harmful to their eyes but they did not know the safest way. As there is no effective treatment for solar retinopathy, the emphasis should be on prevention. We need to increase public awareness regarding the safest way to watch an eclipse, which is by indirect method using projection. Myths regarding ill effects of solar eclipse on pregnant mother and on fetus need to be removed