Pattern of vitamin D among Pakistani pregnant women

Vitamin D deficiency is an emerging health concern around the world, highly prevalent in south Asian population, despite abundant sunlight. In Pakistan, all age groups are vulnerable to Vitamin D deficiency including pregnant women. This systematic review aimed to determine the pattern of Vitamin D deficiency among Pakistani pregnant women as well as exploring the causes and possible interventions that have had a substantial effect on improving the vitamin D level. Three databases [PubMed, Pub Get and Google Scholar], for the present review up to 2016, were used for the identification of published peer reviewed original relevant studies regarding Vitamin D deficiency among Pakistani pregnant women with the keywords Vitamin D or 25-hydroxyvitamin D or 25[OH]D in combination with pregnant women. Five studies were included for the final analysis. Vitamin D deficiency was common and highly prevalent among Pakistani pregnant women and their neonates. The main reasons for this were found to be avoiding sun exposure, quality of diet, and lower intake of calcium. Maternal vitamin D supplementation was found to be a key intervention to improve the maternal and neonatal vitamin D status. These review findings can be emerging in ensuring the adequate vitamin D level for Pakistani pregnant women during pregnancy, ultimately to achieve positive maternal and neonate's health outcomes

Knowledge and perception about polio vaccination approval among religious leaders

Objective: To examine the knowledge and perception among religious leaders regarding polio vaccine approval

Methodology: A cross sectional population study was conducted in three districts [Bahawalpur, Bahawalnagar and Rahim Yar Khan]. Sample of size of 120 religious leaders [RLs] was taken by using convenient sampling technique. Descriptive and inferential analysis was carried out

Results: Every 9 out of 10 participants heard about the polio vaccination whereas every 2 out of 10 tend to disapprove it. Several reasons for disapproval were reported, majority [32.26%] of the participants believed that polio vaccine reduces the sexual power and affect the sperm [sterilize] as children grown up this was followed up by the vaccine consist of forbidden [Haram] ingredients [29.03%], its Jews lobby to destroy the muslim generation [22.58%] and it's a plan to reduce the muslim population [16.13%]

Conclusion: Although higher proportion of religious leaders approves the polio vaccination but at the same time misconception exists

HIV/AIDS awareness in Pakistan; binary logistic regression analysis of PDHS-2012-13

Globally 35 million people were living with HIV in 2013 whereas around 78 million people have been infected since the start of the epidemic and 39 million people have died of AIDS- related illness. To examine the factors associated with HIV/AIDS awareness of ever married men and women age 15-49. The secondary data sets are used of Pakistan demographic and health survey [PDHS] of ever married men and women with sample size 3134 and 13558. PDHS 2012-13. The national institute of population studies done this survey with the technical support from ICF International and Pakistan bureau of statistics and the USAID supported the financially. Bivariate and binary logistic regression analysis has been carried out to evaluate the significant socio demographic factors. Every 7 out of 10 ever married men have heard about AIDS, while the situation is much critical for ever married women, 6 out of 10 have not heard about HIV/AIDS. Generally finding revealed that almost both of the respondents have misconception regarding HIV/AIDS transmission. Two binary logistic regression models are executed one for ever married man and other for ever married women. Two models revealed that early age groups have less knowledge about HIV/AIDS; urban has more knowledge compared to rural. Education level, media assess and wealth index have positive association regarding to HIV/AIDS awareness. Socio-demographic aspects such as age, education, place of residence and access to media TV, radio and newspaper, wealth index and occupation are found to be significant varied systematically with the awareness of HIV/AIDS. These statistical outcomes will enhance the capability in disease management and control

Road traffic accidents; prediction in Pakistan

To determine the trend of road traffic accidents [RTAs] and forecasting their incidence is an emerging to take safety measures so that general public health related morbidity and mortality can be minimized. The data for present study has been taken from Pakistan bureau of statistics [statistics House]. January 2002-2003 to December 2011-2012. A set of eleven curve fitting models namely linear, quadratic, cubic, logarithmic, inverse, exponential growth model, logistics-curve ,and compound models were carried out for prediction. Under the descriptive analysis, the annual average number of fatal and non-fatal accidents is 43.3% and 56.7% respectively. In provinces Punjab contributes to a high rate of total number of accidents, while Khyber Pakhtunkhwa, Sindh and Baluchistan placed second, third and fourth respectively. Under the curve fitting estimation, the cubic model was selected for predicting the annual traffic road accident for all categories i.e. [i] Total Number of Accident [ii] Fatal Accident [iii] Non-Fatal Accident [iv] Killed People [v] Injured People and [vi] The Number of Vehicle Involved. Rising trend in all categories are expected in Pakistan. The traffic road accident is expected to rise in Pakistan

TB knowledge and perception; trends: evidence from Pakistan

To uncover the trend regarding TB knowledge and perception of its transmission as well as underlining the socio demographics aspects associated with TB cure among the reproductive venerable women. Quantitative frame work along with inferential analysis have been carried out by using the Pakistan Demographic and Health Survey 2006-07 and 2012-13 of ever married women. Trend regarding TB awareness and its cure and treatment have been changed over time by 4.31% and 4.49% respectively in PDHS 2012 compared to PDHS 2006. Whereas an adequate knowledge of TB transmission thought air when coughing and sneezing remain constant after equating the two surveys. To understand the functional relationship of variables multinomial logistic regression analysis was carried out separately for PDHS 2006 and PDHS 2012. Two models revealed that early reproductive age group 15-19 of ever married women believed that TB cannot be curable compared to their counterparts upper age groups 45-49. Illiterate ever married women are more pronounced [OR=5.38 and OR=10.30] that TB is an incurable infectious disease compared to women having higher educational degree in PDHS 2006 and PDHS 2012 respectively. Location and geographical area of residence, wealth index, and media exposure have positive association about TB knowledge of cure and treatment. Although the awareness level improved but it still needs to launch some massive and wide-ranging awareness programme regarding an adequate knowledge of various diffusion modes of tuberculosis by utilizing all media modes predominantly television. Potential struggles are obligatory where the subordinate literacy rate and limited health care settings meticulousness in remote areas, so that the illness and death due to TB can be minimized

Sexually transmitted infections; trends and differentials

Objectives: This study aimed to uncover the trend regarding knowledge about sexually transmitted infections [STIs] among Pakistani women of reproductive age 15-49 as well as evaluating the socio demographic differentials associated with STIs knowledge

Design: The secondary data sets are used of Pakistan demographic and health survey [PDHS] of ever married women with sample size 10023and 13558

Period: PDHS 2006-07 and PDHS 2012-13

Setting: The national institute of population studies done this survey with the technical support from ICF International and Pakistan bureau of statistics and the USAID supported the financially

Methods: Descriptive frame work along with bivariate analysis was performed to understand the trend regarding STIs knowledge and evaluate the significant socio demographic factors respectively

Results: The awareness regarding STIs and knowledge to use always condom during sex to reduce the risk of getting HIV/AIDS after equating the two PDHS has improved over time just by 3.85% and 6.50% respectively in PDHS-2012-13 compared to PDHS 2006-07. Early age group [15-19] women have sufficient lack of knowledge about STIs. Urban has more knowledge regarding STIs compared to rural. Education, wealth index and media awareness have positive association with STIs knowledge

Conclusions: Socio demographic differentials such as age, education, location and geographical area of residence, media access, wealth index and women occupation are found to be statistically highly significant with respect to sexually transmitted infections knowledge. These statistical outcomes will enhance the capability in disease management and control

HIV/AIDS awareness; long distance truck drivers

Objectives: to examine the awareness regarding HIV/AID and sexual behavior among long distance truck drivers [LDTDs] in Bahawalpur division

Study design: a cross sectional population study

Setting: three districts [Bahawalpur, Bahawalnagar and RYK]

Data: sample of size of 120 LDTDs is taken by using convenient sampling technique

Methods: descriptive and inferential analysis carried out

Results: every 6 out of 10 LDTDs have heard aboutHIV/AIDS and believed that sexual intercourse is a major mode of its transmission. The use of condom before sex is seldom among truckers. Exactly half of LDTDs have only one sexual partner while nearly quarter [23.3%] of the respondents currently having two sexual partners. Over half [54.2%] of truckers made payment for sex with commercial sex workers [CSWs] and only 3.3% did so with their helper/conductor. Two models are executed separately to explore the association of trucker's knowledge about HIV/AIDS [Model 1] and those who paid for sex [Model 2]. Pearson chi-square analysis exhibits that respondents having age group 25-30 year, those with native of Punjabi language, those who manage to earn more than 15,000 Pakistani rupees per month, those having secondary level of schooling and those watching TV has higher knowledge regarding HIV/AIDS. LDTDs with age thirty years and over, Saraiki speaking, monthly income less than 10,000, illiterate, unmarried, watching TV and remain away from home during current trip a week are found to be more prone to pay for sex to CSW

Conclusions: the awareness of HIV/AIDS and knowledge of its transmission through sexual contact is high among LDTDs but still public health strategies are needed to promote the knowledge of all possible transmission modes of HIV/AIDS and use of condom before sex, ultimately to improve health outcomes

Anti retroviral life-saving therapy; a curve fitting approach in Pakistan

Effective implementation of mathematical and statistical models maximizes the likelihood of understanding the trajectory, level and pattern of incurable diseases and their therapies, so that precise demand strategies for costly lifesaving therapies for future, resource allocation and timely intervention could be ensured, a significant concern for less developed countries like Pakistan. The record of monthly number of patients on lifesaving anti-Retroviral Therapy for more than 18 HIV treatment centers in Pakistan was acquired for the period January 2011 to July 2013.A set of eleven curve fitting models namely linear, quadratic, cubic, logarithmic, inverse ,exponential growth model, logistics-curve and compound models was carried out for prediction. After the execution of various curve fitting models by taking the ANOVA approach along with coefficient of determination and the forecast accuracy measures namely, mean percentage error [MAPE], mean absolute error [MAE] and mean square error [MSE] in the selection of final efficient model. Cubic model was selected for forecasting the monthly anti-retroviral therapy cases for all categories i.e. overall, male female and children. On the basis of final selected model 3% increment is expected number of paticuts on anti-retroviral therapy annually in HIV treatment center in all Pakistan. Male patients are expected to increase 14% who will get lifesaving anti-retroviral therapies. While the annually expected reduction of 17% and 42% in female and children cases taking anti-retroviral therapy is expcted in future respectively. The overall number of people on anti-retroviral therapy are expected to increase in Pakistan. Males are expected to have greater risk as compared to female and children in Pakistan

Infant polio immunization; time series modeling towards coverage in Pakistan

Poliomyelitis is a highly infectious disease but preventable by effective vaccines. Children under five year of age affected by this disease as a result a permanent paralysis. To uncover the trend of infant polio immunization coverage through modeling is a significant concern to formulate an adequate vaccination strategies and program after the outbreak of new cases of polio in a recent year in Pakistan. The reported data of monthly infant polio immunization coverage to National Institute of Health, Islamabad, Pakistan from January 2008 to July 2013 for the present study has been taken from Pakistan bureau of statistics with total time series entities 67. National Institute of Health, Islamabad took the record of per month number of doses administered [0-11 months] children by the registered health centre in pakistan. January 2008 - July 2013. Pakistan bureau of statistics [Statistics House]. A set of various short term time series forecasting models namely Box-Jenkins, single moving average, double moving average, single parameter exponential smoothing, brown, Holts and winter models were carried out to expose the infant polio immunization coverage trend. Among the several forecasting models ARIMA models are chosen due to lower measure of forecast errors namely root mean square error [RMSE], mean absolute error [MAE] and mean absolute percentage error [MAPE]. ARIMA [2,1,1], ARIMA [1,0,2], ARIMA [0,1,2] and ARIMA [2,1,1] models are established as an adequate models for the prediction of OPV-0, OPV-1, OPV-2 and OPV-3 respectively. With the exception of OPV-1 the infant polio immunization coverage is expected to rise in Pakistan

Socioeconomic status and impact of treatment on families of children with congenital heart disease

To assess the socioeconomic status, treatment being offered and the impact of congenital heart disease treatment on families. Observational study. The Children's Hospital / Institute of Child Health, Lahore, from 1st March to 31[st] August 2010. All patients undergoing a cardiac surgical or angiographic intervention were enrolled. Socioeconomic status was assessed by Kuppuswamy socioeconomic status scale with income group modification. The impact was measured by the source of financing, effect on family financing source and schooling and health of siblings. Of 211 patients undergoing treatment in the study period, surgery was the definitive treatment in 164 [77.7%] and angiographic intervention in 47 [22.3%] patients. Male to female ratio was 1.5:1. The mean age of the patient was 39.1 +/- 3.2 months [range 01 day to 15 years]. Majority of families belonged to middle [66.4%, n=140] and lower [27%, n=57] socioeconomic class. The mean cost of medicines and disposables was PKR 78378.2 +/- 8845.9 [US$ 933.1 +/- 105.3] in open heart surgery, PKR 12581 +/- 7010.8 [US$ 149.8 +/- 83.5] in closed heart surgery and PKR 69091 +/- 60906 in angiographic interventions. In 63.1% patients, families contributed towards these costs either completely [12.3%] or partly [50.8%] with significant contribution from the hospital. Adverse effect on families ranged from leave without pay to losing jobs or business [46%], and selling their assets [11.3%]. It also affected schooling and health of siblings [22.7% and 26.1% respectively]. Majority of children with congenital heart disease belonged to middle and lower socioeconomic status in this study. Main definitive treatment was surgery. The cost of health care facilities posed a marked socioeconomic burden on those families

Contraceptive attitude and behaviour among university men: a study from Punjab, Pakistan

The men's attitudes towards family planning and on the use of family planning method may affect not only their wives intention to use contraception but also the choice of a particular family planning method. This focus of this study is to assess the educated men's role, belief, practice and their participation in family planning. A cross-sectional data on 150 university male employees was taken. The logistic regression in connection with stepwise procedures is used to find the most significant variables that influence the men's current use of contraception status. About 42 percent of the married male employees were users of family planning methods. Among family planning methods, condom was the most used method [about 71%] followed by traditional methods [14%]. The mean age at first marriage of the respondents was 23 years and for the spouses it was 19 years. The knowledge of men in family planning methods is quite universal and general; but the attitude on the use of contraceptives and the family planning method is much different between the employees who had the awareness of contraception and those who had no awareness