Spatial distribution of health facilities in Islamabad, Pakistan

There are no comprehensive, spatially referenced databases of public and private health facilities in any of the countries of the Eastern Mediterranean Region. This study in Pakistan was conducted to demonstrate the feasibility of creating a spatially referenced health facility database for a medium-sized city, in a low-cost, non-resource intensive manner and to visualize the spatial relationship between hospitals and clinics in the city of Islamabad. Cumulatively, 166 [77.6% of all clinics mapped] were in close proximity [within 1 km] to a hospital. Repeating such studies elsewhere would help us to better understand different spatial distribution patterns, the reasons for them and the implications for health-care planning

Road rage and road traffic accidents among commercial vehicle drivers in Lahore, Pakistan

Road rage and road traffic accidents increase the burden of morbidity and mortality in a population. A cross-sectional survey with convenience sampling was conducted among commercial vehicle drivers in Lahore, Pakistan [N= 901] to record their behaviours/experiences regarding road rage and road traffic accidents. Respondents were asked about incidents of shouting/cursing/rude gestures or threats to physically hurt the person/vehicle, by others or themselves, in the previous 24 hours or 3 months, and their involvement in road traffic accidents in the previous 12 months. Auto-rickshaw drivers were significantly more likely to report various road rage experiences/ behaviours and involvement in accidents compared with bus and wagon drivers. A total of 112 respondents [12.4%] reported being involved in a road traffic accident in the previous 12 months but traffic police did not record the accident in 52.7% of cases. The results of this study underline the need to improve road safety in Pakistan

Beliefs about euthanasia among university students: perspectives from Pakistan

Opinions of university students about euthanasia were studied in 4 cities in Pakistan using convenience sampling. A total of 836 students [316 males and 520 females] completed a questionnaire in which euthanasia was defined as deliberate administration of an overdose of a drug by a doctor to relieve pain and suffering of a dying patient at his/her explicit request to end his/her life. Only 25.6% of students agreed that euthanasia should be legalized in Pakistan. The most common reason cited for legalization of euthanasia was to relieve patient's suffering but only when a committee of physicians agreed to recommend it Students who opposed legalization [74.4%] cited impediments to future medical research as the most common reason, followed by the risk of misuse by physicians or family members. Only 8.9% of students cited religious beliefs as a reason against legalization. There is a need in Pakistan for more debate about euthanasia

Road rage behaviour and experiences of rickshaw drivers in Rawalpindi, Pakistan

A cross-sectional survey with convenience sampling was conducted among rickshaw drivers in Rawalpindi, Pakistan to study their road rage behaviour and experiences. Cumulatively 318 male drivers participated in this study. The most common forms of road rage reported were: having been shouted at; and having experienced rude gestures from other drivers [78.9% each]. Least common forms of road rage reported were: threats of physical hurt or having actually been physically hurt [

Prevalence of resistance to antituberculosis drugs in Riyadh and a review of previous reports

Resistance to antituberculosis drugs is an important cause of treatment failure. We evaluated the prevalence and pattern of antituberculosis drug resistance in the central region of Saudi Arabia, and reviewed previous reports from Saudi Arabia. Materials and We retrospectively examined the records of sputum smear and culturepositive pulmonary tuberculosis patients admitted consecutively from 1998 through 1999 in a main referral hospital in Riyadh, and analyzed drug sensitivity reports. We also reviewed previous reports on antituberculosis drug resistance in Saudi Arabia. Of 515 patients with pulmonary tuberculosis, 80 [15.5%] had resistance to at least one antituberculosis drug. Resistance to streptomycin was most frequent [9.7%], followed by rifampicin [9.5%], isoniazid [4.3%], and ethambutol [0.2%]. Resistance to one antituberculosis drug was found in 8.9%, resistance to two drugs in 5.2%, resistance to three drugs in 1.2%, and resistance to four drugs in 0.2%. Multidrug resistance [defined as resistance to at least isoniazid and rifampicin] was found in 1.9% of patients. A literature review including 6114 patients in Saudi Arabia showed that resistance against streptomycin was most common [8.8%], followed by rifampicin [8%], and isoniazid [7.2%]. Of the 6114 patients, 6.8% patients were resistant to only one drug, 3.6% were resistant to two drugs, and 3.7% to three drugs. The high prevalence of rifampicin resistance and resistance to multiple drugs in the Riyadh region and in other parts of Saudi Arabia is a major challenge to the control of tuberculosis in this country. Efforts should be made to prevent the emergence of further antituberculosis drug resistance

Acute eosinophilic pneummonia: certain atypical presentations

Patients with Acute eosinophilic pneumonia [AEP] usually present with acute respiratory failure, chest infiltrates with or without pleural effusions and have eosinophilia in the broncho-alveolar lavage fluid. Early institution of steroids is usually rewarded with rapid recovery. Therefore, AEP needs to be distinguished from other common diffuse alveolar disease. Two patients with AEP who had certain atypical manifestation, not described before, are being presented. Pertinent literature has also been reviewed

Adenomyosis with tuberculosis of uterus

AIMS: To establish various factors that affect TB treatment adherence over time. DESIGN/SETTING: Semi-structured questionnaire. All newly diagnosed cases of TB at Bethamia Hospital, Sialkot were interviewed at the beginning of treatment, one month of therapy and at the end of intensive phase. Perception of TB as a stigmatising disease was found related to early defaulting and to a lesser degree to late defaulting. Knowledge of TB in itself did not have a clear impact on defaulting, but the attitude towards interruption of treatment did. The strongest risk factor is irregularity of drug intake and appointment keeping. Strategies to improve treatment adherence should concentrate on methods to increase patient's motivation for treatment

Knowledge and misconceptions about sexually transmitted infections in married women-perspective from Islamabad

To study the knowledge of married women regarding existence of sexually transmitted infection [STI] their complications, treatment seeking, ways of preventing STI acquisition and opinion about sex education in schools/colleges and media. Setting: The Mother and Child Health Center, a tertiary care hospital in Islamabad. A cross-sectional survey based on sample of convenience was conducted, using a structured questionnaire with both close and open-ended questions. Trained women physician interviewers conducted the interviews after obtaining verbal consent. Out of 218 women approached for interviewing, only two refused to participate in the study. The mean age of the respondents was 28.5 years [range 18 - 53 years]. One hundred and sixty-eight [77.8 percent] respondents had heard/knew about sexually transmitted infections STIs. Two hundred and ten [97.2 percent] respondents had heard/knew about AIDS and out of these 162 [77.1 percent] knew that it is also transmitted through sexual contact. One hundred and eighty two [84.2 percent] felt a need for sex education in the media, both print and electronic and 204 [94.4 percent] respondents said that they would like to learn more about sexually transmitted infections. One hundred ninety four [98.8 percent] respondents had heard the Latin term Luekorrhoea. Of these 158 [81.5 percent] thought it was a gynecological disease. Majority thought it caused weakness. Widespread misperceptions were found to exist, which does not augur well for the effective prevention of STls in the country. Population based studies are required to study the knowledge and epidemiology of STIs, as well as a need for a health education campaign in the country

Hazard perception and occupational injuries in the welders and lathe machine operators of Rawalpindi and Islamabad

OBJECTIVE: To study the prevalence of occupational injuries in the welders and lathe machine operators and their hazard perception. SETTING: This study was conducted in the welders and lathe machine operators working in the welding and metal working shops in Rawalpindi and Islamabad. METHODS: A cross-sectional survey was conducted by two trained health interviewers using uniform questionnaire with both close and open-ended questions. Two hundred and eight welders and 104 lathe machine operators were interviewed. Thirty nine [18.7%] welders and 27 [26%] lathe machine operators reported an injury in the past three months, while 63 [30.3%] welders and 76 [73.8%] lathe machine operators reported sustaining an injury in the past twelve months. However, only half of the welders and 31 [29.8%] lathe machine operators believed that their occupation was hazardous for health. For effective public health policy there is a need preventive education and enforcement of safety regulations for the informal occupational sector in Pakistan

Adolescent's Knowledge about AIDS - Perspective from Islamabad

OBJECTIVE: To study the adolescent student's knowledge and its sources about AIDS, and its mode of spread in Islamabad. SETTING: One boys and two girls schools in Islamabad. METHODS: A cross-sectional survey was conducted, using an anonymous, self-administered, brief Urdu questionnaire which was distributed among 100 boys and 182 girls. The response rate was 100% and the average age of respondents was 14.6 years in boys and 12 years in girls. Most respondents knew about AIDS and reported television as their main source of knowledge. Most respondents also correctly believed that AIDS patient can pass on the disease to others, however, they had erroneous beliefs about its mode of transmission. This study testifies to the effectiveness of the successful television based health education campaign regarding AIDS in the adolescent boys and girls, in Islamabad