Evaluation of knowledge attitude and practice of health care staff on biosafety and biohazards, district Pakpattan Punjab

To evaluate the knowledge, attitude and practice of health care staff on bio-safety and biohazards in District Pakpattan. Cross Sectional epidemiological Study. This study was conducted in District Pakpattan Punjab, Pakistan from 1[st] August 2013 to 30[th] August 2013. The study was carried out to evaluate the knowledge attitude and practice on bio-safety and biohazards of health care providers, who are directly involved in the patient handling e.g. doctors, lady doctor, laboratory and blood bank technicians, Nurses, Dispensers, Lady Health Visitors, Vaccinators, OT Assistants, dental technicians, dental surgeons, while others were excluded. The target population was 552, and 33% [N=184] population was included in the study as non probability sample to reduce the bias in this reference epidemiological study. A standard questioner was pretested to identify weaknesses and strengths. Respondents interviewed individually and data was analyzed by using SPSS.15.0 for Widows Evaluation Version. Keeping Ethical Consideration in view, formal consent and permission was obtained from concerned Authorities and respondents. The study results on the variables were as; 27[14.6%] had specific training on bio-safety and biohazards,157[85.3%] had no structured training. 96[52%] respondents had habit of eating at work place, laboratory, dressing or examination rooms, 83[45%] don't have this habits or practice while 6 [3.2%] do this practice sometimes. 98[53%] had habits of storing edibles in the refrigerators meant for vaccines or laboratory purpose, 84[45.6%] don't have this habits and 2[1.0%] do this practice sometimes. Among females[N91], 35[38.4%]using cosmetics at work place,42[46%] don't have this habits or practice,11[12%] do this practice sometimes. Out of 161 the 62[40%] had habits of smoking or sniffing at work place, 99[60%] don't have this habits or practice. 89[48.3%] had habits of cutting nail with teeth and putting pen in the mouth at work, rest 93[50%] don't have this habits or practice. The study results are consistent and supported by many studies already conducted. Results showing poor knowledge, attitude and poor practices. It demonstrates the serious need of trainings on bio-safety and continuous monitoring on the practices to minimize the health risk, which is a hidden public health problem

Infrastructure, inventory, human resource of mother and child health centers of Lahore and its impact on maternal health services

It is a common observation that there is load on tertiary care facilities which is logical outcome of under utilized primary level. For identification, quantification and gauging of these gaps current study was conducted at MCH Centers of City District Government Lahore. It was cross-sectional descriptive study conducted at City District Government, Lahore. 18 MCH centers were selected by randomization technique at each town. The current study depicted that 44.44% centers were not having any telephone, fax, generator and ambulance service. While at 11.11% centers the post of dai are vacant. It was also found the 27.78% centers were not delivering service of IUD and inject able family planning services. It was also found that 88.89% of centers had the approved furniture, equipment and linen but in majority of cases it was non functional conditions. It was also found that 83.33% MCH Centers were lacking oxygen cylinder, artery forceps and tooth forceps. 88.89% MCH centers were not having vaginal retractors and dressing seizers. Umbilical Tape, Casco Vaginal Speculum, weighing machine were absent at 100% MCH centers. First aid box was present at 17 94.44% MCH Centers. Examination Couch, almirah, towel stand, iron bed and overalls were available at 88.89% of the MCH Centres but mostly they were in poor condition. Office chair, delivery couch, bed sheet and table cloth were available in all MCH Centres while bench, bucket, towel stand and durries were available in 94.44 MCH Centres. The preceding lines depict that although majority of centers have got sanctioned equipment and furniture but they are non functional and due to this fact this chain of MCH Centers for Maternal Health Services are not delivering up to the mark. Investment in the form of financial resources determines the success or failure of any setup

effect of a modified surgical technique on the incidence of vault haematomas

To evaluate the effects of a modified incision and closure technique on the incidence of vault haematomas and post operative morbidity after vaginal hysterectomy. This study was conducted in Lady Aitchison Hospital, Lahore from November 2011 to December 2012. 100 patients aged 40 to 70 years having utero-vaginal prolapse undergoing vaginal hysterectomy were included in the study. Vaginal hysterectomy was performed with a modified Incision. Patients were observed for fever, pain and vaginal bleeding. Pelvic ultrasound was carried out for any pelvic collection or haematomas. Patients were followed for one month. Patients with complaints of lower abdominal pain, vaginal spotting, bleeding or fever were readmitted and evaluated. Out of 100 patients, 2% patients developed vault haematomas, 11% developed pain, 5% developed fever. 7% patients stayed at hospital for 5-6 days due to complications. Haematoma was confirmed by ultrasound in 2% cases and those were readmitted. Conservative management was done. No patient required surgical evacuation. Adoption of the modified technique resulted in a significant fall in postoperative morbidity due to haematoma formation.

Assessment of factors contributing to third delay in obstetric care in lady Willington hospital, Lahore

Objective: Study was designed to assess the underlying factors causing third delay in getting obstetric care after reaching tertiary care hospital

Study Design: This was a descriptive study conducted through cross sectional approach, employing non-probability convenience sampling technique

Place and Duration of Study: The study was carried out from 08th July to 15th July 2008 in Lady Willingdon Hospital, Lahore, a tertiary care obstetrics institution affiliated with King Edward Medical University, Lahore

Subjects and Methods: A study sample of 50 obstetric cases [pregnant women] was selected: half [25] were interviewed from 08.00 am to 08.00 pm during first four days and next half [25] from 08.00 pm to 08.00 am during the next four days to observe the situation / condition round the clock. As such, every pregnant woman coming to the emergency with any presenting complaint requiring immediate intervention during study period was followed till the outcome of pregnancy. A precise, pre-tested questionnaire was used for the purpose of data collection including demographic information. The record of subjects was consulted for any useful information. Physical verification for all drugs and equipments was also carried out. Data was cleaned, analyzed manually and partially on computer for applying test of significance. Data of timings was entered on SPSS computer programme. Students "t" test was employed for calculating the significance of time difference during day and night. P value <0.05 was considered significant

Results: Out of study sample of 50, 28 [56%] subjects presented with some complications, while 22 [44%] with normal pregnancy. 15 [54%] subjects from amongst those who presented with some complication had low educational status / were illiterate -whereas- 16 [74%] subjects from amongst those who presented with normal pregnancy had high education. It was due to the fact that educated couples utilize health care services, which eventually have positive impact on the pregnancy outcome. There was delay in transferring the subjects to operation theatre. Moreover, the subjects presenting with some complications were not evaluated urgently

Conclusion: The socio-demographic factors like educational status of subjects / both spouses have been found impacting the third delay. There was no appreciable delay in providing services with insignificant difference of day and night. Third delay is avoidable, if functional healthcare delivery system is in place and through rational solutions, improvement can be brought in the quality of care. The results of study underline a need to vigorously implement well planned supervision and monitoring system to provide training for quality service delivery