Prevalence and risk factors for psychological distress and functional disability in urban Pakistan.

Background: There is a close association between poor mental health status and both poor physical health and decreased productivity. An evidence base on the risk factors for psychological distress in low-income countries is lacking and is much needed to help develop appropriate interventions. We aimed to estimate the prevalence of psychological distress in urban Pakistan and identify associated risk factors and functional disability. Methods: This was a population-based study of 18–75-year-olds in urban Pakistan. The Self-Reporting Questionnaire (SRQ) was offered to 1000 adults to measure psychological distress. The Life Events Checklist, Oslo-3 for Social Support and Brief Disability Questionnaires were used to establish social stressors, support and functional disability. Results: Questionnaires were completed by 880 (94%) eligible participants, of whom 41% of women and 19% of men scored 9 or more on the SRQ (possible range 0–20). Low educational status was associated with high rates of psychological distress. Women had significantly higher levels of distress than men and were less likely to receive practical support. Conclusions: The prevalence of psychological distress was lower in urban Karachi than that reported previously for rural Punjab province, Pakistan. However, in urban Karachi, as in rural Punjab, socioeconomic status seemed to have more of an impact on the mental health of women than that of men.

Morbidity associated with obesity in pregnancy

Obesity is associated with increased risk of illness and disability. It is one of the leading preventable causes of death in the World. Major maternal complications associated with obesity include diabetes mellitus, hypertension, deep vein thrombosis, respiratory diseases, infections and birth defects and even decreased fertility. Economic consequences of obesity are operative delivery and its complications, prolonged hospital stay. 1. To review maternal and fetal morbidity associated with obesity. 2. To observe the mode of delivery in obese pregnant female. Observational study [cross section]. This study was conducted at Khair-un-Nisa Hospital affiliated with Fatima Memorial Hospital from April 2011 to October 2011. 60 patients were enrolled in this study. Women with BMI more than 30 were included in our study. BMI was calculated by pre-pregnancy weight or weight during first trimester at booking within outpatient department. Patients with history of chronic hypertension, diabetes mellitus were not included in the study. The prevalence of obesity is increasing in our young population. In this study mean age is 30 years +/- SD 91.25. Most of the patients had BMI 33 +/- SD 2.80. Hypertension, diabetes, urinary tract infection 18.33%, congenital abnormalities 16.7%. Most of the patients ended on LSCS 30.5%, wound infection noted in 11 patients 18.3%. During normal vaginal delivery 4 patients 6.7% had third degree prenieal tear and 11 patients had post-partum hemorrhage. Fetal complications were birth asphyxia in 8 [13.3%] neonates and shoulder dystocia in 2 [3.3%] babies. Obesity is a public health problem because of its prevalence, cost and health effects. Maternal obesity carries significant risk for mother and fetus. Risk increases with degree of obesity. Feto-maternal morbidity associated with it, can be prevented by creating awareness and preventing overweight and obesity in adults and children

Training of non-physician practitioners to identify and refer diabetic patients

To improve the practices of non-physician practitioners on early diagnosis and referral of patients with diabetes mellitus. Study will be conducted in a peri-urban village community in Lahore, Pakistan, during 2007 - 2008. Quasi - experimental study, one group before and after design was used to document the effect of training of non-physician practitioners on improving their diabetic patient identification practices and referral to the hospital for diagnostic and treatment facilities. Fasting blood glucose test was used to identify hyperglycaemics out of those referred by the NPPs. Patient referral was increased by 48.44% after training. Identification of hyperglycaemic patients on the basis of signs and symptoms was 47% before and 48% after training and the difference between two proportions was not significant. increased number of referral showed motivation of NPPs towards the task however more prolonged and structured training program is required to utilize their services in community as part of our health care delivery system