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Background: Multiple renal pathogenesis manifested as unilateral or bilateral size changes, therefore there should be normative reference data for proper comparison. Our goal is to determine normal standard value ranges for renal dimensions in pediatric population in Karachi. Sonographically renal length in 150 children were measured and correlate with age, gender, body height, weight and BMI
Objective: Sonographic Measurement of Normal Renal Size and Correlation with Somatic Variables in Subset of Karachi Pediatric Population
Methods: A six month cross sectional hospital based assessment of kidney size [length, width] was evaluated with the help of sonography. XarioTM 200 Toshiba with convex 3.5 frequency transducer will be used. The mean renal dimensions with standard deviation [SD] were estimated for every group of age. The renal length and width were determined and corresponded with different somatic variables. Descriptive statistics with Regression analysis was done
Results: The normal length and the width of kidneys and its ranges were obtained. Right kidney length moderately and significantly correlated with height and weight [r=0.651, r=0.654] and age [r=0.538] respectively. However, moderately insignificant with BMI [0.129]. Lefts kidney moderately and significantly correlated with height and weight [r=0.665 r=0.705], negative insignificant with age [0.564] and moderately weak insignificant relationship with BMI [0.174]
Conclusion: The research presents the normal range parameters of renal size and measurements by sonography in healthy pediatric population in Karachi. Guideline measurements of kidneys represent a statistically important and comprehensive interaction with specifications of growth which allows us to easily calculate the renal size by derived regression analysis
Subject(s)
Humans , Female , Male , Child , Child, Preschool , Infant , Adolescent , Ultrasonography , Cross-Sectional Studies , Organ Size , PediatricsABSTRACT
Background: It is estimated that more than 6 million children die in the developing world at the hands of preventable conditions; primarily pneumonia and diarrhea. WHO in 1992 initiated the Integrated Management of Childhood Illness [IMCI] program as a strategy to provide an integrated approach for the management of major causes of childhood morbidity and mortality
Objective: To assess if IMNCI workshops that are held in hospitals that have post graduate training program in field of pediatrics are effective in enhancing knowledge; hence skills for improving health care delivery in limited resources
Methods: A KAP survey was conducted in 2013 among IMNCI trained doctors working in 5 tertiary care hospitals of Karachi. N=57 doctors were identified and administered a structured questionnaire based on recall questions and scenarios. Questionnaire was developed from a similar study conducted elsewhere. Data entry and analysis was done on SPSS version 20
Results: A total of n=57 doctors were included in the study, out of them resident medical officers [RMO] were n=10, postgraduate trainees [PG] n=38 and Medical Officers [MO] were n=9. Mean score of correct answers was 14 [3]. No significant difference was observed when mean scores of PGs was compared with RMO and MO combined through application of Independent sample t test
Conclusion: The study revealed gaps in knowledge and practices of trained doctors regarding management according to IMNCI guidelines
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Background: Infertility is a common problem globally affecting a large proportion of world population. Laparoscopy provides meaningful information regarding different factors that may cause infertility
Objective: To determine the frequency of causes of primary infertility in women by diagnostic laparoscopy
Study Design: Cross sectional study design
Setting: Study was performed at the Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre, Karachi
Duration: September 2011 to February 2012
Subjects and Methods: 86 patients with primary infertility were included in the study and underwent laparoscopy for determining causes of infertility. Data was analyzed on SPSS, frequencies and percentages were determined for qualitative variables while mean and standard deviation was determined for quantitative variable
Results: Eighty six females were included in the study with mean age of 28.6 + 5.2 years and mean duration of infertility was 4.9 + 1.9 years. Findings on laparoscopy were analyzed and 51.2% of females were found with tubal blockage, while other findings were; hydrosalpinx in 25.6%, PCOs in 22.1%, Ovarian abnormalities in 38.4%, Pelvic adhesions in 38.4% and uterine congenital anomalies in 3.5%
Conclusion: Tubal diseases found to be one of the major factor causing primary infertility and diagnostic laparoscopy will play a valuable role in early and prompt diagnosis and management of causes leading primary infertility
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It is an emerging concept now a day that epicardial adipose tissue [EAT] thickness has an essential character in the progression for cardiac risk profile. It is now consider as a new and consistent cardiovascular risk factor. EAT thickness is the indicator for cardiac adiposity. It modifies the cardiac morphology and function. It has close anatomical relation to myocardium. It causes local paracrine interactions between myocardial tissues. It causes enlargement of left ventricle with its diastolic dysfunction. Measurement and assessment of epicardial adipose tissue thickness is now done by new method echocardiography. It appraises visceral adiposity and inflammation. Association of EAT location and its physiological or pathological importance requires advance research. EAT in future may replace waist circumference, as a marker of abdominal obesity. This article briefly discussion the structure of epicardial adipose tissue and its function. It also describes the method for its assessment
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Background: Thyroid gland volume [TGV] is highly variable as it is greatly influenced by age, gender, anthropometric measurements and geographical location. It has become essential for every population to determine reference range of their normal thyroid gland volume [TGV] in healthy individuals. This in turn will help the population in grading of goiter and will guide in large scale iodine monitoring programs
Objective: To determine TGV in a subset of Karachi population and to determine its association with age and gender
Methods: A cross-sectional study employing 421 volunteers aged 21 years and above went through the ultrasound [US] examination of their thyroid gland [TG] after being confirmed euthyroid by their serum thyroid stimulating hormones [TSH] evaluation
Results: TGV in the study was found to be 6.26 +/- 2.89 ml. Males had significantly higher TGV 6.78 +/- 2.88 ml as compared to females 5.7 +/- 2.79 ml [P=0.00]. Volume of right lobe was significantly greater than that of left lobe [P=0.00] in both the genders. TGV increased significantly with age till 60 years [P<0.05] and after the age of 60 years it decreased [P=0.035]
Conclusion: Mean volume of thyroid gland in this studied population is not only smaller than that of the Western countries but is also much smaller than the neighboring country Iran. The study has also proved that there was a significant decrease in mean thyroid gland volume after the age of 60 years. Prolonged and severe iodine deficient status of Pakistan till recent past could be an answer for small thyroid gland volume in the studied population. Similar studies in future will give more accurate facts and figures regarding mean thyroid gland volume in this population if Pakistan retains itself as an iodine sufficient State
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Background: Diarrhea is cited as one of the main causes of death for infants and children, especially in squatter settlements, owing to poor sanitary conditions. Treatment and prevention of diarrhea can be managed at home by primary caregivers. It is therefore important for mothers and primary care givers to be aware of strategies for management and treatment of diarrhea
Objective: To assess the awareness of mothers regarding home management of childhood diarrhea in a squatter settlement of Karachi
Methods: A cross sectional study was conducted from 2012 to 2013 among mothers from Gulshan-eSikanderabad of Karachi who had at least one child under age of 5 years. In total 110 mothers were interviewed. Non probability convenience sampling technique was used. Data was collected by structured questionnaire filled via personal interview. Informed consent was obtained before collection of data. Data Analysis was done by using SPSS version 20
Results: Out of total 110, 93 [84.5%] mothers said that their children had an episode of childhood diarrhea during last 3 months. For the management of diarrhea 91 [82.7%] mothers took their children to PHC centre and 99 [89.9%] mothers were aware about ORS. Almost two third of them aware about the ingredients of homemade ORS but their knowledge about correct amount was poor. Dirty water and food was identified as the important causes of diarrhea by 106 [96%] and 76 [69%] mothers respectively. According to 101 [91.8%] mothers hand washing would be an effective measure to prevent diarrhea
Conclusion: Despite the high rate of diarrhea in this community, knowledge of mothers regarding home management of diarrhea was found satisfactory. Adopting the preventive measures and intensifying the mothers education is the dire need to reduce the high rate of diarrhea in this community
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Background: Motivation and job satisfaction ultimately effect work performance of an individual. There are various factors which influence the work motivation and knowledge of these factors can help in improving the work performance
Objectives: To assess the different factors that are associated with work motivation among nurses working in private and public tertiary care hospitals of Karachi
Methods: This descriptive, cross-sectional study was carried out among nurses for duration of 3 months in 2013. Total 240 nurses from two tertiary care hospitals of Karachi were selected by convenience sampling. A pretested and self-administered questionnaire was used to assess factors associated with work motivation. Data was analyzed using SPSS version 20.0
Results: Of total 240 study participants, 48.8% [117] nurses were in favor of financial incentives that motivate them most. Salary structure and appraisal system both showed significant difference [p-value= 0.000] between nurses from public and private hospitals while the most content place to work was reported government hospitals by 43.4% [104] nurses. Work motivation mean score revealed significant difference [p-value =0.003] among nurses from different working areas of hospital. Factors associated with job satisfaction showed significant difference [p value = 0.000] among nurses from private and public sector hospitals
Conclusion: Financial incentives were found to be the most important motivating factor for nurses that improve their performance. It was also concluded that public sector hospitals along with so many factors of satisfaction are the most content place of working that motivate them most
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The aim of this study was to determine frequency of thyroid incidentalomas [TI] through ultrasound [US] and its association with age, gender and ethnicities. It was a cross-sectional study. Total 269 adults who were asymptomatic for thyroid disease aged 21 years and above underwent ultrasound examination of their thyroid. Frequency of TI found was 21%. TI was detected in 25% of females and 16% males [P= 0.078]. 61% had thyroid nodules [TNs] in one lobe [right, left or isthmus] and 39% had TNs in more than one location. About 55% had single TN and 45% had multiple TNs. 38% had TNs greater than 1cm while 57% had TNs smaller than 1 cm. 5% had TNs greater and smaller than 1 cm. TI was equally common in individuals of different ethinicities [P= 0.758]. Frequency of thyroid incidentalomas found in our study was higher than most of the other iodine sufficient states. Unlike other studies, incidentalomas were equally common in both the genders of our study. This may be due to the previous iodine deficient status of Pakistan which was prevalent. However further studies on the same topic will help us in identifying the correct status of thyroid incidentalomas if Pakistan retains it's status as an iodine sufficient state
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Background: The ABO Blood group system has been evaluated many a times for increased risk of vascular accidents and heart diseases. This study aims to prove that the reason behind the decreased risk of thrombosis in O blood group population could be the decreased levels of clotting factors in its plasma compared to other blood groups
Objective: To assess the levels of clotting factors VII, VIII, IX and X in all blood groups to determine whether blood group O has the lowest levels of all clotting factors in its plasma
Methods: This is a Descriptive Cross sectional study, conducted at Dr. Ziauddin Hospital Karachi and Dow University of Health Sciences over a period of six months. The study involves 16 plasma units divided into four of each blood group. On the day of testing plasma was thawed and assays of factor VII, VIII, IX and X were performed on all blood groups and results noted
Results: Levels of Factor VIII, IX and X were found to be highest in blood group AB and lowest in blood group O. Factor VII levels varied from others
Conclusion: Our results showed that factor VII levels vary in different blood groups, may be due to its short half-life. Thus we could not establish a link between ABO blood groups and clotting factor levels
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Background: Hepatosplenic sizes of children vary with age .There are many diseases which affect the sizes of the liver and spleen ranging from acute liver disease to other hepatosplenic disorders . Ultrasound is a quick and reliable method .Unfortunately there is lack of sufficient data in our population therefore my study would be beneficial in determining various disease processes
Objective: To establish normative data of Hepato-Splenic sizes in Pakistani pediatric population using ultrasonography
Methods: The study was conducted at the Ziauddin University Hospital, a tertiary care teaching facility in Karachi. The cross sectional prospective hospital based study was conducted with 150 patients aged 1 month to 14 years. Ultrasonographic evaluation for the assessment of liver, spleen and portal vein size was performed. These were correlated with the age, sex, height/length and weight of the children
Results: Normal liver and spleen length and its ranges with portal vein diameter were obtained. The liver, spleen length and portal vein significantly correlated highly with the height/length [r=0.7,0.7,0.6]respectively and weight of the subjects [r=0.7,0.7,0.4 respectively]
Conclusion: The study provides the normal values of liver and spleen size by ultrasonography in healthy Pakistani pediatric population
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Obesity is considered a disease and one of the fastest growing global threats. In Pakistan General Physicians [GPs] are approached first in case of any disease thus their knowledge and practices regarding obesity are very important to assess. Our objective was to assess the knowledge and practices of GPs regarding obesity and management. This was a cross-sectional study conducted among GPs of Karachi. 140 GPs from 17 towns of Karachi were selected by convenience sampling. Data was analyzed using SPSS-16. Total 140 GPs with mean age of 46.1 +/- 11.1 years were included in the study. Among them 90 [64.3%] were males and 40 [28.3%] were females. Awareness was assessed regarding factors related to obesity and knowledge was compared on basis of qualification and knowledge update. Significant difference was found for insufficient physical activity [p=0.001] and social problems [p=0.02]. On the basis of knowledge update, stress and anxiety [p=0.013] were found to be significant. Significant difference was found in readings for BMI [p=0.038] and waist circumference [p=0.000] to label patient obese. Among several lifestyle modifications advised, significant difference was found for increase fibre in diet [p=0.006], low fat intake [p=0.003], low carbohydrate intake [p=0.02]. Overall awareness regarding obesity was fair among GPs, while certain gaps were found in criteria for labelling patient obese. Significant difference in knowledge of GPs was found among those GPs who update their knowledge and who did not
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Background: During the whole period of pregnancy women's body undergoes various physical and physiological changes. Due to the change during and after pregnancy common problems faced by the women's are low back pain, stress urinary incontinence, pelvic pain. Physiotherapy can help in this through postural reeducation, strengthening of pelvic floor muscles and through some modalities
Objective: To assess the awareness of obstetricians/ gynecologist regarding the role of physiotherapy in managing obstetric patients
Methods: A cross-sectional study was done among gynecologists and obstetricians selected from tertiary care hospitals of Karachi through non-probability convenient sampling, total sample size of the study was 300. Data was entered and analyzed by using SPSS version 17. Chi square test was used to find association for qualitative variables and p value <0.05 was considered as significant
Results: From the sample size [n=300] including gynecologists/obstetricians 123[41%] were from government hospitals and 177[59%] from private settings, 156[52%] had 3 to 5 years of experience while 144[48%] had more than 5 years of experience. Regarding referral during antenatal and postnatal period, it was found that 41[13.7%] participants advised most of the time, 203[67.7%] occasionally and 56[18.7%] never advised their patients. Out of total, 194[64.7%] had an awareness about pre-natal physiotherapy exercises sessions but only 56[18.7%] refer their patients for the antenatal classes [p-value 0.001]. From total 204[68.0%] answered yes regarding the role of postnatal exercise sessions but out of them only 60[20.0%] refer for the post-natal physiotherapy sessions regularly and 74[24.7%] occasionally [p-value=0.218]
Conclusion: Obstetrician/ Gynecologists had awareness about the role of physiotherapy in management of their obstetric patients but only a small portion of them concern and refer their patients for physiotherapy
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Background: News viewing is directly linked to a person's cognitive behavior and hence deeply affects psychological status of the viewer. Live events and deteriorating images affects different aspects of a person's cognition. Stress is one of them which was measured in this study using a Psychological Stress Scale [PSS]
Objective: To assess the psychological effects of viewing news channels among adult population of Karachi, Pakistan
Methods: This Cross Sectional study was carried out for a 2 month duration targeting the adult population of Karachi. Total 400 participants were selected through the convenience sampling technique. A pretested and self administered questionnaire was used to collect data. PSS [Psychological Stress Scale] was used to measure stress among study participants. The data was analyzed using SPSS version 20
Results: Of total n=400 participants, 273 [68.3%] used TV as the source of getting news and at the time of watching TV 166 [41.5%] preferred to watch news channels. 115 [28.8%] individuals had lasting effect after watching news of violence and 173 [43.3%] participants were stressed after watching news. Using PSS, 288 [72%] individuals had moderate stress score, 78 [19.8%] had low and 34[8.3%] had high stress score
Conclusion: It was concluded from the research that news is adversely affecting the psychological health
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Background: Urinary Incontinence is a worldwide problem that remains a highly prevalent cross-cultural and costly condition affecting millions regardless of age and gender. Physiotherapy is among the recommended treatment options for the management of stress incontinence
Objectives: To assess the awareness among doctors regarding the role of physiotherapy in stress incontinence management
Methods: A cross-sectional study was done among gynecologists, nephrologists and urologists selected from public and private hospitals of Karachi through non-probability convenient sampling; total sample size of the study was 100. Data was entered and analyzed using SPSS version 17. Chi square test was used to find association for qualitative variables and p value <0.05 was considered as significant
Results: Awareness regarding role of physiotherapy management in stress incontinence was found among 79% doctors. Urinary tract infection [55%], Post partum [45%] and post surgical [45%] were considered by doctors as the most common causes of stress incontinence. Preferable choice of management for stress incontinence was physiotherapy by 75% doctors. Regarding referral of patients with stress incontinence for physiotherapy 47% of the doctors referred their patients depending on patient condition and about 25% of the doctors were of the opinion that their patients recovered completely
Conclusion: The study showed that there was awareness among doctors about the role of physiotherapy in management of stress incontinence and most of them referred their patients for physiotherapy
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Background: Obesity is a chronic disease which requires aggressive management. Obesity, although not a direct cause of most diseases, unfavorably alters the risk factor profile. It may lead to high blood pressures and high cholesterol levels, which can result in cardiovascular diseases or strokes. In addition to these diseases, the quality of life is also severely impaired. Successful treatment of obesity not only alleviates the associated medical problems, but also improves the quality of life dramatically
Objectives: To observe and compare obesity, its perception and complications among different socioeconomic classes in Karachi
Methods: A predesigned questionnaire was filled out at two hospitals of Karachi for a sample representing patients from lower and higher socioeconomic strata. BMI of these patients was calculated and assessed with respect to their income, education level and occupation, eating patterns, frequency of exercise. The presence of associated non-communicable diseases like hypertension and diabetes mellitus was also recorded. Data was analyzed using SPSS software
Results: The patients' population comprised 31 males and 19 females. The mean age was 45.56 [SD +/- 12.08]. Minimum age was 15 years, while maximum was 75 years. Pathological analysis revealed that majority of SCC cases were moderately differentiated, SCC with clinical stage T2 or T3, NO,MO/N1,M0. Most common oral sites came out to be buccal mucosa of cheeks followed by lateral borders of tongue and lips. All patients underwent primary resection +/- neck dissection and reconstruction when necessary
Conclusion: Obesity was observed in all classes irrespective of the education, income and occupation of the respondents with sedentary lifestyle being the main causal factor. There exists lack of awareness of the harmful consequences of obesity
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Background: Cupping therapy is a type of alternative medicine that is gaining popularity among people during last few years but the extent of its use and awareness of public towards it has not been widely studied
Objectives: The aim of this study was to assess the opinion and attitude about cupping therapy among general population of Karachi
Methods: A descriptive cross sectional study with ample size of 400 individuals from general population. Data was collected using non probability convenience sampling technique thru structured and self administered questionnaire from April to June 2013. Data was analyzed by using SPSS version 19
Results: Out of total study participants, 58% were females. Among them 48.7% said that they have used alternative medicine and out of them 23% opt for it as it is natural and effective. 59.6% of the respondent agreed that the cupping therapy helps in treatment; 59% said that it has fewer side effects and 57.8% said it is cost effective
Conclusion: There is increased public interest to know more about cupping therapy. A positive attitude towards cupping therapy was observed, yet most people are reluctant to discuss it with their physicians. Campaigns should be organized to increase the level of awareness towards the alternatives for treatment of ailments
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Obesity is considered as a global epidemic. Obesity in childhood and adolescent is an issue of concern because it is an important predictor of adult obesity. Identifying individuals who are physically inactive, overweight or obese in school going age is very important. The objective of this study was to determine the frequency and factors leading to obesity in school children. A cross-sectional survey was conducted on children aged 13-16 years. It was a questionnaire based survey with measurement of height and weight. Total 431 children were included in the study. Three hundred and nine [71.7%] of the students were in the normal category, i.e., less than 85[th] centile while 122 [28.3%] had weight greater than 85[th] centile and were overweight and obese. Positive association was found between eating out and weight categories, eating breakfast, intake of fresh fruits and vegetables and soft drinks, low physical activity, and increased screen time. Frequency of overweight and obese children was high in children from higher socioeconomic status. There is strong association between strong determinants of obesity and overweight. Health education of students for known risk factors should be integrated with curriculum of science from elementary classes.