Depression among type 2 diabetes mellitus and its association with poor glycemic control in patients visiting tertiary care hospital of Islamabad

Background: Depression among type 2 diabetes mellitus patient results in negative health outcomes

Objectives: To determine the association between depression and glycemic control in patients suffering from type 2 diabetes mellitus

Study design, settings and duration: This comparative cross-sectional study was conducted in the diabetic patients attending diabetic clinic of Capital Hospital, Islamabad which is a tertiary care hospital from 1[st] September 2015 to 30[th] November 2015

Patients and Methods: The serum glycosylated hemoglobin levels [HbA1c] were recorded from the medical records of patients while Patient Health Questionnaire [PHQ-9] was used to assess depression in these patients. Poor glycemic control was taken as value of HbA1c >/= 7%. Equal number of depressive and non-depressive type 2 diabetics were recruited. The data was analyzed using SPSS 20.0 and Chi-square was used to find out association between depression and glycemic control among type 2 diabetes mellitus patients

Results: A total of 250 type 2 diabetes patients were enrolled in the study. Their mean HbA1c level was 8.5% [S.D +/- 2.15] and the PHQ-9 score was 9.0 [S.D +/- 4.11]. Almost 83.2% patients had poor glycemic control and were depressed while 57.6% had poor glycemic control but were non-depressed. Depression was strongly associated with poor glycemic control in type 2 diabetes mellitus

Conclusion: Depression among type 2 diabetes patients was significantly associated with poor glycemic control

Policy message: Type 2 diabetic patients should be regularly monitored for their glycemic control and assessed for depression and treated accordingly

Are lhws equipped enough to detect malnutrition in under-5 children? a kap survey of district Rawalpindi

Background: Malnutrition remains one of the major problems in developing countries including Pakistan. Despite raised awareness, there is little improvement in nutrition indicators in Pakistan, which calls for identification of the causes of stagnant rates

Objectives: To assess the proficiency of lady health workers [LHWs] to detect malnourishment in under-5 children using Salter scales and growth charts

Study design, settings and duration: Cross sectional study done in district Rawalpindi from May to August 2013

Subjects and Methods: Knowledge and skills of 59 LHWs related to growth charts were determined by cross-sectional method; and availability of tools were assessed by a short survey in district Rawalpindi

Results: None of the LHWs had growth chart while Salter-weighing scale was available with 34 [57.6%]. In knowledge assessment 78.8% LHWs scored good marks [above 80%] while 19.2% scored average [60-79% marks]. Skills of LHWs related to child weighing were satisfactory but major deficiencies were noted regarding hanging the Salter-scale to stable support and tarring the scale-needle to zero reading

Conclusion: For timely identification of malnutrition in children, availability of Salter-weighing scales and growth charts must be ensured with the LHWs

Policy message: LHWs trainings should be updated with frequent trainings and refresher courses. They should be provided with updated materials like charts for Weight-for-Height and Mid-Upper Arm Circumference [MUAC] measuring tapes