Appraisal of knowledge, attitude and practices of trained doctors regarding IMNCI

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

Psychological effects of viewing news channels among adult population of Karachi, Pakistan

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

Role of physiotherapy in managing pressure ulcers: physiotherapists' perspective

Background: Pressure ulcers, although being very common, are still a neglected field of study in Pakistan. They can result in debilitating complications if not tre9ted early and properly. Proper medical care along with prompt physiotherapy is the idealistic choice in managing pressure ulcers

Objectives: Assess the awareness among doctors about the role of physiotherapy in management of pressure ulcers

Methods: The cross sectional survey involved 200 doctors selected by convenience sampling from government and private hospitals of Karachi. Doctors were interviewed through a structured questionnaire and p value <0.05 was considered as significant

Results: Awareness of physiotherapy among doctors, in managing pressure ulcer patients was83.5% [n=167]. "Usual practice" followed by doctors in their hospital settings, involved the application of various physical agents to enhance pressure ulcer healing such as HVPCs [high voltage pulse current] 18.0% [n=36],US [ultrasound] 28.5% [n=57] and cold laser 11.0% [n=22]. Practices to prevent ulceration included health education sessions only up to 44.5% [n=89]

Conclusion: Our study results showed that there was awareness among doctors about the role of Physiotherapy in management of pressure ulcers, but even after realizing not all the doctors were referring patients for physiotherapy. Further awareness sessions are required for spreading more knowledge among the doctors and the patients and their families to prevent pressure ulceration

Hospital waste management in the teaching hospitals of Karachi

To evaluate the current practices of segregation approaches, storage arrangements, collection and disposal systems in the teaching hospitals of Karachi. A cross-sectional survey was conducted in eight teaching hospitals of Karachi, using convenient sampling technique. The instrument of research was a self administered questionnaire, with four sections, relating to the general information of the institution, administrative information, information regarding Health Waste Management personnel and a check-list of Hospital Waste Management activities. Out of eight hospitals visited 2 [25%] were segregating sharps, pathological waste, chemical, infectious, pharmaceutical and pressurized containers at source. For handling potentially dangerous waste, two [25%] hospitals provided essential protective gears to its waste handlers. Only one [12.5%] hospital arranged training sessions for its waste handling staff regularly. Five [62.5%] hospitals had storage areas but mostly it was not protected from access of scavengers. Five [62.5%] hospitals disposed off their hazardous waste by burning in incinerators, two [25%] disposed off by municipal landfills and one [12.5%] was burning waste in open air without any specific treatment. No record of waste was generally maintained. Only two [25%] hospitals had well documented guidelines for waste management and a proper waste management team. There should be proper training and management regarding awareness and practices of waste disposal. Research must be undertaken to seal existing gaps in the knowledge about hospital waste management. The hospital waste management guidelines enacted on 7th June 2004 should be followed and regulated by law enforcement agencies rigorously [JPMA 55:192;2005].

Health and safety measures available for young labourers in the cottage industries industries industries of Karachi

To determine the health problems faced by labourers, 18 years and under, working in the cottage industries of Karachi and know the safety measures available and utilized at these places. Cross-sectional study using two-stage cluster sampling. From February 2002 to March 2003, 95 cottage industries from 10 different locations of five districts of Karachi were included. All workers, 18 years and below, present were interviewed. The environmental and safety gadgets present at the industry were inspected by the surveyors and the manager was interviewed for presence of health and safety benefits for the workers. A total of 280 workers were interviewed, 26 [9.3%] children were between 9-12 years, 82 [29.3%] were between 13-15 and 172 [61.4%] were between 16-18 years of age. Health benefit was given to only one 13-year-old worker in silk industry; appropriate gadgets were absent in 93 [97.8%] industries, present only in 2 industries [one silk and one loom]. First Aid box was present in only one loom industry. Two hundred and forty workers [85.7%] were unaware of the materials they were using. One hundred and ninety-three [69%] children were working in improper light, 199[71%] workers experienced high level of noise, 232[83%] were working in high temperature and 155[55.3%] were working with improper ventilation. Health problems faced included joint pains [n=64, 22.85%], backache [n=85, 30.35%], vertigo [n=48, 17.14%], numbness of fingers [n=77, 27.5%] and fatigue experienced by 143 [51.07%] children. The children and adolescents employed in cottage industry are suffering from health problems due to lack of knowledge on their part, and improper ergonomics, environmental and safety conditions at the workplace. The cottage industry should be regulated and brought under labour law. The health sector non-governmental organizations should make concerted efforts for the rehabilitation of this workforce by creating awareness and providing opportunities for education and development of skills

Awareness about DOTS amongst medical teachers of private and public sector medical colleges of Karachi

To assess knowledge of medical teachers belonging to private and public sector medical colleges of Karachi, regarding the widely accepted domiciliary treatment strategy of tuberculosis, that is 'DOTS' - Directly Observed Treatment Short course. Methodology / Study Design: This was a cross-sectional study, the study population, comprised of teachers from three public and three private medical colleges, of the rank of demonstrators and assistant professors. A sample of 120 subjects were interviewed. Convenient Sampling was done as those faculty members who were present on the day were interviewed. The survey was conducted by a self administered questionnaire comprising of questions related to personal information, knowledge of DOTS, details of complications of tuberculosis, diagnosis and its treatment. The data collected was analyzed by using SPSS system. Out of the 120 study subjects [60 from private and 60 from public sector medical colleges], 50 teachers [42%] had good knowledge regarding epidemiology, complications and diagnostic tests of tuberculosis, 42 [35%] teachers had average knowledge and 28 teachers [23%] had poor knowledge. Teachers from public and private sector medical colleges had a very striking difference. The teachers of private sector medical colleges / universities were mostly post-graduates, therefore had better scores as compared to Public sector teachers. The medical teachers who practiced in the evenings got higher scores as compared to non-practicing teachers. Conclusions: The medical teachers of private medical college were more aware and knowledgeable as compared to medical teachers of public sector college. The source of knowledge being a workshop or a seminar on tuberculosis treatment and prevention. For creating awareness and motivating the teachers / trainers of future doctors. Government or the national tuberculosis control program must emphasize on dissemination of knowledge through every media and source available in order to combat this highly infectious disease of our country

AIDS - the new global epidemic. What should be done to combat with this emergency?

It is high time for the government and NGO's to join hands in combating this growing menace which might play havoc with our lives in near future, if not now. We still have time to educate our masses regarding the ways in which the disease is transmitted and prevented. This is possible only with commitment at all levels and not mere lip service by top government functionaries and health professionals. This is a review article