ABSTRACT
Background: Chronic Hepatitis C [CHC] is highly prevalent in Pakistan. Current standard treatment is Interferon alpha/ Peginterferon with oral ribavirin. Interferon therapy is associated with development and worsening of depressive symptoms in CHC patients and to determine the frequency of depressive and anxiety symptoms among patients on treatment with interferon/ Pegasus
Methods: This cross sectional study was conducted at OPD of Liaquat University Hospital Hyderabad during a period of 4 months [from July2013 to October2013]. A sample of 120 patients aged 18-60 years, either currently receiving interferon/ Pegasus treatment or had received that treatment during last 12 months was taken. Known cases of anxiety, depression and those suffering from other debilitating co morbid conditions like carcinoma and non-consenting were excluded. Ethical approval was taken from LUH ethical review committee. A Proforma was used to gather the data. The data collected were analyzed using SPSS version 20.0. Mean [+/-SD] were computed for quantitative variables. Categorical variables [such as gender and outcome variables i.e. anxiety and depressive symptoms] were measured in frequencies and percentages. Stratification was done with regard to age group and gender to see the impact of these on the outcome followed by application of chi-square test with P-value <0.05 taken significant
Results: Total 120 patients were included in the study and 119 completed the questionnaire. Male patients were 55.5%. Mean age of patients was 32.59 +/- 8.56 years [Range: 16-56 years]. Primary outcome i-e; frequency of depression and anxiety in patients on interferon were 77.3% and 70.6% respectively. [n=92] had depression. Frequency of depression of almost similar in both genders [77.3% in males and 77.4% in females; p value= 0.584], while anxiety was more in females than males [75% vs 68.2%; p value= 0.273]. Both psychiatric symptoms increased with increasing age from 16-26 years to 47-56 years of age [p values = 0.432 and 0.736 respectively]. Vast majority [86.6%] were treated with interferon while only 13.4% received the PEGylated interferon therapy. Patients treated with PEGylated interferon had less frequency of depression than those treated with interferon [62.5% vs 79.6%; p value= 0.131]
Conclusion: Depression and anxiety were found to be common in CHC patients who had been or are being treated with antiviral treatment leading to increased risk of morbidity and mortality. Screening for risk of depression, proper education and timely treatment through anti-depressant followed by close monitoring is mandatory to achieve success in antiviral treatment
ABSTRACT
Background: To assess the satisfaction levels of employees in a health care organization at Karachi, Pakistan
Methods: A cross sectional survey was conducted on 598 employees working at University and tertiary care hospital for a period of 5 months. Purposive sampling technique was used for collection of data. All employees working for at least one year at any level of management were included in the study. Part time employees, visiting staff, those absent at the time of data collection and those who refused to consent were excluded from the study. Self administered questionnaires were utilized for the purpose of data collection. Entire analysis was performed using SPSS version 20. P value less than 0.05 was taken as significant. For descriptive statistics frequency and percentages were calculated for categorical variables while mean and standard deviation for numerical variables. Analysis of Variance was applied to see association between different groups. The study was approved by the ethical review board
Results: Majority 69.4% [n=415] employees were found to be satisfied. Upper management was seen to have slightly lower scores of satisfaction compared to middle and lower management levels. Between clinical and non-clinical side there was also no significant difference observed in the satisfaction level. Satisfaction levels were seen directly proportional to age and length of service. When overall benefits were seen non clinical side 61% [n=84] were found to be more dissatisfied than clinical side 40% [n=53]
Conclusion: Study findings conclude that majority employees were satisfied. However most were dissatisfied with the overall benefit package and vacation policy
ABSTRACT
Background: To find an association between presence of Chronic disease with Oral Health
Methods: It was a cross sectional study conducted in the Dental OPD of LCMD Karachi in 2014. Three hundred participants were enrolled in this study through consecutive sample technique. Data was collected using the self administered questionnaire along with the assessment of oral health examination, which was carried out by the Researcher and data was analyzed on SPSS version 20
Results: It was observed that 59% [n=176] suffered from chronic diseases and when oral examination was conducted, it was revealed that 39% [n=117] had mobile teeth [P value= 0.001], 39.3% [n=118] had missing teeth P value=[0.001], 60.8% [n=115] had bleeding gums, 60.2% [n=112] had halitosis, 60.2% [n=71] had dry mouth, 61.3% [n=84] had oral ulcers,60.6% [n=117] had complain of food deposition and 60% [n=90] had tooth spacing due to periodontal diseases
Conclusion: It was concluded from this study that majority of participants with chronic diseases had poor oral health which needs immediate attention by the medical practitioners during the treatment of chronic diseases and as well as dentists should counsel the patients for maintenance of oral health. It still remains a chicken egg dilemma regarding the temporal sequence of events as many oral pathogens share a common factor with NCDs
ABSTRACT
Objective: Large number of fetal weight formulae derived using different populations suggest that there is no fetal weight formula which is acceptable worldwide. Ethnicity and gender of the fetus are the well reported and recognized causes of inaccuracies in these fetal weight formulae. The aim of this study was to compare the accuracies of Schild's gender specific formula with Hadlock's, Shepard's and Aoki's formulae in Pakistani population
Study Design: Cross sectional study
Place and Duration of Study: This study was conducted at Ziauddin University Hospital, from May 2014 to May 2015
Material and Methods: This cross sectional study recruited 150 primary gravida with singleton pregnancy. Patients with hypertension, diabetes and smoking were excluded. Sonographic evaluation for fetal parameters was done during 36.39 +/- 0.684 weeks of gestation. Mean fetal weight was estimated from these formulae. Mean error, mean percentage error and the limit of agreement by Bland -Altman plot was determined. Anova was applied to compare the means of estimated fetal weight, error and percentage error. Gender and weight was noted after birth
Results: No significant difference was found between the means of estimated fetal weightobtained by these formulae. Statistically significant difference was found between mean error of these formulae [p -value = 0.012] ranging between -217.24 gram to - 310.93 gram. Insignificant difference in mean percentage errors was noted which was between - 6.74% to - 9.37%. The narrowest and widest limit of agreement was found with Schild's formula and Hadlock's formula respectively
Conclusion:In our population,for pregnancies with in normal range of fetal weight, Hadlock's, Shepard's, Aoki's and Schild's fetal weight formulae, all showed low values of mean errors and mean percentage errors which were within acceptable range
ABSTRACT
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
ABSTRACT
Background: Continuing professional education [CPE] or continuous education [CE] is the means by which people maintain their knowledge and skills related to their profession. Mandatory continuing education is a major factor in relicensure that is being licensed to practice for a specific period with the license either getting renewed at the end of that period or forfeited. This study is designed to assess the awareness regarding importance of continuing professional education as a requirement for re-licensing among General Dental Practitioners and Specialists and to identify the role of governing bodies for endorsing re-licensure procedure on the basis of CME
Methods: Cross sectional study was conducted among 450 dentists practicing in Karachi [July 2013 to Dec 2013], divided in to two groups ;General Dental Practitioners [n=350]and Consultant Specialists[n=100]. Simple Random sampling technique was applied thorough lottery from available list of Dentists and Consultants. Data was collected through a self administered questionnaire. SPSS version 20 was used for analysis and Chi -square test to assess associations of categorical variables. P value less than 0.05 was considered as significant
Results: Majority participants n= 250 [55.6%] were aware about re -certification and re-licensing and n= 292 [64.9%]knew the difference between the two. Only n=153 [34%] were of the view that re -certification and re-licensing should be made mandatory in Pakistan
Conclusion: The awareness of CME and re-certification is high among our professionals
ABSTRACT
Background: Osteporosis is increasingly observed as a major public health concern as it leads to poor quality of life, pain and often disability for those effected. Especially in the developing countries, its prevalence in alarming in the face of poor awareness and management
Objective: To assess the risk factors for osteoporosis in females coming to a tertiary care hospital of Karachi
Methods: This was hospital based case control study conducted in a private tertiary healthcare facility of Karachi. It was carried out in 2012. 57 cases and 60 controls were selected through WHO Sample size calculator. Matching among cases and controls was based on gender, socioeconomic status and age group. Data was collected through questionnaire based personal interviews. Data entry and analysis was done using Epi Info. Association between categorical variables was found using chi square. Odds ratio was calculated for finding association between different risk factors and osteoporosis. The study was cleared through the Ethical review board
Results: One hundred and seventeen cases and controls were taken in this study with the age range of 45+ years [mean age 56.8 +/- 11.8]. Statistically significant difference was found in under 50 age group where cases were only n=8 [14%] as compared to controls n=25[42%]. Parsi ethnicity showed strong association with osteoporosis [OR 2.23]. Strong association was observed between smoking and osteoporosis with an Odds Ratio of 4.0. Strong association was observed with Rheumatoid arthritis [OR 2.8, CI at 95% 1.2-6.3] and Calcium deficiency [OR 2.2, CI at 95% 1.1-4.7]
Conclusion: The study revealed specific to Parsi ethnicity, family history, smoking, rheumatoid arthritis and Vitamin D deficiency were found to be potent risk factors. Therefore as reaffirmed from our study also, risk factors except from the non modifiable ones should be tackled well in advance through health education and interventions
ABSTRACT
Background: For an adolescent the requirement of sleep does not decline though the opportunity to sleep is limited on account of lifestyle predilections, academic schedules, and compelling changes in the biological processes. Sleep affects physical growth, performance and emotional thinking in addition to influencing the cognitive functioning and attention span
Objective: The primary purpose of this study was to know the effects of late sleeping habits on academic performance in school girls aged 10-13 years and to identify the factors leading to late sleeping habits in school girls aged 10-13 years
Methods: A cross sectional survey was conducted on 355 girls studying in girls only schools. Multistage sampling technique was used. Sleep and academic performance questionnaire was administered after taking written informed consents from principals, students and their parents/guardians. Chi square test was applied for finding association between sleep habits and academic performance. P value less than 0.05 was taken as significant
Results: No significant association was found between late sleeping habit and academic performance since majority of the students i.e. 267 [75%] students slept before 11pm, the time which demarcates the late sleeping time with normal time. Significant association was found between habit of book reading before bed time and above average academic performance. Around 43% students drink milk before sleeping and majority watch television before sleeping. Likewise students who wake up fresh in the morning and do breakfast have above average academic performances
Conclusion: Study findings conclude that majority of the girl students in the age group of 10-13 years sleep at an appropriate time and satisfy the day's requirement of 9 hours sleep. Therefore it does not affect their academic performance as majority of the students in the survey secured good grades