Awareness about hepatitis C among patients suffering from hepatitis C in Karachi, Pakistan

Objectives: To assess the level of awareness about hepatitis C among patients suffering from hepatitis C in Karachi. Pakistan. Study design, settings and duration: A descriptive, cross-sectional study, conducted among hepatitis C patients recruited from the Aga Khan University Hospital and the Civil Hospital, Karachi, between March and May 2013

Patients and Methods: A sample size of 247 was calculated using the Open Epi software. Data were collected using a questionnaire and all eligible patients were briefed about the study purpose, risks, benefits, and their rights as participants. All patients who agreed to participate gave written informed consent. The completed questionnaire took a maximum of 2530 minutes. For the data analysis, frequencies and percentages were computed to find out the estimated proportions of different variables

Results: A total of 250 HCV patients participated in the study. Most of the patients had incorrect knowledge about transmission of disease where 76.8% said that it is transmitted through sharing of towel/clothes, coughing [75.2%] or eating in same utensils [53.6%]. Tattooing [66.4%], kissing [66%], sexual intercourse [54.4%], ear and nose piercing [53.6%] were also identified as transmission sources. Almost 91% patients had misconceptions that preventive vaccine for hepatitis C infection is available. Almost 61% patients thought that exposure to needles/syringes was the cause of their hepatitis C while 22% said it was medical instruments. Food and water as the cause of their hepatitis was reported by 19.1%

Conclusion: Patients suffering from hepatitis C have misconceptions about disease transmission, its risk factors, and the availability of preventive vaccine for hepatitis C. There is a dire need to improve public awareness about common diseases and their prevention

Domestic violence among female healthcare providers: a meta-analysis

Objective: To estimate the prevalence of domestic violence among married female healthcare providers within the Pakistani context

Design: A systematic review has been done

Place and duration: From January 1992 to December 2011 the international and national published literature on domestic violence analyzed and scrutinized

Results: Of the total 54 researched articles revealed that worldwide domestic violence prevalence is ranged of 10% - 69% however, in Pakistan it is 30% to 79%. Verbal violence is the most common type which further leads to other form of domestic violence such as emotional, physical, and sexual violence. Internationally, very limited literatures were available on domestic violence among female healthcare providers but, no literature was found in the Pakistani context

Conclusion: Our literature review reveals that globally female are significantly experiencing in a large proportion with domestic violence and verbal violence in more common. Further research is also need in this regard especially on the ground of domestic violence among healthcare providers

Rapidly pregressive periodontal disease associated with human immunodeficiency virus

Severe periodontal inflammation with generalized dental plaque accumulation, spontaneous and severe gingival bleeding, fungal infection, and interdental papillae necrosis are presented in a patient infected with human immunodeficiency virus [HIV]. Bite-wing radiographs revealed a generalized horizontal alveolar bone loss of 7-8 millimetres in both arches. Erythematous patches were noted on the gingival mucosa in both jaws. DNA testing was performed to indentify the periodontopathogens. The patient had no signs or symptoms of acquired immunodeficiency syndrome. This case-report presents the massive periodontal destruction that occurred in a patient infected with HIV. Therefore, it is highly recommended that patients infected with HIV should be regularly monitored to aid in early detection and to provide proper management of periodontal inflammatory conditions to minimize its destruction

Critical illness myopathy

Critical illness myopathy [CIM] is a syndrome of widespread muscle weakness and neurological dysfunction which can develop in critically ill patients receiving intensive care. CIM are often distinguished largely on the basis of specialized electrophysiologic testing or muscle and nerve biopsy and its causes are unknown, though they are thought to be a possible neurological manifestation of systemic inflammatory response syndrome usually developing in patients after a brief period of stay in the Intensive Care Unit [ICU]. This case report aims to analyze the Clinical feature, diagnosis and treatment of CIM of 60 years old male case with Chronic Obstructive Lung disease [COPD] admitted to the intensive care. Health professionals working at critical care unit should be aware that any ICU patient may develop CIM

influence of psychosocial factors on academic performance of adolescents: a quality assurance project

Adolescence is a time of rapid psychological and physiological changes and is associated with anxiety and mental distress. This project looks at the potential of school-based programs to reduce these negative effects of academic performance in both the short-and long-term. This study was conducted in a private school in Karachi, Pakistan between October 1998 and December 2006 on 305 students with low academic performance. Results show that students scoring low grades had a mean of 55 +/- 2.8 and postintervention score of 56 +/- 2.6. The intervention package significantly created a difference in reducing the number of students receiving low grades. Qualitative analysis showed that study participants had enhanced self-esteem, confidence levels, positive attitudes towards learning, improved time management and decision-making skills. This suggests that in an academic institution, the presence of a professional support system enhances learning and coping mechanisms

Are unhygienic practices during the menstrual, partum and postpartum periods risk factors for secondary infertility?

This study was aimed at identifying practices during the menstrual, partum and postpartum periods posing possible risk factors contributing towards secondary infertility in women of a selected population in Karachi, Pakistan. A matched case-control study was conducted from April 2003 to March 2004. Four hundred cases were selected from five infertility clinics affiliated with tertiary-care hospitals, and 400 age-matched controls were recruited from the neighbourhood of each case. After taking written consents, trained interviewers conducted interviews using a pretested structured questionnaire. Factors found to be independently associated with secondary infertility were: previous delivery' at an unclean place (adjusted odds ratio [AOR]=1.7, 95% confidence interval [CI] 1.1-2.6), delivery by a birth attendant without washing hands with soap (AOR=4.2, 95% CI 2.36-7.47), use of unclean material for absorption of lochia (AOR=3.1, 95% CI 1.5-6.5), non-washing of perineal area after urination/defaecation (AOR=7.1, 95% CI 1.4-35.7), and insertion of home-made vaginal medications (AOR=2.5, 95% CI 1.3-4.7). Since these factors are preventable/modifiable to a great extent, public-health interventions are, thus, recommended to address these risk factors at various levels.

Evaluation of a cancer awareness campaign: experience with a selected population in Karachi.

The incidence and prevalence of cancer is rapidly increasing in both developed and developing countries. The most common cancers reported in Pakistan are breast and cervical cancers in females, and lung and oral cancers in males. Public awareness of cancer can play a vital role in its prevention, early diagnosis and treatment. A pilot survey conducted by the Cancer Support Group (CSG) of Aga Khan University Hospital from 2001 till 2004 to gauge the public awareness of cancer in Pakistan revealed that people were afraid of cancer and had little knowledge about its prevention and early detection. The survey also identified several social, religious and cultural misconceptions which hinder cancer screening and treatment. In order to create awareness amongst the general public, especially the young generation, members of the CSG also organized fifteen health education sessions in schools, colleges, hospitals and communities in Karachi which were attended by more than 1,500 people. With the help of the results generated in the pilot project, education material was designed and developed for these health education sessions. Ten percent of the participants contacted CSG members for some unusual finding after administering a self screening tests taught in these sessions. This indicates the importance of holding cancer awareness sessions and the positive feedback obtained suggests that people would like to have cancer awareness sessions continued.

Evaluation of efficacy of self breast examination for breast cancer prevention: a cost effective screening tool.

Breast cancer is the most prevalent neoplasm among females and every year the number of associated deaths increases so that there is a dire need for implementation of cancer screening and early detection. A survey conducted by various locally organised cancer registries indicated breast cancer to be the most prevalent cancer among females and the second most common cause of cancer deaths among Pakistani women. Since Pakistani females do not generally engage in screening practices we argue that nurses and lady health workers should team up to educate women for the possible early detection of cancer using Self Breast Examination as a screening tool. In this paper, we attempt to evaluate the primary efficacy of self breast examination as an early and cost effective cancer screening measure, and to discuss the relation of community health nurses as well as the lady health workers to education of females of low income countries such as Pakistan to possibly lower the cancer burden.

Health seeking behavior of couples with secondary infertility

To determine the factors affecting the health-seeking behavior of couples with secondary infertility in Karachi. A descriptive case series. The data was collected from women attending infertility clinics in five tertiary care hospitals in Karachi from March to June 2003. All currently married women, between the age of 15-35 years, with at least one previous conception, irrespective of outcome, attending an infertility clinic and consenting to participate in the study, were included. Women with corrective surgery on vagina and uterus, and cases of primary infertility, were excluded. Multiple logistic regression models were used to determine the association of various factors, affecting the health-seeking behavior, with statistical significance set at p < 0.05 for the covariates and the interaction terms between various factors. The women consulted multiple health care providers for treatment of secondary infertility. The main reasons for seeking treatment were couple's wish [54.2%], family pressure [22.6%] and want of a son by husbands or in-laws [20.4%]. The most commonly sought providers were physicians [74.7%], Traditional Birth Attendants [TBA, 39.5%], Spiritual healers [26%], Hakeems [23%] and Homeopaths [17.2%]. Most of the women who consulted non-physicians were illiterate [69.4%] as compared to those who consulted a physician [37.8%, p-value = 0.00]. The non-physicians were more commonly consulted by women belonging to low socioeconomic group. The posttreatment complications were more common among women who consulted non-physicians. Pressure from husbands and in-laws compels women for consulting multiple providers. Health seeking behavior for infertility is affected by the literacy and socioeconomic status of the women

Psycho-social consequences of secondary infertility in Karachi

To explore the experiences of social consequences among women suffering from secondary infertility. Descriptive case series of 400 women with secondary infertility attending tertiary care hospitals in Karachi, Pakistan. More than two thirds [67.7%] of women stated that their inability to give live births or give birth to sons had resulted in marital dissonance. The respondents had been threatened for divorce [20%], husband's remarrying [38%] or to be returned to their parent's home [26%] by their in laws or husbands. Majority [68%] of the women threatened did not have any live births. However, those who had live births [32%] had a girl child only followed by difficulty in conceiving again. Secondary infertility was described as a cause of violence against infertile women. The women reported that they were being physically and verbally abused by husbands [10.5%] and in-laws [16.3%] for being infertile. Nearly 70% of women facing physical abuse and 60% of the women facing verbal abuse suffered severe mental stress. The experience of infertility is a stressful condition itself. This becomes particularly traumatic with previous pregnancies ending up in abortions, stillbirths and neonatal/infant deaths or the live births being daughters only. However, it subjects the woman to contempt and exploitation resulting in severe psychological

Understanding of puberty and related health problems among female adolescents in Karachi, Pakistan

To understand the level of knowledge, a community based study conducted with the objectives as follows: To estimate the proportion of common facilities available and accessible and frequency of utilizing of it. To estimate the proportion of female adolescent utilizing the availability of facilities. To assess the level of understanding related to puberty and related health problems among female adolescents. This cross-sectional study was conducted to determine the understanding and level of knowledge related to puberty and related health problems among female adolescents of Karachi, Pakistan. Data was collected from 150 female adolescents between 10-19 years of age. The pre-coded questionnaire was used to collect the data which was double entered and analyzed in SPSS