Degree of pain/discomfort experienced by patients during and after scaling and root planing

Objectives: To determine: the degree of pain experienced by patients during periodontal probing and periodontal debridement by using a Visual Analog Scale [VAS]

Study Design: Cross sectional descriptive study

Place and Duration: Conducted at Periodontology Department of Margalla Institute of Health Sciences [MIHS] Rawalpindi from December 2011 to May 2012

Methodology: Measurements for probing depths were performed, followed by pain ratings by each patient using a VAS. The hygienists also completed a VAS, estimating the pain level perceived by their patients

Results: Among 106 patients, 70% showed low pain responses to both probing and instrumentation. In our study a group of 106 [56 male and 50 female] patients were included, which received scaling and root planing procedures, out of which 36.6% of the patients experienced mild pain, 33.3% felt moderate pain while only 13.3% felt severe pain. In addition the pain and discomfort remain low with 23.3% and 53% during procedures but increases to 53.3% and 86.7% after treatment respectively

Conclusion: Majority of the patients experience mild to moderate pain during scaling and root planing; moreover intensity of pain and discomfort felt after these procedures are greater than the pain sensation felt during the procedures

Child laborers; abuse is universal at Rawalpindi

In Pakistan there are about 3.3 Million unprotected child laborers. They are constantly exposed to all kinds of dangers and abuse intimidating the future of the country. These child laborers are without the basic necessities of life including food, shelter, schooling and healthcare services, which has devastating effects on our socio-economic fabric. It is quite imperative to comprehend and unveil the perilous picture of the working conditions of child laborers and the abuse inflicted upon them at such an impressionable age. Cross sectional study. Rawalpindi city including workshops, shops and streets of Rawalpindi. January 2008-Dec 2008. Objective: To assess the presence of any Verbal, Physical and Sexual abuse among the child laborers at Rawalpindi city. Out of the total sample of 700 study subjects 315 [45%] of the Child laborers reported being abused whereas 385 [55%] reported no abuse. Out of the fraction which reported to be abused the break up is as follows. 214 [67.9%] reported verbal abuse, 75 [23.8%] reported Physical abuse and 25 [7.9%] reported sexual abuse. This study concluded that the child laborers are open to the elements of the adversities that come along with their work environment. The government should be urged to take necessary steps to trim down the abuse against child laborers and its frightening effects on their families, society and nation at large by constituting strict laws and ensuring their speedy implementation

Women beliefs and practices regarding food during pregnancy- a hospital based study

The aim of the study was to assess the existing beliefs and practices regarding food during pregnancy. Cross-sectional study. The present study was conducted in Antenatal Clinic, Department of Gynecology and Obstetrics at Holy Family Hospital, Rawalpindi. This study was conducted in four months time from September 1[st] to December 31[st], 2008. Sample size was 189 pregnant females who were attending the Antenatal Clinic, Department of Gynecology and Obstetrics at Holy Family Hospital, Rawalpindi. This was calculated by computer software called Raosoft- a sample size calculator by keeping confidence level 95%, margin of error 5%, and response rate 86%. Simple Convenience Sampling technique was used. 89% believed that there is an effect of food on pregnancy and 11% did not. Despite of high literacy rate [93%] there are certain strong food beliefs regarding pregnancy which have been practiced by pregnant ladies, which were effecting their food intake like hot, cold, badi and having difficult labour. All available resources for creating awareness among the masses regarding the importance of diet during pregnancy should be used properly by using all means of communication [especially mass media]

Through service learning to provide social justice

In Pakistan there are 3.3 Million child laborers without healthcare services and educational opportunities, which affect our social fabric. We report how structured 'Service Experience' helped broaden medical students understanding of social justice. To produce health professionals who are ready to work for a cause without voracity. A Cross sectional survey through a focal group discussion. Do opportunities for structured Service Learning help modify student's perception of their role as doctors in society? Foundation University Medical College, Islamabad. Fifteen months, from January 2008-April 2009. Fifteen students interviewed 700 child laborers using a piloted interview form during a fifteen months period. Focus group discussions were held with these students to discuss their experiences. Qualitative analysis of the discussion is reported. Students empathized that children worked on a contractual basis averaging $1 per 10 hours with no meals. Parents encouraged them to earn money and they felt more satisfied pleasing them. Children didn't attend school because of the school quality and fear of abuse. "Our exposure to child labor had been limited; this has taken us to the core of the issue. We now feel responsible as a physician and a leader to ensure 'security of children in every respect' as part of their health." "We will avoid employing children at our homes and will council parents, trying to be role models for others." "As future leaders we will propose measures including establishment of free quality educational systems with paid vocational tracks." Service learning will inculcate empathy for the oppressed groups of the community and also develop a social and civic responsibility in medical students

Contraceptives knowledge and practices in district Rawalpindi: a hospital based study

To assess the knowledge and practices of contraception and reasons for non utilization of family planning services at Rawalpindi, Pakistan. A cross sectional survey. Fauji Foundation Hospital Rawalpindi from January 2007 to September 2007. This study was designed to investigate contraceptive knowledge and practice in Pakistani women attending a tertiary care hospital. A sample of 200 married women of reproductive age were interviewed to record their age, educational status, relatives practicing contraception, knowledge about contraceptive methods, source of the information and family support for contraception. Simple convenience sampling technique was used in this study. Close ended questionnaire was used to record the information. Subjects [99%] of study population were aware of currently available contraceptives and among them [48%] were practicing these methods. Educated females were [71%] and 93% practiced contraception while [29%] were uneducated and among them [47%] practiced contraception. [51%] of Females were supported by their families for practicing contraception. Source of information for [53%] was health service providers and for [39%] female was mass media. Most of [67%] female relatives also practiced contraception .Only [3%] of the subject's did not practice because of fear of Allah and [32%] had some other reasons. Level of Knowledge in study population was high but there was a huge gap of practice of contraception. Reasons for not practicing was not religious rather it was social pressure

Assessment of knowledge and practice of contraceptives in females of reproductive age group at a tertiary care hospital

To assess the knowledge and practice of contraceptives in females of reproductive age group. Cross sectional descriptive. OPD of Fauji Foundation Hospital from February 2008 - September 2008. 339 females of age b/w of 15-49 years attending OPD of Fauji Foundation Hospital were included in study. A structured questionnaire was used to collect data. Eighty eight percent of the females in our study sample were familiar with one or more methods of contraception [72.7% were familiar with combined oral contraceptive pill [COCP], 60.7% were aware of intra uterine contraceptive device [IUCD] and 76% knew about condoms] whereas 12% showed ignorance. 64.4% of the study population was contraceptive users and 35.4% were not using any method of contraception. Regarding preferred method of contraception 34.6% of females said they are using COCP, about 21.8% females said their tubes had been liagated whereas 26.9% and 16.7% were using IUCD and condoms respectively. Almost 46% of our study population said that contraceptive method they were using was suggested by their husbands, 44% said by health professional. Only 10% of the study population were using a method of their own choice. The present study concludes that there is a gap between knowledge [88%] and use [64.6%] of contraceptives among females of reproductive age group. Another important inference drawn from the study is that men should be made equal targets of such programs in Pakistan since 46% females in our study population were using method of contraceptive suggested by their husband

Infant feeding; beliefs and practices of mothers

To evaluate the infant feeding beliefs and practices of methods in our setup. A cross-sectional study. Fauji Foundation Hospital, Rawalpindi. From Jan 2007 to September 2007. 336 mothers of infants attending Fauji, Foundation Hospital were interviewed by using pre-tested questionnaire. Data was collected for Mothers beliefs and practices regarding infant feeding. Descriptive statistics like percentage, mean and range were obtained by using SPSS version 11. 366 mothers from rural and urban areas attending hospitals were interviewed. 63.9% mothers believed that breast milk should be given as first feed. Pre-lacteal feeds were given to 56% of infants. Major source of information for giving pre-lacteal feeds was relatives. At birth, 43.7% mothers discarded clostrum considering it harmful and useless for baby. Frequency of breast feeding was high initially at birth but decline rapidly by early supplementation with bottle feeding. Inadequate weaning in terms of timing, quality and quantity was observed. Cultural beliefs and taboos like hot and cold food influenced 61.5% of mothers due to which they restricted important food items. A targeted health education campaign should stress the main advantages of breast feeding. Messages should stress on protective benefits of clostrum and encourage mothers to start breast feeding immediately after birth. Potentially hazardous practices including pre lacteal feeding should be discarded. Local cultural and traditional practices and beliefs regarding different food items should be identified. This help to improve the food intake of infants by strengthening the useful beliefs and discontinuing harmful ones

Frequency of helmet use among motorcycle riders in Rawalpindi

To find the frequency of helmet use as a safety tool and to investigate how many of the motorcyclists are aware of the beneficial effects of using a helmet. A cross sectional study. In Community Medicine Department of Foundation University Medical College, Rawalpindi from March 2007 to September 2007. A total of 1000 questionnaires were randomly distributed among motorcyclists during visits to Lalkurti, Saddar and Karchi chowk in Rawalpindi. Inclusion criteria included those motor bike rider volunteering to participate in the study. 44 responses were invalid and the total valid responses were therefore 956. No incentive was offered for participation in the study and no individual follow- up was possible. From a total sample size of 956 riders 541 were putting on a helmet and 415 were without the helmet. The frequency of helmet use was therefore 56.6% and that the use non user is 43.4%. A bog majority i.e 80.7% of the respondent s left that use of helmet while riding a motorbike should be mandatory while only 19.3% left that it should be the discretion of the riders. 57.6% of the riders left that in case of pillion riding both the riders should put on the helmet while 42.4% did not support the idea. The study implies that we need to enact and enforce policy intervention for mandatory use of helmet, effective traffic law enforcement and imparting awareness among our masses especially the younger generation to reduce Road Traffic Accidents. Print and electronic media should be utilize extensively to disseminate basic traffic knowledge at all levels of the society

Crimean congo haemorrhagic fever: a hidden means of public health importance trends in Pakistan

Crimean Congo haemorrhagic fever [CCHF] is one of the most severe human viral diseases, with mortality rate of up to 50%. Apart from Pakistan; CCHF is a public health problem in many regions of the world, including Africa, Middle East, Southern and Eastern Europe, and western Asia. The causative agent for CCHF is Crimean Congo haemorrhagic Fever Virus [CCHFV] which is a type species of the genus Nairovirus in the Bunyaviridae family. Laboratory studies have shown that the virus is related to Hazara virus isolated from ticks in Pakistan, and to Nairobi sheep disease virus. CCHFV is a spherical, enveloped virion 85-100 nm in diameter, like all members of the genus, is a single-stranded RNA virus. Lipid solvents and detergents inactivate it. CCHFV has a tripartite genome consisting of a small [S], a medium [M], and a large [L] segment. The S RNA segment codes for the nucleocapsid [N] protein, and the M RNA segment codes for the glycoprotein precursor, resulting in the two envelope glycoproteins G1 and G2, while the L segment encodes the putative RNA-dependent polymerase. Humans gain infection from tick bite or from contact with infected blood/tissues coming either from human patients [Nosocomial infections - needle sticks etc], or other animals, commonly sheep and cattle. Only humans and newborn mice readily succumb to disease; other animals including nonhuman primates are either refractory or undergo mild infection

Protein and plasma amino acid metabolism in cancer patients

Proteins present in the human body have numerous functions. Amino acids are the building blocks of proteins used for structural and regulatory functions of body. In cancer cachexia the patients develop anorexia, diminished intake of calories with significant abnormalities in carbohydrate, lipid and protein metabolism and progressive tissue depletion accompanied by weight loss. The gradual loss of host protein stores is central to this process which leads to amino acid imbalance in the blood and some times decreased levels of certain amino acids. Increased urinary amino acids occur in patients of certain cancers. These changes in the amino acid result into altered host defence against cancer and also the therapeutic complications in these patients. Extra nutritional support through gut and total parenteral nutrition [TPN] can alter the tumour host nutrition balance and repletion occur

Chemical warfare-protective measures and first aid treatment

Ever since its employment in the First World War, chemical warfare has always aroused controversy. Government have responded by pursuing the policies of disarmament and deterrence in the hope of avoiding its recurrence. However, despite signing of the Geneva Protocol in 1925 which banned the use of poison gases, chemical weapons have been used in subsequent conflicts and most recently in the Gulf War between Iraq and Iran. The chemical agents are capable of brining radical change in modern warfare because of their devastation and crippling effects on the human beings and environments. The objectives to be attained by the medical services include the management of casualties to minimize the injuries of chemical exposure by prompt administration of first aid and specific treatment. Properties of chemical warfare agents and therapeutic approaches to the management of injuries induced by these agents are reviewed in this article