Awareness regarding breast cancer a global health problem - a study amongst adult women in Karachi

Objective: To determine the level of knowledge regarding breast cancer amongst women and their practice of breast self-examination

Methods: A Knowledge, Attitude and Practice [KAP] study was conducted in the community of Gulshan Town, Karachi, during July 2013 to June 2014 through non-probability convenient sampling technique after taking written consent. The sample size of 560 was calculated by using World Health Organization [WHO] calculator. All women aged 20-40 years were included except those who had breast cancer and any type of swelling in the breast. Data was collected through semi-structured questionnaire. Data was entered and analysed on SPSS 16. For descriptive statistic mean +/- SD and frequencies were calculated

Results: A total of 559 women participated. Mean age of women was 30 +/- 1.5 years. About 84% females were married, 37% attained education in universities and 71% were housewives. Around 34% women thought that frequency of breast cancer was present in one out of every 9 women, while, 60% said breast cancer is a genetic disease. Those who said breast cancer is not accompanied by painful swelling were 61%. While 79% women said a swelling in the breast is not always breast cancer and 64% said that mastectomy is the only treatment of breast cancer. The women who said that use of contraceptives was closely associated with breast cancer were 69% women, 83% thought breast feeding decreases the risk of breast cancer while 45% women did not know what precautions to take against breast cancer. Only 40% women said consumption of fruits and vegetables decreases the incidence of breast cancer. Regarding awareness of the breast self-examination, 56.9% responded negatively

Conclusion: The study concluded that overall knowledge regarding breast cancer was low. The practice of breast self-examination in this cohort of subjects was only 40%. We recommend public awareness regarding the risk and screening modalities for breast cancer, and breast self-examination be emphasised using mass media

Morbidity due to stress in postgraduate trainee doctors of Karachi

To find out stress level and its related morbidity among Postgraduate Medical Trainees. This Descriptive cross sectional study was conducted at Dow University of Health Sciences and Agha Khan University Hospital Karachi during January to December 2008. Postgraduate Medical trainees who were pursuing FCPS, MCPS and DCPS were included. Self administered Questioner were distributed and doctors were selected by non-probability convenience sampling technique. Trainee doctors were found stressed 62.3%. A large no of trainees [34%] complained of Indigestion. Palpitation, tearfulness, waking at night, poor appetite found in [24 - 25%]. Complain of minor psychiatric illnesses, tiredness and lack of energy, having more responsibility than can handle, in ability to stop thinking about problem, difficulty in taking decisions, feeling of being trapped or cornered in 45- 50% doctors. The stress level of Postgraduate trainees was found to be high There were high prevalence of physical morbidities as well as minor psychiatric illnesses

Awareness about tuberculosis in community and compliance for D.O.T.S in patients

To assess awareness about Tuberclosis in community and compliance for DOTS [directly observed treatment short-course] in patients. It is Descriptive cross sectional study was conducted at two places, i.e., Arafat Town and Sindh Government Hospital, Karachi. A sample of 175 subjects were selected, out of which 75 subjects were selected from Arafat town [community] while 100 subjects [patients] were selected from Sindh Government Hospital, Karachi. The survey was conducted by interview comprising of questions related to personal information regarding Tuberculosis, its symptoms, different mechanisms of its spread, diagnosis and its treatment by DOTS, knowledge of DOTS and satisfaction of patients receiving DOTS. The data collected was analyzed by using SPSS version 11. Out of 75 study subjects from community 43.5% of subjects were uneducated or had only religious knowledge, 65% did not know Tuberculosis, 20% did not have any knowledge regarding the symptoms of Tuberculosis, 22% of subjects were unaware of the preventive measure against TB. In the hospital setup, 99% of patients were satisfied from DOTS and the compliance rates was 88%.Most of the subjects were unaware of Tuberculosis that seems to be due to their illiteracy and those who knew had got the knowledge from media but the majority of the patients who were on DOTS were found to be satisfied

Complications of labor in cases referred to Abbasi Shaheed hospital and Qatar hospital, Karachi

The purpose of this study was to find out the frequency of complicated labor in cases which are referred to Abbasi Shaheed Hospital and Qatar Hospital, and to identify the risk factors and the fetal outcome. It was a descriptive cross sectional study, conducted in gynea and obstetric wards of Abbasi Shaheed Hospital and Qatar Hospital. Non-probability convenient sample of 100 referred cases was considered. Questionnaire were filled by interviewing patients and from their records too. Out of 100 referred cases, complication of labor occurred in 77% cases. Major complications were obstructed labor 24 [31.2%] cases, post partum hemorrhage [PPH] 16 [20.8%] cases, premature rupture of membrane [PROM] 8 [10.4%] cases and purpeural sepsis 6 [7.8%] cases. Age of the patient, bleeding during pregnancy, previous C.section, any instrumentation, and complication during previous parturition are found to be the risk factors associated with complicated labor [p-value <0.05]. 88% of the fetus survived in all the referred cases and 87% in complicated cases. A considerable proportion of referred cases had complicated labor. Most common complication were obstructed labor, PPH. Maternal age, bleeding during pregnancy, any instrumentation, history of Cesarean section and any complication during previous parturition were found to be the important predisposing factors that must be considered during pregnancy

KAP study of exclusive breast feeding among the poor population - an institutional based study

Objective: To assess the practices and analyze the perceptions of mothers of poor population regarding exclusive breast feeding

Methodology: it is a descriptive institutional based study. Five-hundred women were enrolled at Maternal and Child Health [MCH] center, Civil Hospital Karachi [CHK] through systematic sampling during January to August 2007. Questionnaire was used for data collection and interview was conducted. Data were analyzed through SPSS version 11.5 continuous variables were categorized into different categories and proportions of all categorical variables were calculated

Results: It was observed that only 34% women were practicing exclusive breast feeding. Awareness regarding exclusive breast feeding was 88%. The use of prelacteal feeds like honey, ghutti was about 56.4% irrespective of age, education, area of residence and income level, due to various religious believes and family norms. Water was given by 65.5% mothers along with breast milk whereas 53.6% mothers try to improve their diet to enhance milk production. Difficulty in breast feeding was that the baby seems unsatisfied [36.8%]

Conclusion: Although breast feeding practices are not common in population studied but awareness regarding exclusive breast feeding was found in majority of women. The use of prelacteal feeds like honey, ghutti is very common. Most common problem in exclusive breast feeding was that the baby seems unsatisfied

Self medication among university students of Karachi

Objective: To find out frequency of self medication among university student of Karachi Pakistan

Methodology:A cross sectional study was conducted between July - August 2008. For the purpose 207 students from 2 Universities of Karachi, one medical and one Non-medical were selected through non-probability convenience sampling. Data was collected through self administered questionnaire, analyzed using SPSS v 10

Result: Among 207 participants', 103 were students of Karachi University while 104 were studying at Dow University. Mean age was 22 years and male: female ratio was 1:4. Frequency of self medication was found to be 80.4%. The most common reason for not consulting the doctor was "Problem not serious" and the most common symptoms when self medication sought were headache [62.3%] and fever [49.8%]. The 62% participants' knew that Self medication could be harmful

Conclusion: Frequency of self medication was high in educated youth despite the fact that majority found aware of its harmful effects. There is need to revisit the definition and relative significance of 'self-medication' in our local setting

Stress in postgraduate trainee doctors of public and private Universities of Karachi

To evaluate and compare stress level of Postgraduate trainee doctors in public and private sector Medical Universities. A comparative cross sectional study was conducted at Dow University of Health Sciences and Agha Khan University Hospital Karachi among Postgraduate Medical trainee who are doing FCPS, MCPS, and DCPS from Jan. 2008-Dec. 2008. A total of 207 doctors were selected by non-probability convenience sampling technique. Main outcome was major stress level of Medical trainees or resident. Out of the total 207 trainee doctors 62.3% were found to be under stress. Proportion of females with stress was 66.3%. Most of the married PGs 67.2% had high stress level. A large proportion almost 69.7% of doctors who were in stress belongeds to low income group. This study did not find any statistical significance of stress with respect to different demographic and socioeconomic variable that were age, gender, monthly income, specialty and university. The stress level of Postgraduate trainees in both the universities was found to be high. The stress was found to be high among female trainees but no risk factor showed significant association with stress. Every effort should be made to help the future healers in understanding the symptoms of stress and ways to deal with it effectively and safely

Morbidity, co-morbidity profile and disability status among elderly in civil hospital Karachi

To evaluate the Morbidity, Co-morbidity profile and Disability status among elderly in Civil Hospital Karachi. A Descriptive cross sectional study. The study was conducted at Civil Hospital Karachi from 15 June 2009 to 15 August 2009. Patients aged 60 years and above admitted to selected wards i.e. Medicine, Cardiac medicine, Surgery, Gynecology, E.N.T and Ophthalmology were included except those patients who had psychiatric illnesses, history of trauma and neurological deficits. A questionnaire was designed for assessment of morbidity, co morbidity and disability status of elderly patients. SPSS version 16 was used for data analysis. A total of 220 elderly subjects [60+] were included in the study. Most common morbidities were cerebrovascular accidents [13.6%], chronic liver diseases [7.7%] and hernias [7.7%]. When classified according to organ systems most common disorders were of digestive system [28.6%], nervous system [15%] and malignancies [12.2%]. Hypertension was the most frequent co-morbidity [28.63%], followed by diabetes mellitus [27.2%] and ischemic heart diseases [7.27%]. 63.6% of elderly had minimal disability, 12.3% had moderate disability, 2.7% were severely disabled and 21.4% had no disability. Most of elderly patient admitted to CHK for C.V.A [13.6] Most common disorder were related to Digestive System 28.6%, among Co-Morbidities [Chronic] Hypertension was frequent 28.63%. A large number [78.6%] of elderly patient had some sort of disabilities

Directly observed treatment short course [DOTS] program for treatment of tuberculosis in Balochistan-role of lady health workers

The main objective of the study was to reduce problem of tuberculosis by increasing the success rate by implementing DOTS through LHWs. The study was an observational descriptive one. The patients for this study were recruited from the four districts of Balochistan; Mastung, Dera Allah Yar, Dera Bugti and Nasirabad, Balochistan. The study was done during January 2004 to September 2004. All those who were sputum smear positive and presented for the first time were included as 'new' patients and those on re-treatment as "relapses". The study population consisted of all pulmonary tuberculosis patients over 15 years old in the four districts of Balochistan, who started a new course of tuberculosis treatment after sputum examination at any of the diagnostic clinics. Patients were excluded from the study if they had multiple-drug resistance [MDR] or severe illness where facility based management was indicated. The results of study showed that the majority [47%] of affected persons belonged to younger age group [15-35], and out of the 111 persons who were enrolled in the study, 65% wore males. Fifty percent of affected persons were daily wagers and farmers [49%] and earning less than 2500 rupees per month. Majority [75%] were illiterate. Regarding sputum conversion, there was significant impact of DOTS to sputum conversion within adequate time period, majority [74%] of DOTS cases converted to negative within two months and 14% within 3 months of starting the treatment. It is concluded that DOTS is an effective strategy to treat tuberculosis in Pakistan. However, if we have to replicate it on a wider scale, we need to strengthen the LHW program