Osteopenia and osteoporosis; frequency among females

Objective: Osteopenia and osteoporosis are one of the main health concerns of Pakistani females now days. Our objective was to study the frequency of osteopenia and osteoporosis among females in the Faisalabad and its suburbs

Material and Methods: Study was initiated after approval of Ethical Review Committee. It was an observational cross sectional study conducted by the Department of Community Medicine, University Medical and Dental College Faisalabad in a private sector university of Faisalabad city and a private clinic in People's colony, Faisalabad. Study included a total of 600 women. Convenient sampling was done. Study was conducted from 1[st] January 2013 to 30[th] September 2013 in six different sessions. Age, marital status, education, socio-economic status [SES], occupation, parity and residence were variables of interest. Bone Mineral Density [BMD] was tested using calcaneal quantitative ultrasound machine and right heel of participant. Machine converted the BMD values into TScore. According to the recommendations of World Health Organization [WHO] participant was considered normal, osteopenic and osteoporotic. SPSS version 16 for windows was used to analyze data. Results were considered significant if p - value was < 0.05

Results: Our results reflected that 72.9% of study participants were osteopenic while 2.4 % were osteoporotic and 24.7% were normal. By place of residence no significant difference was observed, 48% of rural population and 47% of urban population was osteopenic and insignificant correlation was found [p=0.438]. However, 46.77% and 10% of urban participants were normal and osteoporotic respectively. Education in relation to osteopenia and osteoporosis revealed that 42% of educated females were osteopenic while 31.33% of illiterate females were osteopenic [p > 0.05]. 69.88% married females were osteopenic and 43.22% unmarried females were osteopenic [p < 0.001]

Conclusions: In our study frequency of osteopenia and osteoporosis was significantly high in all age groups. There is need for large-scale population-based studies using calcaneal quantitative ultrasound or DEXA scan to assess the prevalence of osteopenia and osteoporosis in the community. Further health education with special reference to balanced diet should be imparted to target population

Knowledge, attitude and practices regarding counterfeit drugs among nurses of Madina teaching hospital Faisalabad

Objective: To assess the knowledge, attitude and practices among nurses regarding counterfeit drugs.

Methodology: Cross sectional study. The study was conducted in Madina Teaching Hospital which is attached to the University Medical and Dental College Faisalabad. Total number of nurses was 60 and all were included in the study. Only nurses were chosen because of their direct involvement in administering the drug/injection during duty hours and also they are the first to notice any adverse effects of drugs. Data was collected through pretested restrictive form of questionnaire. Written permission from ethical review committee and informed consent from the participants was taken before conducting the survey. All questionnaires were edited before entering in the computer. Once the data had been cleaned as thoroughly as possible, the distribution of each variable was re-examined as a final check. Non-sampling errors like selection bias, non-coverage, non-contact and non-response were tried to minimize

Results: Out of the 59 nurses who responded from a total of 60, 57 [96.6%] had heard of incidences regarding counterfeit drugs [see table I]. 59 [100%] considered them substandard in quality, 33 [55.9%] thought they were expired drugs, while 9 [15.3%] said that they were made from herbs [see table II]. However a majority of 94.9% understood that they were harmful drugs. 100% nurses said they examined the packaging meticulously and checked the expiry date before administrating the drug [see table III]. 98.3% sent any such drugs for laboratory testing [see table IV]. 100% nurses immediately stopped the use of such drug [see table V]. 34 out of the 59 nurses [57.6%] had seen adverse drug reaction in multiple patients. 89.8% said they kept records of such drugs and all of the participants [100%] reported such incidents to the authorities [see table VI]

Conclusion: Majority of the nurses were aware of the counterfeit drugs problem and its effects on the patients. Over all, most of them understood that counterfeit drugs were harmful to the health of the patients and this study further helped to clear their concepts

Vitamin D deficiency; prevalence in pregnant women

To study the Prevalence of Vitamin D deficiency in pregnant women. A Cross-sectional analytical study through convenient sampling technique. At a private Clinic located at East Canal Road Faisalabad, from March 2011 to June 2011. The study included consecutive 61 pregnant women of reproductive age and non-pregnant women were excluded. Blood samples were taken in morning i.e. overnight fasting samples, by venepuncture by disposable syringes sample were taken and samples were stored at -20 degree centigrade till they were analyzed. Our interest was in age and serum Vitamin D 3 levels. Out of 61 pregnant women results showed that 87.0% pregnant women were having Vitamin D deficiency, 10.0% were having Vitamin D insufficiency, 3.0% had Vitamin D sufficiency and none shows Vitamin D intoxication. Vitamin D deficiency was more prevalent in pregnant women of younger age group. Furthermore prevalence was higher among the pregnant mothers with high parity. Moreover, 65% women were not exposed to sunlight properly, 60% women had muscle cramps and bony aches. 90% women never were tested for tested Vitamin D levels before. Prevalence of Vitamin D deficiency is significant in pregnant women. It is also important for its effects on various organs and systems of body as well as on pregnancy and neonate. The different aspects of study led to conclusion to emphasize that Health education be imparted to pregnant women and their families in terms of diet, proper sunlight exposure and taking Vitamin D supplements in pregnancy. It is thus recommended to perform Vitamin D levels in every pregnant woman

study on Acute Myocardial Infarction with special reference to age, sex, type of infarct and associated risk factors

To study the frequency of acute myocardial infarction [AMI] and its types in patients admitted in CCU of Divisional Headquarter Hospital [DHQ], Faisalabad Institute of Cardiology [FIC] Faisalabad and to investigate associated risk factors. It was an observational hospital based study conducted at Cardiac Care Centre, DHQ Hospital Faisalabad and FIC from 30th March 2009 to 30th June 2009. One hundred patients were included in the study at both centers. A Performa was filled with tabulated questions and information was recorded. The data was analyzed on SPSS version 13. It revealed statistically significant difference by patient's age and sex. AMI was higher in males [CI = 75 - 91%] than females [CI = 9 - 25%]. Types of infarction including inferior and anteroseptal were observed in significantly higher number of patients, while extensive anterior, non-STEMI and lateral infarction was observed in significantly less number of patients. Results showed significant association [P<0.05] of fat sources in diet with types of AMI. Hypertension [CI = 36-56], smoking [CI = 30-50], family history of IHD [CI = 26-45] were stronger risk factors than others and 19% patients admitted with AMI had Diabetes Mellitus. AMI was significantly higher in patients between 40 and 50 years of age. Age and sex and fat sources in the diet showed significant association with AMI, while family history of IHD, hypertension and smoking were other stronger risk factors

Comparison between auramine-rhodamine [AR] and Ziehl-Neelsen [ZN] staining in cases of chronic granulomatous lymphadenopathy

Experimental study. This study was conducted at various hospitals of Quetta. This study includes 103 cases of chronic granulomatous lymphadenitis, with 101 cases of tuberculosis lymph nodes amongst a total of 200 cases of non-neoplastic lymphadenopathy.Their ages ranged from 2 to 79 years. Maximum number of cases were in 10-29 years age group. Females [69.31%] were affected more as compared to males. The commonest presenting symptom was fever. Cervical lymph nodes [83 cases] were the commonest site of involvement whereas 18 cases showed multiple site involvement. Fluorescent staining of histopatholigical sections from 103 chronic granulomatous lymphadenitis gave positive results in 76 out of 103 [73.78%] cases, however Ziehl-Neelsen staining was positive only in 29 out of 103 [28.15%] cases. The yield of mycobacteria on fluorescent staining was higly significant [p<0.00l] as compared to Ziehl-Neelsen staining thereby providing the superiority of fluorescent stain. In a total of 200 cases of non-neoplastic lymphadenopathy 101 cases showed granulomatous lesions, histologically consistant with tuberculosis. Other causes of lymphadnopathy were chronic non-specific lymphadenitis [n=87] viral lymphadenitis [n=8], fungal lymphadenitis [n=2] and acute bacterial lymphadenitis [n=2]. Fluorescent staining of histopathological sections from 103 chronic granulomatous lymphadenitis gave positive results in 76 out of 103 [73.78%] cases, however Ziehl-Neelsen staining was positive only in 29 out of 103 [28.15%] cases. In 101 cases, the finding were consistent with the diagnosis of tuberculous lymphadenopathy. In our study, significantly greater number of cases, 78 out of 101 [P<0.001] diagnosed as tuberculous lymphadenitis were in age groups 10-29 years. Female [69.31%] were more affected than males [30.69%]. The common presenting symptom was fever. Cervical lymph nodes were commonest site of biopsy. Haemoglobin estimation in 98 cases revealed anaemia in 65 out of 101 [66.32%] patients of tuberculous lymphadenopathy. Erythrocyte sedimentation rate was performed in 63 cases and was raised in 52 [82.53%] cases. In a total of 80 cases in whom X-ray chest was performed, 14 [15.5%] cases revealed foci of tuberculosis. Thus, in conclusion, this study has highlighted the superiorty of fluorescent stain over ZN stain

Osteoporosis; prevalence among the post menopausal women

To Study the prevalence of osteoporosis among post menopausal women in the Faisalabad city and compare that with other developed and developing countries. A Cross Sectional Study. Medina Teaching Hospital Faisalabad and Al Bari Hospital Faisalabad from February 2008 to April 2008. A total of 300 post menopausal women were included after valid consent and observing inclusion and exclusion criteria. Quantitative Ultrasound Device [QUO] that is BMD was assessed from the heel of each participant. T-Scores were obtained and WHO classification was followed. A scale was used to assess the Body Mass Index measuring height and weight. Data collection sheet having structured questions was used for checklist for obtaining pertinent information. Out of 300 post menopausal women overall prevalence of Osteoporosis [OP] was 20%. Further, 44% were Osteopenic. Results were comparable with other countries as well. Osteoporosis [OP] is not uncommon in our country. It should be considered as a Public Health Problem. Early screening and prompt treatment can prevent the heavy cost on fracture managements. In Pakistan, even in Asia Key data is not available to convince Policy makers that OP is a serious burden on population and to invest in prevention is the better option. Health Education is imperative for target population

Prevalence of diabetes mellitus among obese people in Faisalabad

Remarkable increases in obesity have occurred all over the world particularly in the last decade. This is true even for the developing countries. Excess weight is a high risk factor for diabetes in both men and women, especially those with excess abdominal fat. The reason has been attributed to the growing insulin resistance. The prevalence of diabetes mellitus in obese general public is 30% in the international literature. It is less studied in Pakistani. population living in Pakistan. To study the prevalence of raised blood sugar among obese persons in a population attending Madina Teaching Hospital, Faisalabad. A questionnaire containing personal and socioeconomic information was completed for each participant. Height, weight, and waist circumference were recorded by trained professionals and BMI was calculated. BMI more than 30 was inclusion criteria. Blood sugar was performed from a venous blood sample analyzed by Merck, Microlab 300 semiautomatic chemistry analyzer with Biocon, Germany's, Fluitest GLU, GOD - PAP reagent. Data was analyzed by SPSS statistical tool. A total of 40 [M: 17, F: 23] subjects were included in the study, among whom 8 [20%] had raised random blood sugar in diabetic range. Two of the 8 raised blood sugar group knew they had diabetes mellitus on subsequent questioning and 6 were told first time they have diabetes mellitus. Obesity is a significant risk factor for the development of diabetes mellitus and we recommend every obese person in general public should have their blood sugar measured to make an earlier diagnosis to reduce the subsequent risk of complications. Furthermore health education may be imparted to general population. This is perhaps the only cost effective way to address the issue of diabetes and "double burden of diseases" which Pakistan is facing