Assessment of socio demographic and environmental factors predisposing to tuberculosis in Lahore, Pakistan

Objective: to understand various predisposing factors for tuberculosis infection that help to prioritize tuberculosis research and intervention among the most vulnerable persons in our population

Methods: it was cross sectional study which was conducted in Lahore .The duration was from December 2013 to May 2015. A total of 129 cases of tuberculosis were included in the study

Results: questionnaire was completed for 129 tuberculosis subjects. 65 patients [51.39%] were male and 64 [49.61%] female, among the total number of subjects, Diabetes was the most common illness among chronic diseases. Smoking was the most common addiction and all smokers were male

Conclusion: there are multiple environmental and host related factors, present in tuberculosis patients in Lahore. A proper understanding of their risk factors will contribute in appropriate disease management

Medical rehabilitation services for addict prisoners confined in district jail Lahore

Drug addiction is one of the leading causes of crime. The quality of health care in prisons is patchy around the country and do not meet the needs required. Rehabilitation is a planned intervention that attempts to change or alter whatever aspects cause addiction and to rescue the likelihood of recidivism. The objective of the study was to assess the medical related rehabilitative services rendered by prison department for addicted prisoners and to formulate recommendations for improvement of rehabilitation services in prisons. Observational study. This study was conducted in District Prison Lahore in February, 2011. Total population of District Jail Lahore was 4330 out of which 1072 [24.8%] were addicted prisoners. Out of 1072, 218 addicted prisoners were randomly selected for the study. Majority of addict prisoners 153 [70.2%] were 21-40 years old while 127 [58.3%] were illiterate. 179 [82.1%] addict prisoners were in habit of using opiate derivatives. 137 [62.8%] addict prisoners were not provided with detoxification treatment upon entry into to prison. 120[55%] addict prisoners were provided medical facilities after delay of many hours. Personal hygiene was good while orodental hygiene was just satisfactory. Illiteracy, scarcity of resources, low socio-economic status and poverty were the major factors that motivated them to start taking drugs. Literacy rate should be increased, vocational training, health education and proper job opportunities should be provided to young population to overcome the problem of drug addiction. Addict prisoner must have access to doctors and treatment must be provided to them without delay as loosing freedom should not mean losing health. Drug trafficking in Jail should be controlled. Addiction should be treated as a disease and not as a sin which will help addicts to keep them away from drugs

Spatial and seasonal variation of dengue fever in Lahore 2008

To find out the spatial and demographic profile of cases of dengue fever outbreak in Lahore [2008]. 2. To find out the seasonal variation of the dengue fever outbreak. Jan 2008 to Dec 2008. Retrospective cross-sectional study. Bacteriologist laboratory at Institute of Public Health Lahore. All the cases reported from Lahore city to the Bacteriologist laboratory during the study period. Blood samples from 3215 dengue suspected cases referred to Bacteriologist laboratory from different areas of Lahore were tested for IgM antibodies by ELISA after subjecting them to initial screening by rapid immunochromatographic technique [ICT]. Demographic and residential data was recorded. Among 3215 dengue suspected cases, 1766 [54.94%] were found serologi-cally reactive for IgM antibody. Reactive cases were stratified spatially according to administrative towns of Lahore. Higher positivity of dengue cases was observed in densely populated areas of the Lahore. Maximum reactive cases [73.21%] were observed during month of November. Patients in age group 20 - 29 years were more frequently affected [32.33%]. Only 74 cases [4.1%] were children below 9 years. Males [58.55%] were affected more commonly than females [41.44%]. It is concluded that during epidemic of dengue fever in Lahore [2008], more cases were observed from September to December from densely populated areas of Lahore in age group 20-29 years. Protective measures should be adopted for at risk population. Our study forms the basis for public health measures for better control of vector

Prevalence of HBV and HCV infection in Faisalabad

Blood-borne pathogens like hepatitis B virus [HBV] and hepatitis C virus [HCV] are considered major but preventable public health problems in the developing world. Routes of transmission include unsafe injections, blood, sex and transmission from infected mothers to their babies and many other unusual routes like through barbers, dentists and beauty parlors. In Pakistan, national efforts have been made to reduce potential transmission of HBV and HCV, e.g. HBV vaccination programmes, public health education programmes on safe sex, blood and injection practices and legislation to standardise and ensure safety in blood banks. A common element of these programmes and initiatives is a baseline situation analysis using routine surveillance data, or data from surveys or studies, typically followed by a repeat analysis to determine if any change has occurred as a result of an intervention. Given the paucity of surveillance data in Pakistan, high risk areas are an excellent sites for sentinel surveillance of blood-borne pathogens to determine trends in prevalence and disease distribution defined on social, demographical, geographical, and biological variables. We therefore conducted a baseline analysis of residents in Faisalabad city which is a high risk area as part of a pilot phase to develop a sentinel surveillance system for HBV and HCV infections. Similar analysis are expected to follow data in subsequent years to allow comparisons based on time, place and person to determine trends and evaluate interventions. A total of 193 blood samples were collected from Faisalabad. Blood samples safely reached Laboratory and were tested for HBV and HCV by ELISA technique. Results showed that 4.5% blood samples were reactive for HBV and 22% blood samples were reactive for HCV. In HBV reactive cases co-infection is 22% and in HCV reactive cases co-infection is 4.6%

Prevalence of HIV and tuberculosis among jail inmates in Lahore - Pakistan

The purpose of this study was to determine the prevalence of HIV and tuberculosis. Using sputum smear examination for AFB screening and double PCR for HIV among jail inmates of Camp Jail, Lahore. This was a cross-sectional descriptive study and was carried out in district Camp Jail, Lahore, during the period between Jan 2007 to June 2008. The study population comprised of 3851 prisoners, all were males. Data was collected by administering closed-ended questionnaire. Sputum and blood samples were collected from symptomatic prisoners in standardised sputum containers and vials respectively. Majority of respondents [73.6%] were of urban background and most of these respondents [46.4%] were illiterate. Majority [36.8%] were factory workers before being locked up in the jail. The prevalence of smoking and drug/ alcohol abuse was 63.1% and 37.9% respectively. One hundred and thirty seven respondents [52.2%] had cough. Lab tests on serum done on jail inmates showed that 6 of 261 respondents [2.3%] were HIV positive. However none of the jail inmates was sputum smears positive for Mycobacterium tuberculosis. The study found clustering of risk factors among jail inmates which are conducive to the transmission of STIs, HIV/AIDS and tuberculosis. This study revealed that 6 of 261 jail inmates were seropositive for HIV

Anti-HIV seroprevalence in tuberculous patients

Seroprevalence of anti-HIV in tuberculous patients was carried out in collaboration with the AIDS surveillance Centre in Microbiology Division of IPH Lahore and Provincial AIDS control programme, D. G. Office Lahore. The sample consisted of 1348 patients admitted in Ghulab Devi Hospital during the period of July-August '2002. Out of these 774 [57.4%] were male patients and 574 [42.6%] were female patients. Two male patients [0.10%] were found to be positive for antiHIV, which definitely points towards future problem if left uncontrolled

Diagnosis of diabetic autonomic neuropathy - A multivariate approach

Seventy five [75] diabetic patients in the age range of 30 - 65 years were evaluated for autonomic nervous system affections, by using 3 bed side tests to detect cardiac neuropathy. Out of a total of 75 cases, 38 were symptomatic for diabetic autonomic neuropathy [DAN], while 37 were asymptomatic. 37 healthy age matched controls were also included in the study. Amongst the study population, the abnormality of the parasympathetic division i.e. valsalva response and heart variation during deep breathing were found to be greater than the sympathetic component i.e. blood pressure response to standing. Similarly the frequency of abnormality in the values of autonomic function tests were greater in the symptomatic diabetic group than the asymptomatic diabetic group. This study also proved that the frequency of DAN was directly proportional to the duration of disease

Microalbuminuria and early diagnosis of diabetic nephropathy in insulin dependent and non insulin dependent diabetes mellitus

Diabetic nephropathy is one of the microvascular complications of diabetes and accounts for almost a third of all causes of end stage renal disease. Microalbuminuria screening among diabetics can offer early detection of incipient nephropathy. The study was designed to explore if an elevated albumin excretion would predict the development of overt proteinuria and to describe risk factors associated with the development and progression of microalbuminuria. The study was conducted at Diabetic Research Clinic of Sir Ganga Ram Hospital, Lahore. The study subjects included 25 insulin dependent diabetes mellitus patients, 25 non-insulin dependent diabetes mellitus [NIDDM] patients between 18-60 years of age. 25 age matched normal subjects were taken as control group. Of the 25 patients with IDDM 4% had overt nephropathy. Microalbuminuria was present in 40% of patients, each in IDDM and NIDDM. 56% patients in IDDM and 60% patients in NIDDM had normal albumin excretion rate. Hypertension was present in 20% of IDDM patients and 28% of NIDDM patients. The microalbuminuric patients both insulin dependent and non-insulin dependent diabetics had longer duration of diabetes, higher diastolic, systolic blood pressure and glucose concentration than did the normoalbuminuric subjects. There was no difference between the normoalbuminuric and microalbuminuric subjects in terms of age and sex. A significant correlation was found between hypertension, duration of diabetes, metabolic control and development of diabetic nephropathy. In conclusion early detection of patients at high or low risk of developing persistent proteinuria is possible by using a sensitive method for urinary albumin excretion. Microalbuminuria above 20ug/min carries the conviction of its predictive value for clinical proteinuria, a known precursor of renal failure

Role of fine needle aspiration cytology in the diagnosis of focal liver lesions

Fine Needle Aspiration [FNAC] of focal liver lesions was carried out at Allama Iqbal Medical College / Jinnah Hospital, Lahore and author's lab. in 108 patients between January 2000 to August 2002 to evaluate the role of FNAC in diagnosis of focal liver lesions and to find out different patholigies which present as focal liver. Out of these 108 patients, most of them [87.96%] were above the age of 40 with male preponderance [55.55%]. Morphologically, malignant lesions were more common [74.08%] with hepatocellular carcinoma[HCC] as the most common malignancy [42.59%] followed by metastatic malignancies [23.15%], undifferentiated malignancies [5.55%] and Non-Hodgkin's Lymphoma in 3[2.78%] patients while in two patients [1.85%] only normal hepatocytes were aspirated. In 13 [12.04%] patients aspirates were inadequate for any morphological evaluation. It is concluded that FNAC is a useful technique in evaluating the liver masses. However there are some difficulties which can be overcome by more experience in aspiration and better coordination between radiologist, pathologist and clinicians

Comparison of prevalence of intestinal parasites in children and adult population

A study to investigate the prevalence of intestinal helminthes and protozoa was carried out in children [below 12 years of age] and adult population of residents of quarters of Institute of Public Health. Parasitic infestation was prevalent in 60% of children and 30% of adult population. In children protozoal infestation was found in 44% of the cases and helminthic infestation in 16% of the children population. Whereas in adult population, protozoal infection was found in 30% and helminthic infestation was found in none