Are We Aware of Dengue Fever? A Community Based KAP Survey on Dengue Fever in Rawalpindi

To assess the knowledge, attitude and practices regarding dengue fever and its prevention in Rawalpindi. A Cross Sectional Survey. Community of Rawalpindi, from July to Sept. 2012. A total of 215 participants were selected through consecutive sampling echnique. A structured questionnaire was self administered after informed consent was obtained from all the participants. Knowledge of dengue was measured by asking questions related to disease symptoms and preventive measures. Association between knowledge and awareness at p<0.05 was accepted as significant. It was found that the knowledge of the community regarding Dengue fever was adequate [91%]. The respondents' awareness about preventive measures for dengue was also satisfactory [88%]. A significant association found between knowledge and awareness of dengue fever and preventive measures [P= 0.01]. Mass media was identified as an effective tool in raising awareness. However; adequate knowledge about prevention did not reflect in community practices [P=0.031]; factors identified responsible for it, were like water storage for domestic use due to water shortage and excessive load shedding. Local community is well aware about dengue fever and its prevention; however it was found that good knowledge doesn't necessarily lead to good practice. Health educational campaigns should be designed to improve behavior and practices of prevention and control measures against dengue fever

Serological profile of patients with liver cirrhosis in northern Pakistan

To evaluate the role of hepatitis B and C in the pathogenesis of liver cirrhosis. An observational study. The present study was conducted in the medical wards of Military Hospital, Rawalpindi from Ist January 2002 to 24th September 2004. Patients and Six hundred and fifty patients admitted in the medical wards of Military Hospital Rawalpindi were evaluated for seromarkers of Hepatitis B and C. Viral markers studied were anti HCV, HBs Ag anti HDV, anti HBcIgG, anti HBs, and HBeAg. One hundred and eighty two out of 650 patients were positive for HBsAg positive and 468 patients were negative for HBsAg. Anti HBcIgG was positive in 345 and anti HBs in 322 of HBsAg negative patient. HBeAg was present in 45 and anti HDV in 26 of HBsAg positive patients. Anti HCV was positive in 455 [70%] patients and no seromarkers were seen in 52 patients. It was evident from the seromarkers that exposure to hepatitis B and C had occurred but which one was responsible for cirrhosis was hard to determine. In as much as vaccine against hepatitis B is available, mass vaccination in the population may be consideration to prevent cirrhosis due to hepatitis B virus

Present scenario of disease early warning system in district Bagh [Azad Kashmir]

Disease Early Warning System [DEWS] is a programme by which health workers can detect signs of an epidemic at an early stage in order to prevent its occurrence or expansion. It is a cost effective and sustainable programme especially in the developing countries like Pakistan, where infectious diseases cause a significant magnitude of morbidity, and mortality in the country. The objective of this study was to assess the practice of DEWS in district Bagh of Azad Jammu and Kashmir and suggest ways and means to improve its practice in future. It was a cross sectional descriptive study and was conducted in thirteen First Level Care Facilities [FLCFs] of the district where DEWS was in operation. Questionnaires were designed to collect information about present scenario of practice of the system and a checklist was also prepared for physical verification. The study revealed that most of the health personnel dealing with DEWS were not trained properly and many facilities were not having even essential "case definition" documents. Some of the health facilities were deficient in recording and reporting materials. 90% of laboratories of health centres/hospitals/clinics were not having even containers for getting samples and transport media to carry to referral laboratories. Some FLCFs were not having laboratory facility at all. 95% personnel involved in DEWS were not satisfied by the present ways of monitoring by the supervisors. For better functioning of DEWS, following measures are suggested: [a] Proper training of the health personnel about DEWS should be carried out. [b] Provision of DEWS tools to each facility should be ensured. [c] Regular, effective and efficient monitoring of all facilities should be done

Risk factors in development of multi drug resistant tuberculosis in the hospitalized patients

The emergence of multi-drug resistant tuberculosis [MDR-TB] is becoming a global threat. A study was carried out to determine the frequency and risk factors associated in the development of MDR-TB in the hospitalized patients. It was a retrospective study in which five hundred patients of tuberculosis, admitted in the TB wards of Military Hospitals Rawalpindi, were include. Diagnosis of MDR-TB was established based on susceptibility pattern of Mycobacterium tuberculosis by Agar diluted method on Lowenstein Jensen Medium. The isolates which showed simultaneous resistance to INH and Rifampicin either with or without resistance to other drugs were labeled as MDR-TB. Out of 500 diagnosed patients of tuberculosis, 40 [8%] patients developed MDR-TB. Smokers were at high risk to develop MDR-TB [12.9%] as compared to non-smokers [5.6%]. MDR-TB was found more in extra pulmonary tuberculosis [35%], secondary tuberculosis [21.4%] and patients taking irregular anti tuberculosis treatment [36.6%] as compared to pulmonary tuberculosis [6.9%], primary cases [1.8%] and patients taking regular treatment [2.4%] respectively [p<0.05]. smoking, extra pulmonary tuberculosis secondary tuberculosis and poor compliance to the anti-tuberculosis treatment are the main contributing factors in MDR-TB. The development of MDR-TB in community can be reduced by modifying these MDR-TB associated risk factors